The Outcomes of Biologic Therapies for Fistulizing Crohn's Disease: A Systematic Review
Chidera Emmanuel Okezie
American University of Antigua, College of Medicine, Antigua & Barbuda.
Angioshuye Asinde
Windsor University, School of Medicine, St Kitts and Nevis.
Roshan Goswami *
American University of Antigua, College of Medicine, Antigua & Barbuda.
Clara C. Okpara
American University of Barbados, Medical School, Barbados.
Mulusew Tibebu Goshe
Jimma University, Ethiopia.
Opeyemi Oluwatobi Bamikole
Zaporizhzhia State Medical University, Ukraine.
Tope Mwuese Anyiman
College of Health Sciences, Benue State University, Nigeria.
Chiedozie Steven Nzotta
People’s Friendship University, Russia.
Chiamaka Vivien Uzochukwu
University of Nigeria, College of Medicine, Nigeria.
Sajid Razaq
Bacha Khan Medical College, Pakistan.
Khudija Nayab
Khyber Girls Medical College, Pakistan.
Chidera Precious Chukwuneta
Chukwuemeka Odumegwu Ojukwu University, Nigeria.
Ogochukwu Ekpeleamaka Chioma
College of Medicine, Ebonyi State University, Nigeria.
Ifeyinwa Monica Oraekwute
Bogomolet National Medical University, Ukraine.
Farzana Rahman
Jalalabad Ragib Rabeya Medical College and Hospital, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Fistulizing Crohn's Disease (FCD) is a distinct and aggressive subset of Crohn's Disease, contributing to substantial morbidity, hospitalizations, and reduced patient well-being. The intricate interplay of factors influencing FCD outcomes warrants an in-depth exploration to refine patient care and therapeutic strategies. The aim of this paper is to conduct a comprehensive systematic review to critically evaluate the effectiveness, safety, and cost-effectiveness of biologic therapies and other interventions for FCD
Methods: In line with the PRISMA Statement 2020 guidelines, we conducted a systematic review. We extensively searched databases including PubMed, Embase, and Cochrane Library, with the last search update on November 5, 2023. Studies evaluating FCD patients were examined, emphasizing the disease's clinical burden and influential parameters. Observational studies that underlined treatments and various FCD management strategies correlating with clinical outcomes were primarily considered for inclusion.
Results: Beginning with an initial review of 438 studies, ten met the inclusion criteria and were incorporated into this systematic review. A total of 1122 patients were included. Spanning the years 2014–2022, the incorporated studies delve into diverse FCD treatment modalities. These range from the use of anti-TNF agents, surgical procedures, stem cell therapies, drug amalgamations, to intensifying dosing regimens. The synthesized findings from these studies carve out a progressively evolving treatment milieu for Crohn's disease, emphasizing the indispensability of individualized and empirically supported therapeutic avenues.
Conclusion: FCD presents a formidable challenge in the realm of inflammatory bowel diseases, impacting patient outcomes. This review accentuates the pivotal nature of comprehensive care, early intervention, and addressing intricate disease mechanisms. The collated evidence highlights an imperative for innovative care modalities, targeted therapeutic endeavors, and tailored interventions to manage FCD more effectively and improve patient prognosis.
Keywords: Fistulizing crohn's disease, therapeutic strategies, anti-tnf therapies, surgical interventions, personalized treatment, inflammatory bowel diseases, systematic review