Related Experiment Video
Updated: Nov 23, 2025
Mechanistic Insight into the Development of TNBS-Mediated Intestinal Fibrosis and Evaluating the Inhibitory Effects of Rapamycin
Published on: September 12, 2019
Mucosal and Histologic Healing in Children With Inflammatory Bowel Disease Treated With Antitumor Necrosis
Luca Scarallo1, Patrizia Alvisi2, Giulia Bolasco2
1Gastroenterology and Nutrition Unit, Meyer children's Hospital, Florence.
Insights
Mucosal healing and histological healing are new targets for pediatric inflammatory bowel disease (IBD) treated with anti-TNF-alpha agents. Real-world data show lower achievement rates than expected, particularly in Crohn's disease.
Area of Science:
- Pediatric gastroenterology
- Inflammatory Bowel Disease (IBD) research
- Gastrointestinal immunology
Background:
- Mucosal healing (MH) and histological healing (HH) are emerging therapeutic goals in inflammatory bowel disease (IBD).
- Anti-TNF-alpha (ATA) agents are commonly used in pediatric IBD management.
- Real-world data on achieving MH and HH in pediatric IBD patients on ATA are limited.
Purpose of the Study:
- To assess the real-life achievement rates of MH and HH in pediatric IBD patients treated with ATA.
- To compare MH and HH outcomes between Crohn's disease (CD) and ulcerative colitis (UC) pediatric populations.
- To identify factors associated with achieving MH and HH in this cohort.
Main Methods:
- Retrospective analysis of pediatric IBD patients receiving ATA at two referral centers.
- Calculation of incidence and cumulative rates for MH and HH.
- Endoscopic re-assessment data utilized for outcome evaluation.
Main Results:
- Of 170 patients (105 CD, 65 UC), 78 CD and 56 UC underwent re-assessment.
- MH achieved by 41% CD and 53.6% UC; HH achieved by 33.3% CD and 39.3% UC.
- Remission at induction correlated with higher MH/HH in CD; adalimumab associated with lower rates in UC.
Conclusions:
- Real-world MH and HH rates in pediatric IBD patients on ATA appear lower than previously reported.
- Less than half of CD patients and just over half of UC patients achieved MH.
- Microscopic inflammation persisted in a significant proportion of patients achieving MH.
Objectives:
Mucosal healing (MH) and histological healing (HH) have been recently proposed as a novel treatment target for inflammatory bowel disease (IBD). The aim of the present study was to evaluate real-life achievement of such outcomes in a cohort of pediatric patients with IBD treated with anti-TNF-alpha (ATA) agents.
Methods:
A retrospective analysis was performed on patients affected by IBD who received ATA and were followed up at two referral centers. Incidence and cumulative rates for MH and HH for each group were calculated.
Results:
Of 170 (105 Crohn's disease [CD] and 65 ulcerative colitis [UC]) patients, 78 with CD and 56 with UC underwent endoscopic re-assessment during the study period. MH was achieved by 32 CD (41%) and 30 UC (53.6%) patients; 26 CD (33.3%) and 22 UC (39.3%) patients achieved HH. MH incidence rate was 19.1/1000 and 47/1000 person-months, whereas HH incidence rate was 15.5/1000 and 34.7/1000 person-months for CD and UC, respectively. Remission at the end of induction was associated with higher MH and HH rates (HR: 2.43, P = 0.049 and HR: 2.94, P = 0.046, respectively) in CD. In UC, adalimumab was associated with lower MH and HH rates (HR: 0.16, P = 0.004 and HR: 0.07, P = 0.003).
Conclusions:
We reported a real-life experience arising from a large cohort of pediatric IBD who received ATA scheduled treatment. Less than half of patients with CD and only a little >50% of UC patients achieved MH. Microscopical inflammation was observed in 18.8% CD and 26.7% UC patients who achieved MH. Overall, MH and HH rates appear lower compared to previously published data.
More Related Videos
07:05Important Endpoints and Proliferative Markers to Assess Small Intestinal Injury and Adaptation using a Mouse Model of Chemotherapy-Induced Mucositis
Published on: May 12, 2019
07:38Multimodal Quantitative Phase Imaging with Digital Holographic Microscopy Accurately Assesses Intestinal Inflammation and Epithelial Wound Healing
Published on: September 13, 2016
Related Concept Videos
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents