Clinical updates on perianal fistulas in Crohn's disease.

Clinical updates on perianal fistulas in Crohn's disease. Expert Rev Gastroenterol Hepatol. 2018 May 24;: Authors: Rackovsky O, Hirten R, Ungaro R, Colombel JF Abstract INTRODUCTION: Perianal fistulizing disease is an aggressive and debilitating phenotype of Crohn's disease (CD), representing a significant therapeutic challenge. New work has led to advancement in epidemiology and long term outcomes of perianal disease. The range of therapeutic options continues to expand, including new biologic agents, biosimilars, and stem cell therapy. Areas covered: We discuss updates to all aspects of management of perianal disease, with a focus on the last three years of published data. Areas considered include new data on epidemiology and prognostication, medical and surgical therapy, and stem cell therapy. Expert commentary: The presence of perianal disease at CD diagnosis portends a significantly worse disease course. Patients with perianal disease require close monitoring to identify patients who are at risk for worsening disease, suboptimal biologic drug levels, and signs of developing neoplasm. With the impending availability of local mesenchymal stem cell therapy this becomes increasingly important as this therapy, although extremely promising, is thus far only effective in patients without proctitis. PMID: 29792734 [PubMed - as supplied by publisher]
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research