Background: Transmural healing (TH) of Crohn’s disease (CD) is a still unexplored and interesting outcome correlated to concept of deep remission. Aim: To assess the rate of TH in CD patients treated with anti-TNF alpha agents using two cross-sectional procedures: bowel sonography (BS) and magnetic resonance enterography (MRE). Methods: We performed a 2-year observational longitudinal study, evaluating steroid-free clinical remis- sion (CR), mucosal healing (MH), and TH in CD patients who would complete a 2-year treatment period with anti-TNFs. All patients underwent endoscopy, BS, and MRE before and after 2 years of treatment. Results: Forty out of 80 CD patients were treated with anti-TNFs for 2 years. CR was achieved in 24 patients (60%) while MH in 14 (35%). Using BS, TH was observed in 10 patients (25%), while using MRE, TH was observed in 9 patients (23%) (k = 0.90; P < 0.01). A good agreement was observed between MH and TH, both using BS (k = 0.63; P < 0.01) and MRE (k = 0.64; P < 0.01). A poor agreement was found between CR and TH, with both BS and MRE (k = 0.27 and 0.29, respectively; P < 0.01); even though all patients with TH had achieved CR. Conclusions: TH can be achieved in about 25% of CD patients treated with anti-TNFs, as shown by BS and MRE. BS could be used as the first cross-sectional procedure to detect TH.

Cross-sectional evaluation of transmural healing in patients with Crohn's disease on maintenance treatment with anti-TNF alpha agents / Castiglione, F; Mainenti, P; Testa, A; Imperatore, N; De Palma, Gd; Maurea, S; Rea, M; Nardone, Om; Sanges, M; Caporaso, N; Rispo, A. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 49:5(2017), pp. 484-489. [10.1016/j.dld.2017.02.014]

Cross-sectional evaluation of transmural healing in patients with Crohn's disease on maintenance treatment with anti-TNF alpha agents

Castiglione, F;Mainenti, P;Testa, A;Imperatore, N;De Palma, Gd;Maurea, S;Rea, M;Nardone, Om;Sanges, M;Caporaso, N;Rispo, A
2017

Abstract

Background: Transmural healing (TH) of Crohn’s disease (CD) is a still unexplored and interesting outcome correlated to concept of deep remission. Aim: To assess the rate of TH in CD patients treated with anti-TNF alpha agents using two cross-sectional procedures: bowel sonography (BS) and magnetic resonance enterography (MRE). Methods: We performed a 2-year observational longitudinal study, evaluating steroid-free clinical remis- sion (CR), mucosal healing (MH), and TH in CD patients who would complete a 2-year treatment period with anti-TNFs. All patients underwent endoscopy, BS, and MRE before and after 2 years of treatment. Results: Forty out of 80 CD patients were treated with anti-TNFs for 2 years. CR was achieved in 24 patients (60%) while MH in 14 (35%). Using BS, TH was observed in 10 patients (25%), while using MRE, TH was observed in 9 patients (23%) (k = 0.90; P < 0.01). A good agreement was observed between MH and TH, both using BS (k = 0.63; P < 0.01) and MRE (k = 0.64; P < 0.01). A poor agreement was found between CR and TH, with both BS and MRE (k = 0.27 and 0.29, respectively; P < 0.01); even though all patients with TH had achieved CR. Conclusions: TH can be achieved in about 25% of CD patients treated with anti-TNFs, as shown by BS and MRE. BS could be used as the first cross-sectional procedure to detect TH.
2017
Cross-sectional evaluation of transmural healing in patients with Crohn's disease on maintenance treatment with anti-TNF alpha agents / Castiglione, F; Mainenti, P; Testa, A; Imperatore, N; De Palma, Gd; Maurea, S; Rea, M; Nardone, Om; Sanges, M; Caporaso, N; Rispo, A. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 49:5(2017), pp. 484-489. [10.1016/j.dld.2017.02.014]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/667291
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