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Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn's Disease

Samuel R Fernandes1, Rita V Rodrigues, Sónia Bernardo

  • 1*Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Lisboa, Portugal; †Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal; ‡Serviço de Imagiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal; and §Serviço de Imagiologia, Hospital de Santa Maria, Lisboa, Portugal.

Inflammatory Bowel Diseases
|May 13, 2017
PubMed
Abstract

Insights

Transmural healing (TH) in Crohn's disease, confirmed by MRI and colonoscopy, leads to better long-term outcomes. Achieving TH is a more beneficial treatment target than mucosal healing (MH) alone.

Area of Science:

  • Gastroenterology
  • Inflammatory Bowel Disease Research
  • Medical Imaging in Gastroenterology

Background:

  • Mucosal healing (MH) is a primary treatment goal for Crohn's disease.
  • Residual inflammation may persist despite MH, detectable by imaging.
  • Long-term benefits of transmural healing (TH) remain under-assessed.

Purpose of the Study:

  • To evaluate the long-term benefits of achieving transmural healing (TH) in Crohn's disease patients.
  • To compare outcomes between patients achieving TH, MH, or no healing.

Main Methods:

  • Observational study of 214 Crohn's disease patients.
  • Utilized magnetic resonance enterography (MRE) and colonoscopy within a 6-month interval.
  • Classified patients into TH, MH, or no healing groups; assessed surgery, hospital admission, and therapy escalation at 12 months.

Main Results:

  • Patients achieving TH showed significantly lower rates of hospital admission, therapy escalation, and surgery.
  • Both endoscopic remission and MRE remission were independently linked to reduced unfavorable outcomes.
  • Logistic regression indicated strong associations (P < 0.001) for both remission types.

Conclusions:

  • Transmural healing (TH) is associated with improved long-term outcomes in Crohn's disease.
  • TH may represent a more optimal and comprehensive treatment target compared to MH alone.
  • Achieving complete healing, including bowel wall integrity, is crucial for better patient prognosis.

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