Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2017; 23(34): 6197-6200
Published online Sep 14, 2017. doi: 10.3748/wjg.v23.i34.6197
Defining and predicting deep remission in patients with perianal fistulizing Crohn’s disease on anti-tumor necrosis factor therapy
Konstantinos Papamichael, Adam S Cheifetz
Konstantinos Papamichael, Adam S Cheifetz, Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States
Author contributions: Papamichael K wrote the manuscript; Cheifetz AS contributed to the manuscript critical revision; all authors approved the final version of the article.
Conflict-of-interest statement: Papamichael K has nothing to disclose; Cheifetz AS has received consultancy fees from AbbVie, Janssen, Takeda, Ferring, AMAG, Miraca and Pfizer.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Konstantinos Papamichael, MD, PhD, FEBGH, Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, United States. kpapamic@bidmc.harvard.edu
Telephone: +1-617-6672802 Fax: +1-617-6675826
Received: July 28, 2017
Peer-review started: July 28, 2017
First decision: August 10, 2017
Revised: August 16, 2017
Accepted: September 5, 2017
Article in press: September 5, 2017
Published online: September 14, 2017
Core Tip

Core tip: Defining and predicting deep remission is important to guide the management of patients with perianal fistulizing Crohn’s disease (CD). Deep remission, defined as complete fistula healing based on objective endoscopic and radiologic findings, should be the goal of care in the treatment of patients with perianal CD. Currently, anti-tumor necrosis factor (anti-TNF) are the standard of care for perianal CD, but long-term outcomes are disappointing. Data suggests that higher infliximab concentrations are associated with better clinical outcomes in patients with perianal fistulising CD and thus therapeutic drug monitoring may be a valid therapeutic strategy for optimizing anti-TNF therapy towards improved objective outcomes and deep remission.