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Transmural remission improves clinical outcomes up to 5 years in Crohn's disease

2022-12Journal article Open access
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dc.contributor.authorFernandes, Samuel Raimundo
dc.contributor.authorSerrazina, Juliana
dc.contributor.authorBotto, Inês Ayala
dc.contributor.authorLeal, Tiago
dc.contributor.authorGuimarães, Andreia
dc.contributor.authorGarcia, Joana Lemos
dc.contributor.authorRosa, Isadora
dc.contributor.authorPrata, Rita
dc.contributor.authorCarvalho, Diana
dc.contributor.authorNeves, João
dc.contributor.authorCampelo, Pedro
dc.contributor.authorVentura, Sofia
dc.contributor.authorSilva, Andrea
dc.contributor.authorCoelho, Mariana
dc.contributor.authorSequeira, Cristiana
dc.contributor.authorOliveira, Ana Paula
dc.contributor.authorPortela, Francisco
dc.contributor.authorMinistro, Paula
dc.contributor.authorSousa, Helena Tavares
dc.contributor.authorRamos, Jaime
dc.contributor.authorClaro, Isabel
dc.contributor.authorGonçalves, Raquel
dc.contributor.authorCorreia, Luís Araújo
dc.contributor.authorMarinho, Rui Tato
dc.contributor.authorCortez‐Pinto, Helena
dc.contributor.authorMagro, Fernando
dc.date.accessioned2023-02-13T09:50:28Z
dc.date.available2023-02-13T09:50:28Z
dc.date.issued2022-12
dc.description.abstractIntroductionEvidence 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. MethodsMulticenter 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). Results20.8% 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. ConclusionsTR 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.doi10.1002/ueg2.12356pt_PT
dc.identifier.eissn2050-6414
dc.identifier.urihttp://hdl.handle.net/10400.1/19062
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJohn Wiley & Sonspt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectCrohn's diseasept_PT
dc.subjectEndoscopypt_PT
dc.subjectInflammatory bowel diseasept_PT
dc.subjectMRI enterographypt_PT
dc.subjectTransmural remissionpt_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.issue1pt_PT
oaire.citation.startPage51pt_PT
oaire.citation.titleUnited European Gastroenterology Journalpt_PT
oaire.citation.volume11pt_PT
person.familyNameCampelo
person.familyNameSousa
person.givenNamePedro
person.givenNameHelena Tavares
person.identifier.ciencia-idCF1F-1163-1C4A
person.identifier.orcid0000-0002-6455-3996
person.identifier.orcid0000-0002-6626-205X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication536b9313-58d8-407c-b7de-32b2f08359e7
relation.isAuthorOfPublication6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e
relation.isAuthorOfPublication.latestForDiscovery536b9313-58d8-407c-b7de-32b2f08359e7

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