Transmural remission improves clinical outcomes up to 5 years in Crohn's disease

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Fernando José Magro Dias

    Autor

Participantes de fora da FMUP

  • Fernandes, Samuel Raimundo
  • Serrazina, Juliana
  • Botto, Ines Ayala
  • Leal, Tiago
  • Guimaraes, Andreia
  • Garcia, Joana Lemos
  • Rosa, Isadora
  • Prata, Rita
  • Carvalho, Diana
  • Neves, Joao
  • Campelo, Pedro
  • Ventura, Sofia
  • Silva, Andrea
  • Coelho, Mariana
  • Sequeira, Cristiana
  • Oliveira, Ana Paula
  • Portela, Francisco
  • Ministro, Paula
  • Tavares de Sousa, Helena
  • Ramos, Jaime
  • Claro, Isabel
  • Goncalves, Raquel
  • Correia, Luis Araujo
  • Marinho, Rui Tato
  • Pinto, Helena Cortez

Unidades de investigação

Abstract

IntroductionEvidence supporting transmural remission (TR) as a long-term treatment target in Crohn's disease (CD) is still unavailable. Less stringent but more reachable targets such as isolated endoscopic (IER) or radiologic remission (IRR) may also be acceptable options in the long-term. MethodsMulticenter retrospective study including 404 CD patients evaluated by magnetic resonance enterography and colonoscopy. Five-year rates of hospitalization, surgery, use of steroids, and treatment escalation were compared between patients with TR, IER, IRR, and no remission (NR). Results20.8% of CD patients presented TR, 23.3% IER, 13.6% IRR and 42.3% NR. TR was associated with lower risk of hospitalization (odds-ratio [OR] 0.244 [0.111-0.538], p < 0.001), surgery (OR 0.132 [0.030-0.585], p = 0.008), steroid use (OR 0.283 [0.159-0.505], p < 0.001), and treatment escalation (OR 0.088 [0.044-0.176], p < 0.001) compared to no NR. IRR resulted in lower risk of hospitalization (OR 0.333 [0.143-0.777], p = 0.011) and treatment escalation (OR 0.260 [0.125-0.540], p < 0.001), while IER reduced the risk of steroid use (OR 0.442 [0.262-0.745], p = 0.002) and treatment escalation (OR 0.490 [0.259-0.925], p = 0.028) compared to NR. ConclusionsTR improved clinical outcomes over 5 years of follow-up in CD patients. Distinct but significant benefits were seen with IER and IRR. This suggests that both endoscopic and radiologic remission should be part of the treatment targets of CD.

Dados da publicação

ISSN/ISSNe:
2050-6406, 2050-6414

United European Gastroenterology Journal  John Wiley &amp; Sons Inc.

Tipo:
Article
Páginas:
51-59
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 10

Citações Recebidas na Scopus: 12

Documentos

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Métricas

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Keywords

  • Crohn's disease; endoscopy; inflammatory bowel disease; MRI enterography; transmural remission

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Contributo da endoscopia, biomarcadores e imagiologia na evolução clinica dos doentes com doença inflamatória intestinal

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