Dr Regueiro reviews his presentation of the Patricia and Ralph Gianella lecture from DDW 2025 on the updates to the treatment algorithm for perianal Crohn's disease.

I'm Dr. Miguel Regueiro, and hopefully you enjoyed DDW 2025 as much as I did. I'd like to present my work that I looked at in perianal Crohn's disease. This was part of the postgraduate course and I was honored that this was part of the Patricia and Ralph Gianella lecture on recent advancements in inflammatory bowel disease. My topic was the update in the treatment algorithm of perianal Crohn’s disease, something that I've studied, but really this was a comprehensive overview.

The take-home messages from this lecture were that perianal Crohn’s is common, up to 25% of our patients; that this is a multidisciplinary approach where we need to work with our colorectal surgeons and our gastroenterologists and especially to first, for most of these patients, place a perianal seton in the fistula. Our medications that are still the best after all these years are infliximab, but I also outlined how upadacitinib and some of our other treatments may play a role. And then finally, I discussed a bit about stem cells. And although the study in the United States was negative, and we don't have stem cells coming to the United States soon for the treatment of perianal fistula, many of our colleagues in Europe and other parts of the world are using stem cells to treat perianal fistula.

I ended the lecture with an algorithm that really outlined everything that I just mentioned. Hopefully you found this informative. Thank you very much.