J Adler et al. Inflamm Bowel Dis 2024; https://doi.org/10.1093/ibd/izae020.056. EARLY TUMOR NECROSIS FACTOR ANTAGONIST TREATMENT PREVENTS PERIANAL FISTULA IN PEDIATRIC CROHN’S DISEASE

The authors utilized the prospectively-enrolled RISK cohort to assess the effect of early ANTI-TNF therapy and the development of perianal fistulizing complications (PFCs); this included 621 propensity-matched pediatric patients without PFCs at enrollment. ”The study included a moderately ill population, including 21% with growth delay, 43% with deep ulcers, and 70% with weighted pediatric Crohn’s disease activity index (wPCDAI) >30.”

Key findings:

• Anti-TNF therapy was associated with 79% reduced odds of developing PFCs
• The presence of perianal lesions increased the risk of PFCs more than 3-fold

My take: This study, in agreement with others (see below), shows that early treatment with effective therapy reduces the risk of disease complications like perianal fistulas.

Related blog posts:

• Preventing Fistulas and Improving Radiologic Remission with Infliximab | gutsandgrowth
• Early Treatment with Anti-TNF Agents and Development of Perianal Fistulas | gutsandgrowth
• CCFA: Updates in Inflammatory Bowel Disease 2017 (part 3) Dr. Kugathasan reviews the RISK study findings
• AntiTNF Therapy Associated with Reduced Surgical Resections | gutsandgrowth