Anti-TNF-alpha treatments and obstructive symptoms in Crohn's Disease: A prospective study

BackgroundThe development of symptomatic strictures in Crohn's Disease after anti-Tumour Necrosis Factor-α antibodies is undefined.AimTo assess, in a prospective longitudinal study, the frequency of sub/obstructions in Crohn's Disease patients after treatment with Infliximab or Adalimumab. Changes of small bowel lesions after these biological therapies were searched by ultrasonography.Materials and MethodsFrom January 2007 to October 2008, 36 Crohn's Disease patients with no previous sub/obstructions were treated with either Infliximab (n = 13) or Adalimumab (n = 23) for ≥12 months (mean follow-up duration after the first treatment 23.2 ± 6.8 months). Small Intestine Contrast Ultrasonography was performed before and after treatment in 19/36 patients. Sonographic parameters included: bowel wall thickness, lumen diameter, bowel dilation and lesion extent.ResultsSub/obstructions developed in 3/36 patients treated with Infliximab (n = 1) or Adalimumab (n = 2), all with fibrostricturing Crohn's Disease. Sonographic parameters did not significantly change after treatment.ConclusionsSub/obstructive symptoms may develop in one tenth of Crohn's Disease patients treated with anti-Tumour Necrosis Factor-α antibodies, with no significant sonographic changes of the small bowel lesions.