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Ustekinumab for ileal stricturing Crohn's disease-an international multicenter retrospective cohort study

Sara El Ouali1,2, Mark E Baker3, Cathy Lu4

  • 1Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

Journal of Crohn'S & Colitis
|April 4, 2026
PubMed

Insights

Ustekinumab (USTE) shows promise for treating stricturing Crohn's disease (CD) by reducing the need for interventions like endoscopic balloon dilation or surgery. This biologic therapy is a viable option for patients with ileal strictures, particularly those with prior biologic treatment experience.

Area of Science:

  • Gastroenterology
  • Inflammatory Bowel Disease Research
  • Pharmacological Studies

Background:

  • Stricturing Crohn's disease (CD) presents a significant clinical challenge with limited targeted anti-fibrotic therapies.
  • Current management relies on anti-inflammatory approaches, but data on ustekinumab (USTE) for ileal strictures are scarce.

Purpose of the Study:

  • To evaluate the efficacy of ustekinumab (USTE) in adult patients with symptomatic stricturing ileal Crohn's disease.
  • To assess intervention rates, symptom recurrence, and treatment persistence with USTE in this patient population.

Main Methods:

  • An international multicenter observational cohort study was conducted.
  • Adult CD patients receiving USTE within six months of imaging-confirmed symptomatic strictures were analyzed.
  • Outcomes included rates of endoscopic balloon dilation (EBD), surgery, composite interventions, obstructive symptoms, and USTE persistence.

Main Results:

  • Fifty-seven patients were included, with intervention rates at 12, 24, and 48 months being 35%, 45%, and 69%, respectively.
  • USTE persistence rates were 78%, 76%, and 52% at 12, 24, and 48 months.
  • Factors associated with increased intervention risk included prior EBD; USTE discontinuation was linked to bowel wall thickness, prior biologics, and symptom duration.

Conclusions:

  • Ustekinumab (USTE) is a suitable medical treatment option for biologic-experienced CD patients presenting with ileal strictures.
  • Further prospective studies are necessary to refine understanding of outcomes and identify predictors of response to USTE in this specific CD subset.
Abstract

Keywords:
Crohn’s diseasestrictureustekinumab

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