1. Long‐term outcomes of endoscopic balloon dilation for intestinal strictures in patients with Crohn's disease during maintenance treatment with anti‐tumor necrosis factor alpha antibodies
- Author
-
Masaki Miyaoka, Kenshi Yao, Teruyuki Takeda, Tsuyoshi Beppu, Fumihito Hirai, Toshiharu Ueki, Noritaka Takatsu, Hisatomi Arima, Yasumichi Takada, Masahiro Kishi, and Takashi Hisabe
- Subjects
medicine.medical_specialty ,Constriction, Pathologic ,Disease ,Gastroenterology ,Endoscopy, Gastrointestinal ,Crohn Disease ,Maintenance therapy ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies ,Crohn's disease ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,medicine.disease ,Dilatation ,Confidence interval ,Endoscopy ,Treatment Outcome ,Balloon dilation ,Tumor Necrosis Factor Inhibitors ,business ,Intestinal Obstruction - Abstract
BACKGROUND AND AIMS Efficacy of endoscopic balloon dilation (EBD) for intestinal strictures in patients with Crohn's disease (CD) receiving anti-tumor necrosis factor alpha antibodies (anti-TNF) as maintenance therapy is unclear. We investigated the long-term efficacy and safety of EBD for intestinal strictures in patients with CD receiving anti-TNF. METHODS We retrospectively analyzed data from patients with CD who received anti-TNF as maintenance therapy from 2008 to 2017, underwent EBD, and were followed up for ≥6 months. The primary endpoint was the cumulative surgery-free rate. The main secondary endpoints were technical success, repeat EBD rate, risk factors affecting surgical outcomes, and safety. RESULTS Seventy-two patients with CD were assessed. The median observation period after EBD was 50 months. The technical success rate was 67%. The 3- and 5-year cumulative surgery-free rates were 81.1% and 73.5%, respectively. The repeat EBD rate was 74%. Multivariable analyses showed that risk factors affecting surgical outcomes were age at disease onset ≤16 years (hazard ratio 3.69; 95% confidence interval 1.36-10.01; P = 0.011). Serious complications requiring surgery developed in three patients. CONCLUSIONS Endoscopic balloon dilation was an effective and safe short-term treatment and a useful long-term treatment for CD patients with intestinal strictures receiving anti-TNF as maintenance therapy.
- Published
- 2021
- Full Text
- View/download PDF