{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:51:54Z","timestamp":1787003514232,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Crohn\u2019s disease (CD) is often complicated by strictures and associated with increased risk for surgery. Inflammatory strictures respond to medical therapy, and anti-tumor necrosis factor (TNF) therapy is often used after the failure of steroids. However, data on efficacy of anti-TNF therapy in stricturing CD is limited. We retrospectively analysed the\u00a0records of patients with stricturing CD who were treated with anti-TNF therapy and were prospectively followed from January 2005 to July 2020. Treatment success was defined as continuation of anti-TNF without the requirement for steroids or parenteral nutrition, switch to other anti-TNF, endoscopic dilation, surgery and severe adverse events leading to the withdrawal of anti-TNF. Fifty-nine patients were included [50-infliximab, 9-adalimumab; mean age-30.1\u2009\u00b1\u200915\u00a0years; males-69.5%; median disease duration-124 (range 30\u2013396) months; median follow-up duration-42 (range 8\u2013180) months]. Ileum was the most common site of stricture (69.5%), 20.3% of patients had colonic strictures, and 64.4% had multiple strictures. 55.9% of patients were steroid dependent and 37.3% were steroid refractory. The median duration of anti-TNF therapy was 14 (range 2\u201396) months, and 54.2% (n\u2009=\u200932) patients received concomitant immunomodulators. 88% improved with induction (11.8% primary non-response), secondary loss of response was seen in 52.2%, and the cumulative probability of treatment success at 1, 2 and 5 years was 69%, 51%, and 28% respectively. Anaemia at presentation predicted poor response. Only 30% of patients retained biologics on long-term (lack of response, cost, adverse events). 16.9% had adverse events, the commonest being reactivation of tuberculosis (5.1%). Anti-TNF therapy is associated with good short-term treatment success with modest long-term response in stricturing CD.<\/jats:p>","DOI":"10.1038\/s41598-021-90660-2","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T06:15:03Z","timestamp":1622700903000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Real world analysis on the efficacy and safety of anti-tumor necrosis factor therapy in patients with stricturing Crohn\u2019s disease"],"prefix":"10.1038","volume":"11","author":[{"given":"Sudheer K.","family":"Vuyyuru","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar","family":"Kante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peeyush","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pabitra","family":"Sahu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Kedia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh Kumar","family":"Ranjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raju","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Panwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govind","family":"Makharia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"issue":"3","key":"90660_CR1","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1136\/gutjnl-2017-315568","volume":"68","author":"J Burisch","year":"2019","unstructured":"Burisch, J. et al. Natural disease course of Crohn\u2019s disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study. Gut 68(3), 423\u2013433. https:\/\/doi.org\/10.1136\/gutjnl-2017-315568 (2019).","journal-title":"Gut"},{"issue":"4","key":"90660_CR2","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1097\/00054725-200207000-00002","volume":"8","author":"J Cosnes","year":"2002","unstructured":"Cosnes, J. et al. Long-term evolution of disease behavior of Crohn\u2019s disease. Inflamm. Bowel Dis. 8(4), 244\u2013250. https:\/\/doi.org\/10.1097\/00054725-200207000-00002 (2002).","journal-title":"Inflamm. Bowel Dis."},{"issue":"2","key":"90660_CR3","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1038\/ajg.2009.579","volume":"105","author":"L Peyrin-Biroulet","year":"2010","unstructured":"Peyrin-Biroulet, L., Loftus, E. V., Colombel, J.-F. & Sandborn, W. J. The natural history of adult Crohn\u2019s disease in population-based cohorts. Am. J. Gastroenterol. 105(2), 289\u2013297. https:\/\/doi.org\/10.1038\/ajg.2009.579 (2010).","journal-title":"Am. J. Gastroenterol."},{"issue":"12","key":"90660_CR4","doi-asserted-by":"publisher","first-page":"3207","DOI":"10.1007\/s00261-018-1626-9","volume":"43","author":"MM Amitai","year":"2018","unstructured":"Amitai, M. M. et al. Diffusion-weighted magnetic resonance enterography for prediction of response to tumor necrosis factor inhibitors in stricturing Crohn\u2019s disease. Abdom. Radiol. (NY). 43(12), 3207\u20133212. https:\/\/doi.org\/10.1007\/s00261-018-1626-9 (2018).","journal-title":"Abdom. Radiol. (NY)."},{"issue":"1","key":"90660_CR5","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1136\/gutjnl-2016-312581","volume":"67","author":"Y Bouhnik","year":"2018","unstructured":"Bouhnik, Y. et al. Efficacy of adalimumab in patients with Crohn\u2019s disease and symptomatic small bowel stricture: A multicentre, prospective, observational cohort (CREOLE) study. Gut 67(1), 53\u201360. https:\/\/doi.org\/10.1136\/gutjnl-2016-312581 (2018).","journal-title":"Gut"},{"issue":"8","key":"90660_CR6","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1097\/MEG.0000000000000399","volume":"27","author":"DJ Gibson","year":"2015","unstructured":"Gibson, D. J. et al. Magnetic resonance enterography findings as predictors of clinical outcome following antitumor necrosis factor treatment in small bowel Crohn\u2019s disease. Eur. J. Gastroenterol. Hepatol. 27(8), 956\u2013962. https:\/\/doi.org\/10.1097\/MEG.0000000000000399 (2015).","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"issue":"12","key":"90660_CR7","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.3748\/wjg.14.1885","volume":"14","author":"N Pallotta","year":"2008","unstructured":"Pallotta, N. et al. Effect of infliximab on small bowel stenoses in patients with Crohn\u2019s disease. World J. Gastroenterol. 14(12), 1885\u20131890. https:\/\/doi.org\/10.3748\/wjg.14.1885 (2008).","journal-title":"World J. Gastroenterol."},{"issue":"3","key":"90660_CR8","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.dld.2012.10.009","volume":"45","author":"G Condino","year":"2013","unstructured":"Condino, G. et al. Anti-TNF-alpha treatments and obstructive symptoms in Crohn\u2019s disease: A prospective study. Dig. Liver Dis. 45(3), 258\u2013262. https:\/\/doi.org\/10.1016\/j.dld.2012.10.009 (2013).","journal-title":"Dig. Liver Dis."},{"issue":"6","key":"90660_CR9","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1007\/s10620-017-4572-4","volume":"62","author":"C Campos","year":"2017","unstructured":"Campos, C. et al. Medical therapies for stricturing Crohn\u2019s disease: Efficacy and cross-sectional imaging predictors of therapeutic failure. Dig Dis Sci. 62(6), 1628\u20131636. https:\/\/doi.org\/10.1007\/s10620-017-4572-4 (2017).","journal-title":"Dig Dis Sci."},{"issue":"3","key":"90660_CR10","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1111\/j.1365-2036.2008.03887.x","volume":"29","author":"A-L Pelletier","year":"2009","unstructured":"Pelletier, A.-L., Kalisazan, B., Wienckiewicz, J., Bouarioua, N. & Soul\u00e9, J.-C. Infliximab treatment for symptomatic Crohn\u2019s disease strictures. Aliment Pharmacol Ther. 29(3), 279\u2013285. https:\/\/doi.org\/10.1111\/j.1365-2036.2008.03887.x (2009).","journal-title":"Aliment Pharmacol Ther."},{"issue":"1","key":"90660_CR11","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1093\/ecco-jcc\/jjx110","volume":"12","author":"P Bossuyt","year":"2018","unstructured":"Bossuyt, P. et al. Risk stratification for surgery in stricturing ileal Crohn\u2019s disease: The BACARDI risk model. J. Crohns Colitis. 12(1), 32\u201338. https:\/\/doi.org\/10.1093\/ecco-jcc\/jjx110 (2018).","journal-title":"J. Crohns Colitis."},{"issue":"1","key":"90660_CR12","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.crohns.2009.12.003","volume":"4","author":"G Van Assche","year":"2010","unstructured":"Van Assche, G. et al. The second European evidence-based consensus on the diagnosis and management of Crohn\u2019s disease: Definitions and diagnosis. J. Crohns Colitis. 4(1), 7\u201327. https:\/\/doi.org\/10.1016\/j.crohns.2009.12.003 (2010).","journal-title":"J. Crohns Colitis."},{"issue":"6","key":"90660_CR13","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1136\/gut.2005.082909","volume":"55","author":"J Satsangi","year":"2006","unstructured":"Satsangi, J., Silverberg, M. S., Vermeire, S. & Colombel, J. The Montreal classification of inflammatory bowel disease: Controversies, consensus, and implications. Gut 55(6), 749\u2013753. https:\/\/doi.org\/10.1136\/gut.2005.082909 (2006).","journal-title":"Gut"},{"issue":"3","key":"90660_CR14","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1111\/apt.14853","volume":"48","author":"F Rieder","year":"2018","unstructured":"Rieder, F. et al. An expert consensus to standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Crohn\u2019s disease. Aliment Pharmacol. Ther. 48(3), 347\u2013357. https:\/\/doi.org\/10.1111\/apt.14853 (2018).","journal-title":"Aliment Pharmacol. Ther."},{"issue":"1","key":"90660_CR15","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1093\/ecco-jcc\/jjw168","volume":"11","author":"F Gomoll\u00f3n","year":"2017","unstructured":"Gomoll\u00f3n, F. et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn\u2019s disease 2016: Part 1: Diagnosis and medical management. J. 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Gastroenterol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-90660-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-90660-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-90660-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T04:03:47Z","timestamp":1670040227000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-90660-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,3]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["90660"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-90660-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,3]]},"assertion":[{"value":"19 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11704"}}