Current evidence supporting mucosal healing and deep remission as important treatment goals for inflammatory bowel disease.
Fiche publication
Date publication
août 2016
Journal
Expert review of gastroenterology & hepatology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEYRIN-BIROULET Laurent
Tous les auteurs :
Pineton de Chambrun G, Blanc P, Peyrin-Biroulet L
Lien Pubmed
Résumé
Mucosal healing (MH) is now considered as a major treatment goal in clinical trials and clinical practice for patients with inflammatory bowel disease (IBD). MH is associated with sustained clinical remission, steroid-free remission, and reduced rates of hospitalization and surgery. There is a well-known disconnect between clinical symptoms and mucosal lesions that is more pronounced in CD. More stringent therapeutic goals have been discussed recently such as deep remission defined as clinical remission associated with MH. Recent international guidelines from the IOIBD recommended deep remission as a treatment goal in clinical practice. However there is no validated definition of deep remission in IBD. Also, the efficacy of available drugs to induce and maintain deep remission in IBD is poorly known. Finally, whether deep remission is the best way to modify the course of IBD and whether it should be achieved before considering drug de-escalation have to be formally evaluated in upcoming disease-modification trials.
Mots clés
Crohn’s disease, clinical remission, deep remission, endoscopic remission, inflammatory bowel disease, mucosal healing, treatment goals, ulcerative colitis
Référence
Expert Rev Gastroenterol Hepatol. 2016 Aug;10(8):915-27