I read with interest the paper by Lichtenstein
et al. on factors associated with the development of
strictures in Crohn’s disease (CD). The authors’ observations,
based on the TREAT registry and the ACCENT I
study, indicate that CD severity and duration, ileal disease,
and new corticosteroid use—but not infliximab therapy—are
associated with a greater risk of developing strictures. The
latter observation, in particular, runs against previous results, which might have been affected by unadjusted analyses.
Taken together with other data showing an antifibrogenic
effect of infliximab in CD, the Lichtenstein et al. paper suggests, inter alia, that infliximab should be given earlier in
the course of disease, before collagen deposition has begun.
