2021
DOI: 10.3748/wjg.v27.i25.3693
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Approach to medical therapy in perianal Crohn’s disease

Abstract: Perianal Crohn’s disease remains a challenging condition to treat and can have a substantial negative impact on quality of life. It often requires combined surgical and medical interventions. Anti-tumor necrosis factor (anti-TNF) therapy, including infliximab and adalimumab, remain preferred medical therapies for perianal Crohn’s disease. Infliximab has been shown to be efficacious in improving fistula closure rates in randomized controlled trials. Clinicians can be faced with a number of questions relating to… Show more

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Cited by 21 publications
(20 citation statements)
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“…A incorporação do TGN aos ácidos nucleicos resulta em efeitos citotóxicos do fármaco, podendo evoluir com importante leucopenia, trombocitopenia, anemia, e insuficiência de Brazilian Journal of Health Review, Curitiba, v. 7, n. 3, p. 01-13, may./jun., 2024 medula óssea. O monitoramento de infecções secundárias à imunossupressão e os riscos de sangramento devem ser feitos de forma periódica, assim como a avaliação de lesão hepática e renal (Veauthier;Hornecker, 2018, Vasudevan et al, 2021.…”
Section: Tratamento Farmacológicounclassified
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“…A incorporação do TGN aos ácidos nucleicos resulta em efeitos citotóxicos do fármaco, podendo evoluir com importante leucopenia, trombocitopenia, anemia, e insuficiência de Brazilian Journal of Health Review, Curitiba, v. 7, n. 3, p. 01-13, may./jun., 2024 medula óssea. O monitoramento de infecções secundárias à imunossupressão e os riscos de sangramento devem ser feitos de forma periódica, assim como a avaliação de lesão hepática e renal (Veauthier;Hornecker, 2018, Vasudevan et al, 2021.…”
Section: Tratamento Farmacológicounclassified
“…Além disso, essa classificação considera o comportamento da doença como não-estenosante e não-perfurante (B1), estenosante (B2) ou perfurante (B3), com ou sem doença perianal. Essas características são cruciais para determinar a abordagem cirúrgica adequada para cada paciente (Veauthier;Hornecker, 2018, Maria et al, 2021, Vasudevan et al, 2021.…”
Section: Tratamento Cirúrgicounclassified
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“…The major issue we identified with this study was the use of only adalimumab as an anti-tumour necrosis factor (TNF) agent. This meant that patients treated with infliximab, the most common anti-TNF α agent used in fistulating perianal Crohn's disease [3], were excluded from the study. This resulted in a lack of patients eligible for analysis and thus left the study significantly underpowered with a sample size approximately 75% less than their target.…”
Section: Dear Editormentioning
confidence: 99%
“…These characteristics leave patients with chronic immunosuppression and they need repeated surgery to treat the symptoms of the disease [ 4 , 5 ], but surgery cannot cure the disease [ 6 ]. More than a quarter of patients with CD develop perianal fistulizing Crohn’s disease (PFCD) [ 7 ], which has been treated with biologics and surgical procedures [ 8 ]. These patients experience an endless cycle of perianal abscess, pain, persistent drainage [ 9 ], recurrent perianal sepsis [ 10 ], and anal stricture [ 11 ], which cause ongoing medical costs, negative stress on the family, and a significant burden to the healthcare system [ 12 ].…”
Section: Introductionmentioning
confidence: 99%