Classifying perianal fistulising Crohn's disease: an expert consensus to guide decision-making in daily practice and clinical trials

Geldof, Jeroen; Iqbal, Nusrat; LeBlanc, Jean-Frédéric; Anandabaskaran, Sulak; Sawyer, R; Buskens, Christianne J.; Bemelman, Willem A.; Gecse, Krisztina; Lundby, Lilli; Lightner, Amy L.; Danese, Silvio; Spinelli, Antonino; Carvello, Michele; Faiz, Omar; Warusavitarne, Janindra; Lung, Phillip F. C.; Looze, Danny De; D’Hoore, André; Vermeire, Séverine; Hart, Ailsa; Tozer, Phil

doi:10.1016/s2468-1253(22)00007-3

Cited by 42 publications

(17 citation statements)

References 42 publications

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“…A recent consensus guideline has been designed to simplify the classification of perianal fistulae and to include proactive medical and surgical approaches. 70 Although there is no histological stratification of the perianal fistula, ECM analysis could inform the choice of combined therapy (ie, to stop ECM-dependent EMT events), and may also allow the design of new strategies for generating antibodies against ECM molecules and using them for novel combined therapies.…”

Section: Discussionmentioning

confidence: 99%

Dysfunctional Extracellular Matrix Remodeling Supports Perianal Fistulizing Crohn′s Disease by a Mechanoregulated Activation of the Epithelial-to-Mesenchymal Transition

Rizzo¹,

Rubbino²,

Elangovan³

et al. 2023

Cellular and Molecular Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

Dysfunctional Extracellular Matrix Remodeling Supports Perianal Fistulizing Crohn′s Disease by a Mechanoregulated Activation of the Epithelial-to-Mesenchymal Transition

Rizzo¹,

Rubbino²,

Elangovan³

et al. 2023

Cellular and Molecular Gastroenterology and Hepatology

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“…It has identified 37 descriptive items across six key domains. This work should complement previously published studies on outcomes [12] and may provide more granular detail for other phenotype/treatment‐driven classifications [13].…”

Section: Discussionmentioning

confidence: 53%

“…This study has completed an international consensus process to agree key patient and disease descriptors to be reported in previously published studies on outcomes [12] and may provide more granular detail for other phenotype/treatment-driven classifications [13].…”

Section: Discussionmentioning

confidence: 99%

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Development of a core descriptor set for Crohn's anal fistula

Williams¹,

Lamidi²,

Coe³

et al. 2022

Colorectal Disease

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“…In recent years, IBD has become a global disease with higher incidence and prevalence in the course of industrialization [ 1 , 2 ]. IBD is associated with a variety of complications [ 3 ], such as strictures [ 4 ], fistulas [ 5 ], infections [ 6 ], and cancers [ 7 ], which bring a heavy economic burden to society. Due to long-term chronic inflammation of the intestine, abnormal connections, known as fistulas, may form between the intestine and the skin or adjacent organs, including the bladder and vagina.…”

Section: Introductionmentioning

confidence: 99%

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

Tan

Zhu

Liu

et al. 2023

JCM

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Background: Previous observational studies have found that fistulas are common in Crohn’s disease (CD) and less common in ulcerative colitis (UC). However, some patients have a fistula before diagnosis. Based on retrospective analysis, it was not possible to determine whether there was a bi-directional causal relationship between inflammatory bowel disease (IBD) and fistulas. Methods: Data were extracted from the open GWAS database; 25,042 cases and 34,915 controls were included for IBD, and 6926 cases and 30,228 controls were included for fistula. Two-sample Mendelian randomization and multivariable Mendelian randomization were used in combination to determine the causal relationship between IBD and fistula. Results: Forward MR showed that IBD increased the risk of colonic or urogenital fistula (FISTULA) (OR: 1.09, 95% CI: 1.05 to 1.13, p = 1.22 × 10−6), mainly associated with fissure and fistula of the anal and rectal regions (FISSANAL) (OR:1.10, 95% CI:1.06 to 1.14, p = 6.12 × 10−8), but not with fistulas involving the female genital tract (FEMGENFISTUL) (OR:0.97, 95% CI: 0.85 to 1.11, p = 0.669). Furthermore, both UC and CD increased the risk of FISTULA. However, after adjusting by MVMR, only CD increased the risk of FISTULA (OR: 1.06, 95% CI: 1.02 to 1.11, p = 0.004), and UC did not increase the risk of FISTULA (OR: 1.01, 95% CI: 0.95 to 1.06, p = 0.838). Reverse MR showed that fistulas did not increase the risk of IBD. Conclusion: Our study confirms it is CD, rather than UC, that casually leads to an increased risk of fistula, but fistulas do not increase the risk of IBD.

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Classifying perianal fistulising Crohn's disease: an expert consensus to guide decision-making in daily practice and clinical trials

Cited by 42 publications

References 42 publications

Dysfunctional Extracellular Matrix Remodeling Supports Perianal Fistulizing Crohn′s Disease by a Mechanoregulated Activation of the Epithelial-to-Mesenchymal Transition

Dysfunctional Extracellular Matrix Remodeling Supports Perianal Fistulizing Crohn′s Disease by a Mechanoregulated Activation of the Epithelial-to-Mesenchymal Transition

Development of a core descriptor set for Crohn's anal fistula

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

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