N008 Inflammatory bowel disease and complicated perianal fistulas. A 15 year follow-up

Morete, Márcia Carla; Puig, Pere; Fuster, L.; Vila, Greisa; Ollero, Virginia; Echarri, Ana

doi:10.1016/s1873-9946(13)60737-0

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“…The cumulative incidence of CPF in patients with CD reported in two separate retrospective Spanish studies (including 2391 and 350 distinct CD patients) was 12% and 14% (follow-up: Mean 12 years per patient and total 15 years within institution, respectively)[ 8 , 9 ] (Figure 2 ). In the larger study, the authors reported an annual incidence of CPF of 0.7 per 100 patient-years[ 8 ].…”

Section: Resultsmentioning

confidence: 99%

“…Definition of complex perianal fistulas (CPF): A fistula meeting any of the following criteria: High location (high intersphincteric, high transsphincteric, extrasphincteric, or suprasphincteric), multiple external openings, perianal abscess, anal stenosis, or proctitis. Retrospective multicentre study conducted in 11 hospitals in Madrid, Spain (study period was not reported); 2 Morete et al[ 9 ] published in 2013. Definition of CPF not given.…”

Section: Resultsmentioning

confidence: 99%

“…This systematic literature review revealed that published data on the epidemiology and burden of CPF in patients with CD are scarce. The cumulative incidence of CPF in patients with CD ranged from 12% to 14% (follow-up: mean 12 years per patient and total 15 years within institution, respectively)[ 8 , 9 ]. These findings are aligned with the results of previous studies of all perianal fistulas in CD.…”

Section: Discussionmentioning

confidence: 99%

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Burden and outcomes for complex perianal fistulas in Crohn’s disease: Systematic review

Panés

Reinisch

Rupniewska³

et al. 2018

WJG

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AIMTo systematically review the literature on epidemiology, disease burden, and treatment outcomes for Crohn’s disease (CD) patients with complex perianal fistulas.METHODSPubMed, Embase, and Cochrane were searched for relevant articles (published 2000-November 2016) and congress abstracts (published 2011-November 2016).RESULTSOf 535 records reviewed, 62 relevant sources were identified (mostly small observational studies). The cumulative incidence of complex perianal fistulas in CD from two referral-centre studies was 12%-14% (follow-up time, 12 years in one study; not reported in the second study). Complex perianal fistulas result in greatly diminished quality of life; up to 59% of patients are at risk of faecal incontinence. Treatments include combinations of medical and surgical interventions and expanded allogeneic adipose-derived stem cells. High proportions of patients experience lack of or inadequate response to treatment (failure and relapse rates, respectively: medical, 12%-73% and 0%-41%; surgical: 0%-100% and 11%-20%; combined medical/surgical: 0%-80% and 0%-50%; stem cells: 29%-47% and not reported). Few studies (1 of infliximab; 3 of surgical interventions) have been conducted in treatment-refractory patients, a population with high unmet needs. Limited data exist on the clinical value of anti-tumour necrosis factor-α dose escalation in patients with complex perianal fistulas in CD.CONCLUSIONComplex perianal fistulas in CD pose substantial clinical and humanistic burden. There is a need for effective treatments, especially for patients refractory to anti-tumour necrosis factor-α agents, as evidenced by high failure and relapse rates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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