Long-term outcome of infliximab combined with surgery for perianal fistulizing Crohn's disease.
OBJECTIVE
To evaluate the efficacy and long-term outcome of infliximab combined with surgery to treat perianal fistulizing Crohn's disease (CD).


METHODS
The work was performed as a prospective study. All patients received infliximab combined with surgery to treat perianal fistulizing CD, which was followed by an immunosuppressive agent as maintenance therapy.


RESULTS
A total of 28 patients with perianal fistulizing CD were included. At week 30, 89.3% (25/28) of the patients were clinically cured with an average healing time of 31.4 d. The CD activity index decreased to 70.07±77.54 from 205.47±111.13 (P<0.01) after infliximab treatment. The perianal CD activity index was decreased to 0.93±2.08 from 8.54±4.89 (P<0.01). C-reactive protein, erythrocyte sedimentation rate, platelets, and neutrophils all decreased significantly compared with the pretreatment levels (P<0.01). Magnetic resonance imaging results for 16 patients after therapy showed that one patient had a persistent presacral-rectal fistula and another still had a cavity without clinical symptoms at follow-up. After a median follow-up of 26.4 mo (range: 14-41 mo), 96.4% (27/28) of the patients had a clinical cure.


CONCLUSIONS
Infliximab combined with surgery is effective and safe in the treatment of perianal fistulizing CD, and this treatment was associated with better long-term outcomes.
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Bo-Lin
BL
Yang
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Yu-Gen
YG
Chen
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Yun-Fei
YF
Gu
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Hong-Jin
HJ
Chen
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Gui-Dong
GD
Sun
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Ping
P
Zhu
Bo-Lin Yang, Yu-Gen Chen,Yun-Fei Gu, Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Wan-Jin Shao, Department of Colorectal Surgery, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Wan-Jin
WJ
Shao
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002681:China; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012003:Rectal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D000069285:Infliximab
Anal fistula; Crohn’s disease; Infliximab; Surgery