Gastroenterology
Volume 138, Issue 2 , Pages 463-468 , February 2010

Mucosal Healing Predicts Sustained Clinical Remission in Patients With Early-Stage Crohn's Disease

  • Filip Baert

      Affiliations

    • H.–Hartziekenhuis Roeselare–Menen vzw, Roeselare, Belgium
    • Corresponding Author InformationReprint requests Address requests for reprints to: Filip Baert, MD, Department of Gastroenterology, H.-Hartziekenhuis Roeselare-Menen vzw, Wilgenstraat 2, B-8800 Roeselare, Belgium. fax: 00-32-51-23 72 96
    • ,
  • Liesbeth Moortgat

      Affiliations

    • H.–Hartziekenhuis Roeselare–Menen vzw, Roeselare, Belgium
    • ,
  • Gert Van Assche

      Affiliations

    • University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Philip Caenepeel

      Affiliations

    • Ziekenhuis Oost–Limburg, Genk, Belgium
    • ,
  • Philippe Vergauwe

      Affiliations

    • Groeninge Ziekenhuis, Kortrijk, Belgium
    • ,
  • Martine De Vos

      Affiliations

    • Ghent University, University Hospital, Belgium
    • ,
  • Pieter Stokkers

      Affiliations

    • Academic Medical Centre, Amsterdam, The Netherlands
    • ,
  • Daniel Hommes

      Affiliations

    • Leiden University Medical Centre, Leiden, The Netherlands
    • ,
  • Paul Rutgeerts

      Affiliations

    • University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Severine Vermeire

      Affiliations

    • University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Geert D'Haens

      Affiliations

    • Imelda GI Clinical Research Centre, Bonheiden, Belgium
    • ,
  • Belgian Inflammatory Bowel Disease Research Group
    • ,
  • North-Holland Gut Club

Received 16 January 2009 ,Accepted 30 September 2009.

References 

  1. D'Haens G, Baert F, Van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial. Lancet. 2008;371:660–667
  2. Frøslie KF, Jahnsen J, Moum BA, Vatn MH IBSEN Group. Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology. 2007;133:412–422
  3. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60:505–512
  4. Travis SP, Stange EF, Lémann M, et al. European evidence based consensus on the diagnosis and management of Crohn's disease: current management. Gut. 2006;55(suppl 1):i16–i35
  5. Rutgeerts P, Geboes K, Vantrappen G, et al. Natural history of recurrent Crohn's disease at the ileocolonic anastomosis after curative surgery. Gut. 1984;25:665–672
  6. Rutgeerts P, Geboes K, Vantrappen G, et al. Predictability of the postoperative course of Crohn's disease. Gastroenterology. 1990;99:956–963
  7. D'Haens G, Geboes K, Rutgeerts P. Endoscopic and histologic healing of Crohn's ileo colitis with azathioprine. Gastrointest Endosc. 1999;50:667–671
  8. Hanauer SB, Feagan BG, Lichtenstein GR, et al. Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet. 2002;359:1541–1549
  9. D'Haens GR, Noman M, Baert F, et al. Endoscopic healing after infliximab treatment for Crohn's disease provides a longer time to relapse. Gastroenterology. 2002;122:776;(A)
  10. Rutgeerts P, Diamond RH, Bala M, et al. Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's disease. Gastrointest Endosc. 2006;63:433–442
  11. Goekoop–Ruiterman YP, De Vries-Bouwstra JK, Allaart CF, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt Study): a randomized, controlled trial. Arthritis Rheum. 2005;52:3381–3390
  12. Desilva S, Kaplan G, Panaccione R. Sequential therapies for Crohn's disease: optimizing conventional and biologic strategies. Rev Gastroenterol Disord. 2008;8:109–116
  13. Colombel JF, Rutgeerts P, Reinisch W, et al. Sonic: a randomized, double-blind, controlled trial (Comparing infliximab and infliximab plus azathioprine to azathioprine in patients with Crohn's disease naive to immunomodulators and biologic therapy). Gut. 2008;57(suppl II):A1
  14. Sipponen T, Savilahti E, Kärkkäinen P, et al. Fecal calprotectin, lactoferrin, and endoscopic disease activity in monitoring anti-TNF-alpha therapy for Crohn's disease. Inflamm Bowel Dis. 2008;14:1392–1398

 View this article's video abstract at www.gastrojournal.org

 This article has an accompanying continuing medical education activity on page e10. Learning Objective: Upon completion of reading this article, successful learners will be able to interpret the concept of mucosal healing in Crohn's disease, as well as identify patients that would benefit from an endoscopic evaluation and integrate the endoscopic findings as a prognostic marker in the management of Crohn's disease patients.

 Conflicts of interest This study was sponsored by Centocor B.V. This study is a follow-up of an earlier published investigator initiated trial. Although this study was sponsored by an unrestricted grant from Centocor B.V., the authors are fully responsible for its content and the sponsor did not participate in the design or the analysis of the data.

 These authors disclose the following:

 Dr Baert received a research grant to conduct this trial from Centocor.

 Prof De Vos received research support from Schering Plough and UCB.

 The remaining authors disclose no conflicts.

PII: S0016-5085(09)01751-X

doi: 10.1053/j.gastro.2009.09.056

Gastroenterology
Volume 138, Issue 2 , Pages 463-468 , February 2010

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