title: [Efficacy of infliximab combined with surgery in the treatment of perianal fistulizing Crohn disease].
abstract: OBJECTIVE
  To evaluate the efficacy of infliximab combined with surgery in the treatment of perianal fistulizing Crohn disease (CD).
  
  
  METHODS
  Clinical data of 15 patients with perianal fistulizing CD receiving infliximab combined with surgery in the Affiliated Hospital of Nanjing University of Chinese Medicine from March 2010 to June 2011 were analyzed retrospectively. One week after operation, all the patients received infliximab infusion thrice at weeks 0, 2, and 6. Crohn disease activity index (CDAI), perianal Crohn disease activity index (PDAI), body mass index (BMI), routine blood test and endoscopy were evaluated at week 0, 14. Adverse reactions and healing time were recorded.
  
  
  RESULTS
  At week 14, the response rate was 100% with 86.7% (13/15) complete responders. One patient had local improvement and one developed recurrent fistula. The mean healing time was 32.5 (20-45) d. Anorectal stenosis in 4 patients was significantly improved. At week 14, CDAI decreased to 114.0±90.3 from 230.5±97.5 after IFX treatment. PCDAI decreased to 2.8±3.2 from 9.9±3.4, and BMI increased to (21.5±3.0)kg/m(2) from (19.1±3.1)kg/m(2). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet and neutrophil were significantly decreased from baseline (all P<0.01). Intestinal mucosa healed completely in one patient. There were no serious adverse events except hypokalemia in one patient and severe infusion reaction in another.
  
  
  CONCLUSIONS
  Infliximab combined with surgery is effective and safe for perianal fistulizing CD.
authors.affiliation: Department of Anorectal, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Bo-lin
authors.initials: BL
authors.lastname: Yang
authors.forename: Qiu
authors.initials: Q
authors.lastname: Lin
authors.forename: Hong-jin
authors.initials: HJ
authors.lastname: Chen
authors.forename: Gui-dong
authors.initials: GD
authors.lastname: Sun
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.forename: Yi-qi
authors.initials: YQ
authors.lastname: Chen
authors.forename: Yun-fei
authors.initials: YF
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D008297:Male; D012003:Rectal Fistula / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D000069285:Infliximab