Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease

Lansdorp, Corine A; Gecse, Krisztina; Buskens, Christianne J.; Löwenberg, Mark; Stoker, Jaap; Bemelman, Willem A.; D’Haens, Geert; Hulst, Rob A. van

doi:10.1111/apt.16228

Cited by 28 publications

(38 citation statements)

References 32 publications

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“…[12][13][14][15] Adjuvant HBOT used with immunosuppressive agents has benefits for treating autoimmune conditions including perianal fistulas in Crohn's disease, systemic scleroderma, and lupusprone autoimmunity in mice. [25][26][27] Therefore, HBOT, alone or combined with acupuncture, may provide benefits by reducing inflammation and promoting oxygen delivery to damaged tissues; thus, it can be considered for patients with autoimmune diseases and associated complications as an adjunctive treatment to standard immunosuppressive agents.…”

Section: Discussionmentioning

confidence: 99%

Bilateral sudden sensorineural hearing loss in patient with Behçet disease

2021

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Bacckground: Approximately 80% to 85% of sudden sensorineural hearing loss (SSNHL) is idiopathic, but immune-mediated mechanisms are thought to be involved. Behçet disease is an autoinflammatory vasculitis that may involve vessels of the inner ear. It can cause sensorineural hearing loss (SNHL) and an increased risk of SSNHL. Study Sample: We report a 21-year-old man who was diagnosed with Behçet disease in childhood and presented to our clinic with a 10-day history of abrupt hearing deterioration in both ears. Pure-tone audiometry showed severe to profound bilateral SNHL. Results: Oral prednisolone was prescribed for 3 weeks. Concurrent intratympanic steroid injections (ITSIs) were administered in each ear every 2 days for 5 days. A total of 15 daily sessions of hyperbaric oxygen therapy (HBOT) were completed. Acupuncture was performed every 2 days for 1 month. After these combined therapies, the patient’s hearing threshold by 20 dB and his speech recognition threshold were improved. Conclusions: Some patients with SSNHL recover no hearing improvement after routine treatment, and alternative treatments including ITSI, HBOT, and acupuncture can be considered as optional. We used an aggressive multimodal approach to treat severe bilateral SSNHL in patient with Behçet disease.

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Section: Discussionmentioning

confidence: 99%

Bilateral sudden sensorineural hearing loss in patient with Behçet disease

2021

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“…The outcomes of week 16 have been published previously. 16 The study was performed in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. The protocol has been approved by the Medical Ethical Committee (METC 2017_132) and has been published previously.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to the original study protocol, scores of the MAGNIFI-CD index were also calculated. The median score at baseline was 16 (95% CI [13][14][15][16][17][18] and decreased to 14 (95% CI 13-16, p = 0.001 as compared to baseline) at week 16. At week 60 the median score remained 14 (interquartile range [IQR] 9-16, p = 0.001 as compared to baseline).…”

Section: Co-primary Outcome Parameters: Perianal Disease Activity Ind...mentioning

confidence: 99%

“…The HOT‐TOPIC trial was designed in order to assess efficacy, safety and feasibility of the treatment in patients with therapy‐refractory perianal fistulas 15 . Short‐term results, assessed 2 months after treatment, were published previously and showed a significant improvement in clinical, radiological, biochemical and patient‐reported outcomes after treatment with hyperbaric oxygen 16 . Here, we present the long‐term outcomes of the HOT‐TOPIC trial, assessed 1 year after treatment with hyperbaric oxygen therapy.…”

Section: Introductionmentioning

confidence: 99%

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Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn's disease: Results of the HOT‐TOPIC trial after 1‐year follow‐up

et al. 2022

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Background: Previously published short-term results (week 16) of this trial showed a significant improvement in clinical, radiologic and biochemical outcomes in Crohn's disease patients with therapy-refractory perianal fistulas after treatment with hyperbaric oxygen therapy.Objective: To assess the long-term (week 60) efficacy, safety and feasibility of hyperbaric oxygen therapy in perianal fistula in Crohn's disease.Methods: Crohn's disease patients with high perianal fistula(s) failing conventional treatment >6 months were included. Exclusion criteria were presence of a stoma, rectovaginal fistula(s) and recent changes in treatment regimens. Patients received 40 hyperbaric oxygen sessions and outcomes were assessed at week 16 and week 60.Results: Twenty patients were included (median age 34 years). At week 16, median scores of the perianal disease activity index and modified Van Assche index (coprimary outcomes) decreased from 7.5 (95% CI 6-9) to 4 (95% CI 3-6, p < 0.001) and 9.2 (95% CI 7.3-11.2) to 7.3 (95% CI 6.9-9.7, p = 0.004), respectively. At week 60, the respective scores remained significantly lower than baseline: 4 (95% CI 3-7, p < 0.001) and 7.7 (95% CI 5.2-10.2, p = 0.003). Perianal disease activity index score of 4 or less (representing inactive perianal disease) was observed in 13 patients at week 16 and 12 patients at week 60. Using fistula drainage assessment, 12 and 13 patients showed a clinical response at week 16 and 60, respectively, and clinical remission was achieved in four patients for both time points. At week 16, a statistically significant biochemical improvement (C-reactive protein and faecal calprotectin levels) was found, but this effect was no longer significant at week 60. Conclusions:The clinical and radiologic improvement of perianal fistula in Crohn's disease, that was found at week 16 after treatment with hyperbaric oxygen therapy, is maintained at 1-year follow-up.

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“…The treatment consists of breathing 100% oxygen under increased atmospheric pressure, provoking tissue hyperoxygenation and oxidative stress which has been associated to stem cell mobilization and upregulation of growth factors and ultimately to anti-inflammatory effects. Considering its safety and limited costs if the equipment is available, this treatment appears a valid supportive method for patients with otherwise unsatisfactory healing [ 77 ].…”

Section: Therapeutic Approaches To Cd-related Fistulaementioning

confidence: 99%

Journey through Crohn’s Disease Complication: From Fistula Formation to Future Therapies

Rubbino

Greco

Cristofaro

et al. 2021

JCM

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Crohn’s Disease (CD) is a chronic inflammatory disorder in which up to 50% of patients develop fistula within 20 years after the initial diagnosis, and half of these patients suffer perianal fistulizing disease. The etiopathogenesis of CD-related perianal fistula is still unclear, and its phenotypical and molecular characteristics are even more indefinite. A better understanding would be crucial to develop targeted and more effective therapeutic strategies. At present, the most accredited theory for the formation of CD-related fistula identifies the epithelial-to-mesenchymal transition (EMT) as the driving force. It has been well recognized that CD carries an increased risk of malignancy, particularly mucinous adenocarcinoma is often associated with long-standing fistula in CD patients. Despite the availability of multiple treatment options, perianal fistulizing CD represents a therapeutic challenge and is associated with an important impact on patients’ quality of life. To date, the most effective management is multidisciplinary with the cooperation of gastroenterologists, surgeons, radiologists, and nutritionists and the best recommended treatment is a combination of medical and surgical approaches.

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Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease

Abstract: 20 Crohn's disease patients with therapy‐refractory fistulas were treated with 40 sessions of hyperbaric oxygen therapy. At week 16 a significant improvement in clinical, radiological and biochemical outcomes was seen.

Cited by 28 publications

References 32 publications

Bilateral sudden sensorineural hearing loss in patient with Behçet disease

Bilateral sudden sensorineural hearing loss in patient with Behçet disease

Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn's disease: Results of the HOT‐TOPIC trial after 1‐year follow‐up

Journey through Crohn’s Disease Complication: From Fistula Formation to Future Therapies

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