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

Data de publicação: 01/02/2023 Data Ahead of Print: 01/12/2022

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

Biomedicina
Laboratório Associado RISE- Rede de Investigação em Saúde

Investigador

Fernando Carlos De Landér Schmitt
RISE-Health

Investigador

Fernando Carlos De Landér Schmitt

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
Tipo:: Article
Páginas:: 51-59
DOI:: 10.1002/ueg2.12356
Link para outro recurso:: www.scopus.com

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Fernandes, Samuel Raimundo:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Serrazina, Juliana:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Botto, Ines Ayala:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Leal, Tiago:: Hosp Braga, Serv Gastrenterol, Braga, Portugal
Guimaraes, Andreia:: Hosp Braga, Serv Gastrenterol, Braga, Portugal
Garcia, Joana Lemos:: Inst Portugues Oncol Francisco Gentil, Serv Gastrenterol, Lisbon, Portugal
Rosa, Isadora:: Inst Portugues Oncol Francisco Gentil, Serv Gastrenterol, Lisbon, Portugal
Prata, Rita:: Ctr Hosp Univ Lisboa Cent, Hosp St Antonio Capuchos, Serv Gastrenterol, Lisbon, Portugal
Carvalho, Diana:: Ctr Hosp Univ Lisboa Cent, Hosp St Antonio Capuchos, Serv Gastrenterol, Lisbon, Portugal
Neves, Joao:: Univ Algarve, Ctr Hosp Univ Algarve, Biomed Ctr Algarve, Serv Gastrenterol, Portimao, Portugal
Campelo, Pedro:: Univ Algarve, Ctr Hosp Univ Algarve, Biomed Ctr Algarve, Serv Gastrenterol, Portimao, Portugal
Ventura, Sofia:: Ctr Hosp Tondela Viseu, Serv Gastrenterol, Viseu, Portugal
Silva, Andrea:: Ctr Hosp Univ Coimbra, Serv Gastrenterol, Coimbra, Portugal
Coelho, Mariana:: Hosp Sao Bernardo, Serv Gastrenterol, Setubal, Portugal
Sequeira, Cristiana:: Hosp Sao Bernardo, Serv Gastrenterol, Setubal, Portugal
Oliveira, Ana Paula:: Hosp Sao Bernardo, Serv Gastrenterol, Setubal, Portugal
Portela, Francisco:: Ctr Hosp Univ Coimbra, Serv Gastrenterol, Coimbra, Portugal
Ministro, Paula:: Ctr Hosp Tondela Viseu, Serv Gastrenterol, Viseu, Portugal
Tavares de Sousa, Helena:: Univ Algarve, Ctr Hosp Univ Algarve, Biomed Ctr Algarve, Serv Gastrenterol, Portimao, Portugal
Ramos, Jaime:: Ctr Hosp Univ Lisboa Cent, Hosp St Antonio Capuchos, Serv Gastrenterol, Lisbon, Portugal
Claro, Isabel:: Inst Portugues Oncol Francisco Gentil, Serv Gastrenterol, Lisbon, Portugal
Goncalves, Raquel:: Hosp Braga, Serv Gastrenterol, Braga, Portugal
Correia, Luis Araujo:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Marinho, Rui Tato:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Pinto, Helena Cortez:: Ctr Hosp Univ Lisboa Norte, Hosp St Maria, Fac Med Lisboa, Serv Gastrenterol & Hepatol,Clin Univ Gastrentero, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
Magro, FERNANDO:: Hosp Sao Joao, Serv Gastrenterol, Porto, Portugal

Univ Porto, Inst Mol & Cell Biol, Dept Pharmacol & Therapeut, Porto, Portugal