Endoscopic and histologic evidence of persistent mucosal healing and correlation with clinical improvement following sustained infliximab treatment for Crohn's disease

Background: Mucosal healing (MH) is the key aim of the treat-to-target strategy for patients with Crohn’s disease (CD). The efficacy of infliximab (IFX) on MH in different ileocolonic segments is unclear. The aim of this study was to investigate endoscopic MH in different ileocolonic segments in patients with CD who received IFX treatment. Methods: A retrospective, single-center study was performed in patients with active ileocolonic CD between January 2012 and December 2018. All patients underwent IFX treatment for at least 30 weeks. The MH of five ileocolonic segments was assessed by the Simple Endoscopic Score for CD (SES-CD) at baseline, 14/22 weeks and 30/38 weeks. The SES-CD values were analyzed by a mixed-effects model after the correction for confounding factors. Results: A total of 101 eligible patients were included. The baseline endoscopic severity was similar across segments. At 30/38 weeks, the greatest changes in the SES-CD ulcer size and ulcerated surface subscores were −94.29% and −94.32% both in the transverse colon ( p < 0.0001), and the smallest changes were −67.88% and −69.67% both in the terminal ileum ( p < 0.0001) compared with baseline. Stenosis mainly presented in the right colon (12/29, 41.38%). The change in the SES-CD stenosis subscore was −6.25% in the right colon at 30/38 weeks compared with −71.88% at 14/22 weeks ( p = 0.0030). At 30/38 weeks, the transverse colon achieved the highest rate of complete MH (CMH) at 81.2%, and the lowest CMH rate occurred in the terminal ileum at 45.6%. Moreover, the degree of improvement in the rectum was negatively correlated with disease progression ( p = 0.011). Conclusions: Ileocolonic segments in CD presented different degrees of endoscopic MH during IFX treatment. The transverse colon showed the highest CMH rate, whereas the right colon with stenosis showed the poorest improvement. The differing propensities of ileocolonic segments may provide an individualized IFX treatment strategy.

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Visceral Fat Is Associated With Mucosal Healing of Infliximab Treatment in Crohn’s Disease

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001074 ◽

2018 ◽

Vol 61 (6) ◽

pp. 706-712 ◽

Cited By ~ 6

Author(s):

Weisong Shen ◽

Lei Cao ◽

Yi Li ◽

Xingchen Cai ◽

Yuanyuan Ge ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Visceral Fat ◽

Mucosal Healing ◽

Infliximab Treatment

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P.1.191: FACTORS INFLUENCING MUCOSAL HEALING IN CROHN'S DISEASE DURING INFLIXIMAB TREATMENT IN CLINICAL PRACTICE

Digestive and Liver Disease ◽

10.1016/s1590-8658(11)60419-2 ◽

2011 ◽

Vol 43 ◽

pp. S211

Author(s):

A. Tursi ◽

W. Elisei ◽

G. Giorgetti ◽

A. Penna ◽

P.G. Lecca ◽

...

Keyword(s):

Crohn’S Disease ◽

Clinical Practice ◽

Crohn's Disease ◽

Mucosal Healing ◽

Infliximab Treatment ◽

Factors Influencing

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Combination of Serological Biomarkers and Clinical Features To Predict Mucosal Healing in Crohn’s Disease: A Multicenter Cohort Study

10.21203/rs.3.rs-985096/v1 ◽

2021 ◽

Author(s):

Nana Tang ◽

Han Chen ◽

Ruidong Chen ◽

Wen Tang ◽

Hongjie Zhang

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Statistical Significance ◽

Mucosal Healing ◽

Infliximab Treatment ◽

Clinical Tool ◽

Multicenter Cohort Study ◽

Reactive Protein ◽

Primary Model ◽

Serological Biomarkers

Abstract Background Mucosal healing (MH) has become the treatment goal of patients with Crohn’s disease (CD). This study aims to develop a noninvasive and reliable clinical tool for individual evaluation of mucosal healing in patients with Crohn’s disease. Results The following variables were independently associated with the MH and were subsequently included into the prediction model: PLR (platelet to lymphocyte ratio), CAR (C-reactive protein to albumin ratio), ESR (erythrocyte sedimentation rate), HBI (Harvey-Bradshaw Index) score and infliximab treatment. A primary model and a simple model were established, respectively. The primary model performed better than the simple one in C-index (87.5% vs 83.0 %, p=0.004). There was no statistical significance between these two models in sensitivity (70.43% vs 62.61%, p=0.467), specificity (87.12% vs 80.69%, p=0.448), PPV (72.97% vs 61.54%, p=0.292), NPV (85.65% vs 81.39%, p=0.614), and accuracy (81.61% vs 74.71%, p=0.303). The primary model had good calibration and high levels of explained variation and discrimination in validation cohort. Conclusions This model can be used to predict MH in post-treatment CD patients. It can also be used as an indication of endoscopic surveillance to evaluate mucosal healing in patients with CD after treatment.

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