Safety Prediction of Infants Born to Mothers with Crohn's Disease Treated with Biological Agents in the Late Gestation Period

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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Draft interdisciplinary guidelines for diagnosis, methods for estimation of the degree of activity, for evaluation of therapeutic efficacy, and for use of biological agents in patients with concomitant immunoinflammatory diseases (psoriasis, psoriatic arthritis, Crohn's disease)

Modern Rheumatology Journal ◽

10.14412/1996-7012-2018-3-4-18 ◽

2018 ◽

Vol 12 (3) ◽

pp. 4-18 ◽

Cited By ~ 7

Author(s):

D. I. Abdulganieva ◽

A. L. Bakulev ◽

E. А. Belousova ◽

L. F. Znamenskaya ◽

T. V. Korotaeva ◽

...

Keyword(s):

Crohn’S Disease ◽

Psoriatic Arthritis ◽

High Risk ◽

Crohn's Disease ◽

Early Diagnosis ◽

Russian Federation ◽

Therapeutic Efficacy ◽

Working Group ◽

Biological Agents ◽

The Russian Federation

Due to that one patient may be at high risk for developing several immunoinflammatory diseases (psoriasis, psoriatic arthritis (PsA), and Crohn's disease (CD)), their early diagnosis and adequate therapy are extremely relevant. The Interdisciplinary Working Group that includes experts in rheumatology, gastroenterology and dermatology has developed draft guidelines for early diagnosis, methods for activity assessments and for indications for the use of biological agents in patients with concomitant immunoinflammatory diseases (psoriasis, PsA, and CD). In accordance with the decision adopted by the Council of Experts and with the results of a discussion with experts from different regions of the Russian Federation, further steps will be undertaken to validate the guidelines.

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Will the Inducing and Maintaining Remission of Non-biological Agents and Biological Agents Differ for Crohn's Disease? The Evidence From the Network Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.679258 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mingjun Rui ◽

Zhengyang Fei ◽

Yingcheng Wang ◽

Fenghao Shi ◽

Rui Meng ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Biological Agents ◽

Biologic Agents ◽

Controlled Trials ◽

Second Line Therapy ◽

Randomized Controlled ◽

First Line Therapy ◽

Line Therapy ◽

Maintenance Of Remission

Background: Several drugs currently are available for the treatment of Crohn's disease, including non-biological agents such as anti-inflammatory agents, steroids, immunosuppressive agents, and biologic agents such as anti-tumor necrosis factor (TNF), anti-α4β7 integrin, anti-alpha-4 integrin and anti-interleukin 12/23. However, the choice of treatments for induction and maintenance is still a challenge. The relevant comparison between non-biologic agents and biologic agents is few. In our research, we aimed to help making decisions, as well as providing clinicians and patients with medication references.Methods: We searched MEDLINE, Embase, and the Cochrane Central Register of controlled trials for relevant randomized controlled trials published through to July 2020 and systematic reviews published from January 2011 to December 2020. Search results were screened by 2 independent reviewers first by title and abstract and then by full text. Disagreements were resolved through discussion with a third reviewer.Results: 54 randomized controlled trials were included in our analysis. For induction of remission, azathioprine (OR, 3.5; 95% Crl, 1.4–8.9), infliximab (OR, 4.1; 95% Crl, 1.2–16.0), infliximab + azathioprine (OR, 7.0; 95% Crl, 1.2–41.0) and infliximab+ methotrexate (OR, 7.8; 95% Crl, 1.2–65.0) were more effective in first-line therapy than placebo. Adalimumab showed superiority to placebo in second-line therapy, but the range of SD was wide. For maintenance of remission, adalimumab (OR,2.24;95% Crl,1.17–4.76) and azathioprine (OR,2.05; 95% Crl,1.14–3.96) were more effective than placebo. Adalimumab (OR,0.56; 95%Crl,0.27–1.2), budesonide (OR,0.63; 95%Crl,0.26–1.6) and natalizumab (OR,0.65; 95%Crl,0.30–1.4) was associated with less risk of withdrawals when compared with placebo.Conclusion: For induction of remission, azathioprine, infliximab, and infliximab + azathioprine were more effective in first-line therapy. In second-line therapy, adalimumab was more effective but should be interpreted carefully. For maintenance of remission, adalimumab and azathioprine were more effective. Besides, adalimumab, budesonide, natalizumab had lower withdrawals. Therefore, biological agents were not always better than non-biological agents and they have their own advantages in different treatment methods of Crohn's disease.

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