Magnetic resonance enterography findings 46 weeks after initiation of biological therapy predict long-term adverse...

Area of Science:

• Gastroenterology
• Radiology
• Inflammatory Bowel Disease

Background:

• Magnetic resonance enterography (MRE) assesses transmural changes in Crohn's disease (CD) patients undergoing biological treatment.
• The long-term predictive value of MRE findings after 46 weeks of therapy remains unclear.

Purpose of the Study:

• To identify MRE findings at 46 weeks post-biological therapy initiation that predict adverse long-term outcomes in CD patients.
• To evaluate the prognostic significance of specific radiologic markers for disease progression and complications.

Main Methods:

• Prospective follow-up of 89 CD patients for 2 years after MRE at 46 weeks of biological treatment.
• Logistic regression analysis to correlate MRE findings with predefined adverse outcomes.

Main Results:

• Over 50% of patients experienced adverse outcomes, including clinical recurrence, surgery, and hospitalization.
• Persistent severe lesions (MaRIA ≥11) predicted surgery, endoscopic dilation, and clinical relapse.
• Penetrating lesions, creeping fat, and complications were associated with increased risk of surgery, hospitalization, and corticosteroid use.

Conclusions:

• MRE findings at 46 weeks of biological therapy are predictive of long-term adverse outcomes in CD.
• Identifying severe inflammatory lesions, complications, or creeping fat on MRE can guide timely therapeutic interventions.