The aim of this study was to assess the incidence and course of perianal CD in adult patients, and to describe changes in medical and surgical management as well as rates of cancer [1]. The cohort comprised all individuals >18 years diagnosed with CD in Denmark within a 19-year period (1997-2016). Of 9,739 CD patients, 1,697 (17%) had perianal CD. Perianal fistulas accounted for 943 cases (56%). The overall incidence of perianal CD was 20/1,000 patient-years and remained stable over time. More patients with perianal CD than without were treated with immunomodulators (70% vs 51%; P<0.001) and biologics (35% vs 15%; P<0.001). The continuing high incidence of perianal CD suggests disease-modifying effects of biologics are limited, according to the authors. Patients with perianal CD had a significantly higher risk of undergoing major abdominal surgery than patients without perianal CD (HR 1.52; 95% CI 1.40-1.65; P<0.001).
The incidence rate ratios of anal and rectal cancer in perianal CD patients were 12.46 (95% CI 5.07-30.59; P<0.001) and 2.41 (95% CI 1.31-4.42; P=0.003) respectively, compared with non-IBD matched controls. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 2.36 (95% CI 0.86-6.50; P=0.09) and 1.35 (95% CI 0.68-2.68; P=0.38) respectively, compared with CD patients without perianal CD.
- Wewer MD, et al. ECCO-IBD 2020, OP12.
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Table of Contents: ECCO 2020
Featured articles
Gut Microbiome as Treatment Target
Response to faecal microbiota transplantation in UC
Bioactives produced by gut bacteria to modulate immune response
Big Data Analysis
Multi-omics help describe CD phenotypes
The positive impact of genetic data on drug development
Experimental Therapies: Study Results
AMT-101: an oral human IL-10 fusion protein
Phase 2 results of first-in-class TL1A inhibitor
Open-label extension study of risankizumab: final results
Clinical remission after dose escalation of upadacitinib
Short- and Long-Term Treatment Results
Infliximab discontinuation increases relapse risk
Tofacitinib ‘real-world’ effectiveness in active UC
Subcutaneous ustekinumab as maintenance therapy in UC
Subcutaneous vedolizumab maintenance therapy in CD
Vedolizumab treatment persistence and safety
Specific Therapeutic Strategies
Impact of strategies on intestinal resection rate
Early ileocaecal resection in CD patients failing conventional treatment
Biologics before surgery in IBD do not elevate infection risk
Top-down infliximab superior to step-up in children with CD
High versus standard adalimumab in active UC
Head-to-Head Comparison of Treatments
Vedolizumab and anti-TNF therapies: a real-world comparison
Cancer Risk
Increased risk of small bowel cancer in IBD
Increased incidence of colorectal cancer and death in CD
Risk of rectal, anal cancer increased in perianal CD
Glyco-fingerprint as risk factor of UC-associated cancer
Miscellaneous Topics
Resolution of mucosal inflammation has dramatic effect
PICaSSO validated in real-life study
Re-inducing inflammation in organoids from UC patients
Role of immune cells in intestinal fibrosis
Association between meat consumption and IBD risk
CD exclusion diet corrects dysbiosis
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