Clinical Impact of Sonographic Transmural Healing After Anti-TNF Antibody Treatment in Patients with Crohn's Disease
| Autor: | María Jesús Martínez, Tomás Ripollés, Nadia Moreno, José Vizuete, José María Paredes, Patricia Latorre, Eduardo Moreno-Osset |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Disease Gastroenterology Severity of Illness Index 03 medical and health sciences Young Adult 0302 clinical medicine Maintenance therapy Crohn Disease Gastrointestinal Agents Internal medicine Medicine Humans Prospective Studies Ultrasonography Doppler Color Prospective cohort study Aged Crohn's disease Wound Healing biology business.industry Tumor Necrosis Factor-alpha Ultrasound Adalimumab Middle Aged medicine.disease Infliximab Regimen C-Reactive Protein Treatment Outcome 030220 oncology & carcinogenesis biology.protein 030211 gastroenterology & hepatology Tumor necrosis factor alpha Female Antibody business |
| Zdroj: | DIGESTIVE DISEASES AND SCIENCES r-FISABIO. Repositorio Institucional de Producción Científica instname r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Aim To assess the clinical benefits of transmural healing (TH) shown on intestinal ultrasound (IUS) after treatment with tumor necrosis factor-alpha antibodies (anti-TNF) in patients with Crohn's disease. Materials and Methods This prospective study included consecutively 36 patients who underwent IUS in the week prior to start anti-TNF treatment, at 12 weeks, and 1 year after starting treatment. The clinical response to treatment was assessed using the Crohn's disease activity index and C-reactive protein (CRP) values. TH was defined as the normalization of bowel wall thickness on IUS. Treated patients were considered to have a good outcome if none of the following situations presented: need to reintroduce corticosteroids or intensify maintenance therapy and/or need for surgery. Results After the induction regimen, 29 patients (80.6%) achieved clinical remission, and serum CRP values returned to normal in 20 patients (55.6%). In the IUS at 12 weeks, treatment induced a statistically significant reduction in the wall thickness (p < 0.001) and color Doppler grade (p < 0.001), as well as resolution of complications in 66.7% of patients (p < 0.03). IUS after 1 year of biological therapy showed TH in 14/33 patients (42.4%). During the follow-up (median 48.5 months), 23 of the 33 (69.7%) patients in remission or response after induction therapy presented a good outcome. Sonographic TH was significantly related with better outcomes, with only 1/14 patients having a poor outcome compared to 9/19 without TH (OR 11.7, 95% CI 1.2-108.2 p = 0.01, Chi-squared test). Conclusion Patients who achieve TH on IUS with biological treatment have better clinical outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink