engleski

Efficacy of infliximab in fistulising perianal Crohn's disease: a comparison of clinical and radiological response.

AIM: to determine whether clinical benefit of infliximab is associated with radiological closure of fistula tracts. METHODS: Clinical responses and endoscopic imaging studies (transrectal ultrasound) were evaluated in 11 patients with fistulising perianal Crohn's disease after treated with infliximab 5mg/kg at 0, 2 and 6 weeks. Assessment of clinical healing and radiological scores of perianal fistula severity, based on Parks criteria was performed at baseline and 4 weeks after the last infusion. RESULTS: Fistula tracts were found in all 11 patients before treatment, most being transsphincteric (7/11). After the treatment, complete clinical fistula closure occurred in 4 patients (each after 1. dose), partially in 2 (54%). The radiological score improved considerably in patients with clinical fistula closure in comparison to those who showed no clinical improvement. However, endosonography demonstrated the persistence of fistula tracts in all clinical responders despite closure of the external orifices. CONCLUSION: Good clinical response to short-term treatment of fistulising perianal Crohn's disease with infliximab was not accompanied by radiological disappearance of fistula tracts.

infliximab; Crohn's disease; fistulising perianal Crohn's disease; tranrectal ultrasound; perianal fistula

nije evidentirano