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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(02): 126-130
DOI: 10.1055/s-0041-1739549
Original Article

Infliximab for Anoperineal Lesions in Crohn's Disease: Remission Appears to be Based on Rapid Combination Therapy at High Doses

Nadia Fathallah 
1   Groupe Hospitalier Paris Saint-Joseph, MedicoSurgical Proctology Department, Paris, France
,
Cosmin Cristea 
1   Groupe Hospitalier Paris Saint-Joseph, MedicoSurgical Proctology Department, Paris, France
,
Hélène Beaussier 
2   Groupe Hospitalier Paris Saint-Joseph, Clinical Research Center, Paris, France
,
Sonia Khirani 
3   Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Clinical Investigation Center, Paris, France
,
Vincent de Parades 
1   Groupe Hospitalier Paris Saint-Joseph, MedicoSurgical Proctology Department, Paris, France
› Author Affiliations Funding None.
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Abstract

Study Aim The aim of the present study was to compare in real life the characteristics of treatment with infliximab according to the presence or absence of anoperineal involvement in Crohn's disease.

Methods We performed a single-center, prospective, non-interventional study, on patients with Crohn's disease in remission who had been treated with infliximab for at least 1 year. Patients with poor treatment compliance, on antibiotics, or those with a stoma were excluded.

Results We included 52 patients in this study: 34 with anoperineal lesions with or without luminal lesions, and 18 with luminal lesions only. Patients with anoperineal lesions were more likely to have undergone surgery (70.6% versus 38.9%, p = 0.027), had a shorter median time to infliximab treatment initiation (0.5 versus 5.5 years, p = 0.005), a higher mean dose of infliximab (6.6 versus 5.1 mg/kg, p = 0.015), and were more likely to receive combination treatments including infliximab (52.9% versus 11.1%, p = 0.008) than patients with luminal involvement only.

Conclusions In our study, infliximab treatment was initiated more quickly, at higher doses, and more in combination therapy for anoperineal Crohn's disease than for luminal damage alone. Additional studies are required to confirm this finding and to assess the tolerance of this treatment throughout patient management.

Keywords

Crohn's disease - infliximab - anal fistula - anoperineal disease


Publication History

Received: 04 September 2021

Accepted: 25 October 2021

Article published online:
10 December 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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