Evidence map›Paper›PMID 35949350›Full record

ArticleWorld journal of gastroenterology2022

Higher infliximab and adalimumab trough levels are associated with fistula healing in patients with fistulising perianal Crohn's disease.

Bonita Gu, Kavya Venkatesh, Astrid-Jane Williams, Watson Ng, Crispin Corte, Ali Gholamrezaei, Simon Ghaly, Wei Xuan, Sudarshan Paramsothy, Susan Connor

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. 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 · 2026
    Guideline
  2. Guideline
  3. Review
  4. Exclusive enteral nutrition improves radiological outcomes in adults with perianal fistulizing Crohn's disease: A real-world retrospective cohort study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Review
  12. Review
  13. Article
  14. Review
  15. Article
  16. Management and Treatment of Perianal Fistulizing Crohn's Disease.Clinical and experimental gastroenterology · 2025
    Review
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Bonita GuSouth Western Sydney Clinical School, University of New South Wales, Sydney 2170, New South Wales, Australia.
Kavya VenkateshDepartment of Medicine, University of Newcastle, Newcastle 2308, New South Wales, Australia.
Astrid-Jane WilliamsSouth Western Sydney Clinical School, University of New South Wales, Sydney 2170, New South Wales, Australia.
Watson NgSouth Western Sydney Clinical School, University of New South Wales, Sydney 2170, New South Wales, Australia.
Crispin CorteAW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney 2050, New South Wales, Australia.
Ali GholamrezaeiDepartment of Gastroenterology and Hepatology, Liverpool Hospital, Sydney 2170, New South Wales, Australia.
Simon GhalyDepartment of Gastroenterology, St Vincent's Hospital Sydney, Sydney 2010, New South Wales, Australia.
Wei XuanSouth Western Sydney Clinical School, University of New South Wales, Sydney 2170, New South Wales, Australia.
Sudarshan ParamsothyDepartment of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney 2139, New South Wales, Australia.
Susan ConnorSouth Western Sydney Clinical School, University of New South Wales, Sydney 2170, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTumor necrosis factor-alpha inhibitors, including infliximab and adalimumab, are effective medical treatments for perianal fistulising Crohn's disease (CD), but not all patients achieve fistula healing.

aimTo determine the correlation between perianal fistula healing and closure with infliximab and adalimumab trough levels.

methodsIn this multicentre retrospective study conducted across four tertiary inflammatory bowel disease centres in Australia, we identified CD patients with perianal fistulae on maintenance infliximab or adalimumab who had a trough level within twelve weeks of clinical assessment. Data collected included demographics, serum infliximab and adalimumab trough levels (mg/L) within 12 wk before or after their most recent clinical assessment and concomitant medical or surgical therapy. The primary outcome was fistula healing, defined as cessation in fistula drainage. The secondary outcome was fistula closure, defined as healing and closure of all external fistula openings. Differences between patients who did or did not achieve fistula healing were compared using the chi-square test,

resultsOne hundred and fourteen patients (66 infliximab, 48 adalimumab) were included. Forty-eight (72.7%) patients on maintenance infliximab achieved fistula healing and 18 (27.3%) achieved fistula closure. Thirty-seven (77%) patients on maintenance adalimumab achieved fistula healing and 17 (35.4%) achieved fistula closure. Patients who achieved fistula healing had significantly higher infliximab and adalimumab trough levels than patients who did not [infliximab: 6.4 (3.8-9.5)

conclusionHigher maintenance infliximab and adalimumab trough levels are associated with perianal fistula healing in CD.

Indexed as

Crohn DiseaseRectal FistulaAdalimumabGastrointestinal AgentsHumansInfliximabRetrospective StudiesTreatment OutcomeTumor Necrosis Factor-alphaAdalimumabGastrointestinal AgentsInfliximabTumor Necrosis Factor-alphaBiologicsCrohn’s diseaseInflammatory bowel diseasePerianal disorders

Identifiers

PMID35949350
PMCPMC9254145

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.