Infliximab for the Treatment of Fistulas in Patients with Crohn's Disease

Crohn's disease is a chronic inflammatory bowel disease of unknown cause, which is characterized by segmental transmural inflammation and granulomatous lesions of the intestinal mucosa. The disease is complicated by the development of fistulas in approximately one third of patients. 1 Fistulas may be internal (e.g., bowel to bowel, bowel to bladder, or rectovaginal) or enterocutaneous (extending through the abdominal wall or into the perineum). These fistulas rarely heal spontaneously or as a result of drug treatment and frequently require surgery. According to anecdotal evidence, antibiotics have short-term efficacy in their treatment. Although the use of immunomodulatory agents is associated with . . .