PubMed Central
Cure8 research brief
Why This Matters
Perianal fistulas are a common and impactful complication of Crohn’s disease; this review summarizes randomized trial data suggesting some biologics and a JAK inhibitor can improve fistula response and remission compared with placebo.
The strongest randomized evidence supports infliximab, which may guide treatment discussions for people with pCD.
Who Should Pay Attention
Patients with perianal Crohn’s disease, caregivers, gastroenterologists and colorectal surgeons managing fistulizing disease, and researchers designing pCD trials.
Study Snapshot
Story typeResearch paper
Evidence typeResearch paper
Source depthMetadata only
What To Know
This review pooled RCT data up to Oct 2, 2025, comparing advanced therapies to placebo for perianal fistulizing Crohn’s disease. Overall, biologics and small molecules as a group increased the chance of fistula response and fistula remission during both induction (4–28 weeks) and maintenance (22–52 weeks) periods compared with placebo.
Among individual drugs evaluated in the pooled trials, infliximab had the most consistent evidence of benefit for both inducing and maintaining fistula response and remission. Adalimumab showed benefit for maintenance fistula remission.
Ustekinumab showed an increase in fistula remission in pooled analyses, and upadacitinib showed benefit for both response and remission in induction analyses.
However, only four trials were specifically designed for perianal disease; most other data came from post hoc analyses of luminal Crohn’s trials, and the authors rate many studies as having moderate to serious risk of bias. This limits how confidently these findings can be applied to all patients with pCD.
Keep In Mind
Most included trials were not primarily designed for perianal disease and many analyses were post hoc, raising risk of bias. The review calls for well-designed RCTs targeting pCD and newer therapies. This synthesis is based on the article’s published full text (systematic review and meta-analysis) and does not represent primary trial data review by Cure8.
Source Details
Review the original publication for the complete reporting, methods, and context.
Research paper
Evidence type derived from source or registry metadata.
PublicationPubMed Central
JournalInflamm Bowel Dis
AuthorsYuan, Yuhong, Jairath, Vipul, Hanzel, Jurij +7 more
Indexed viaPubMed Central
Source typeResearch repository record
PublishedMay 30, 2026, 12:00 AM
Content availableMetadata only
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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