The degree of bowel remission predicts phenotype progression in Crohn's disease.

Autor: Fernandes SR; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Clínica Universitária de Gastrenterologia da Faculdade de Medicina de Lisboa, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Bernardo S; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Saraiva S; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Gonçalves AR; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Moura Santos P; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Clínica Universitária de Gastrenterologia da Faculdade de Medicina de Lisboa, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Valente A; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal., Araújo Correia L; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Clínica Universitária de Gastrenterologia da Faculdade de Medicina de Lisboa, Lisboa, Portugal.; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal., Cortez-Pinto H; Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.; Clínica Universitária de Gastrenterologia da Faculdade de Medicina de Lisboa, Lisboa, Portugal., Magro F; Grupo de Estudos de Doença Inflamatória do Intestino (GEDII), Porto, Portugal.; CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Sep; Vol. 12 (7), pp. 891-900. Date of Electronic Publication: 2024 May 16.
DOI: 10.1002/ueg2.12581
Abstrakt: Background: Patients with Crohn's disease (CD) are at risk of progressing from inflammatory to stricturing and penetrating phenotypes. The influence of the depth of remission on the risk of progression has not been adequately evaluated.
Methods: A retrospective cohort study including surgically naïve CD patients with inflammatory phenotype evaluated concomitantly by magnetic resonance enterography and colonoscopy. The degree of remission was correlated with the risk of progressing to stricturing and penetrating phenotypes.
Results: Three hundred nineteen CD patients were included: 27.0% with transmural remission, 16.0% with isolated endoscopic remission, 14.4% with isolated radiologic remission, and 42.6% without remission. Patients with transmural remission presented the lowest rates of phenotype progression (1.2%), with a significant difference compared to isolated radiologic remission (10.9%, p = 0.019), to isolated endoscopic remission (19.6%, p ≤ 0.001), and to no remission (46.3%, p ≤ 0.001). In multivariate regression analysis, transmural remission (OR 0.017 95% CI 0.002-0.135, p < 0.001), isolated radiologic remission (OR 0.139 95% CI 0.049-0.396, p < 0.001), and isolated endoscopic remission (OR 0.301 95% CI 0.123-0.736, p = 0.008) resulted in lower rates of phenotype progression compared to no remission. No patient with transmural or isolated radiologic remission progressed to penetrating phenotypes.
Conclusion: The degree of bowel remission correlates with the risk of phenotype progression. Patients with transmural remission are at the lowest risk of progressing to stricturing and penetrating phenotypes.
(© 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
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