{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:37:19Z","timestamp":1781613439409,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T00:00:00Z","timestamp":1680912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Chronic anal fissure (CAF) is an extremely frequent finding in clinical practice. Several topical agents have been proposed for its treatment with the common goal of increasing anodermal blood flow to promote healing. The aim of this study was to compare the efficacy and safety of a <jats:italic>Propionibacterium<\/jats:italic> extract gel (PeG) and 0.4% glyceryl trinitrate ointment (GTN) in patients with CAF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients were randomly allocated to a PeG or GTN group and medication was administered every 12\u2009h for 40\u2009days. The primary outcome was the success rate, as measured by a decrease in the REALISE scoring system for anal fissure at 10, 20 and 40\u2009days after initiating either treatment. The secondary outcomes recorded at the same time points were healing rate, visual analogue scales for itching and burning, rate of complications and adverse events, patient quality of life and satisfaction, and cost analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 120 patients were enrolled, and 96 patients (PeG, <jats:italic>n<\/jats:italic>\u2009=\u200953; GTN, <jats:italic>n<\/jats:italic>\u2009=\u200943) completed the primary outcomes. A significant decrease over time in the REALISE score was observed in both groups. Adverse events occurred more frequently in the GTN group than in the PeG group, peaking at visit 1 [37 (63.8%) vs. 2 (3.4%), respectively], with headache being the most prevalent. The between\u2010treatment cumulative average costs per patient were significantly higher for GTN than that for PeG at each follow\u2010up visit. There were no other significant differences between the two groups for any of the other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While there was no difference in healing rates between the two treatments, PeG was more cost\u2010effective and associated with fewer adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16576","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T08:34:02Z","timestamp":1680942842000},"page":"1698-1707","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy and safety of <i>Propionibacterium<\/i> extract gel versus glyceryl trinitrate ointment in the treatment of chronic anal fissure: a randomized controlled trial"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1066-4671","authenticated-orcid":false,"given":"Gaetano","family":"Gallo","sequence":"first","affiliation":[{"name":"Department of Surgery Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Trompetto","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery S. Rita Clinic  Vercelli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Fulginiti","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery S. Rita Clinic  Vercelli Italy"},{"name":"Department of Medical and Surgical Sciences University of Catanzaro  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7051-6120","authenticated-orcid":false,"given":"Marco","family":"La\u00a0Torre","sequence":"additional","affiliation":[{"name":"Department of Surgery Sapienza University of Rome  Rome Italy"},{"name":"Pelvic and Proctological Center University Pittsburgh Medical College (UPMC), Salvator Mundi International Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Tierno","sequence":"additional","affiliation":[{"name":"Pelvic and Proctological Center University Pittsburgh Medical College (UPMC), Salvator Mundi International Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cantarella","sequence":"additional","affiliation":[{"name":"Centro Proctologico e Perineologico, Ospedali Privati Forl\u00ec  Forl\u00ec Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Vanini","sequence":"additional","affiliation":[{"name":"Centro Proctologico e Perineologico, Ospedali Privati Forl\u00ec  Forl\u00ec Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tomasicchio","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation and Inter\u2010Department Research Center for Pelvic Floor Disease (CIRPAP) University Aldo Moro of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8980-2752","authenticated-orcid":false,"given":"Donato Francesco","family":"Altomare","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation and Inter\u2010Department Research Center for Pelvic Floor Disease (CIRPAP) University Aldo Moro of Bari  Bari 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