Comparison between infliximab and adalimumab in the treatment of perianal fistulas in Crohn's disease

Abstract

Introduction The fistulizing form of Crohn's disease (CD) represents a great challenge regarding treatment, especially perianal fistulas, for its high prevalence. Objective To assess factors related to the response to surgical treatment associated with anti-TNF inpatients with CD and perianal fistulas. Method Retrospective study of patients with CD and perianal fistulas who used IFX or ADA in association with surgical treatment. Results 30 patients with a mean age of 35 years were studied; 16 were treated with ADA (9 ADA + AZA) and 14 with IFX (10 IFX + AZA); ten of those treated with ADA responded, and of the six non-respondents, only one responded to IFX; eight responded to IFX, and among those non-respondents, no one showed response with ADA; among the respondents, there were 10 men and nine women; of those non-respondents, eight were men and 3 women; of those under 40 years, 16 responded compared with only three non-respondents; of those over 40 years, three responded versus eight non-respondents; as to the time elapsed between the onset of the disease and the beginning of anti-TNF, 14 (<2 years), one (2–5 years) and four (>5 years) responded, and five (<2 years), four (2–5 years) and two (>5 years) were non-respondents. Conclusion There was no difference in response between the anti-TNF agents used; a better response was noted in those who used anti-TNF in combination with azathioprine, among women, in those under 40 years and in those treated within two years of the onset of the disease.