Journal of clinical medicine
Cure8 research brief
Why This Matters
Perianal fistulas are a common, hard-to-heal complication of Crohn's disease. This review collects current options beyond infliximab and explains where evidence is stronger or still emerging, which can help patients and clinicians discuss next-step treatments after anti-TNF failure.
Who Should Pay Attention
Adults with Crohn's disease and perianal fistulas, gastroenterologists and colorectal surgeons, IBD researchers, and clinicians managing anti-TNF nonresponders.
Study Snapshot
Story typeResearch paper
Evidence typeResearch paper
Source depthJournal abstract
What To Know
This review reports that while infliximab remains first-line, alternatives such as ustekinumab and the JAK inhibitor upadacitinib have shown effectiveness after anti-TNF failure; vedolizumab appears less effective. Evidence for IL-23 inhibitors (risankizumab, guselkumab) is limited but growing and awaiting prospective trial data.
The authors also describe nonstandard or adjunctive strategies under study — dual-targeted biologic combinations, subcutaneous infliximab optimization, hyperbaric oxygen, and exclusive enteral nutrition — but note most data come from post hoc analyses, retrospective cohorts, or small prospective studies.
The review emphasizes the need for adequately powered randomized trials using harmonized clinical and MRI-based endpoints; until such data exist, individualized multidisciplinary care (surgery for drainage, imaging, tailored medical therapy) remains central.
Keep In Mind
This article is a narrative review (literature search through Feb 2026) and summarizes mostly retrospective, post hoc, or small prospective studies. It does not present new randomized trial results; the authors call for standardized, MRI-inclusive RCTs to define optimal sequencing.
Source Details
Review the original publication for the complete reporting, methods, and context.
Research paper
Evidence type derived from source or registry metadata.
PublicationJournal of clinical medicine
AuthorsFuentes-Valenzuela E, Tarrasó FJ, Botella B +3 more
Study typeReview, journal article
Indexed viaEurope PMC
Source typeResearch paper
PublishedSep 21, 2026, 12:00 AM
Content availableJournal abstract
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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