Anal ulcerations in Crohn's disease: Natural history in the era of biological therapy.
Dig Liver Dis
; 49(11): 1191-1195, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28847470
ABSTRACT
BACKGROUND:
The natural history of anal ulcerations in Crohn's disease remains unknown.AIMS:
To assess the long-term outcomes of anorectal ulcerations.METHODS:
Data from consecutive patients with perineal Crohn's disease were prospectively recorded. The data of patients with anal ulceration were extracted.RESULTS:
Anal ulcerations were observed in 154 of 282 patients (54.6%), and 77 cases involved cavitating ulcerations. The cumulative healing rates were 47%, 70% and 82% at 1, 2 and 3 years, respectively. Patients with a primary fistula phenotype had a shorter median time to healing of their anal ulceration (28 [13-83] weeks) than those with a stricture (81 [28-135] weeks) or those with isolated ulceration (74 [31-181] weeks) (p=0.004). Among patients with ulcerations but no fistula at referral (n=67), only 4 (6%) developed de novo abscesses and/or fistula during follow-up. There was no benefit associated with introducing or optimising biologics, nor with combining immunosuppressants and biologics.CONCLUSION:
Anal ulceration in Crohn's disease usually requires a long time to achieve sustained healing. Determining the impact of biologics on healing rates will require dedicated randomised trials although it does not show a significant healing benefit in the present study.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Crohn
/
Fístula Retal
/
Fissura Anal
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article