Combined surgery and anti-tumor necrosis factor (anti-TNF) therapy was not significantly associated with improved outcomes in perianal fistulizing Crohn’s disease (PFCD) compared with anti-TNF therapy alone, according to a study published in the Journal of Crohn’s and Colitis. Moses Fung, MD, and colleagues evaluated outcomes with combined surgical intervention and anti-TNF therapy versus each approach individually. The analysis included 13 studies: 515 patients received combined therapy, 330 underwent surgical intervention, and 406 were treated with anti-TNF therapy. Follow-up periods ranged from 10 weeks to 3 years. The researchers defined the primary outcomes as fistula response, indicated by a decrease in drainage or number of draining fistulas, and fistula healing, defined as fistula closure. While Dr. Fung and colleagues found that combined therapy did not significantly improve fistula response or healing compared with anti-TNF therapy alone, they did identify a notable benefit when combined therapy was measured against surgical intervention alone, indicating superior efficacy in terms of fistula response and healing
