Deep remission in inflammatory bowel disease: looking beyond symptoms
Camille Zallot1, Laurent Peyrin-Biroulet
1Department of Hepato-Gastroenterology, Nancy University Hospital, Allée du Morvan, 54511, Vandœuvre-lès-Nancy, France.
Current Gastroenterology Reports
|January 29, 2013
Summary
Achieving deep remission, including mucosal healing, is crucial for altering the course of Inflammatory Bowel Diseases (IBD). Current treatments aim for this deeper healing beyond symptom control to improve long-term outcomes.
Area of Science:
- Gastroenterology and Immunology
- Chronic Disease Management
- Therapeutic Goal Evolution
Background:
- Inflammatory Bowel Diseases (IBD) are chronic, disabling conditions where symptom control alone has not altered disease progression.
- Therapeutic strategies for IBD are shifting from symptom management towards achieving mucosal healing (MH).
Purpose of the Study:
- To explore the concept of deep remission in IBD, defined as clinical remission, biomarker remission, and MH.
- To discuss the current definitions of deep remission in Crohn's disease (CD) and the need for a definition in ulcerative colitis (UC).
Main Methods:
- Review of current evidence and therapeutic goals in IBD management.
- Analysis of proposed definitions for deep remission in CD and potential definitions for UC.
Main Results:
- Deep remission, encompassing clinical, biomarker, and mucosal healing, is proposed as a key strategy to modify IBD disease course.
- Specific definitions for deep remission exist for CD (CDAI <150 and MH) but require validation; a definition for UC (clinical and endoscopic remission) is proposed.
- Future definitions may incorporate transmural healing in CD and histologic healing in UC.
Conclusions:
- Achieving deep remission is a realistic goal due to advances in IBD drug development.
- Further validation studies are needed for proposed deep remission definitions.
- The impact of deep remission on long-term outcomes like surgery and disability requires evaluation in future trials.
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