ArticleJGH open : an open access journal of gastroenterology and hepatology2021
Long-term outcomes of perianal fistulizing Crohn's disease in the biologic era.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Perianal fistulizing Crohn's disease: Clinical practice update from Colitis and Crohn's Foundation (India).Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Guideline
- Efficacy and safety of tumor necrosis factor-α inhibitors and mesenchymal stem cells in the treatment of fistulizing Crohn's disease: a systematic review and network meta-analysis.Frontiers in immunology · 2026Pooled it
- Understanding Remission of Long-Term Conditions Through Electronic Health Records: Scoping Review.Journal of medical Internet research · 2026Article
- Epidemiology, treatment patterns, and associated risk factors in perianal fistulizing Crohn's disease: A systematic literature review.World journal of gastrointestinal surgery · 2025Article
- TOpCLASS Expert Consensus Classification of Perianal Fistulising Crohn's Disease: A Real-world Application in a Serial Fistula MRI Cohort.Journal of Crohn's & colitis · 2024Article
- Tumor necrosis factor receptor-associated factor 5 enhances perianal fistulizing Crohn's disease through epithelial-mesenchymal transition.CytoJournal · 2024Article
- The development of a minimum dataset for MRI reporting of anorectal fistula: a multi-disciplinary, expert consensus process.European radiology · 2022Article
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimWhile the advent of biologic therapy has led to improved outcomes in perianal fistulizing Crohn's disease (pfCD), loss of response is common. Previous studies suggest that patients who achieve radiological healing (with healing of underlying tracts on magnetic resonance imaging [MRI]) have a longer duration of response. The aim of this study was to characterize MRI outcomes of pfCD at a specialist inflammatory bowel disease (IBD) unit and compare the long-term clinical outcomes between patients achieving MRI and clinical healing.
methodsA retrospective analysis of perianal fistulizing Crohn's patients treated at one specialist IBD unit was performed. Records were reviewed for patient demographics, disease history, clinical assessments, investigation results, and disease flares. Clinical remission was defined as closure of all baseline fistula openings. Radiological healing was defined as the absence of any T2-hyperintense sinuses, tracts, or collections. The primary end-point was rate of MRI healing. The secondary outcome was defined as flare-free period (time between clinical or radiological healing and patients' first signs/symptoms requiring therapy escalation).
resultsA total of 93 patients were included, with a median follow-up of 4.8 years (interquartile range, 2.4-6 years). Of 44 patients, 22 (50%) achieved clinical remission, while 15 of 93 (16%) achieved radiological healing. Of 22 patients, 10 (45%) with clinical remission had a subsequent disease flare (median time of 7 months) compared with 3 of 15 (20%) patients with MRI healing (median time of 3.6 years). Radiological healing was associated with a significantly longer flare-free period (
conclusionRadiological healing occurs less commonly but represents a deeper form of healing, associated with improved long-term clinical outcomes.
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