tacrolimus and Cutaneous-Fistula

Crohn's disease (CD) is a complex disorder with important incidence in North America. Perianal fistulas occur in about 20% of patients with CD and are almost always classified as complex fistulas. Conventional treatment options have shown different success rates, yet there are data indicating that these approaches cannot achieve total cure and may not improve quality of life of these patients. Fibrin glue, fistula plug, topical tacrolimus, local injection of infliximab, and use of hematopoietic stem cells (HSC) and mesenchymal stem cells (MSC) are newly suggested therapies with variable success rates. Here, we aim to review these novel therapies for the treatment of complex fistulizing CD. Although initial results are promising, randomized studies are needed to prove efficacy of these approaches in curing fistulizing perianal CD.

Topics: Crohn Disease; Cutaneous Fistula; Fibrin Tissue Adhesive; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Infliximab; Mesenchymal Stem Cell Transplantation; Rectal Fistula; Tacrolimus; Tumor Necrosis Factor-alpha

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibodies, Monoclonal; Ciprofloxacin; Crohn Disease; Cutaneous Fistula; Endosonography; Female; Humans; Hyperbaric Oxygenation; Infliximab; Magnetic Resonance Imaging; Male; Metronidazole; Perineum; Randomized Controlled Trials as Topic; Rectal Fistula; Rectovaginal Fistula; Tacrolimus