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Transmural Remission Improves Clinical Outcomes Up to 5 years in Crohn's Disease

2023-02Journal article Open access
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dc.contributor.authorRaimundo Fernandes, S
dc.contributor.authorSerrazina, J
dc.contributor.authorAyala Botto, I
dc.contributor.authorLeal, T
dc.contributor.authorGuimarães, A
dc.contributor.authorLemos Garcia, J
dc.contributor.authorRosa, I
dc.contributor.authorPrata, R
dc.contributor.authorCarvalho, D
dc.contributor.authorNeves, J
dc.contributor.authorCampelo, P
dc.contributor.authorVentura, S
dc.contributor.authorSilva, A
dc.contributor.authorCoelho, M
dc.contributor.authorSequeira, C
dc.contributor.authorOliveira, AP
dc.contributor.authorPortela, F
dc.contributor.authorMinistro, P
dc.contributor.authorTavares de Sousa, H
dc.contributor.authorRamos, J
dc.contributor.authorClaro, I
dc.contributor.authorGonçalves, R
dc.contributor.authorAraújo Correia, L
dc.contributor.authorTato Marinho, R
dc.contributor.authorCortez Pinto, H
dc.contributor.authorMagro, F
dc.date.accessioned2023-02-13T12:45:16Z
dc.date.available2023-02-13T12:45:16Z
dc.date.issued2023-02
dc.description.abstractIntroduction: Evidence 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. Methods: Multicenter 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). Results: 20.8% 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. Conclusions: TR 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationUnited European Gastroenterol J. 2023 Feb;11(1):51-59.pt_PT
dc.identifier.doi10.1002/ueg2.12356.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4399
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHSAC GASpt_PT
dc.subjectColonoscopypt_PT
dc.subjectCrohn Disease* / diagnostic imagingpt_PT
dc.subjectCrohn Disease* / drug therapypt_PT
dc.subjectMagnetic Resonance Imaging / methodspt_PT
dc.subjectHumanspt_PT
dc.subjectRemission Inductionpt_PT
dc.subjectRetrospective Studiespt_PT
dc.titleTransmural Remission Improves Clinical Outcomes Up to 5 years in Crohn's Diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage59pt_PT
oaire.citation.startPage51pt_PT
oaire.citation.titleUnited European Gastroenterology Journalpt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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