Does Infliximab Infusion Impact Results of Operative Treatment for Crohn's Perianal Fistulas?

Gaertner, Wolfgang B.; Decanini, Alejandra; Mellgren, Anders; Lowry, Ann C.; Goldberg, Stanley M.; Madoff, Robert D.; Spencer, Michael P.

doi:10.1007/s10350-007-9077-3

Cited by 100 publications

(72 citation statements)

References 43 publications

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“…Regueiro et al have studied the efficacy of IFX in PFCD, and demonstrated that the healing rates were higher and recurrence rates were lower when the biological agent was associated with seton placement, as compared to its use in isolation (17) . Gaertner et al also demonstrated similar results, showing 42% of healing rates in patients treated with seton placement associated with IFX, a higher index as compared to surgery alone (18%) (8) .…”

Section: Introductionsupporting

confidence: 62%

“…Some studies demonstrated the results of case series of patients that used antibiotics (ciprofloxacin or metronidazole) for 1 or 2 weeks after the first IFX infusion (2,7,8) . One prospective study even demonstrated that the association of ciprofloxacin for 12 weeks with ADA had lead to better results than monotherapy with ADA in this scenario (6) .…”

Section: Discussionmentioning

confidence: 99%

“…There are several outcomes to be achieved as a result of the approach to PFCD described in the literature, as a reduction of 50% of fistula drainage, closure of external fistulas and complete healing (8,16,19) . Some patients remain well even maintaining their setons during biological therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Advancement flaps can also heal the fistulas in CD patients, mainly in the absence of active proctitis (12) . Combined therapy with anti-TNF agents and seton placement during EUA seems to be the most effective form of treatment of PFCD (2,7,8) . The curettage of the fistula tracks associated with the economic excision of the inflammed external openings prepare the perianal tissue for the proper action of biological agents.…”

Section: Introductionmentioning

confidence: 99%

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PERIANAL COMPLETE REMISSION WITH COMBINED THERAPY (SETON PLACEMENT AND ANTI-TNF AGENTS) IN Crohn’s DISEASE: a Brazilian multicenter observational study

Kotze

Albuquerque

Moreira

et al. 2014

Arq. Gastroenterol.

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-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.

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Section: Introductionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

PERIANAL COMPLETE REMISSION WITH COMBINED THERAPY (SETON PLACEMENT AND ANTI-TNF AGENTS) IN Crohn’s DISEASE: a Brazilian multicenter observational study

Kotze

Albuquerque

Moreira

et al. 2014

Arq. Gastroenterol.

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“…Nevertheless, there is evidence suggesting that luminal bacteria might play a role in development and maintenance of fistulas [18,[39][40][41]. Perhaps for this reason, antibiotics are a widely used and recommended first-line treatment for fistulas in CD patients, despite the near absence of randomized controlled trials supporting this approach [4,11].…”

Section: Discussionmentioning

confidence: 99%

CARD15 Mutations and Perianal Fistulating Crohn’s Disease: Correlation and Predictive Value of Antibiotic Response

et al. 2010

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Background CARD15 mutations alter bowel immunity and increase susceptibility to Crohn 0 s disease (CD). However, the relation between these mutations and Crohn 0 s perianal fistulas has not been fully clarified. Aims To assess whether CARD15 mutations are associated with risk of developing Crohn's perianal fistulas and whether these mutations are predictors of the response of perianal fistulas to antibiotics. Methods CARD15 mutations were investigated in 203 consecutive CD patients. Presence/absence of history of perianal fistula was recorded. Patients with history of perianal fistula were divided into two groups (with/without CARD15 mutations), and response to antibiotics was evaluated in both groups. Results Of the 203 patients, 60 (29.6%) showed at least one CARD15 mutation and 55 (27.1%) had history of perianal fistula. History of perianal fistula was identified in 13 (21.7%) patients with mutations and in 42 (29.4%) patients without mutations (P = 0.260). Mean age at diagnosis of first perianal fistula was similar in patients with/without CARD15 mutations (28.7 ± 9.8 versus 29.7 ± 10.1 years, P = 0.758). Average time between disease onset and diagnosis of first perianal fistula was also similar in the two groups (4.6 ± 5.1 versus 5.0 ± 5.9 years, P = 0.816). Response of perianal fistulas to antibiotics (metronidazole alone or combined with ciprofloxacin) was significantly higher in patients without CARD15 mutations (7.7% versus 40.5%, P = 0.041). Conclusions In CD, CARD15 mutations are not associated with risk of developing perianal fistulas or with time of their outbreak. Nevertheless, patients with perianal fistulas and CARD15 mutations showed worse response to antibiotics.

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Surgical Considerations for the Patient with Crohn's Disease/Perianal Crohn's Disease

McLeod

2010

Inflammatory Bowel Disease

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Does Infliximab Infusion Impact Results of Operative Treatment for Crohn's Perianal Fistulas?

Abstract: Operative treatment of perianal fistulas in patients with Crohn's disease resulted in complete healing in approximately 60 percent of patients. Preoperative infliximab infusion did not affect overall healing rates.

Cited by 100 publications

References 43 publications

PERIANAL COMPLETE REMISSION WITH COMBINED THERAPY (SETON PLACEMENT AND ANTI-TNF AGENTS) IN Crohn’s DISEASE: a Brazilian multicenter observational study

PERIANAL COMPLETE REMISSION WITH COMBINED THERAPY (SETON PLACEMENT AND ANTI-TNF AGENTS) IN Crohn’s DISEASE: a Brazilian multicenter observational study

CARD15 Mutations and Perianal Fistulating Crohn’s Disease: Correlation and Predictive Value of Antibiotic Response

Surgical Considerations for the Patient with Crohn's Disease/Perianal Crohn's Disease

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