Bowel wall healing assessed using magnetic resonance imaging predicts sustained clinical remission and decreased risk of surgery in Crohn's disease

Journal of Gastroenterology
Anthony BuissonGilles Bommelaer

Abstract

Endoscopic mucosal healing is considered as the best therapeutic target in Crohn's disease (CD) as it is associated with better long-term outcomes. We investigated whether bowel wall healing (BWH) assessed using magnetic resonance imaging (MRI) could predict favorable outcomes and could be a potential therapeutic target. We performed a post hoc analysis from two prospective studies (n = 174 patients). All the patients with previous objective signs of bowel inflammation and assessed by MRI for therapeutic efficacy had a standardized and blinded evaluation, and underwent MRI. Complete BWH was defined as no segmental MaRIA > 7 or no segmental Clermont score > 8.4 and BWH as no segmental MaRIA > 11 or no segmental Clermont score > 12.5. Clinical corticosteroid-free remission (CFREM) was defined as no reappearance or worsening of clinical manifestation leading to therapeutic modification, hospitalization or CD-related surgery. Multivariate analyses were performed including all the relevant parameters. Overall, 63 patients with CD were included (mean follow-up = 4.8 ± 3.1 semesters). In multivariate analysis (n = 303 semesters), complete BWH or BWH was associated with sustained CFREM according to MaRIA [OR = 4.42 (2.29-26.54); p = 0....Continue Reading

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Citations

Apr 22, 2020·Expert Review of Gastroenterology & Hepatology·Salvatore CucchiaraLaura Stronati
Jun 6, 2020·Journal of Clinical Medicine·Ferdinando D'AmicoLaurent Peyrin-Biroulet
Feb 3, 2021·Topics in Magnetic Resonance Imaging : TMRI·David J GrandJordi Rimola
Jun 7, 2021·The Lancet. Gastroenterology & Hepatology·Sophie GeylLaurent Peyrin-Biroulet

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