Terapia ANTI-TNF versus NO ANTI-TNF en el manejo de la enfermedad de Crohn perianal fistulizante

Abstract

Title: Anti-TNF Therapy versus Non-Anti-TNF Therapy in Perianal Fistulizing Crohn's Disease Objective: To determine the effectiveness of Anti-TNF Therapy versus Non-Anti-TNF therapy in managing fistulizing perianal Crohn's disease. Methodology: The PRISMA declaration was used through databases such as PubMed, Cochrane, SciELO, ProQuest, and ScienceDirect, using search algorithms based on keywords. In addition, eligibility and inclusion criteria were applied, including articles published within the last five years, a list of biologics as therapy for CD (Crohn’s Disease) perianal fistulizing, original articles in Spanish and English; and exclusion criteria such as those that are not scientific and do not support the research question. Additionally, to determine the risk of bias in the studies, the Newcastle-Ottawa scale was applied, and finally, to synthesize the results, the Excel tool was used in which the interventions of the participants in each article were initially described, whether with the use of one or another biological. Results: In this review, a total of 31 articles, including both descriptive studies and clinical trials, were used, involving a total of 6803 participants with fistulizing perianal CD. On average, the included articles demonstrated a clinical remission rate of 37.82% and a response rate of 59.21% non-anti-TNF therapy patients. However, those patients with anti-TNF therapy achieved a remission rate of 50.67% and a response rate of 67.77%. In addition, adverse effects were found in both therapeutic profiles, such as skin erythema, recurrent infections, and worsening of perianal CD, among others. Conclusions: Although both therapies are feasible, TNF inhibitors stand out in response and clinical remission in maintenance. However, they present more significant adverse effects.