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Current options for drug therapy in perianal Crohn’s disease


Authors: M. Lukáš
Authors place of work: Klinické a výzkumné centrum pro střevní záněty, Klinické centrum ISCARE a. s. a 1. LF UK v Praze
Published in the journal: Gastroent Hepatol 2026; 80(3): 250-254
Category: IBD: přehledová práce
doi: https://doi.org/10.48095/ccgh2026250

Summary

Perianal lesions in Crohn’s disease occur in 20–30% of patients, which are divided into perforating and non-perforating phenotypes, where recurrent perianal abscesses and fistulas appear more frequently. Diagnosis and therapy of perianal Crohn’s disease has changed dramatically in the last couple of years. Close cooperation of gastroenterologists with experienced colorectal surgeons using the “conservative” surgical approach is critical. In medicamentous therapy, infliximab and antibiotics have been used for many years, but recently new drugs were introduced such as upadacitinib. This year, the results of a FUZION study have been published showing that guselkumab is effective in those patients. This overview summarised the current role of medicamentous therapy in patients with perianal Crohn’s disease.

Keywords:

perianal Crohn’s disease – infliximab – upadacitinib – guselkumab


Zdroje

1. Bortlík M. Perianální Crohnova nemoc. In: Lukáš M (ed). Idiopatické střevní záněty II. Nové trendy a mezioborové souvislosti. Praha: Grada Publishing 2021 : 279.

2. McCurdy JD, Hartley I, Behrenbruch C et al. Management of perianal fistulising Crohn’s disease according to principles of wound repair. Aliment Pharmacol Ther 2025; 61 (4): 600–613. doi: 10.1111/apt.18466.

3. Parisan A, Li L, Duraes L et al. A novel patients-like swine model of perianal Crohn’s disease. Dis Colon Rectum 2023; 66 (3): 425–433. doi: 10.1097/DCR.0000000000002369.

4. Present D, Rutgeerts P, Targan S et al. Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Eng J Med 1999; 340 (18): 1398–1405. doi: 10.1056/NEJM199905063401804.

5. Sands B, Anderson FA, Bernstein C N et al. Infliximab maintenance therapy for fistulasing Crohn’s disease. N Eng J Med 2024; 350 (9): 876–885. doi: 10.1056/NEJMoa030815.

6. Gu B, De Gregorio M, Pipicella JL et al. Prospective randomised controlled trial of adults with perianal fistulising Crohn‘s disease and optimised therapeutic infliximab levels: PROACTIVE trial study protocol. BMJ Open 2021; 11 (7): e043921. doi: 10.1136/bmjopen-2020-043921.

7. Peyrin-Biroulet L, Jairath V, Hart A et al. Guselkumab for fistulising perianal Crohn’s disease: week 24 results from the phase 3, randomized, double blind, placebo controlled, multicenter Fuzion study. Gastroenterology 2026; 170 (Suppl): S2857.

8. Panes J, Garcia-Olmo D, Van Assche G et al. Expanded allogeneic-adipose derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn’s disease: a phase 3 randomized, double-blind controlled trial. Lancet 2016; 388 : 1281–1290. doi: 10.1016/S0 140-6736 (16) 31203-X.

9. Colombel JF, Garcia-Olmo D, Chen TS et al. Darvadstrocel in patients with Crohn’ s disease with complex perianal fistulas: The Admire II phase 3 randomized trial. Gastroenterology 2026; 170 : 1562–1570. doi: 10.1053/j.gastro.2025.12.033.

10. Devi J, Patel A, Qurashi B et al. Real-world effectiveness of upadacitinib for perianal Crohn’s disease. A multicenter retrospective study. Clin Gastro Hepatol 2026; S1542-3565 (26) 00332-0. doi: 10.1016/j.cgh.2026.05.003.

11. Colombel JF, Lacerda AP, Irving PM et al. Efficacy and safety of upadacitinib for perianal fistulizing crohn‘s disease: a post hoc analysis of 3 phase 3 trials. Clin Gastroenterol Hepatol 2025; 23 (6): 1019–1029. doi: 10.1016/j.cgh.2024.08.032.

12. Abourshaid T, Beran A, Hijazi M et al. Comparison between adalimumab and infliximab in perianal Crohn’s disease: A systemic review and meta-analysis. Gastro Hep Adv 2025; 4 (8): 100697. doi: 10.1016/j.gastha.2025.100697.

13. Schwartz D, Peyrin-Biroulet L, Lasch K et al. Efficacy and safety of 2 vedolizumab intravenous regimens for perianal fistulasing Crohn’s disease: enterprise study. Clin Gastro Hepatol 2022; 20 (5): 1059.e9–1067.e9. doi: 10.1016/j.cgh.2021.09.028.

14. Sands BE, Gasink Ch, Jacobstein D et al. Fistulas healing in pivotal studies of ustekinumab in Crohn’s disease. Gastroenterology 2017; 5 (Suppl): S185. Doi: 10.1016/S0016-5085 (17) 30930-7

Štítky
Detská gastroenterológia Gastroenterológia a hepatológia Chirurgia všeobecná

Článok vyšiel v časopise

Gastroenterologie a hepatologie

Číslo 3

2026 Číslo 3
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