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01-04-2005 | Original Contribution

Anti-TNF-α (Infliximab) Used as Induction Treatment in Case of Active Proctitis in a Multistep Strategy Followed by Definitive Surgery of Complex Anal Fistulas in Crohn’s Disease: A Preliminary Report

Authors: Stephan J. van der Hagen, M.D., Cor G. Baeten, M.D., Ph.D., Peter B. Soeters, M.D., Ph.D., Maurice G. V. M. Russel, M.D., Ph.D., Regina G. Beets-Tan, M.D., Ph.D., Wim G. van Gemert, M.D., Ph.D.

Published in: Diseases of the Colon & Rectum | Issue 4/2005

PURPOSE

This study was designed to assess the healing rate of complex perianal fistulas in Crohn’s disease after a multistep strategy, including induction treatment with In-fliximab in case of active proctitis, followed by definitive surgery.

METHODS

From 2000 to 2003, all consecutive patients with complex fistulas and Crohn’s disease underwent pretreatment with noncutting setons and, in case of severe recurrent fistulas or abscesses, a diverting stoma. Infliximab was added in cases of active proctitis. After definitive surgical treatment, patients were examined.

RESULTS

Seventeen patients were included (median age, 34 (range, 22–58) years). Seven patients were treated by surgery only, and in ten patients Infliximab was added. After a median follow-up of 19 (range, 8–40) months, fistula healing was observed in 17 patients (100 percent). One patient of the Infliximab group developed a recurrent fistula (10 percent) after 24 months, and in one patient (10 percent) soiling occurred. Two patients of the surgical group developed a recurrent fistula (29 percent) and soiling occurred in two patients (29 percent).

CONCLUSIONS

A multistep strategy followed by definitive surgery for the treatment of complex perianal fistulas in patients with Crohn’s disease is a promising treatment modality. The preliminary results of this study suggest that Infliximab treatment has a beneficial additive effect in the multistep treatment followed by definitive surgery of complex anal fistulas and active proctitis in Crohn’s disease.

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Title: Anti-TNF-α (Infliximab) Used as Induction Treatment in Case of Active Proctitis in a Multistep Strategy Followed by Definitive Surgery of Complex Anal Fistulas in Crohn’s Disease: A Preliminary Report
Authors: Stephan J. van der Hagen, M.D.
Cor G. Baeten, M.D., Ph.D.
Peter B. Soeters, M.D., Ph.D.
Maurice G. V. M. Russel, M.D., Ph.D.
Regina G. Beets-Tan, M.D., Ph.D.
Wim G. van Gemert, M.D., Ph.D.
Publication date: 01-04-2005
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 4/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0828-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anti-TNF-α (Infliximab) Used as Induction Treatment in Case of Active Proctitis in a Multistep Strategy Followed by Definitive Surgery of Complex Anal Fistulas in Crohn’s Disease: A Preliminary Report

PURPOSE

METHODS

RESULTS

CONCLUSIONS

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PURPOSE

METHODS

RESULTS

CONCLUSIONS

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