The Outcome of Anoperineal Lesions in Crohn´s Patients after Biological Treatment

Abstract

Introduction: The development of APL is associated with a more severe prognosis of the disease, and with a significant alteration of the quality of life. For this reason, the advent of biological agents has allowed in a significant number of patients a healing of these APL. Through this work, we illustrate the evolution of these lesions by comparing patients before and after the beginning of biotherapy. Materials and Methods: A retrospective analytical study carried out in our department between January 2015 and January 2021 including all patients receiving biological treatment for CD with APL. Results: Among 355 patients with CD, 45 patients were on biological treatment which 32 (71%) had APL. Among these 32 patients, sex ratio (W/M) was 1.9, mean age was 37 +/- 9.3. The type of anal involvement was as follow: 20 patients (75%) had anal suppurations, 7 patients (20%) had ulcerations and 5 patients (5%) had anal stenosis. In 5% it was an isolated anal Crohn's disease, in 15% it was intestinal disease with APL, in 31% it was colonic disease with APL. 25 patients (78%) were under Infliximab and 7 (21.8%) under Adalumimab. The number of patients with APL before treatment has significantly decreased after treatment with a p=0.002, with an improvement of APL in 20 patients (60%) of under anti-TNF agent. Conclusion: Anti-TNF agents allowed a better management and a favorable evolution of APL in most of our CD patients. However, to overcome the failure of anti-TNF in some of our patients, the availability of other biological molecules on the Moroccan market remains more than desirable.