Lansdorp CA, Gecse KB, Buskens CJ, Löwenberg M, Stoker J, Bemelman WA, D'Haens GRAM, van Hulst RA, et al.
Alimentary pharmacology & therapeutics. Date of publication 2021 Mar 1;volume 53(5):587-597.
1. Aliment Pharmacol Ther. 2021 Mar;53(5):587-597. doi: 10.1111/apt.16228. Epub
2020 Dec 16.
Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients
with Crohn's disease.
Lansdorp CA(1), Gecse KB(2), Buskens CJ(3), Löwenberg M(2), Stoker J(4),
Bemelman WA(3), D'Haens GRAM(2), van Hulst RA(1).
Author information:
(1)Department of Anesthesiology/Hyperbaric Medicine, Amsterdam UMC, location
AMC, Amsterdam, The Netherlands.
(2)Department of Gastroenterology and Hepatology, Amsterdam UMC, location AMC,
Amsterdam, The Netherlands.
(3)Department of Surgery, Amsterdam UMC, location AMC, Amsterdam, The
Netherlands.
(4)Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC,
Amsterdam, The Netherlands.
Comment in
Aliment Pharmacol Ther. 2021 Mar;53(5):667-668. doi: 10.1111/apt.16253.
BACKGROUND: Positive effects of hyperbaric oxygen on perianal fistulas in
Crohn's disease have been reported.
AIM: To assess efficacy, safety and feasibility of hyperbaric oxygen in Crohn's
disease patients with therapy-refractory perianal fistulas.
METHODS: Twenty consecutive patients were recruited at the out-patient fistula
clinic of the Amsterdam UMC. Crohn's disease patients with high perianal
fistula(s) failing conventional treatment for over 6 months were included.
Exclusion criteria were presence of a stoma, rectovaginal fistula(s) and recent
changes in treatment regimens. Patients received treatment with 40 hyperbaric
oxygen sessions and outcome parameters were assessed at Week 16.
RESULTS: Seven women and 13 men were included (median age 34 years). At Week 16,
median scores of perianal disease activity index and modified van Assche index
(co-primary outcome parameters) decreased from 7.5 (95% CI 6-9) to 4 (95% CI
3-6, P < 0.001), and from 9.2 (95% CI 7.3-11.2) to 7.3 (95% CI 6.9-9.7,
P = 0.004) respectively. Perianal disease activity index scores ≤4 (representing
inactive perianal disease) were observed in 13/20 patients (65%). Twelve
patients showed a clinical response (60%) and four (20%) clinical remission,
assessed with fistula drainage assessment. Median C-reactive protein and faecal
calprotectin levels decreased from 4.2 mg/mL (95% CI 1.6-8) to 2.2 (95% CI
0.9-4.3, P = 0.003) and from 399 µg/g (95% CI 52-922) to 31 (95% CI 16-245,
P = 0.001), respectively.
CONCLUSIONS: We found significant clinical, radiological and biochemical
improvement in Crohn's disease patients with therapy-refractory perianal
fistulas after treatment with hyperbaric oxygen.
CLINICAL TRIAL REGISTRATION: www.trialregister.nl/trial/6489.
© 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John
Wiley & Sons Ltd.
DOI: 10.1111/apt.16228
PMCID: PMC7898636
PMID: 33326623 [Indexed for MEDLINE]
