Marion Chambaz1, Mikael Verdalle-Cazes2, Charlotte Desprez1, Lucie Thomassin1, Cloé Charpentier1, Sébastien Grigioni3, Laura Armengol-Debeir1, Valérie Bridoux4, Guillaume Savoye1, Céline Savoye-Collet5. 1. Department of Gastroenterology, Rouen University Hospital, Normandie Univ, UNIROUEN, INSERM U1073, Rouen cedex, France. 2. Department of Radiology, Rouen University Hospital, Normandie Univ, UNIROUEN, Quantif-LITIS EA 4108, Rouen cedex, France. 3. Department of Nutrition, Rouen University Hospital, Normandie Univ, UNIROUEN, INSERM U1073, Rouen cedex, France. 4. Department of Surgery, Rouen University Hospital, Normandie Univ, UNIROUEN, INSERM U1073, Rouen cedex, France. 5. Department of Radiology, Rouen University Hospital, Normandie Univ, UNIROUEN, Quantif-LITIS EA 4108, Rouen cedex, France. Electronic address: celine.savoye-collet@chu-rouen.fr.
Abstract
BACKGROUND: The long-term management of perianal Crohn's disease for patients on anti-TNF-α therapy remains challenging. AIM: To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI. METHODS: Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission. RESULTS: Forty-eight consecutive patients were included with a median follow-up of 62 months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116 months (95-130) versus 42 months (8-72) in patients with pathological MRI (p < 0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p < 0.05). The mean duration of cumulative hospital stays was 0.75 ± 0.52 days in the deep remission group versus 19.7 ± 7.4 in the pathological group (p < 0.05). CONCLUSIONS: Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission.
BACKGROUND: The long-term management of perianal Crohn's disease for patients on anti-TNF-α therapy remains challenging. AIM: To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI. METHODS:Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission. RESULTS: Forty-eight consecutive patients were included with a median follow-up of 62 months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116 months (95-130) versus 42 months (8-72) in patients with pathological MRI (p < 0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p < 0.05). The mean duration of cumulative hospital stays was 0.75 ± 0.52 days in the deep remission group versus 19.7 ± 7.4 in the pathological group (p < 0.05). CONCLUSIONS: Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission.
Authors: Konstantinos Papamichael; Niels Vande Casteele; Jenny Jeyarajah; Vipul Jairath; Mark T Osterman; Adam S Cheifetz Journal: Am J Gastroenterol Date: 2021-05-01 Impact factor: 12.045
Authors: Corine A Lansdorp; Christianne J Buskens; Krisztina B Gecse; Mark Löwenberg; Jaap Stoker; Willem A Bemelman; Geert R A M D'Haens; Rob A van Hulst Journal: United European Gastroenterol J Date: 2022-02-10 Impact factor: 4.623
Authors: Kyra L van Rijn; Elise M Meima-van Praag; Patrick M Bossuyt; Geert R D'Haens; Krisztina B Gecse; Karin Horsthuis; Harmanna J Snijder; Jeroen A W Tielbeek; Christianne J Buskens; Jaap Stoker Journal: J Crohns Colitis Date: 2022-06-24 Impact factor: 10.020