Infliximab in fistulizing Crohn's disease

Gastroenterol Clin North Am. 2006 Dec;35(4):795-820. doi: 10.1016/j.gtc.2006.09.007.

Abstract

The treatment of fistulizing CD has evolved greatly in the last 15 years, largely caused by improvements in medical therapy. Tables 2 and 3 summarize all published controlled and uncontrolled trials of immunomodulator and biologic therapy for the treatment of Crohn's fistulae. The advent of immunomodulators and anti-TNF-alpha agents has transformed the treatment of Crohn's fistulae from almost exclusively surgical to placing a much larger emphasis on medical therapy, either as initial therapy alone, with surgery reserved for refractory cases, or in combination with surgery from the start. For this reason, surgeons and gastroenterologists must work in concert to provide the best care for each patient. Proper fistula management also relies heavily on accurate diagnosis, especially defining the anatomy of the fistula, ascertaining whether abscess formation is present, and determining the location and extent of intestinal inflammation.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Crohn Disease / complications*
  • Crohn Disease / drug therapy*
  • Crohn Disease / surgery
  • Digestive System Surgical Procedures
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infliximab
  • Intestinal Fistula / drug therapy
  • Intestinal Fistula / etiology*
  • Intestinal Fistula / surgery
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab