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Vedolizumab for stricturing Crohn's disease of the terminal ileum - an international multicenter cohort study - PubMed

3 hours ago
  • #Stricturing
  • #Vedolizumab
  • #Crohn's disease
  • Vedolizumab was assessed in adult patients with imaging-confirmed symptomatic ileal stricturing Crohn's disease.
  • Study participants had high prior biologic exposure (84%) and many had anastomotic strictures (64%).
  • Cumulative intervention rates (endoscopic balloon dilation or surgery) were 23%, 44%, and 50% at 12, 24, and 48 months.
  • Symptom resolution occurred in 52% of patients, with 26% experiencing recurrent obstructive symptoms.
  • Vedolizumab persistence rates were 82%, 74%, and 59% at 12, 24, and 48 months.
  • Anastomotic stricture inversely associated with intervention (HR 0.21) and surgery (HR 0.11).
  • Higher obstructive symptom index and prestenotic bowel dilatation linked to recurrent symptoms.
  • Elevated baseline CRP associated with vedolizumab discontinuation (HR 1.96).
  • Vedolizumab appears effective for terminal ileal strictures, especially in anastomotic strictures without obstruction.