{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:13:46Z","timestamp":1783660426629,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perianal fistulizing Crohn\u2019s disease (pfCD) is a refractory complication of Crohn\u2019s disease (CD) with limited therapeutic options, particularly for patients failing anti-tumor necrosis factor agents. Ustekinumab (UST) shows promise in pfCD, but long-term outcomes and predictive factors remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study enrolled 163 pfCD patients treated with UST (2020\u20132023) with a median 15-month follow-up. Primary endpoints were fistula response and clinical remission rates. Univariate\/multivariate logistic regression identified healing predictors, and a nomogram was developed for outcome prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At final follow-up, the fistula response rate was 88.3% and clinical remission rate 70.1%. Significant improvements were observed in inflammatory biomarkers (CRP: 21.2\u202f\u00b1\u202f28.3\u202f\u2192\u202f5.2\u202f\u00b1\u202f8.9\u202fmg\/L; ESR: 36.6\u202f\u00b1\u202f24.5\u202f\u2192\u202f14.5\u202f\u00b1\u202f18.3\u202fmm\/h) and hemoglobin (126.8\u202f\u00b1\u202f18.5\u202f\u2192\u202f148.2\u202f\u00b1\u202f25.6\u202fg\/L; all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Definitive surgery (adjusted OR\u202f=\u202f9.613,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and fewer prior biologics (adjusted OR\u202f=\u202f0.541,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006) were independent healing predictors. The nomogram exhibited good discriminative ability (AUC\u202f=\u202f0.852 for 24-week remission). UST was well-tolerated (adverse event rate\u202f=\u202f7.4%) with no severe safety issues.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>UST demonstrated clinically meaningful efficacy within a combined multidisciplinary strategy for pfCD, with fistula response and clinical remission rates of 88.3 and 70.1%, respectively, though MRI-confirmed healing was modest (14.2%). Definitive surgery and fewer prior biologic exposures predicted better fistula healing. The developed nomogram facilitates individualized treatment decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1839761","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:24:09Z","timestamp":1783657449000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Ustekinumab for the treatment of perianal fistulizing Crohn\u2019s disease: a multicentre retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Youran","family":"Li","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing TCM Hospital Affiliated to Zhejiang Chinese Medical University","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaze","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zailong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1093\/ibd\/izab287","article-title":"Epidemiology and natural history of perianal Crohn's disease: a systematic review and Meta-analysis of population-based cohorts","volume":"28","author":"Tsai","year":"2022","journal-title":"Inflamm Bowel Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1093\/ibd\/izz056","article-title":"Prevalence of fistulizing Crohn\u2019s disease in the United States: estimate from a systematic literature review attempt and population-based database analysis","volume":"25","author":"Schwartz","year":"2019","journal-title":"Inflamm Bowel Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1093\/ibd\/izy374","article-title":"A 10-year follow-up study of the natural history of perianal Crohn\u2019s disease in a Danish population-based inception cohort","volume":"25","author":"Zhao","year":"2019","journal-title":"Inflamm Bowel Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.dld.2019.11.016","article-title":"Management of patients with complex perianal fistulas in Crohn's disease: optimal patient flow in the Italian clinical reality","volume":"52","author":"Spinelli","year":"2019","journal-title":"Dig Liver Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1007\/s12664-025-01880-7","article-title":"Perianal fistulizing Crohn's disease: clinical practice update from colitis and Crohn's foundation 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