What Researchers Did
Researchers systematically reviewed the role of immunosuppressants in managing complex perianal Crohn's disease.
What They Found
Azathioprine responders showed a reduced risk of perianal surgery (OR = 0.36; 95% CI: 0.27-0.46), and early administration of azathioprine increased the proportion of patients free of perianal surgery. Complex perianal fistulising Crohn's disease typically requires combination therapy with anti-TNF and azathioprine, as corticosteroids are not effective.
Canadian Relevance
This systematic review has Canadian relevance due to the involvement of a Canadian author, contributing to the global understanding of perianal Crohn's disease management.
Study Limitations
The review highlights that the role of certain emerging therapies, such as adipose-derived stem cell injection, requires further long-term studies, indicating a limitation in the current evidence base.