Frequency and prognostic role of mucosal healing in patients with Crohn's disease and ulcerative colitis after one-year of biological therapy

World J Gastroenterol. 2014 Mar 21;20(11):2995-3001. doi: 10.3748/wjg.v20.i11.2995.

Abstract

Aim: To assess the endoscopic activity before and after a one-year period of biological therapy and to evaluate the frequency of relapses and need for retreatment after stopping the biologicals in patients with Crohn's disease (CD) and ulcerative colitis (UC).

Methods: The data from 41 patients with CD and 22 patients with UC were assessed. Twenty-four CD patients received infliximab, and 17 received adalimumab. The endoscopic severity of CD was quantified with the simplified endoscopic activity score for Crohn's disease in CD and with the Mayo endoscopic subscore in UC.

Results: Mucosal healing was achieved in 23 CD and 7 UC patients. Biological therapy had to be restarted in 78% of patients achieving complete mucosal healing with CD and in 100% of patients with UC. Neither clinical remission nor mucosal healing was associated with the time to restarting the biological therapy in either CD or UC.

Conclusion: Mucosal healing did not predict sustained clinical remission in patients in whom the biological therapies had been stopped.

Keywords: Biological therapy; Crohn’s disease; Endoscopy; Mucosal healing; Ulcerative colitis.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Therapy*
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / pathology
  • Colonoscopy
  • Crohn Disease / drug therapy*
  • Crohn Disease / pathology
  • Female
  • Humans
  • Infliximab
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / pathology
  • Male
  • Prognosis
  • Prospective Studies

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Infliximab
  • Adalimumab