Published online Sep 14, 2017. doi: 10.3748/wjg.v23.i34.6197
Peer-review started: July 28, 2017
First decision: August 10, 2017
Revised: August 16, 2017
Accepted: September 5, 2017
Article in press: September 5, 2017
Published online: September 14, 2017
Processing time: 48 Days and 11.3 Hours
Core tip: Defining and predicting deep remission is important to guide the management of patients with perianal fistulizing Crohn’s disease (CD). Deep remission, defined as complete fistula healing based on objective endoscopic and radiologic findings, should be the goal of care in the treatment of patients with perianal CD. Currently, anti-tumor necrosis factor (anti-TNF) are the standard of care for perianal CD, but long-term outcomes are disappointing. Data suggests that higher infliximab concentrations are associated with better clinical outcomes in patients with perianal fistulising CD and thus therapeutic drug monitoring may be a valid therapeutic strategy for optimizing anti-TNF therapy towards improved objective outcomes and deep remission.