1. Inicio
  2. Publicaciones
  3. Long-Term Outcomes of Biological Therapy in Crohn's Disease Complicated With Internal Fistulizing Disease: BIOSCOPE Study From GETECCU.

Long-Term Outcomes of Biological Therapy in Crohn's Disease Complicated With Internal Fistulizing Disease: BIOSCOPE Study From GETECCU.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Barreiro-de Acosta M
  • Fernández-Clotet A
  • Mesonero F
  • García-Alonso FJ
  • Casanova MJ
  • Cañete F
  • de Castro L
  • Gutiérrez A
  • Sicilia B
  • Cano V
  • Merino O
  • de Francisco R
  • González-Partida I
  • Surís G
  • Torrealba L
  • Ferreiro-Iglesias R
  • Castro B
  • Márquez L
  • Sobrino A
  • Elorza A
  • Calvet X
  • Varela P
  • Vicente R
  • Bujanda L
  • Lario L
  • Manceñido N
  • García-Sepulcre MF
  • Iglesias E
  • Rodríguez C
  • Piqueras M
  • Ferrer Rosique JÁ
  • Lucendo AJ
  • Benítez O
  • García M
  • Olivares D
  • González-Muñoza C
  • López-Cauce B
  • Morales Alvarado VJ
  • Spicakova K
  • Brotons A
  • Bermejo F
  • Almela P
  • Ispízua N
  • Gilabert P
  • Tardillo C
  • Muñoz F
  • Navarro P
  • Madrigal Domínguez RE
  • Sendra P
  • Hinojosa E
  • Sáinz E
  • Martín-Arranz MD
  • Carpio D
  • Ricart E
  • Caballol B
  • Núñez L
  • Barrio J
  • Gisbert JP
  • Calafat M
  • Hernández V
  • Muñoz Pérez R
  • Cabriada JL
  • Domènech E
  • Rodríguez-Lago I
  • BIOSCOPE study group from the ENEIDA registry

Grupos

Abstract

INTRODUCTION: The prevalence of penetrating complications in Crohn's disease (CD) increases progressively over time, but evidence on the medical treatment in this setting is limited. The aim of this study was to evaluate the effectiveness of biologic agents in CD complicated with internal fistulizing disease. METHODS: Adult patients with CD-related fistulae who received at least 1 biologic agent for this condition from the prospectively maintained ENEIDA registry were included. Exclusion criteria involved those receiving biologics for perianal disease, enterocutaneous, rectovaginal, anastomotic, or peristomal fistulae. The primary end point was fistula-related surgery. Predictive factors associated with surgery and fistula closure were evaluated by multivariate logistic regression and survival analyses. RESULTS: A total of 760 patients from 53 hospitals (673 receiving anti-tumor necrosis factors, 69 ustekinumab, and 18 vedolizumab) were included. After a median follow-up of 56 months (interquartile range, 26-102 months), 240 patients required surgery, with surgery rates of 32%, 41%, and 24% among those under anti-tumor necrosis factor, vedolizumab, or ustekinumab, respectively. Fistula closure was observed in 24% of patients. Older patients, ileocolonic disease, entero-urinary fistulae, or an intestinal stricture distal to the origin of the fistula were associated with a higher risk of surgery, whereas nonsmokers and combination therapy with an immunomodulator reduced this risk. DISCUSSION: Biologic therapy is beneficial in approximately three-quarters of patients with fistulizing CD, achieving fistula closure in 24%. However, around one-third still undergo surgery due to refractory disease. Some patient- and lesion-related factors can identify patients who will obtain more benefit from these drugs.

Copyright © 2023 by The American College of Gastroenterology.

Datos de la publicación

ISSN/ISSNe:
0002-9270, 1572-0241

AMERICAN JOURNAL OF GASTROENTEROLOGY  LIPPINCOTT WILLIAMS & WILKINS

Tipo:
Article
Páginas:
1036-1046
PubMed:
36516073
Factor de Impacto:
2,683 SCImago ℠
Cuartil:
Q1 SCImago ℠

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Campos de Estudio

Compartir