title: Results of seton drainage and infliximab infusion for complex anal Crohn's disease.
abstract: OBJECTIVE
  To investigate the efficacy of infliximab for complicated perianal Crohn's disease with special reference to maintenance therapy.
  
  
  METHODS
  Between June 2002 and April 2009, 20 patients (15 men and 5 women, aged 31.4±2.9 years old (mean ± standard error)) with complicated fistulizing anal Crohn's disease underwent seton placement. For the induction therapy, intravenous infusion of infliximab was given 3 times after surgical treatment. Thereafter, infliximab was given every 8 weeks as maintenance therapy. Patients were followed-up for 31.8±4.2 months after the first infliximab infusion. The number of the infliximab treatments given was 13.6±2.5.
  
  
  RESULTS
  After induction therapy, complete response (CR) was observed in 8 patients (40%), partial response (PR) in 9 and progress disease (PD) in 3. With (n=17) or without (n=3) maintenance therapy following the induction therapy, CR was observed in 15 of 20 patients (75%). Of the 17 patients who received maintenance therapy, CR was of observed in 13 patients, of whom 7 patients showed PR or PD before maintenance therapy.
  
  
  CONCLUSIONS
  Seton drainage and infliximab therapy is effective in the patients with fistulizing perianal Crohn's disease. Maintenance infliximab therapy might be effective in patients with perianal Crohn's disease.
authors.affiliation: Department of Surgical Oncology, Miyazaki University School of Medicine, Miyazaki, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hotokezaka
authors.forename: Takuto
authors.initials: T
authors.lastname: Ikeda
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003424:Crohn Disease / Q000150:complications / Q000628:therapy*; D004322:Drainage; D005260:Female; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab