Dataset Information

Evaluating the effectiveness of infliximab on perianal fistulizing Crohn's disease by magnetic resonance imaging.

ABSTRACT:

Background and aim

Data on the radiologic evaluation of perianal fistulizing Crohn's disease (PFCD) naïve to anti-tumor necrosis factor therapy are scarce, especially in Asian populations. We assessed the effectiveness of infliximab (IFX) on PFCD and explored predictors of 'deep remission' based on clinical and radiologic assessments.

Methods

Patients with Crohn's disease and active anal fistulas attending our care center for IFX therapy were prospectively enrolled. Each patient underwent clinical examination according to the Fistula Drainage Assessment Index, endoscopy for assessment of Crohn's Disease Activity Index (CDAI) and Perianal Crohn's Disease Activity Index (PCDAI), magnetic resonance imaging (MRI) to determine Van Assche score and Ng score, and laboratory tests up to 2?weeks prior to the start of and up to 2?weeks after the sixth IFX therapy (Week 32).

Results

Among 38 patients treated with IFX, 52.6% achieved clinical remission based on the Fistula Drainage Assessment Index and 42.1% achieved deep remission based on Ng score. Van Assche score (from 14.5?±?4.26 to 7.36?±?7.53), CDAI (from 170?±?92 to 71?±?69) and PCDAI (from 7.45?±?2.65 to 2.44?±?3.20) decreased significantly after six IFX treatments. The only predictor of deep remission was simple fistula (P?=?0.004, odds ratio?=?3.802, 95% confidence interval: 1.541-9.383).

Conclusions

IFX has been shown to have appreciable effectiveness in Chinese patients with PFCD. MRI is the gold standard for evaluating PFCD, but Van Assche score has some limitations.

SUBMITTER: Yan X

PROVIDER: S-EPMC6375345 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Evaluating the effectiveness of infliximab on perianal fistulizing Crohn's disease by magnetic resonance imaging.

Yan Xiaohan X Zhu Mingming M Feng Qi Q Yan Yunqi Y Peng Jiangchen J Xu Xitao X Xu Antao A Ran Zhihua Z

Gastroenterology report 20181024 1

<h4>Background and aim</h4>Data on the radiologic evaluation of perianal fistulizing Crohn's disease (PFCD) naïve to anti-tumor necrosis factor therapy are scarce, especially in Asian populations. We assessed the effectiveness of infliximab (IFX) on PFCD and explored predictors of 'deep remission' based on clinical and radiologic assessments.<h4>Methods</h4>Patients with Crohn's disease and active anal fistulas attending our care center for IFX therapy were prospectively enrolled. Each patient u ...[more]

PMID: 30792866

Similar Datasets

Project description:To evaluate the imaging course of Crohn's disease (CD) patients with perianal fistulas on long-term maintenance anti-tumor necrosis factor (TNF)-α therapy and identify predictors of deep remission.All patients with perianal CD treated with anti-TNF-α therapy at our tertiary care center were evaluated by magnetic resonance imaging (MRI) and clinical assessment. Two MR examinations were performed: at initiation of anti-TNF-α treatment and then at least 2 years after. Clinical assessment (remission, response and non-response) was based on Present's criteria. Rectoscopic patterns, MRI Van Assche score, and MRI fistula activity signs (T2 signal and contrast enhancement) were collected for the two MR examinations. Fistula healing was defined as the absence of T2 hyperintensity and contrast enhancement on MRI. Deep remission was defined as the association of both clinical remission, absence of anal canal ulcers and healing on MRI. Characteristics and imaging patterns of patients with and without deep remission were compared by univariate and multivariate analyses.Forty-nine consecutive patients (31 females and 18 males) were included. They ranged in age from 14-70 years (mean, 33 years). MRI and clinical assessment were performed after a mean period of exposure to anti-TNF-α therapy of 40 ± 3.7 mo. Clinical remission, response and non-response were observed in 53.1%, 20.4%, and 26.5% of patients, respectively. Deep remission was observed in 32.7% of patients. Among the 26 patients in clinical remission, 10 had persisting inflammation of fistulas on MRI (T2 hyperintensity, n = 7; contrast enhancement, n = 10). Univariate analysis showed that deep remission was associated with the absence of rectal involvement and the absence of switch of anti-TNF-α treatment or surgery requirement. Multivariate analysis demonstrated that only the absence of rectal involvement (OR = 4.6; 95%CI: 1.03-20.5) was associated with deep remission.Deep remission is achieved in approximately one third of patients on maintenance anti-TNF-α therapy. Absence of rectal involvement is predictive of deep remission.

Dataset Information

Evaluating the effectiveness of infliximab on perianal fistulizing Crohn's disease by magnetic resonance imaging.

Background and aim

Methods

Results

Conclusions

Publications

Evaluating the effectiveness of infliximab on perianal fistulizing Crohn's disease by magnetic resonance imaging.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets