Conference Coverage

Medical treatment of perianal fistulae often warranted, despite limited evidence


 

EXPERT ANALYSIS FROM DIGESTIVE DISEASES: NEW ADVANCES


Infliximab is the drug that has by far the most robust fistula data, and one of only two drugs where a fistula was the primary outcome of the studies, according to Dr. Osterman.

In a randomized trial, infliximab induction treatment more than doubled fistula-related response and remission rates, compared with placebo, he said.

Maintenance infliximab treatment likewise showed an approximate doubling of both response and remission of fistula versus placebo, he added.

While not designed to look at fistulae as a primary outcome, the randomized CHARM study of adalimumab versus placebo for maintenance of Crohn’s disease remission did demonstrate remission rates about twice as high with the use of adalimumab, compared with placebo, in 117 patients who had draining fistulae at baseline, Dr. Osterman recounted.

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