ArticleFrontiers in medicine2026
Efficacy of Ustekinumab for the treatment of perianal fistulizing Crohn's disease: a multicentre retrospective study.
Article in Frontiers in medicine, 2026. 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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Abstract
Background: Perianal fistulizing Crohn's disease (pfCD) is a refractory complication of Crohn's disease (CD) with limited therapeutic options, particularly for patients failing anti-tumor necrosis factor agents. Ustekinumab (UST) shows promise in pfCD, but long-term outcomes and predictive factors remain unclear. Methods: This multicenter retrospective study enrolled 163 pfCD patients treated with UST (2020-2023) with a median 15-month follow-up. Primary endpoints were fistula response and clinical remission rates. Univariate/multivariate logistic regression identified healing predictors, and a nomogram was developed for outcome prediction. Results: At final follow-up, the fistula response rate was 88.3% and clinical remission rate 70.1%. Significant improvements were observed in inflammatory biomarkers (CRP: 21.2 ± 28.3 → 5.2 ± 8.9 mg/L; ESR: 36.6 ± 24.5 → 14.5 ± 18.3 mm/h) and hemoglobin (126.8 ± 18.5 → 148.2 ± 25.6 g/L; all Conclusion: UST demonstrated clinically meaningful efficacy within a combined multidisciplinary strategy for pfCD, with fistula response and clinical remission rates of 88.3 and 70.1%, respectively, though MRI-confirmed healing was modest (14.2%). Definitive surgery and fewer prior biologic exposures predicted better fistula healing. The developed nomogram facilitates individualized treatment decision-making.
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