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USTEKINUMAB PROMOTES RADIOLOGICAL FISTULA HEALING IN PERIANAL FISTULIZING CROHN’S DISEASE:RETROSPECTIVE REAL-WORLD ANALYSIS

Tarkan Karakan 1, Sezgin Barutcu 2, Ali Karatas 1, KENAN MORAL 1, Mehmet Ali Şahan 2, BURAK MERT AYKUT 2, Vehbi Sökücü 2, Osman Burak Demirbaş 1, Mehmet Cindoruk 1

Affiliations

1 Gazi University Faculty of Medicine, Ankara, Turkey

2 Gaziantep University Faculty of Medicine, Gaziantep, Turkey

Summary

AI Generated

Retrospective real-world study of 17 Crohn's disease patients with perianal fistula found 40% achieved fistula closure after approximately 59 weeks of ustekinumab therapy.

After 58.66 ± 13.48 weeks of ustekinumab therapy, fistula closure was shown in 40% (6 of 17) of patients with perianal fistulizing Crohn's disease.
Most fistulas were inter-sphincteric (65%), and patients had a mean disease duration of 3.4 ± 0.6 years.
No significant difference in fistula closure was detected between patients with and without endoscopic remission at 6 months (57.1% vs 42.9%, p=0.315).
The authors conclude that intestinal endoscopic remission may not be correlated with fistula outcome and further research is needed to determine ustekinumab efficacy for perianal fistula.
This retrospective analysis used MRI to assess radiological fistula outcomes and may be relevant to gastroenterologists managing perianal fistulizing Crohn's disease patients.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Perianal fistula is the most common complication of Crohn’s disease (CD), affectingapproximately 40% of patients. For patients with perianal abscesses and active draining fistula, seton or fistulotomy should be performed, followed by aggressive medical therapies, including anti-TNF agents. However, a significant proportion of patients are non-responders. There is insufficient evidence to confirm the efficacy of ustekinumab (UST), in promoting fistula closure in perianal fistulizing Crohn’s disease (CD) patients.

Aims & Methods

We aimed to evaluate the efficacy of UST in a real-world setting.
The data were retrospectively analyzed. Clinical and endoscopic changes were evaluated. Fistula radiological outcomes were determined using MRI.

Results

A total of 72 patients diagnosed with CD and receiving scheduled UST treatment were enrolled. Of these, 45 patients were excluded due to the absence of perianal fistula based on clinical symptoms and MRI scans, 5 for insufficient follow-up duration, and 5 for incomplete data. A total of 17 eligible patients were finally included, 2 patients did not have follow-up MRI, 65% (n=11) of whom were male, with a mean age of 28.2 ± 2.0 years at diagnosis and a mean disease duration of 3.4 ± 0.6 years. As for the Montreal classification, 62% of the patients were assigned to B1 (non-stricturing, non-penetrating) and 70% to L3 (ileocolonic) phenotypes. Most fistulas were inter-sphincteric (65%). After 58,66+-13,48 weeks of UST therapy, fistula closure was shown in 40% (n=6) of patients. In patients with endoscopical remission at 6 months of UST therapy, we did not detect significant difference in fistula closure (57.1% vs 42.9%, p=0.315).

Conclusion

UST is effective in promoting clinical and radiological fistula remission in patients with CD. Intestinal endoscopical remission may not be correlated with fistula outcome. Further research is needed for determining ustekinumab therapy efficacy for perianal fistula.

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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RISANKIZUMAB IN PERIANAL CROHN’S DISEASE: REAL-WORLD EVIDENCE FROM A MULTICENTER RETROSPECTIVE COHORT

Amer Dakka 1, Lisa Van-Lierop 2,3, Frank Hoentjen 2, Paige Shelemey 2, Alexandros Toskas 4, Nikolaos Kamperidis 4, Magdalini Manti 4, Edoardo Vincenzo Savarino 5, Silvia Castellet 6, Manuel Barreiro de Acosta 7, Giuseppe Cuccia 8, Daniela Pugliese 8, Nicola Imperatore 9, Piotr Eder 10, Uria Shani 11, Shomron Ben-Horin 12,11, Uri Kopylov 11,12, Ahmad Albshesh 11,12

Affiliations

1 Barzilai University Medical Center, Ashkelon, Israel

2 University of Alberta, Edmonton, Canada

3 Radboud University Medical Center, Nijmegen, Netherlands

4 St Mark's National Bowel Hospital and Academic Institute, London, United Kingdom

5 University of Padua, Padua, Italy

6 Hospital de Bellvitge, L'Hospitalet de Llobregat, Spain

7 Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain

8 Università Cattolica del Sacro Cuore, Rome, Italy

9 Santa Maria delle Grazie Hospital, Naples, Italy

10 Poznan University of Medical Sciences, Poznan, Poland

11 Sheba Medical Center, Ramat Gan, Israel

12 Tel Aviv University, Tel Aviv, Israel