P1174Dilation interval predicts long-term discontinuation of endoscopic balloon dilation in Crohn’s disease strictures

Abstract Background Endoscopic balloon dilation (EBD) is an important therapeutic option for intestinal strictures in Crohn’s disease (CD). Long-term outcomes vary among patients, with some achieving sustained discontinuation of EBD while others remain dependent on repeated procedures. Factors predicting EBD independence remain unclear. This study aimed to evaluate whether the dilation interval predicts long-term EBD discontinuation. Methods We retrospectively reviewed CD patients who underwent their first EBD for intestinal strictures at our institution between January 2016 and June 2025. EBD independence was defined as maintaining endoscopic passability without additional EBD for more than 10 months. Patients were divided into an EBD discontinue group (EDG) and an EBD-continue group (ECG). Clinical characteristics, concomitant therapies, stricture details, and EBD-related parameters were compared between groups. ROC analysis was used to determine the optimal cut-off value of the mean EBD interval associated with EBD independence. Cumulative independence rates were evaluated using the Kaplan–Meier method. Results Twenty-two patients were included (17 male, 5 female). The median age at initial EBD was 39.5 years (20–61), median disease duration was 135 months (5–378), and the median number of strictures dilated was 1 (1–5). Concomitant therapies included 5-ASA in 12 patients (50%), prednisolone in 2 (9.1%), thiopurines in 14 (63.6%), and biologics in 14 (63.6%). Over a median follow-up of 19 months (1–95), 10 patients (45.4%) achieved EBD discontinue, while 12 remained continue. The EDG had significantly shorter mean EBD intervals compared with the ECG (4.8 vs 9.3 months, p = 0.04). ROC analysis identified 5.34 months as the optimal cut-off for predicting EBD independence (AUC 0.758; sensitivity 60.0%; specificity 91.8%). Patients with a mean EBD interval 5.34 months had significantly higher 3-year cumulative EBD independence rates than those with intervals ≥5.34 months (80.0% vs 29.9%; log-rank p = 0.007). Conclusion A shorter mean EBD interval was strongly associated with achieving EBD independence in CD-related intestinal strictures. Proactive scheduling of EBD at shorter intervals may help maintain luminal patency and reduce long-term EBD dependence. Conflict of interest: Okabe, Makoto: No conflict of interest Fuyuno, Takashi: No conflict of interest Onoyama, Yusuke: No conflict of interest Namikawa, Mio: No conflict of interest Kitamoto, Hiroki: No conflict of interest Seno, Hiroshi: No conflict of interest