@DCharabaty @P_DeepakIBDMD @drvishal82 @MondayNightIBD @southasianIBD @nehagastrord @ibdesis @ownyourcrohns @FITWITMD @crohnsbabble @rebelliousgut @ibdseb @drsumitbhatia @DrAnjaliPandit @deepakjgastro @shivaramsingh @drroshanag @stevenbollipo @drkeithsiau @doctorboletoh @Rajatgastro @KailashKolhe @DrAnuraagJ @realTBpeople @anupam_gastro @UjjwalSonika @DrAshokGastro @vandana_midha @ashok_doctor @drakashmathur @Khanna_S @miNitinjagtap @jalpa_devi @DharJahnvi @SamirGadepalli @DrSamirAShah1 @SunandaKaneMD @UmaMahadevanIBD @BilalMohammadMD @AsadurRahman87 @ShimaghavimiMD @ibdmd_kaur @IBDMD @PankajG55222170 @bkocharmd @vipuljairath @RocioSedanoMD A7/1: What agents have RCTs for fistulizing disease? IFX and ADA.
pubmed.ncbi.nlm.nih.gov/10228190/
pubmed.ncbi.nlm.nih.gov/14985485/
pubmed.ncbi.nlm.nih.gov/19201775/

So - IFX works, and ADA probably does as well - but the data is weaker.

@sabpeds @NeeraGuptaMD - In peds?
#MondayNightIBD @southasianIBD @DCharabaty @P_DeepakIBDMD @drvishal82 @MondayNightIBD @southasianIBD @nehagastrord @ibdesis @ownyourcrohns @FITWITMD @crohnsbabble @rebelliousgut @ibdseb @drsumitbhatia @DrAnjaliPandit @deepakjgastro @shivaramsingh @drroshanag @stevenbollipo @drkeithsiau @doctorboletoh @Rajatgastro @KailashKolhe @DrAnuraagJ @realTBpeople @anupam_gastro @UjjwalSonika @DrAshokGastro @vandana_midha @ashok_doctor @drakashmathur @Khanna_S @miNitinjagtap @jalpa_devi @DharJahnvi @SamirGadepalli @DrSamirAShah1 @SunandaKaneMD @UmaMahadevanIBD @BilalMohammadMD @AsadurRahman87 @ShimaghavimiMD @ibdmd_kaur @IBDMD @PankajG55222170 @bkocharmd @vipuljairath @RocioSedanoMD @sabpeds @NeeraGuptaMD A7/2: What about Vedo - limited, NO RCTs

35% remission at 12 months (VICTORY)pubmed.ncbi.nlm.nih.gov/27296941/

maintained remission in GEMINI2 post-hoc
pubmed.ncbi.nlm.nih.gov/29471381/

but NOT in P4 ENTERPRISE
pubmed.ncbi.nlm.nih.gov/29471381/

▶️need more data! @GI_PharmD thoughts?

#MondayNightIBD

@DCharabaty @P_DeepakIBDMD @drvishal82 @MondayNightIBD @southasianIBD @nehagastrord @ibdesis @ownyourcrohns @FITWITMD @crohnsbabble @rebelliousgut @ibdseb @drsumitbhatia @DrAnjaliPandit @deepakjgastro @shivaramsingh @drroshanag @stevenbollipo @drkeithsiau @doctorboletoh @Rajatgastro @KailashKolhe @DrAnuraagJ @realTBpeople @anupam_gastro @UjjwalSonika @DrAshokGastro @vandana_midha @ashok_doctor @drakashmathur @Khanna_S @miNitinjagtap @jalpa_devi @DharJahnvi @SamirGadepalli @DrSamirAShah1 @SunandaKaneMD @UmaMahadevanIBD @BilalMohammadMD @AsadurRahman87 @ShimaghavimiMD @ibdmd_kaur @IBDMD @PankajG55222170 @bkocharmd @vipuljairath @RocioSedanoMD Peri-anal fistulas = big problem, but relatively few studies on the efficacy of biologics here.

Before looking at the studies- lets consider their limitations.

▶️ simple vs complex fistulas
▶️ outcome metrics
▶️ biases
#MondayNightIBD @southasianIBD

academic.oup.com/ecco-jcc/artic… @DCharabaty @P_DeepakIBDMD @drvishal82 @MondayNightIBD @southasianIBD @nehagastrord @ibdesis @ownyourcrohns @FITWITMD @crohnsbabble @rebelliousgut @ibdseb @drsumitbhatia @DrAnjaliPandit @deepakjgastro @shivaramsingh @drroshanag @stevenbollipo @drkeithsiau @doctorboletoh @Rajatgastro @KailashKolhe @DrAnuraagJ @realTBpeople @anupam_gastro @UjjwalSonika @DrAshokGastro @vandana_midha @ashok_doctor @drakashmathur @Khanna_S @miNitinjagtap @jalpa_devi @DharJahnvi @SamirGadepalli @DrSamirAShah1 @SunandaKaneMD @UmaMahadevanIBD @BilalMohammadMD @AsadurRahman87 @ShimaghavimiMD @ibdmd_kaur @IBDMD @PankajG55222170 @bkocharmd @vipuljairath @RocioSedanoMD A6: Fistulas = severe disease, but the nat. hx of simple and complex are unknown.

▶️Most studies reporting efficacy do not distinguish between these

▶️ this distinction is important, b/c complex fistulas will probably have lower healing rates
#MondayNightIBD @southasianIBD