ReviewCurrent gastroenterology reports2025
A Guide Through the Tunnel: Updates in the Approach to Classification and Management of Perianal Fistulizing Crohn's Disease.
Review in Current gastroenterology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
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Abstract
purpose of reviewPerianal fistulizing Crohn's disease (PFCD) is a severe and debilitating phenotype of Crohn's disease that presents significant clinical and therapeutic challenges. This review aims to outline a practical approach to classification and management, emphasizing the utility of the TOpClass system. RECENT
findingsThe TOpClass classification incorporates clinical and anatomic characteristics to assess severity, treatment options, and patient-clinician goals. Post-hoc analyses from clinical trials for the Janus kinase inhibitor Upadacitinib and emerging data on IL-23 receptor antagonists suggest potential roles beyond anti-TNFs, while the broader use of mesenchymal stem cell therapy remains limited due to inconsistent efficacy. Fistula conditioning with curettage and internal opening closure-an underutilized technique-alongside adjunctive therapies such as hyperbaric oxygen therapy (HBOT), has shown promise in promoting wound healing in select patients. The TOpClass classification, by integrating patient-centered factors and multidisciplinary management, offers a comprehensive and adaptable framework for PFCD, addressing key gaps in treatment planning, standardization, and research. The classification will enable tailored, evidence-based care across the disease spectrum.
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Registered trials
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.