Efficacy of Ustekinumab for the treatment of perianal fistulizing Crohn’s disease: a multicentre retrospective study
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By
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Youran Li
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Xiaomei Sun
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Ke Wen
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Lu Lu
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Wei Wang
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Minna Wu
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Jiaze Ma
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Zailong Zhou
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Yunfei Gu
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July 10, 2026
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Clinical Scorecard: Effectiveness of Ustekinumab in Managing Perianal Fistulizing Crohn's Disease: A Multicenter Retrospective Analysis
At a Glance
| Category | Detail |
|---|
| Condition | Perianal fistulizing Crohn's disease |
| Key Mechanisms | Ustekinumab targets the p40 subunit of interleukin-12 and interleukin-23. |
| Target Population | Patients with perianal fistulizing Crohn's disease who have failed anti-TNF therapy. |
| Care Setting | Multidisciplinary surgical-gastroenterological management in tertiary referral hospitals. |
Key Highlights
- Fistula response rate of 88.3% and clinical remission rate of 70.1% at final follow-up.
- Significant improvements in inflammatory biomarkers and hemoglobin levels.
- Definitive surgery and fewer prior biologics are independent predictors of healing.
- UST was well-tolerated with an adverse event rate of 7.4%.
- A nomogram was developed for individualized treatment decision-making.
Guideline-Based Recommendations
Diagnosis
- Diagnosis of pfCD based on clinical, endoscopic, radiological, and/or histological criteria.
Management
- Combination of medical therapy and surgical intervention is recommended.
Monitoring & Follow-up
- Fistula response assessed at week 8 and week 16.
Risks
- Exclusion of patients with active infections, severe dysfunctions, or recent major surgeries.
Patient & Prescribing Data
163 patients with perianal fistulizing Crohn's disease.
UST induction at 6 mg/kg followed by subcutaneous maintenance every 8 weeks.
Clinical Best Practices
- Integrate surgical and medical therapies for optimal management of pfCD.
- Utilize a nomogram for predicting treatment outcomes.
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