Predictors of Adalimumab Efficacy in Crohn Disease with Symptomatic Small-Bowel Strictures

Between January 2010 and December 2011, 97 patients with Crohn disease, one or more small-bowel strictures, and obstructive symptoms in the previous 8 weeks were treated with adalimumab. All patients underwent baseline magnetic resonance enterography (MRE).

Successful adalimumab therapy at week 24 — defined as no treatment with steroids, other anti–tumor necrosis factor (anti-TNF) agents, endoscopic dilation, or bowel resection — occurred in 64%. Among the 35 patients who failed treatment, 8 underwent surgery, 2 underwent endoscopic dilation, and 10 were discontinued from adalimumab because of serious adverse events.

Factors associated with adalimumab success were use of immunosuppressive agents at adalimumab initiation, obstructive symptom d…