Combined endoscopic and radiologic healing is associated with a better prognosis than endoscopic healing only in patients with Crohn's disease receiving anti-TNF therapyopen access
- Authors
- Oh, Kyunghwan; Oh, Eun Hye; Noh, Soo Min; Park, Seong Ho; Kim, Nayoung; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong-Hoon; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Ye, Byong Duk
- Issue Date
- Jan-2022
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- MAGNETIC-RESONANCE ENTEROGRAPHY; SUSTAINED CLINICAL REMISSION; INFLAMMATORY-BOWEL-DISEASE; COMPUTED-TOMOGRAPHY; MAINTENANCE TREATMENT; DEEP REMISSION; MUCOSAL; PREDICTS; PROGRESSION; ADALIMUMAB
- Citation
- CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, v.13, no.1, pp.1 - 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
- Volume
- 13
- Number
- 1
- Start Page
- 1
- End Page
- 8
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/189138
- DOI
- 10.14309/ctg.0000000000000442
- ISSN
- 2155384X
- Abstract
- INTRODUCTION: Although endoscopic healing (EH) is recommended as the therapeutic goal in patients with Crohn's disease (CD), combined EH and radiologic healing (RH) could be a more ideal therapeutic goal considering the transmural nature of CD. We compared the prognosis of patients with CD who achieved EH, RH, both EH and RH (deep healing; DH), or no healing under treatment with anti-tumor necrosis factor (TNF) agents. METHODS: We analyzed 392 patients with CD who received anti-TNF treatment for more than 1 year and evaluated with CT enterography or magnetic resonance enterography together with colonoscopy within 3 months between July 2017 and December 2018. Major outcomes (anti-TNF dose intensification, switch to other biologics, CD-related bowel resection, and hospitalization) were compared according to the EH and RH status. RESULTS: During the follow-up (median 18 months; interquartile range, 15-21), the DH group showed a better rate of major outcome-free survival compared with other groups (P < 0.001). In multivariable analysis, elevated C-reactive protein (adjusted hazard ratio [aHR], 2.166; 95% confidence interval [CI], 1.508-3.110; P < 0.001), EH-only (aHR, 3.903; 95% CI, 1.635-9.315; P = 0.002), RH-only (aHR, 3.843; 95% CI, 1.545-9.558; P = 0.004), and no healing (aHR, 8.844; 95% CI, 4.268-18.323; P < 0.001) were associated with increased risks of major outcomes. DISCUSSION: Patients with CD who achieved DH under anti-TNF therapy showed a better prognosis compared with those who only achieved EH. The possibility of DH being used as a new therapeutic target for patients with CD should be investigated in further studies.
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