Original articleAlimentary tractLong-term Outcome of Perianal Fistulizing Crohn's Disease Treated With Infliximab
Section snippets
Study Population
All hospital records of consecutive adult patients (age >18 years) treated with IFX for CD in 2 French referral centers (University Hospitals of Rennes and Nancy, France) between January 1998 and September 2011 were reviewed. A centralized diagnostic index was used to identify all patients with diagnosis of CD. The database of these patients with CD was then compared with the pharmacy records of all patients treated with IFX at these 2 hospitals. All adult patients with documented PCD at first
Characteristics of the Population at Infliximab Initiation
A total of 156 CD patients were included. The baseline characteristics at first IFX infusion are listed in Table 1. Of these patients, 61 (39%) were male (Table 1). The median age at CD diagnosis was 24 years (IQR, 13–84), and the median duration of CD before IFX was 3.8 years (IQR, 1–8). According to the Montreal classification,24 15% of the patients were diagnosed with a penetrating complication (B3), and 45% of the patients had ileocolitis involvement (L3) at the time of diagnosis.
Baseline
Discussion
This is the largest study specifically investigating the long-term outcome of perianal fistulizing CD treated with IFX, with a median follow-up of 5 years. All patients were managed by 2 experienced proctologists (L.S., M.A.B.) according to international guidelines.14, 15
We found that the cumulative probability of first fistula closure was 33% at 1 year. These results are in line with those of the ACCENT II trial that evaluated maintenance IFX treatment until 1 year in fistulizing CD.12 In this
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Conflicts of interest These authors disclose the following: Guillaume Bouguen has received lecture fees from Abbott Laboratories, Ferring, and MSD Pharma. Laurent Peyrin-Biroulet has received consulting and/or lecture fees from Merck, Abbott Laboratories, and UCB Pharma. Laurent Siproudhis has received lecture fees from Abbott Laboratories and MSD Pharma. Jean-François Bretagne has received lecture fees from Abbott Laboratories. The remaining authors disclose no conflicts.