scholarly journals Targeting mucosal healing in Crohn’s disease: what the clinician needs to know

2019 ◽  
Vol 12 ◽  
pp. 175628481985686 ◽  
Author(s):  
Entcho Klenske ◽  
Christian Bojarski ◽  
Maximilian Waldner ◽  
Timo Rath ◽  
Markus F. Neurath ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
Clinical Management ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Mucosal Healing ◽  
Ongoing Debate ◽  
Definition Of

In recent years, mucosal healing has emerged as a key therapeutic goal in the clinical management of patients with Crohn’s disease, as it has been associated with improved long-term clinical outcomes. With the vast improvements in endoscopic imaging techniques and the increase in available treatment options, which reportedly are able to induce mucosal healing, the practising physician is left to wonder: how is endoscopic mucosal healing exactly defined in Crohn’s disease, and how can it effectively be achieved and monitored in daily clinical practice? Within this review, we will give an overview of the ongoing debate about the definition of mucosal healing and the modalities to monitor inflammation, and finally present available therapies with the capacity to induce mucosal healing.

scholarly journals P628 Long-term outcomes with transmural healing vs. mucosal healing in Crohn’s disease: time for new treatment goals ?

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S431-S432
Author(s):  
F Castiglione ◽  
N Imperatore ◽  
A Testa ◽  
G D De Palma ◽  
O M Nardone ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mucosal Healing ◽  
Treatment Goals ◽  
Long Term Outcomes ◽  
New Treatment

scholarly journals P451 Short-and long-term effectiveness of ustekinumab in patients with Crohn’s disease: real-world data from a German IBD cohort

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S405-S405
Author(s):  
A Kubesch ◽  
L Rueter ◽  
K Farrag ◽  
T Krause ◽  
K Stienecker ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Treatment Options ◽  
Real World Data ◽  
Free Response ◽  
Faecal Calprotectin ◽  
Short And Long Term

Abstract Background The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, Real-World German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods Patients with CD receiving UST treatment in three hospitals and two outpatient centres were included and retrospectively analysed. Rates for short- and long-term remission and response were analysed with the help of clinical (Harvey–Bradshaw Index [HBI]) and biochemical (C-reactive protein [CRP], faecal calprotectin [fCal]) parameters for disease activity. Results Data from 180 patients were evaluated. One hundred six patients had a follow-up of at least 8 weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin. The median follow-up was 49.1 weeks (95% CI 42.03–56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 39 (41.9%) responded to UST, and 20 patients (21.5%) were in remission. Steroid-free response and remission at week eight were achieved by 30.1%, and 19.3% of patients. At week 48, 26.9% showed steroid-free response to UST, and 15.1% of the initial patient population was in steroid-free remission. Clinical response at week 16 was independently associated with remission at week 48. Conclusion Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment exposed patients.

scholarly journals Tu1150 Association of Serum Infliximab and Antibodies to Infliximab to Long-Term Clinical Outcome and Mucosal Healing in Crohn's Disease

2013 ◽  
Vol 144 (5) ◽  
pp. S-775 ◽  
Author(s):  
Ofer Ben-Bassat ◽  
Anna Romanova ◽  
Anna Iacono ◽  
Sue P. Irwin ◽  
Gordon R. Greenberg
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Outcome ◽  
Mucosal Healing

644 Early Mucosal Healing Status Predicts Long-Term Clinical Benefits for Adalimumab-Treated Patients With Moderate to Severe Crohn's Disease

2010 ◽  
Vol 138 (5) ◽  
pp. S-85 ◽  
Author(s):  
Paul J. Rutgeerts ◽  
Walter Reinisch ◽  
Roopal Thakkar ◽  
Eric Q. Wu ◽  
Anna Kaltenboeck ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mucosal Healing ◽  
Clinical Benefits

scholarly journals P417 Long-term deep remission after adalimumab discontinuation in Crohn’s disease patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S423-S423
Author(s):  
L Melotti ◽  
F Rizzello ◽  
C Calabrese ◽  
N Dussias ◽  
P Gionchetti
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mucosal Healing ◽  
Treatment Withdrawal ◽  
Biologic Agent ◽  
Drug Discontinuation ◽  
Endoscopic Remission ◽  
Observational Cohort

Abstract Background Adalimumab is a safe and effective drug in treatment of Crohn’s Disease (CD). Current literature is not definitive regarding an exact timing for treatment withdrawal and disease relapses after drug discontinuation. Methods We conducted a single-centre, retrospective, observational cohort study involving patients affected by Crohn’s Disease (CD) treated with adalimumab. Of 575 patients treated with adalimumab for CD, 149 patients suspended treatment for stable deep remission (clinical steroid-free, biochemical, endoscopic remission defined as mucosal healing). Of these, 126 have a minimum follow up of 4 years, the other 23 where lost or finished the follow-up. Patients were assessed clinically, laboratoristically and endoscopically for 4 years. Relapse was defined as clinical (HBI > 4) and biochemical (PCR > 0.5 mg/dL). Results Of the 126 patients with 4 years follow-up, 64 (51%) maintained deep remission during the 4 year follow-up period. Of these, 38 (59%) were on exit-therapy with thiopurines. Twenty-seven patients (18%) had relapsed by year 1, 24 (18%) by year 2, 8 (6%) by year 3, and 1 (0.8%) by year 4. Relapses needed surgical therapy in 9 (15%) cases, whereas 36 (60%) were retreated with adalimumab and 4 (7%) with another biologic agent. The remaining 11 patients (18%) were treated only with a course of steroids. Conclusion Patients who suspend treatment with adalimumab for stable deep remission maintain remission in the long term in approximately half of cases. The majority of relapses occur in the first 24 months after discontinuation.

scholarly journals Current Use of EEN in Pre-Operative Optimisation in Crohn’s Disease

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4389
Author(s):  
Sharafaath Shariff ◽  
Gordon Moran ◽  
Caris Grimes ◽  
Rachel Margaret Cooney
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Patient Outcomes ◽  
Surgical Procedures ◽  
Treatment Options ◽  
Paediatric Population ◽  
Mucosal Healing ◽  
Bowel Surgery ◽  
Operative Complications

Despite the increasing array of medications available for the treatment of Crohn’s disease and a focus on mucosal healing, approximately 35% of patients with Crohn’s disease undergo bowel surgery at some stage. The importance of nutritional optimisation before Crohn’s surgery is well-highlighted by surgical, nutritional, and gastroenterological societies with the aim of reducing complications and enhancing recovery. Surgical procedures are frequently undertaken when other treatment options have been unsuccessful, and, thus, patients may have lost weight and/or required steroids, and are therefore at higher risk of post-operative complications. EEN is used extensively in the paediatric population to induce remission, but is not routinely used in the induction of remission of adult Crohn’s disease or in pre-operative optimisation. Large prospective studies regarding the role of pre-operative EEN are lacking. In this review, we evaluate the current literature on the use of EEN in pre-operative settings and its impact on patient outcomes.

P406 Mucosal healing in children with Crohn's disease on long term maintenance treatment

2014 ◽  
Vol 8 ◽  
pp. S235
Author(s):  
R. Muhammed ◽  
R. Bremner ◽  
W. Theodoric ◽  
S. Protheroe ◽  
S. Murphy
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Maintenance Treatment ◽  
Mucosal Healing ◽  
Term Maintenance
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