Short-term anti-TNF treatment with surgical closure leads to higher rates of radiological healing in patients with Crohn’s perianal fistulas than anti-TNF therapy alone, research shows.

The PISA-II study, a first-of-its-kind direct comparison, also demonstrated improved quality of life and fewer reinterventions in those offered the combined approach to treatment, European clinicians say.

Given its superiority, they suggest that individuals with surgically amenable disease should ideally be counselled for such an approach.

The team, led by the University of Amsterdam in the Netherlands, enrolled 94 adults (median age 33) with Crohn’s disease and an active high perianal fistula with a single opening to compare the treatment strategies.