{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:01:02Z","timestamp":1783947662788,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100006130","name":"Bundesamt f\u00fcr Bev\u00f6lkerungsschutz und Katastrophenhilfe","doi-asserted-by":"publisher","award":["INT-BC-2018-007"],"award-info":[{"award-number":["INT-BC-2018-007"]}],"id":[{"id":"10.13039\/501100006130","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Biocruces Bizkaia Health Research Institute","award":["INT-BC-2018-007"],"award-info":[{"award-number":["INT-BC-2018-007"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There is limited evidence on the effectiveness of biological therapy in stricturing complications in patients with Crohn\u2019s disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The study aims to determine the effectiveness of anti\u2010tumor necrosis factor (TNF) agents in Crohn\u2019s disease complicated with symptomatic strictures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multicentric and retrospective study, we included adult patients with symptomatic stricturing Crohn\u2019s disease receiving their first anti\u2010TNF therapy, with no previous history of biological, endoscopic or surgical therapy. The effectiveness of the anti\u2010TNF agent was defined as a composite outcome combining steroid\u2010free drug persistence with no use of new biologics or immunomodulators, hospital admission, surgery or endoscopic therapy during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 262 patients with Crohn\u2019s disease were included (53% male; median disease duration, 35\u00a0months, 15% active smokers), who received either infliximab (<jats:italic>N<\/jats:italic> \u2009=\u2009141, 54%) or adalimumab (<jats:italic>N<\/jats:italic> \u2009=\u2009121, 46%). The treatment was effective in 87% and 73% of patients after 6 and 12\u00a0months, respectively, and continued to be effective in 26% after a median follow\u2010up of 40\u00a0months (IQR, 19\u201385). Nonetheless, 15% and 21% of individuals required surgery after 1 and 2 years, respectively, with an overall surgery rate of 32%. Postoperative complications were identified in 15% of patients, with surgical site infection as the most common. Starting anti\u2010TNF therapy in the first 18\u00a0months after the diagnosis of Crohn\u2019s disease or the identification of stricturing complications was associated with a higher effectiveness (HR 1.62, 95% CI 1.18\u20132.22; and HR 1.55, 95% CI 1.1\u20132.23; respectively). Younger age, lower albumin levels, strictures located in the descending colon, concomitant aminosalicylates use or presence of lymphadenopathy were associated with lower effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anti\u2010TNF agents are effective in approximately a quarter of patients with Crohn\u2019s disease and symptomatic intestinal strictures, and 68% of patients are free of surgery after a median of 40\u00a0months of follow\u2010up. Early treatment and some potential predictors of response were associated with treatment success in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640620947579","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T06:54:06Z","timestamp":1596005646000},"page":"1056-1066","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Early treatment with anti\u2010tumor necrosis factor agents improves long\u2010term effectiveness in symptomatic stricturing Crohn\u2019s disease"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-4578","authenticated-orcid":false,"given":"Iago","family":"Rodr\u00edguez\u2010Lago","sequence":"first","affiliation":[{"name":"Hospital de Galdakao Gastroenterology Galdakao Spain"},{"name":"Biocruces Bizkaia Health Research Institute Barakaldo 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