Perianal fistulas are among the most serious Crohn’s disease consequences, although there is little information on how they affect children’s development. For a study, researchers sought to identify factors that predicted perianal fistula repair in children who had just been diagnosed with Crohn’s disease.

The one-center retrospective analysis tracked individuals with perianal fistulas from when Crohn’s disease was identified to the healing of the fistula. The Cox proportional hazard regression models were used to analyze time to healing while taking into account pertinent covariates, such as patient characteristics, disease characteristics, medical therapies (no anti-tumor necrosis factor (TNF)α therapy, anti-TNFα therapy ± therapeutic drug monitoring), and perianal surgical procedures, such as fistulotomy, fistulectomy, removal of perianal lesions, seton placement, incision, and drainage.

At the time of Crohn’s disease diagnosis, 107 (22%) of the 485 patients were found to have a perianal fistula. In multivariate analysis, the factors non-White race (hazard ratio (HR) 0.30, P< 0.01), male sex (HR 0.42; P = 0.02), and perianal fistulotomy, fistulectomy, and lesion excision [HR 0.46; P = 0.028], non-White race (HR 0.30, P < 0.01)were linked to delayed fistula healing. With therapeutic medication monitoring and anti-TNFα therapy, faster fistula healing was linked (HR 1.78, P = 0.009). In terms of recovery through therapy, there were no additional variations.

Delay in fistula healing was linked to fistulotomy, fistulectomy, excision of perianal lesions, and non-White race. Compared to all other medical treatment groups, including anti-TNF therapy without therapeutic drug monitoring, anti-TNF therapy combined with therapeutic drug monitoring was related to quicker fistula repair.

Reference: journals.lww.com/jpgn/Abstract/2022/12000/Predictors_of_Perianal_Fistula_Healing_in_Children.7.aspx