Citations 2
Ustekinumab for ileal stricturing Crohn’s disease—an international multicenter retrospective cohort study
Ouali, Sara El , Baker, Mark E, Lu, Cathy , Medellin, A, Bruining, David H, Fletcher, Joel G. , Inoue, Aki, Regueiro, Miguel, Ottichilo, Ronald K. , Schoenoff, Shayla, Rosentreter, Ryan E., Qazi, Taha , Holubar, S. D., Gauriloff, Samantha, Gandhi, Namita , Cohen, Benjamin L, Balci, Numan, Rieder, Florian, Regueiro, Miguel , Lu, Cathy , El Ouali, Sara , Regueiro, Miguel , Qazi, Taha , Sleiman, Joseph , Holubar, Stefan D , Rieder, Florian , Fletcher, Joel G , Baker, Mark E. , Medellin, Alexandra , Bruining, David H. , Inoue, Aki, Bena, Jim , Sleiman, Joseph , Holubar, Stefan D. , Cohen, Benjamin L, Goren, Idan , Rieder, Florian
Journal of Crohn's and Colitis | March 23, 2026 | Volume: 20 | Issue: 3 | Pages: No page available
Abstract Background & Aims Stricturing Crohn’s disease (CD) is a significant problem, and no selective anti-fibrotic therapies are available. Anti-inflammatory approaches are the mainstay of medical treatment. However, data on the efficacy of ustekinumab (USTE) in ileal stricturing CD are lacking. Our aim was to assess its efficacy in this setting. Methods We performed an international multicenter observational cohort study evaluating adult CD patients who received USTE within 6 months of imaging-confirmed symptomatic stricturing small bowel disease. Outcomes were rates of endoscopic balloon dilation (EBD), surgery, intervention (defined as the composite need for EBD or surgery), recurrent obstructive symptoms, and USTE persistence. Results Fifty-seven patients were included (51% female, median age 43 years). Median follow-up was 17 months. Intervention rates were 35%, 45%, and 69% of patients, at 12, 24, and 48 months, respectively. USTE persistence was 78%, 76%, and 52% at 12, 24, and 48 months. Estimated obstructive symptoms rates were 31% and 49% at 12 and 24 months, respectively. EBD within 6 months prior to starting USTE was associated with an increased risk of intervention. Increased bowel wall thickness on imaging, prior biologic use, and obstructive symptom duration were associated with USTE discontinuation. Occurrence of obstructive symptoms during treatment was associated with prior biologic use, EBD within 6 months of starting USTE, and a lower BMI. Conclusions USTE appears to be an appropriate medical option in biologic-experienced CD patients with ileal strictures. Further prospective data are needed to better define outcomes and predictors of response in this setting.
Systematic review: Defining, diagnosing and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound
Lu, Cathy , Rosentreter, Ryan E., Delisle, Maxime , White, Mattie, Parker, Claire E. , Premji, Zahra , Baker, Mark E. , Bhatnagar, Gauraang , Begun, Jakob , Bruining, David H. , Bryant, Robert V. , Christensen, Britt , Feagan, Brian G. , Jairath, Vipul , Knudsen, John M. , Kucharzik, Torsten , Maaser, Christian , Novak, Kerri L. , Taylor, Stuart A. , Wilkens, Rune , Rieder, Florian , Jairath, Vipul , Jairath, Vipul , Begun, Jakob , Bryant, Robert, Christensen, Britt , Jairath, V , Knudsen, John, Maconi, Giovanni , Novak, Kerri , Wilkens, Rune , Rieder, Florian , Lu, Cathy , Jairath, V , Jairath, Vipul , Wilson, Stephanie R. , Fletcher, Joel G. , Rimola, Jordi
Alimentary Pharmacology & Therapeutics | March 4, 2024 | Volume: 59 | Issue: 8 | Pages: 928-940
Summary Background Stricturing Crohn's disease (CD) occurs most commonly in the terminal ileum and poses a clinical problem. Cross‐sectional imaging modalities such as intestinal ultrasound (IUS), computed tomography enterography (CTE), and magnetic resonance enterography (MRE) allow for assessment of the entire bowel wall and associated peri‐enteric findings. Radiologic definitions of strictures have been developed for CTE and MRE; their reliability and responsiveness are being evaluated in index development programs. A comprehensive assessment strategy for strictures using IUS is needed. Aims To provide a detailed summary of definitions, diagnosis and monitoring of strictures on IUS as well as technical aspects of image acquisition. Methods We searched four databases up to 6 January 2024. Two‐stage screening was done in duplicate. We assessed risk of bias using QUADAS‐2. Results There were 56 studies eligible for inclusion. Definitions for strictures on IUS are heterogeneous, but the overall accuracy for diagnosis of strictures is high. The capability of IUS for characterising inflammation versus fibrosis in strictures is not accurate enough to be used in clinical practice or trials. We summarise definitions for improvement of strictures on IUS, and discuss parameters for image acquisition and standardisation. Conclusions This systematic review is the first step for a structured program to develop a stricture IUS index for CD.