Effectiveness of Infliximab on Deep Radiological Remission in Chinese Patients with Perianal Fistulizing Crohn’s Disease

Perianal Fistulizing Crohn’s Disease: No Shortcuts to a Deep Understanding of the Disease

“…Similarly, Zhu et al demonstrated a concentrationdependent effect in patients who are in radiologic remission. Interestingly, however, the cutoff value for predicting radiologic remission of fistula was 2.9 μg/mL, much lower than what is reported in non-Chinese individuals, likely related to the genetic background of Chinese patients and their susceptibility and response rates to infliximab [2]. The present study did not provide data on the effect of increasing the dose of infliximab on healing rates, which would have been interesting especially among the non-responders who had very low infliximab levels.…”

“…The authors investigated the effectiveness of infliximab on PFCD healing as documented during follow-up using clinical and magnetic resonance imaging (MRI) acquired data aimed at identifying predictors of achieving deep radiologic remission. Results demonstrated high perianal fistula healing rates with infliximab, a rate that increased with prolongation of treatment [2]. A higher trough level of infliximab and concomitant treatment with azathioprine increased fistula healing rates further.…”

“…In this issue of Digestive Diseases and Sciences, Zhu et al [2] published a retrospective study: "The effectiveness of infliximab on deep radiologic remission in Chinese patients with perianal fistulizing Crohn's disease." The authors investigated the effectiveness of infliximab on PFCD healing as documented during follow-up using clinical and magnetic resonance imaging (MRI) acquired data aimed at identifying predictors of achieving deep radiologic remission.…”

“…In luminal CD, combination azathioprine and infliximab treatment was superior to monotherapy using either drug alone [6]. Zhu et al [2] showed that concomitant treatment of azathioprine with infliximab increased the fistula healing rate compared with infliximab monotherapy (50% vs 36.9%, P < 0.001), understandable given that PFCD is considered a severe form of CD. Interpretation of these data is tempered by the observation that high-quality data do not exist in PFCD.…”

Efficacy of Early Intervention on the Bowel Damage and Intestinal Surgery of Crohn’s Disease, Based on the Lémann Index

“…Second, the choice of therapeutic strategies was affected partly by the patient's ability to pay. IFX, as the only biologic is approved in China, is not covered by the basic health insurance, which has led to a lower rate of IFX use 28 . Third, the duration of follow-up varied in this study and the median follow-up was only 17.0 months, which might have been insu cient for some subjects to develop to BD complications.…”