Cross-sectional evaluation of transmural healing in patients with Crohn's disease on maintenance treatment with anti-TNF alpha agents(25 visite) Castiglione F, Mainenti P, Testa A, Imperatore N, De Palma GD, Maurea S, Rea M, Nardone OM, Sanges M, Caporaso N, Rispo A
Tipo di articolo: Journal Article, Observational Study,
Impact factor: 3.287, Impact factor a 5 anni: 3.159
Url: Non disponibile.
Parole chiave: Adolescent, Adult, Crohn Disease, Diagnostic Imaging, Drug Therapy, Pathology, Cross-Sectional Studies, Female, Humans, Intestines, Italy, Longitudinal Studies, Magnetic Resonance Imaging, Middle Aged, Mucous Membrane, Drug Effects, Remission Induction, Severity Of Illness Index, Tumor Necrosis Factor-Alpha, Antagonists, Inhibitors, Ultrasonography, Wound Healing, Young Adult, S Disease, Transmural Healing,
Affiliazioni:
*** IBB - CNR *** Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine "Federico II" of Naples, Italy. Electronic address: fabcasti@unina.it., Radiology, IBB-CNR Naples, Italy., Surgical Endoscopy, Department of Clinical Medicine and Surgery, School of Medicine "Federico II" of Naples, Italy., Radiology, Department of Advanced Biomedical Sciences, University "Federico I", Napoli, Italy.,
Riferimenti:
Non disponibile.
BACKGROUND: Transmural healing (TH) of Crohn's disease (CD) is a still unexplored and interesting outcome correlated to concept of deep remission. AIM: To assess the rate of TH in CD patients treated with anti-TNF alpha agents using two cross-sectional procedures: bowel sonography (BS) and magnetic resonance enterography (MRE). METHODS: We performed a 2-year observational longitudinal study, evaluating steroid-free clinical remission (CR), mucosal healing (MH), and TH in CD patients who would complete a 2-year treatment period with anti-TNFs. All patients underwent endoscopy, BS, and MRE before and after 2 years of treatment. RESULTS: Forty out of 80 CD patients were treated with anti-TNFs for 2 years. CR was achieved in 24 patients (60%) while MH in 14 (35%). Using BS, TH was observed in 10 patients (25%), while using MRE, TH was observed in 9 patients (23%) (k=0.90; P<0.01). A good agreement was observed between MH and TH, both using BS (k=0.63; P<0.01) and MRE (k=0.64; P<0.01). A poor agreement was found between CR and TH, with both BS and MRE (k=0.27 and 0.29, respectively; P<0.01); even though all patients with TH had achieved CR. CONCLUSIONS: TH can be achieved in about 25% of CD patients treated with anti-TNFs, as shown by BS and MRE. BS could be used as the first cross-sectional procedure to detect TH.
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497 Records (458 escludendo Abstract e Conferenze). Impact factor totale: 1682.646 (1564.757 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 1826.079 (1687.226 escludendo Abstract e Conferenze).
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