Title :

Anti-TNF therapy for genital fistulas in female patients with Crohn''s disease: a nationwide study from the Groupe d''Etude Therapeutique des Affections Inflammatoires du tube Digestif (GETAID).

Author(s) :

Le Baut, Guillaume [Auteur]
Peyrin-Biroulet, Laurent [Auteur]
Bouguen, Guillaume [Auteur]
Gornet, Jean-Marc [Auteur]
Stefanescu, Carmen [Auteur]
Amiot, Aurelien [Auteur]
Laharie, David [Auteur]
Altwegg, Romain [Auteur]
Fumery, Mathurin [Auteur]
Trang, Caroline [Auteur]
Vuitton, Lucine [Auteur]
Simon, Marion [Auteur]
Gilletta De Saint Joseph, Cyrielle [Auteur]
Nahon, Stephane [Auteur]
Caillo, Ludovic [Auteur]
Del Tedesco, Emilie [Auteur]
Plastaras, Laurianne [Auteur]
Aubourg, Alexandre [Auteur]
Pineton De Chambrun, Guillaume [Auteur]
Seksik, Philippe [Auteur]
Viennot, Stephanie [Auteur]

Journal title :

Alimentary pharmacology & therapeutics

Abbreviated title :

Aliment. Pharmacol. Ther.

Publication date :

2018-09-07

ISSN :

1365-2036

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Genital fistulas represent a devastating complication of Crohn's disease. Only studies with small sample sizes have evaluated the efficacy of anti-TNF therapy for this complication. AIMS: To assess the ...
Show more >BACKGROUND: Genital fistulas represent a devastating complication of Crohn's disease. Only studies with small sample sizes have evaluated the efficacy of anti-TNF therapy for this complication. AIMS: To assess the efficacy of anti-TNF therapy for genital fistulas complicating Crohn's disease and to identify predictive factors associated with clinical response at 1 year. METHODS: Consecutive patients treated with anti-TNF therapy for genital fistulas complicating Crohn's disease from 1999 to 2016 in 19 French centres from the Groupe d'Etude Therapeutique des Affections Inflammatoires du tube Digestif were included in a retrospective cohort study. Outcome was clinical fistula closure at 1 year. RESULTS: Among the 204 women with genital fistulas who received anti-TNF therapy, 131 were analysed. The first anti-TNF given was infliximab (79%), adalimumab (20%), or certolizumab (1%). At start of anti-TNF therapy, 56% of patients had seton drainage and 53% had concomitant immunosuppressive treatment. A complementary surgery was performed during the first year in 10 patients (8%). At 1 year, 37% of patients had complete clinical fistula closure, 22% had a partial response, and 41% had no response. Among patients without complementary surgery, 34% (41/121) had complete clinical fistula closure. Only complementary surgery was associated with better response on multivariate analysis (adjusted relative risk: 2.02, 95% CI: 1.25-3.26, P = 0.0043). CONCLUSIONS: In the anti-TNF era, approximately one-third of patients with genital fistula in Crohn's disease had complete fistula closure at 1 year. Collaboration between surgeons and gastroenterologists appears to be very important to improve the rate of fistula closure.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Inflammatory digestive disease : pathophysiology and therapeutic targets developement

Submission date :

2019-03-01T14:17:38Z