Document Detail


Long-term outcome of non-fistulizing (ulcers, stricture) perianal Crohn's disease in patients treated with infliximab.
MedLine Citation:
PMID:  19583709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In Crohn's disease, anal ulcers and stricture can be disabling. AIM: To evaluate long-term outcome of non-fistulizing perianal Crohn's disease under infliximab. METHODS: The medical records of 99 patients with non-fistulizing perianal Crohn's disease at first infliximab infusion were reviewed. Complete responses (ulcer healing or stricture regression) after induction infliximab therapy and at the maximal follow-up were assessed. RESULTS: Ninety-four patients (94.9%) had ulcers, 22 (22.2%) had stricture and 31 (31.3%) had draining perianal fistulas at first infliximab infusion. After infliximab induction therapy, 40/94 (42.5%) patients with ulcers, 4/22 (18.2%) with stricture and 10/31 (32.2%) with fistulas had a complete response. Eight patients were lost to follow-up. After a median follow-up of 175 weeks (range, 13-459), complete response rates for ulcers, stricture and fistulas were 72.3% (68/94), 54.5% (12/22) and 54.8% (20/31) respectively. Long-term response for cavitating ulcer was positively associated with concomitant immunosuppressant use (P = 0.017) and older age (P = 0.049). Among the 12 patients with complete regression of stricture, 6 patients also had anal dilatation. Complete response was associated with perianal pain relief and disappearance of soiling. Three patients with ulcers developed an anal abscess. CONCLUSIONS: Infliximab therapy may be effective in inducing and maintaining response for ulcers.
Authors:
G Bouguen; I Trouilloud; L Siproudhis; A Oussalah; M-A Bigard; J-F Bretagne; L Peyrin-Biroulet
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-07-06
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  30     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  749-56     Citation Subset:  IM    
Affiliation:
Department of Hepato-Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Constriction, Pathologic
Crohn Disease / complications,  drug therapy*
Dose-Response Relationship, Drug
Drug Evaluation
Female
Fissure in Ano / drug therapy*,  etiology
Gastrointestinal Agents / adverse effects,  therapeutic use*
Humans
Long-Term Care
Male
Middle Aged
Rectal Fistula / drug therapy*,  etiology
Time Factors
Treatment Outcome
Wound Healing
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Gastrointestinal Agents; 0/infliximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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