Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus

A. Hillary Steinhart; Remo Panaccione; Laura Targownik; Brian Bressler; Reena Khanna; John K. Marshall; Waqqas Afif; Charles N. Bernstein; Alain Bitton; Mark Borgaonkar; Usha Chauhan; Brendan Halloran; Jennifer Jones; Erin Kennedy; Grigorios I. Leontiadis; Edward V. Loftus; Jonathan Meddings; Paul Moayyedi; Sanjay Murthy; Sophie Plamondon; Greg Rosenfeld; David Schwartz; Cynthia H. Seow; Chadwick Williams

doi:10.1093/ibd/izy247

Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus

A. Hillary Steinhart, Remo Panaccione, Laura Targownik, Brian Bressler, Reena Khanna, John K. Marshall, Waqqas Afif, Charles N. Bernstein, Alain Bitton, Mark Borgaonkar, Usha Chauhan, Brendan Halloran, Jennifer Jones, Erin Kennedy, Grigorios I. Leontiadis, Edward V. Loftus, Jonathan Meddings, Paul Moayyedi, Sanjay Murthy, Sophie PlamondonGreg Rosenfeld, David Schwartz, Cynthia H. Seow, Chadwick Williams

Research output: Contribution to journal › Review article › peer-review

80 Citations (Scopus)

Original language	English
Pages (from-to)	1-13
Number of pages	13
Journal	Inflammatory Bowel Diseases
Volume	25
Issue number	1
DOIs	https://doi.org/10.1093/ibd/izy247
Publication status	Published - Jan 1 2019
Externally published	Yes

ASJC Scopus Subject Areas

Immunology and Allergy
Gastroenterology

Access to Document

10.1093/ibd/izy247

Cite this

Steinhart, A. H., Panaccione, R., Targownik, L., Bressler, B., Khanna, R., Marshall, J. K., Afif, W., Bernstein, C. N., Bitton, A., Borgaonkar, M., Chauhan, U., Halloran, B., Jones, J., Kennedy, E., Leontiadis, G. I., Loftus, E. V., Meddings, J., Moayyedi, P., Murthy, S., ... Williams, C. (2019). Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus. Inflammatory Bowel Diseases, 25(1), 1-13. https://doi.org/10.1093/ibd/izy247

Steinhart, AH, Panaccione, R, Targownik, L, Bressler, B, Khanna, R, Marshall, JK, Afif, W, Bernstein, CN, Bitton, A, Borgaonkar, M, Chauhan, U, Halloran, B, Jones, J, Kennedy, E, Leontiadis, GI, Loftus, EV, Meddings, J, Moayyedi, P, Murthy, S, Plamondon, S, Rosenfeld, G, Schwartz, D, Seow, CH & Williams, C 2019, 'Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus', Inflammatory Bowel Diseases, vol. 25, no. 1, pp. 1-13. https://doi.org/10.1093/ibd/izy247

@article{ce49fce0d09d41d0a31c8fe63d4bc662,

title = "Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus",

author = "Steinhart, {A. Hillary} and Remo Panaccione and Laura Targownik and Brian Bressler and Reena Khanna and Marshall, {John K.} and Waqqas Afif and Bernstein, {Charles N.} and Alain Bitton and Mark Borgaonkar and Usha Chauhan and Brendan Halloran and Jennifer Jones and Erin Kennedy and Leontiadis, {Grigorios I.} and Loftus, {Edward V.} and Jonathan Meddings and Paul Moayyedi and Sanjay Murthy and Sophie Plamondon and Greg Rosenfeld and David Schwartz and Seow, {Cynthia H.} and Chadwick Williams",

note = "Funding Information: Funding for the consensus meeting was provided by unrestricted, arms-length grants to the CAG by AbbVie Corporation, Janssen Inc., Pfizer Canada Inc., and Takeda Canada Inc. The CAG administered all aspects of the meeting, and the funding sources had no involvement in the process at any point nor were they made aware of any part of the process—from development of search strings and statements to drafting and approval of these guidelines. Funding Information: Supported by: This guideline was supported through unrestricted grants to the Canadian Association of Gastroenterology by AbbVie Canada, Janssen, Pfizer, and Takeda Canada, who had no involvement in any aspect of the guideline development. Funding Information: From the *Division of Gastroenterology, Mount Sinai Hospital, Toronto, Ontario, Canada; †Department of Medicine, University of Calgary, Calgary, Alberta, Canada; ‡Section of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada; §Department of Medicine, Division of Gastroenterology, St Paul{\textquoteright}s Hospital, Vancouver, British Columbia, Canada; ¶Department of Medicine, University of Western Ontario, London, Ontario, Canada; ‖Division of Gastroenterology and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; **Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; ††Faculty of Medicine, Memorial University, St John{\textquoteright}s, Newfoundland, Canada; ‡‡Hamilton Health Sciences, Hamilton, Ontario, Canada; §§Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada; ¶¶Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; ‖‖Division of General Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; ***Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, USA; †††Division of Gastroenterology, University of Ottawa, Ottawa, Ontario, Canada; ‡‡‡Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada; §§§Division of Gastroenterology, Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada; ¶¶¶Inflammatory Bowel Disease Center, Vanderbilt University, Nashville, Tennessee, USA; ‖‖‖Departments of Medicine & Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; ****Division of Digestive Care & Endoscopy, Department of Medicine, Dartmouth General Hospital, Halifax, Nova Scotia, Canada Conflicts of interest: AB has served on advisory boards for AbbVie, Allergan, Ferring, Janssen, Merck, Pfizer, Shire, and Takeda, has received educational support from AbbVie, Allergan, Janssen, and Takeda, has received research grants or clinical trial funding from AbbVie, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Shire, and Takeda. AHS has served on advisory boards for AbbVie, Actavis, Ferring, Janssen, Merck, Pendopharm, Pfizer, Shire, Takeda, has consulted for Pfizer, has received educational support from Janssen, has received research grants or clinical trial funding from AbbVie, Amgen, Celgene, Genentech, Millennium, and Redhill Biopharmn, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Ferring, Hospira, Janssen, Shire, and Takeda. BB has served on advisory boards for AbbVie, Actavis, Celltrion, Ferring, Genentech, Pendopharm, Shire, and Takeda, has received research grants or clinical trial funding from AbbVie, Alvine, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celegene, Genentech, Glaxo-Smith Kline, Janssen, Merck, Qu Biologic, RedHill Biopharm, has participated in speaker{\textquoteright}s bureaus for AbbVie, Actavis, Ferring, Shire, and Takeda, and has stock options in Qu Biologic. BH has served on advisory boards for AbbVie and Janssen and has participated in speaker{\textquoteright}s bureaus for AbbVie, Janssen, Pendopharm, and Shire. CNB has served on advisory boards for AbbVie, Cubist, Shire, and Takeda, has consulted for Theradig, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Janssen, Shire, and Takeda. CHS has served on advisory boards for AbbVie, Actavis, Janssen, Shire, and Takeda. Chadwick Williams has served on advisory boards for AbbVie, Ferring, and Shire and has participated in speaker{\textquoteright}s bureaus for Janssen and Takeda. DS has consulted for AbbVie, Janssen, Takeda, Tigenix, and UCB and has received research grants or clinical trial funding from AbbVie and UCB. EVL has consulted for AbbVie, Amgen, Bristol-Myers Squibb, Celgene, CVS Caremark, Eli Lilly, Genentech, Janssen, Mesoblast, Pfizer, Salix, Seres Therapeutics, Sun Pharmaceuticals, Takeda, Theradig, and UCB, and has received research grants or clinical trial funding from AbbVie, Amgen, Celgene, Genentech, Gilead, Janssen, MedImmune, Pfizer, Receptos, Robarts Clinical Trials, Seres Therapeutics, Takeda, and UCB. GR has served on advisory boards for AbbVie, Janssen, Pendopharm, Shire, and Takeda, has consulted for AbbVie, has received educational support from Janssen, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Janssen, Shire, and Takeda. JJ has served on advisory boards for Takeda, has consulted for AbbVie, Janssen, and Takeda, and has participated in speaker{\textquoteright}s bureaus for Ferring, Janssen, and Shire. John K. Marshall has consulted for AbbVie, Actavis, AstraZeneca, Celltrion, Cubist, Ferring, Hospira, Janssen, Shire, and Takeda, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Actavis, Ferring, Hospira, Janssen, Shire, and Takeda. Laura Targownik has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from Pfizer, Shire, and Takeda, and has received research grants or clinical trial funding from AbbVie and Pfizer. MB has served on advisory boards for AbbVie and Shire and has participated in speaker{\textquoteright}s bureaus for AbbVie, Allergan/Forest, Janssen, Pendopharm, Shire, and Takeda. RK has served on advisory boards for AbbVie, Janssen, and Takeda and has participated in speaker{\textquoteright}s bureaus for Abbvie, Janssen, and Takeda. RP has served on advisory boards for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Bristol-Meyers Squibb, Celgene, Centocor, Cubist, Eisai, Elan, Ferring, Genentech, Glaxo-Smith Kline, Janssen, Merck, Pfizer, Salix, Schering-Plough, Shire, Takeda, UCB, and Warner Chilcott, has consulted for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Bristol-Meyers Squibb, Celgene, Centocor, Cubist, Eisai, Elan, Ferring, Glaxo-Smith Kline, Janssen, Merck, Pfizer, Schering-Plough, Shire, Takeda, UCB, and Warner Chilcott, has received educational support from AbbVie, Abbott, Bristol-Meyers Squibb, Centocor, Elan, Ferring, Janssen, Millennium, Proctor and Gamble, and Schering-Plough, has received research grants or clinical trial funding from AbbVie, Abbott, Bristol-Meyers Squibb, Centocor, Elan, Ferring, Janssen, Millennium, Proctor and Gamble, and Schering-Plough, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Abbott, AstraZeneca, Centocor, Elan, Janssen, Prometheus, Schering-Plough, Shire, Takeda, and Warner Chilcott. SM has served on advisory boards for AbbVie, Shire, and Takeda and has participated in speaker{\textquoteright}s bureaus for AbbVie and Takeda. Sophie Plamondon has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from AbbVie, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Janssen, and Shire. UC has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from AbbVie and Aptalis, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Aptalis, and Janssen. WA has served on advisory boards for AbbVie, Ferring, Janssen, Shire, and Takeda, has received research grants or clinical trial funding from Prometheus, and has participated in speaker{\textquoteright}s bureaus for AbbVie, Janssen, and Takeda. E, GIL, JM, and PM have no industry or government relationships to report. Drs. Steinhart and Panaccione share co-first authorship. Publisher Copyright: {\textcopyright} 2018 Crohn's and Colitis Foundation. Published by Oxford University Press. All rights reserved.",

year = "2019",

month = jan,

day = "1",

doi = "10.1093/ibd/izy247",

language = "English",

volume = "25",

pages = "1--13",

journal = "Inflammatory Bowel Diseases",

issn = "1078-0998",

publisher = "John Wiley and Sons Inc.",

number = "1",

}

TY - JOUR

T1 - Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease

T2 - The Toronto consensus

AU - Steinhart, A. Hillary

AU - Panaccione, Remo

AU - Targownik, Laura

AU - Bressler, Brian

AU - Khanna, Reena

AU - Marshall, John K.

AU - Afif, Waqqas

AU - Bernstein, Charles N.

AU - Bitton, Alain

AU - Borgaonkar, Mark

AU - Chauhan, Usha

AU - Halloran, Brendan

AU - Jones, Jennifer

AU - Kennedy, Erin

AU - Leontiadis, Grigorios I.

AU - Loftus, Edward V.

AU - Meddings, Jonathan

AU - Moayyedi, Paul

AU - Murthy, Sanjay

AU - Plamondon, Sophie

AU - Rosenfeld, Greg

AU - Schwartz, David

AU - Seow, Cynthia H.

AU - Williams, Chadwick

N1 - Funding Information: Funding for the consensus meeting was provided by unrestricted, arms-length grants to the CAG by AbbVie Corporation, Janssen Inc., Pfizer Canada Inc., and Takeda Canada Inc. The CAG administered all aspects of the meeting, and the funding sources had no involvement in the process at any point nor were they made aware of any part of the process—from development of search strings and statements to drafting and approval of these guidelines. Funding Information: Supported by: This guideline was supported through unrestricted grants to the Canadian Association of Gastroenterology by AbbVie Canada, Janssen, Pfizer, and Takeda Canada, who had no involvement in any aspect of the guideline development. Funding Information: From the *Division of Gastroenterology, Mount Sinai Hospital, Toronto, Ontario, Canada; †Department of Medicine, University of Calgary, Calgary, Alberta, Canada; ‡Section of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada; §Department of Medicine, Division of Gastroenterology, St Paul’s Hospital, Vancouver, British Columbia, Canada; ¶Department of Medicine, University of Western Ontario, London, Ontario, Canada; ‖Division of Gastroenterology and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; **Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; ††Faculty of Medicine, Memorial University, St John’s, Newfoundland, Canada; ‡‡Hamilton Health Sciences, Hamilton, Ontario, Canada; §§Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada; ¶¶Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; ‖‖Division of General Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; ***Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, USA; †††Division of Gastroenterology, University of Ottawa, Ottawa, Ontario, Canada; ‡‡‡Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada; §§§Division of Gastroenterology, Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada; ¶¶¶Inflammatory Bowel Disease Center, Vanderbilt University, Nashville, Tennessee, USA; ‖‖‖Departments of Medicine & Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; ****Division of Digestive Care & Endoscopy, Department of Medicine, Dartmouth General Hospital, Halifax, Nova Scotia, Canada Conflicts of interest: AB has served on advisory boards for AbbVie, Allergan, Ferring, Janssen, Merck, Pfizer, Shire, and Takeda, has received educational support from AbbVie, Allergan, Janssen, and Takeda, has received research grants or clinical trial funding from AbbVie, and has participated in speaker’s bureaus for AbbVie, Shire, and Takeda. AHS has served on advisory boards for AbbVie, Actavis, Ferring, Janssen, Merck, Pendopharm, Pfizer, Shire, Takeda, has consulted for Pfizer, has received educational support from Janssen, has received research grants or clinical trial funding from AbbVie, Amgen, Celgene, Genentech, Millennium, and Redhill Biopharmn, and has participated in speaker’s bureaus for AbbVie, Ferring, Hospira, Janssen, Shire, and Takeda. BB has served on advisory boards for AbbVie, Actavis, Celltrion, Ferring, Genentech, Pendopharm, Shire, and Takeda, has received research grants or clinical trial funding from AbbVie, Alvine, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celegene, Genentech, Glaxo-Smith Kline, Janssen, Merck, Qu Biologic, RedHill Biopharm, has participated in speaker’s bureaus for AbbVie, Actavis, Ferring, Shire, and Takeda, and has stock options in Qu Biologic. BH has served on advisory boards for AbbVie and Janssen and has participated in speaker’s bureaus for AbbVie, Janssen, Pendopharm, and Shire. CNB has served on advisory boards for AbbVie, Cubist, Shire, and Takeda, has consulted for Theradig, and has participated in speaker’s bureaus for AbbVie, Janssen, Shire, and Takeda. CHS has served on advisory boards for AbbVie, Actavis, Janssen, Shire, and Takeda. Chadwick Williams has served on advisory boards for AbbVie, Ferring, and Shire and has participated in speaker’s bureaus for Janssen and Takeda. DS has consulted for AbbVie, Janssen, Takeda, Tigenix, and UCB and has received research grants or clinical trial funding from AbbVie and UCB. EVL has consulted for AbbVie, Amgen, Bristol-Myers Squibb, Celgene, CVS Caremark, Eli Lilly, Genentech, Janssen, Mesoblast, Pfizer, Salix, Seres Therapeutics, Sun Pharmaceuticals, Takeda, Theradig, and UCB, and has received research grants or clinical trial funding from AbbVie, Amgen, Celgene, Genentech, Gilead, Janssen, MedImmune, Pfizer, Receptos, Robarts Clinical Trials, Seres Therapeutics, Takeda, and UCB. GR has served on advisory boards for AbbVie, Janssen, Pendopharm, Shire, and Takeda, has consulted for AbbVie, has received educational support from Janssen, and has participated in speaker’s bureaus for AbbVie, Janssen, Shire, and Takeda. JJ has served on advisory boards for Takeda, has consulted for AbbVie, Janssen, and Takeda, and has participated in speaker’s bureaus for Ferring, Janssen, and Shire. John K. Marshall has consulted for AbbVie, Actavis, AstraZeneca, Celltrion, Cubist, Ferring, Hospira, Janssen, Shire, and Takeda, and has participated in speaker’s bureaus for AbbVie, Actavis, Ferring, Hospira, Janssen, Shire, and Takeda. Laura Targownik has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from Pfizer, Shire, and Takeda, and has received research grants or clinical trial funding from AbbVie and Pfizer. MB has served on advisory boards for AbbVie and Shire and has participated in speaker’s bureaus for AbbVie, Allergan/Forest, Janssen, Pendopharm, Shire, and Takeda. RK has served on advisory boards for AbbVie, Janssen, and Takeda and has participated in speaker’s bureaus for Abbvie, Janssen, and Takeda. RP has served on advisory boards for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Bristol-Meyers Squibb, Celgene, Centocor, Cubist, Eisai, Elan, Ferring, Genentech, Glaxo-Smith Kline, Janssen, Merck, Pfizer, Salix, Schering-Plough, Shire, Takeda, UCB, and Warner Chilcott, has consulted for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Bristol-Meyers Squibb, Celgene, Centocor, Cubist, Eisai, Elan, Ferring, Glaxo-Smith Kline, Janssen, Merck, Pfizer, Schering-Plough, Shire, Takeda, UCB, and Warner Chilcott, has received educational support from AbbVie, Abbott, Bristol-Meyers Squibb, Centocor, Elan, Ferring, Janssen, Millennium, Proctor and Gamble, and Schering-Plough, has received research grants or clinical trial funding from AbbVie, Abbott, Bristol-Meyers Squibb, Centocor, Elan, Ferring, Janssen, Millennium, Proctor and Gamble, and Schering-Plough, and has participated in speaker’s bureaus for AbbVie, Abbott, AstraZeneca, Centocor, Elan, Janssen, Prometheus, Schering-Plough, Shire, Takeda, and Warner Chilcott. SM has served on advisory boards for AbbVie, Shire, and Takeda and has participated in speaker’s bureaus for AbbVie and Takeda. Sophie Plamondon has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from AbbVie, and has participated in speaker’s bureaus for AbbVie, Janssen, and Shire. UC has served on advisory boards for AbbVie, Janssen, and Takeda, has received educational support from AbbVie and Aptalis, and has participated in speaker’s bureaus for AbbVie, Aptalis, and Janssen. WA has served on advisory boards for AbbVie, Ferring, Janssen, Shire, and Takeda, has received research grants or clinical trial funding from Prometheus, and has participated in speaker’s bureaus for AbbVie, Janssen, and Takeda. E, GIL, JM, and PM have no industry or government relationships to report. Drs. Steinhart and Panaccione share co-first authorship. Publisher Copyright: © 2018 Crohn's and Colitis Foundation. Published by Oxford University Press. All rights reserved.

PY - 2019/1/1

Y1 - 2019/1/1

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U2 - 10.1093/ibd/izy247

DO - 10.1093/ibd/izy247

M3 - Review article

C2 - 30099529

AN - SCOPUS:85058611505

SN - 1078-0998

VL - 25

SP - 1

EP - 13

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

IS - 1

ER -

Clinical practice guideline for the medical management of perianal fistulizing Crohn's disease: The Toronto consensus

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