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

Background: The development of symptomatic strictures in Crohn's Disease after anti-Tumour Necrosis Factor-alpha antibodies is undefined. Aim: To 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 Methods: From 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. Results: Sub/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. Conclusions: Sub/obstructive symptoms may develop in one tenth of Crohn's Disease patients treated with anti-Tumour Necrosis Factor-alpha antibodies, with no significant sonographic changes of the small bowel lesions. (C) 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.