Perianal complete remission with combined therapy (seton placement and anti-TNF agents) in Crohn's disease: a Brazilian multicenter observational study.

Abstract

BACKGROUND:

Perianal fistulizing Crohn's disease is one of the most severe phenotypes of inflammatory bowel diseases. Combined therapy with seton placement and anti-TNF therapy is the most common strategy for this condition.

OBJECTIVES:

The aim of this study was to analyze the rates of complete perianal remission after combined therapy for perianal fistulizing Crohn's disease.

METHODS:

This was a retrospective observational study with perianal fistulizing Crohn's disease patients submitted to combined therapy from four inflammatory bowel diseases referral centers. We analyzed patients' demographic characteristics, Montreal classification, concomitant medication, classification of the fistulae, occurrence of perianal complete remission and recurrence after remission. Complete perianal remission was defined as absence of drainage from the fistulae associated with seton removal.

DISCUSSION:

A total of 78 patients were included, 44 (55.8%) females with a mean age of 33.8 (±15) years. Most patients were treated with Infliximab, 66.2%, than with Adalimumab, 33.8%. Complex fistulae were found in 52/78 patients (66.7%). After a medium follow-up of 48.2 months, 41/78 patients (52.6%) had complete perianal remission (95% CI: 43.5%-63.6%). Recurrence occurred in four (9.8%) patients (95% CI: 0.7%-18.8%) in an average period of 74.8 months.

CONCLUSIONS:

Combined therapy lead to favorable and durable results in perianal fistulizing Crohn's disease.

• Authors: Paulo Gustavo Kotze, Idblan Carvalho de Albuquerque, André da Luz Moreira, Wanessa Bertrami Tonini, Marcia Olandoski, Claudio Saddy Rodrigues Coy
• Journal: Arquivos de gastroenterologia (Arq Gastroenterol) 2014 Oct-Dec Vol. 51 Issue 4 Pg. 284-9 ISSN: 1678-4219 [Electronic] Brazil
• PMID: 25591155 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Tumor Necrosis Factor-alpha

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Child
• Child, Preschool
• Combined Modality Therapy
• Crohn Disease (therapy)
• Female
• Humans
• Male
• Middle Aged
• Rectal Fistula (therapy)
• Recurrence
• Retrospective Studies
• Severity of Illness Index
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Young Adult