title: Anti-TNF-alpha treatments and obstructive symptoms in Crohn's disease: a prospective study.
abstract: BACKGROUND
  The development of symptomatic strictures in Crohn's Disease after anti-Tumour Necrosis Factor-α antibodies is undefined.
  
  
  OBJECTIVE
  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.
  
  
  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 ≥12months (mean follow-up duration after the first treatment 23.2±6.8months). 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-α antibodies, with no significant sonographic changes of the small bowel lesions.
authors.affiliation: GI Unit, Department of Systems Medicine, University Tor Vergata, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Condino
authors.forename: Emma
authors.initials: E
authors.lastname: Calabrese
authors.forename: Francesca
authors.initials: F
authors.lastname: Zorzi
authors.forename: Sara
authors.initials: S
authors.lastname: Onali
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lolli
authors.forename: Fabiola
authors.initials: F
authors.lastname: De Biasio
authors.forename: Marta
authors.initials: M
authors.lastname: Ascolani
authors.forename: Francesco
authors.initials: F
authors.lastname: Pallone
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab