A study examining the long-term effects of mesenchymal stem cell (MSC) therapy for perianal fistulising Crohn’s disease (pfCD) provides valuable data on its clinical, radiological, and patient-reported outcomes.
This condition often requires surgical interventions and frequent flare-ups. MSC therapy has emerged as a potential alternative for patients with medically refractory cases.
The study included 24 patients treated with a single dose of MSC therapy at two tertiary referral centers in the UK. The patients were followed up for a median of 60 months, with assessments conducted on both clinical and radiological outcomes. Clinical responses were measured using the fistula drainage assessment and the Perianal Disease Activity Index (PDAI), while radiological assessments involved MRI-based activity indices and expert evaluations using the Visual Analogue Scale (VAS) score of disease severity.
Key Findings:
- Clinical Response:
- 54.2% (13/24) of patients were in clinical remission at 5 years.
- 25% (6/24) of patients showed continued improvement at 5 years.
- Radiological Response:
- 75% (18/24) showed improvement within the first year after treatment.
- 37.5% (9/24) kept that improvement after 5 years.
- 16.7% (4/24) had complete healing on imaging at 5 years.
- Disease Activity (PDAI):
- Significant decrease in PDAI scores after 18 months and at 5 years.
- Other Scores:
- Improvement in disease severity scores (Van Assche Index and VAS) at both 1 year and 5 years.
- Surgery:
- 58.3% (14/24) of patients did not need any additional surgery during the 5 years.
- Safety:
- No serious side effects or long-term continence problems were observed.
Overall, MSC therapy showed positive results in controlling symptoms and improving the quality of life for patients with this tough form of Crohn’s disease. This therapy helped reduce the need for surgeries, making it a promising treatment option.
