Review
Gastroenterology & Hepatology
Alyssa M. Parian, Megan Obi, Phillip Fleshner, David A. Schwartz
Summary: Perianal Crohn's disease is a difficult complication of Crohn's disease to treat, affecting 25%-35% of patients. It leads to lower health-related quality of life scores, higher hospitalization rates, surgeries, and healthcare costs. A multidisciplinary approach involving medical and surgical management, including the use of stem cell therapy, is necessary for successful treatment.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Amy L. Lightner, Hassan Buhulaigah, Karen Zaghiyan, Stefan D. Holubar, Scott R. Steele, Xue Jia, John McMichael, Prashansha Vaidya, Phillip R. Fleshner
Summary: Fecal diversion with an ileostomy is not very effective in achieving clinical response in patients with Crohn's disease. Some patients show improvement and undergo ileostomy reversal, but the majority do not improve and require total proctocolectomy.
INFLAMMATORY BOWEL DISEASES
(2022)
Article
Immunology
Sheeva Johnson, Jeffrey S. Hoch, Wissam J. Halabi, Jeffrey Ko, Jan Nolta, Maneesh Dave
Summary: This study developed a decision tree model to compare the cost-effectiveness of MSCs and FD for pCD, and found that both autologous and allogeneic MSCs are more cost-effective than FD. Even in the worst-case scenario, MSCs still save costs compared to FD.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Gastroenterology & Hepatology
Abhinav Vasudevan, David H. Bruining, Edward V. Loftus, William Faubion, Eric C. Ehman, Laura Raffals
Summary: Perianal Crohn's disease is challenging to treat and often requires a combination of surgical and medical interventions. Anti-TNF therapy, such as infliximab and adalimumab, is preferred and has been shown to be efficacious in improving fistula closure rates. Clinicians face various questions regarding the optimal use of anti-TNF therapy for perianal Crohn's disease, including evaluation for sepsis, treatment target, ideal timing, and duration of treatment.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Medicine, General & Internal
Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
Summary: This study showed that the rate of perianal relapse in patients with perianal Crohn's disease after surgical remission was significantly reduced with Infliximab therapy compared to nonbiological treatment. However, around 40% of patients using Infliximab still experienced perianal relapse at 5 years, with factors such as discontinuation of IFX therapy, a penetrating phenotype, or a complex perianal fistula associated with increased relapse rate.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2021)
Review
Gastroenterology & Hepatology
Jeroen Geldof, Nusrat Iqbal, Jean-Frederic Leblanc, Sulak Anandabaskaran, Rachel Sawyer, Christianne Buskens, Willem Bemelman, Krisztina Gecse, Lilli Lundby, Amy L. Lightner, Silvio Danese, Antonino Spinelli, Michele Carvello, Omar Faiz, Janindra Warusavitarne, Phillip Lung, Danny De Looze, Andre D'Hoore, Severine Vermeire, Ailsa Hart, Phil Tozer
Summary: This article proposes a new classification system for perianal fistulising Crohn's disease, developed through an expert consensus process. The classification system identifies four groups of patients based on disease severity and outcome, and provides treatment strategy suggestions and descriptions of clinical trial suitability.
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2022)
Article
Surgery
Jacopo Crippa, Antonino Spinelli
Summary: This review provides insights into the diagnostic, medical, and surgical pathways for perianal Crohn's disease.
BRITISH JOURNAL OF SURGERY
(2022)
Article
Gastroenterology & Hepatology
Jessica Breton, Ceylan Tanes, Vincent Tu, Lindsey Albenberg, Sarah Rowley, Nina Devas, Rosa Hwang, Kelly Kachelries, Gary D. Wu, Robert N. Baldassano, Kyle Bittinger, Peter Mattei
Summary: The microbial community in children with perianal fistulising CD is different in composition and function compared to other CD patients and healthy children, highlighting the importance of understanding the microbiome in the perianal milieu for developing treatment strategies.
JOURNAL OF CROHNS & COLITIS
(2022)
Article
Surgery
Min Young Park, Yong Sik Yoon, Hyoung Eun Kim, Jong Lyul Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Summary: This study assessed the demographic characteristics and surgical outcomes of patients with Crohn's perianal fistula (CPF) at a tertiary referral institution. Fistulotomy had the highest closure rate among different surgical methods, while stem cell therapy showed high closure rates for complex fistulas.
ASIAN JOURNAL OF SURGERY
(2021)
Review
Gastroenterology & Hepatology
Benedicte Caron, Ferdinando D'Amico, Silvio Danese, Laurent Peyrin-Biroulet
Summary: This systematic review described the evolution of endpoints in randomized controlled trials of perianal Crohn's disease patients and observed significant changes in outcomes used in these trials, indicating the increasing use of radiological endpoints in studies of perianal fistulizing Crohn's disease.
JOURNAL OF CROHNS & COLITIS
(2021)
Article
Gastroenterology & Hepatology
Takayuki Yamamoto, Takahiro Shimoyama
Summary: Fecal diversion can alleviate clinical symptoms of complex perianal Crohn's disease but has a low success rate in restoring bowel continuity. Proctectomy is often required in the long term. The impact of biologic therapy on the outcomes of fecal diversion needs further investigation.
CLINICS IN COLON AND RECTAL SURGERY
(2022)
Article
Gastroenterology & Hepatology
Clara Ludewig, Veit Jacob, Andreas Stallmach, Tony Bruns, Niels Teich
Summary: This study aimed to identify clinical, surgical, and drug-related predictors of successful stoma reversal in CD patients. The results showed that clinical and surgical features were more predictive of a successful stoma reversal in CD patients, while medication or laboratory results had little influence.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2022)
Article
Medicine, General & Internal
Mir Zulqarnain, Parakkal Deepak, Andres J. Yarur
Summary: Perianal fistulas are a common complication of Crohn's disease and can be challenging to manage. Although anti-TNF agents are effective in treating perianal fistulizing Crohn's disease, some patients do not respond to therapy. Therapeutic drug monitoring is considered an important tool to optimize and guide biologic treatment and could improve outcomes for patients with perianal fistulas.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Keegan Guidolin, Flora Jung, Richard Spence, Fayez Quereshy, Sami A. Chadi
Summary: An investigation on 173 patients undergoing ileostomy closure revealed a trend towards increased risk of ileus with a longer duration of diversion, with the odds of ileus tripling when diversion lasted more than 328 days.
COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
Mathias Vidon, Nicolas Munoz-Bongrand, Jerome Lambert, Leon Maggiori, Jean-David Zeitoun, Helene Corte, Yves Panis, Philippe Seksik, Xavier Treton, Laurent Abramowitz, Matthieu Allez, Jean-Marc Gornet
Summary: The study suggests that using fibrin glue as an adjunct to conventional medical therapy may be an effective and safe treatment for perianal fistulas in patients with Crohn's disease. Patients who received combination therapy had a higher rate of complete clinical remission at 1 year.
COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
Bente Mertz Norgard, Bjarne Magnussen, Jens Fedder, Punyanganie S. de Silva, Sonja Wehberg, Sonia Friedman
INFLAMMATORY BOWEL DISEASES
(2019)
Article
Rheumatology
Bente Mertz Norgard, Michael Due Larsen, Sonia Friedman, Torben Knudsen, Jens Fedder
ANNALS OF THE RHEUMATIC DISEASES
(2019)
Article
Gastroenterology & Hepatology
Uma Mahadevan, Christopher Robinson, Nana Bernasko, Brigid Boland, Christina Chambers, Marla Dubinsky, Sonia Friedman, Sunanda Kane, Jacob Manthey, Jason Sauberan, Joanne Stone, Rajeev Jain
Article
Obstetrics & Gynecology
Uma Mahadevan, Christopher Robinson, Nana Bernasko, Brigid Boland, Christina Chambers, Marla Dubinsky, Sonia Friedman, Sunanda Kane, Jacob Manthey, Jason Sauberan, Joanne Stone, Rajeev Jain
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2019)
Editorial Material
Gastroenterology & Hepatology
Rachel W. Winter, Sonia Friedman
INFLAMMATORY BOWEL DISEASES
(2020)
Article
Gastroenterology & Hepatology
Sonia Friedman, Jan Nielsen, Ellen Aagaard Nohr, Line Riis Jolving, Bente Mertz Norgard
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2020)
Article
Public, Environmental & Occupational Health
Line Riis Jolving, Michael Due Larsen, Jens Fedder, Sonia Friedman, Bente Mertz Norgard
CLINICAL EPIDEMIOLOGY
(2019)
Article
Gastroenterology & Hepatology
Amy Yu, Sonia Friedman, Ashwin N. Ananthakrishnan
INFLAMMATORY BOWEL DISEASES
(2020)
Article
Gastroenterology & Hepatology
Ellen A. Nohr, Jan Nielsen, Bente M. Norgard, Sonia Friedman
JOURNAL OF CROHNS & COLITIS
(2020)
Article
Gastroenterology & Hepatology
Vanessa Mitsialis, Sarah Wall, Peng Liu, Jose Ordovas-Montanes, Tamar Parmet, Marko Vukovic, Dennis Spencer, Michael Field, Collin McCourt, Jessica Toothaker, Athos Bousvaros, Alex K. Shalek, Leslie Kean, Bruce Horwitz, Jeffrey Goldsmith, George Tseng, Scott B. Snapper, Liza Konnikova
Article
Public, Environmental & Occupational Health
Bente Mertz Norgard, Michael Due Larsen, Sonia Friedman, Jens Fedder
CLINICAL EPIDEMIOLOGY
(2020)
Article
Gastroenterology & Hepatology
Bente Mertz Norgard, Jan Nielsen, Sonia Friedman
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2020)
Article
Gastroenterology & Hepatology
Sonia Friedman, Jan Nielsen, Line Riis Jolving, Ellen A. Nohr, Bente Mertz Norgard
JOURNAL OF CROHNS & COLITIS
(2020)
Article
Oncology
Shilpa Grover, Sheila A. Bond, Michael K. Mansour, Sonia Friedman
Article
Gastroenterology & Hepatology
Alejandro Llanos-Chea, Jason M. Shapiro, Rachel W. Winter, Logan Jerger, Timothy Menz, Meghan Gibson, Alison M. Friedmann, Diana Treaba, Konstantinos Papamichael, Adam S. Cheifetz, Sonia Friedman, Matthew J. Hamilton, Harland S. Winter
Summary: This study reported a case series of young IBD patients who were treated with IFX monotherapy and developed lymphoma, with three of the patients having bone involvement. Further research may be needed to determine the true lymphoma risk in patients treated with IFX monotherapy.
DIGESTIVE DISEASES AND SCIENCES
(2022)