Clinical efficacy of biologics combined with endoscopic balloon dilatation for the prevention of intestinal stenosis in Crohn disease
10.3760/cma.j.cn321463-20240902-00257
- VernacularTitle:生物制剂联合内镜下球囊扩张术预防克罗恩病肠道狭窄复发的疗效初探
- Author:
Yi LIU
1
;
Min SU
1
;
Kewen SUN
1
;
Mei WANG
1
Author Information
1. 常州市第一人民医院消化内科，常州 213003
- Publication Type:Journal Article
- Keywords:
Crohn disease;
Biological agents;
Endoscopic balloon dilation;
Recurrence of intestinal strictures
- From:
Chinese Journal of Digestive Endoscopy
2025;42(5):391-395
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the effectiveness of the combined biological therapy and endoscopic balloon dilation (EBD) for preventing intestinal stricture recurrence in patients with Crohn disease, and to identify the risk factors for post-EBD stricture recurrence.Methods:This retrospective cohort study enrolled Crohn disease patients who underwent EBD with or without biological therapy at the Department of Gastroenterology, the First People's Hospital of Changzhou, from January 2016 to December 2023. The patients were divided into the biologics-EBD group and the EBD monotherapy group, and recurrence rates of intestinal stenosis between the groups were compared. The Kaplan-Meier method was employed to estimate the stricture-free survival, with intergroup differences assessed via log-rank test. The Cox proportional hazards regression model was utilized to perform a multivariate analysis of the survival data of the included cases for the independent risk factors for the recurrence of intestinal strictures after EBD in Crohn disease.Results:In accordance with the inclusion and exclusion criteria, a total of 47 cases were ultimately included in the study, with 29 cases in the biologics-EBD group and 18 cases in the EBD monotherapy group. The baseline data of the two groups were comparable. Stricture recurrence occurred in 6/29 (20.7%) biologics-EBD patients versus 10/18 (55.6%) EBD monotherapy patients. Kaplan-Meier curves demonstrated superior cumulative stricture-free survival in the biologics-EBD cohort ( P=0.014). Cox proportional hazards regression model confirmed elevated recurrence risk with EBD monotherapy ( HR=5.360, 95% CI: 1.340-21.449, P=0.018) and small intestinal strictures ( HR=7.746, 95% CI: 1.908-31.446, P=0.004). Conclusion:The combination of biologics with EBD for the treatment of intestinal strictures in Crohn disease can effectively prevent the recurrence of intestinal strictures. Regarding small intestinal strictures in Crohn disease, it is suggested to combine biologics for treatment to prevent the high recurrence rate of strictures.
