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Multicenter Study
. 2020 Nov;52(11):1323-1330.
doi: 10.1016/j.dld.2020.08.034. Epub 2020 Sep 20.

Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study

Thomas Lambin  1 , Aurélien Amiot  2 , Carmen Stefanescu  3 , Jean-Marc Gornet  4 , Philippe Seksik  5 , David Laharie  6 , Catherine Reenaers  7 , Arnaud Bourreille  8 , Guillaume Cadiot  9 , Franck Carbonnel  10 , Nina Dib  11 , Mathurin Fumery  12 , Cyrielle Gilletta de St Joseph  13 , Jérôme Filippi  14 , Stéphanie Viennot  15 , Laurianne Plastaras  16 , Benoit Coffin  17 , Mélanie Serrero  18 , Stéphane Nahon  19 , Guillaume Pineton de Chambrun  20 , Jean-François Rahier  21 , Xavier Roblin  22 , Médina Boualit  23 , Guillaume Bouguen  24 , Laurent Peyrin-Biroulet  25 , Benjamin Pariente  26 ; UGT-CD-stricture GETAID study group
Affiliations
Free article
Multicenter Study

Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study

Thomas Lambin et al. Dig Liver Dis. 2020 Nov.
Free article

Abstract

Background: There are few data concerning patients with Crohn's disease (CD) complicated by a stricture of the upper gastrointestinal tract (UGT).

Aims: We evaluated the outcome and management of CD patients complicated by a stricture of the UGT.

Methods: We performed a retrospective multicenter study including all CD patients with a non-passable symptomatic UGT stricture on endoscopy. Primary outcome measure was surgery-free survival from diagnosis of stricture. Efficacy of medical, endoscopic, and surgical treatments, and identification of predictors of surgery were also evaluated.

Results: 60 CD patients with an UGT stricture were included. 60% of the strictures were located in the duodenum. With a median follow-up of 5.5 (IQR: 3.0-12.0) years since stricture diagnosis, surgical-free survival was 75% and 64% at 1 and 5 years, respectively. At the end of the follow up, 27 (45%) patients underwent surgery. 77 endoscopic procedures were performed in 30 patients with an immediate success of 81% and a clinical benefit in 84% of the procedures. In multivariate analysis, anti-TNF treatment initiation was associated with a reduced risk of surgery.

Conclusion: CD UGT strictures are mainly located in the duodenum. Medical and endoscopic treatments allow to avoid surgery in half of the patients.

Keywords: Crohn's disease; Endoscopic treatment; Stricture; Surgery; Upper gastrointestinal tract.

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Conflict of interest statement

Declaration of Competing Interest T. Lambin: Travel accommodation: Adacyte therapeutics. A. Amiot: Consulting fees from Abbvie, Hospira, Janssen, Tillotts, Pfizer, Takeda, Gilead and Biocodex. Lecture fees and travel accommodation from Abbvie, Janssen, Biocodex, Hospira, Ferring, Pfizer, Ferring, Tillotts, Takeda and MSD. Advisory board fees from Gilead, Takeda and Abbvie. C. Stefanescu: Consulting: Takeda. Lecture fees: Abbvie, Fresenius Kabi, Pfizer, Janssen. Travel acomodation: MSD, Takeda, Abbvie, Pfizer, Janssen. P. Seksik: Consulting fees : Takeda, Abbvie, Merck-MSD, Biocodex, Janssen, Amgen, Astellas, Pfizer Grants : Biocodex. Sponsored travel : Merck-MSD and Takeda, Amgen. D. Laharie: Counseling, boards, transports or personal fees from Abbvie, Biogaran, Biogen, Ferring, HAC-pharma, Janssen, MSD, Novartis, Pfizer, Prometheus, Roche, Takeda, Theradiag, Tillots. A. Bourreille: Personal fees from AbbVie, Janssen, Ferring, Tillots, Celltrion, Takeda, Pfizer, MSD, Roche, Fresenius Kabi OSE Immunotherapeutics, Medtonic. Grants: Abbvie, MSD, Takeda, MaunaKea Technology, Medtronic. G.Cadiot: Consulting fees: Ipsen, Novartis, AAA, Pfizer, Keocyt. Lecture fees: Takeda. N. Dib: Abbvie, Janssen, Pfizer, Takeda. M. Fumery: Consulting fees : AbbVie, Takeda, Janssen, Pfizer, Celgene, Gilead. Lecture Fees : Boehringer and Biogen Abbvie, MSD, Takeda, Janssen, Ferring, Tillots. C. Gilletta de St Joseph: Lecture fees: Abbvie, Takeda, Janssen, Pfizer. Consulting fees: Abbvie, Takeda, Janssen, Celltrion. J. Filippi: Abbvie, Amgen, Biogen, Celltrion, Ferring, HAC Pharma, Hospira, Janssen, MSD, Pfizer, Takeda, Vifor. S. Viennot: Abbvie, Amgen, Celltrion, Ferring, Janssen, MSD, Pfizer, Takeda. L. Plastaras: Personnal fees or boards from AbbVie, Janssen, Tillots, Takeda, Pfizer, MSD. M. Serrero: Abbvie, Amgen, Biogen, Celltrion, Gilead, Janssen, Ferring, MSD, Pfizer, Takeda, Tillots. S. Nahon: Lecturer or advisory board fees from AbbVie, MSD, Vifor Pharma, Pfizer, Janssen and Ferring. G. Pineton de Chambrun: Lecture fees from Pfizer, MSD, AbbVie, Takeda and Ferring. Consulting fees from Takeda, Tillots Pharma and Janssen. JF. Rahier: Lecture fees from AbbVie, MSD, Takeda, Pfizer, Ferring, and Falk, consulting fees from AbbVie, Takeda, Hospira, Mundipharma, MSD, Pfizer, GlaxoSK, Janssen and Amgen, and research support from Takeda and AbbVie. X. Roblin: Consultant fees from MSD,Pfizer, Abbvie, Amgen, Biogen, Takeda, janssen, crlltrion, Ferring. M. Boualit: Travel accommodation : abbvie, Janssen, Pfizer, Takeda. G. Bouguen: Lecture fees from Abbvie, Ferring, MSD, Takeda and Pfizer and consultant fees from Takeda, Janssen. L. Peyrin-Biroulet: Personal fees from AbbVie, Janssen, Genentech, Ferring, Tillots, Pharmacosmos, Celltrion, Takeda, Boerhinger Ingelheim, Pfizer, Index Pharmaceuticals, Sandoz, Celgene, Biogen, Samsung Bioepis, Alma, Sterna, Nestle, Enterome, Allergan, MSD, Roche, Arena, Gilead, Hikma, Amgen, BMS, Vifor, Norgine ; Mylan, Lilly, Fresenius Kabi, Oppilan Pharma, Sublimity Therapeutics, Applied Molecular Transport, OSE Immunotherapeutics, Enthera, Theravance. Grants: Abbvie, MSD, Takeda. B. Pariente: Consulting fees: AbbVie, MSD, Takeda, Janssen, Lilly, Pfizer, and Biogaran. Lecture fees: Abbvie, MSD, Takeda, Janssen, and Ferring, and other authors declare that they have no conflict of interest.

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