Effectiveness of Biological Agents in the Treatment of Pediatric Patients with Crohn’s Disease and Anal Fistulae

Introduction: Anal fistulae have a significant impact on the quality of life of patients with Crohn’s disease (CD). In this cross-sectional study, we aimed to determine whether biological agents were effective in treating anal fistulae in patients with CD. Methods: Fifty-three patients diagnosed with CD were retrospectively enrolled. Their data regarding symptoms, treatments, and disease progression from January 2007 to December 2016 were reviewed from the medical records. Fifteen (28%) patients with CD were complicated by anal fistulae. Results: The male-to-female ratio was 13:2, and the mean age at onset was 11 years and 6 months. Among the 15 patients, 14 (93%) had anal fistulae as an initial symptom. Almost all patients were treated by providing elemental diet, 5-aminosalicylic acid, and steroids as induction therapy. Biological agents were used in 8 patients (53.3%), and fistula closure was confirmed in all of them. Among the 7 patients not treated with biological agents, 1 (14.3%) had a recurrent anal fistula, while another had incomplete fistula closure. Regarding surgical management, 2 patients were treated using the seton method, and no patients required a colostomy. Conclusion: Treatment with biological agents is highly effective concerning the closure of anal fistulae in patients with CD, and reducing pain may improve their quality of life.

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Oral 5-ASA Versus Prednisone in Short Term Treatment of Crohn's Disease: A Multicentre Controlled Trial

Canadian Journal of Gastroenterology ◽

10.1155/1990/659079 ◽

1990 ◽

Vol 4 (7) ◽

pp. 452-457 ◽

Cited By ~ 49

Author(s):

F Martin ◽

L Sutherland ◽

IT Beck ◽

AH Anderson ◽

CN Williams ◽

...

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Treatment Period ◽

Controlled Trial ◽

Oral Prednisone ◽

Life Assessment ◽

Weekly Dose ◽

Aminosalicylic Acid

A multicencre randomized controlled trial was designed to compare the efficacy and safety of Eudragit-L coated oral 5-aminosalicylic acid (5-ASA) (Salofalk; lnterfalk) 3 g per day to a 'standard' oral prednisone therapeutic regimen in a 12 week treatment period of uncomplicated attacks of Crohn's ileitis and ileocolitis. Fifty patients with active Crohn's disease (Crohn's disease activity index [CDAI] 200 to 450) were randomized to receive either four 250 mg Eudragit-L-100 coated 5-ASA tablets three times a day for 12 weeks or oral prednisone ( 4 mg tablets) at a sustained 40 mg per day for two weeks followed by a 4 mg/day weekly dose reduction for the 10 subsequent weeks. Efficacy was determined by changes in the calculated CDAI and, as a novel assessment, the McMaster University quality of life index at two, four, six, eight, 10 and 12 weeks. Standard blood and urine values were obtained and physician's assessment completed at each two week visit. Clinical remission was obtained in 12 of 26 patients (46%) in the prednisone group and in nine of 19 (47%) in the 5-ASA group. Treatment failure was observed in three patients in each group. All other patients improved during the treatment period. Patients on prednisone reduced their CDAI scores significantly more rapidly during the first four weeks, but the reduction and maintenance of CDAI scores were similar in both groups for the remainder of the study period. In patients with ileocolitis, prednisone was significantly better than 5-ASA. Quality of life assessment parallelled the changes in CDAI, and appear a valid index. The two therapeutic regimens appear safe and did not disclose any unexpected adverse events or side effects. No significant biological abnormalities were detected in either treatment group. In conclusion, in this small trial, it was found that Salofalk at a dose of 3 g per day appears effective treatment for active Crohn's disease, and it is proposed chat higher doses may be beneficial in more extensive disease (ileocolitis) and during the first four weeks of treatment.

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Natalizumab Boosts Quality of Life in Crohn's Disease

Family Practice News ◽

10.1016/s0300-7073(05)72380-x ◽

2005 ◽

Vol 35 (24) ◽

pp. 46

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease

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Determinants of quality of life and psychosocial adjustment to pediatric inflammatory bowel disease: A systematic review focused on Crohn's disease

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2020.110354 ◽

2021 ◽

pp. 110354

Author(s):

Nathalie Touma ◽

Caroline Varay ◽

Carolina Baeza-Velasco

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Psychosocial Adjustment ◽

Bowel Disease ◽

Pediatric Inflammatory Bowel Disease ◽

Inflammatory Bowel

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Effect of Originator Infliximab Treatment on Disease-Related Hospitalizations, Work Productivity and Activity Impairment, and Health Resource Utilization in Patients with Crohn’s Disease in a Real-Life Setting: Results of a Prospective Multicenter Study in Germany

Inflammatory Intestinal Diseases ◽

10.1159/000512159 ◽

2020 ◽

pp. 1-13

Author(s):

Niels Teich ◽

Michael Bläker ◽

Frank Holtkamp-Endemann ◽

Eric Jörgensen ◽

Andreas Stallmach ◽

...

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Multicenter Study ◽

Work Productivity ◽

Infliximab Treatment ◽

Prospective Multicenter Study ◽

Hospitalization Rates ◽

The Mean

Introduction: Infliximab (IFX) therapy is efficacious for inducing and maintaining symptomatic remission in patients with Crohn’s disease (CD), but whether this benefit results in reduced hospitalization rates and therefore may improve patients’ quality of life in an economically sensible way is conflicting so far. Methods: We conducted a noninterventional, multicenter, open-label, prospective study to evaluate the effect of originator IFX treatment on patient-reported outcomes and disease-related hospitalizations in adult CD patients in Germany treated for the first time with IFX according to label. Results: Two hundred and ninety-four patients were included in the study. We observed a statistically significant reduction in the number of CD-related hospitalizations from the year before baseline (mean 1.00 per patient, SD ± 0.93) to the mean value of the 1st (0.62, SD ± 0.95) and 2nd year (0.32, SD ± 0.75) of the observation period (p < 0.0001). After 3 months of IFX therapy, work productivity and activity increased by an average of 12.6 and 17.1%, respectively. Patient’s clinical outcome was markedly improved as the total CD activity index (CDAI) sum score continuously decreased from baseline to month 24 and the mean score of the total inflammatory bowel disease questionnaire (IBDQ) changed substantially from 141 at baseline to 172 after 24 months of IFX treatment. Additionally, the number of work incapacity days declined. Recently, no new safety issues of IFX have been identified. Conclusion: In this large, prospective, multicenter study on disease-related hospitalization rates, work productivity, capacity for daily activities, and HRQoL in patients with CD, IFX significantly reduces their hospitalization rates and improves work productivity, daily activity, and quality of life over 24 months.

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