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

Autores da FMUP
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
- Tipo:
- Article
- Páginas:
- 51-59
- DOI:
- 10.1002/ueg2.12356
- Link para outro recurso:
- www.scopus.com
United European Gastroenterology Journal John Wiley & Sons Inc.
Citações Recebidas na Web of Science: 10
Citações Recebidas na Scopus: 12
Documentos
- Não há documentos
Filiações
Keywords
- Crohn's disease; endoscopy; inflammatory bowel disease; MRI enterography; transmural remission
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Citar a publicação
Fernandes SR,Serrazina J,Botto IA,Leal T,Guimaraes A,Garcia JL,Rosa I,Prata R,Carvalho D,Neves J,Campelo P,Ventura S,Silva A,Coelho M,Sequeira C,Oliveira AP,Portela F,Ministro P,Tavares de Sousa H,Ramos J,Claro I,Goncalves R,Correia LA,Marinho RT,Pinto HC,Magro F. Transmural remission improves clinical outcomes up to 5 years in Crohn's disease. United Eur. Gastroenterol. J. 2023. 11. (1):p. 51-59. IF:6,000. (1).