title: Results of the 2nd scientific workshop of the ECCO (IV): therapeutic strategies to enhance intestinal healing in inflammatory bowel disease.
abstract: Evidence supporting the importance of assessment of mucosal healing in inflammatory bowel disease has increased in the last years. Mucosal healing has been integrated in the assessment of treatment efficacy in ulcerative colitis, but in Crohn's disease this thought has arised after biological agents have been evaluated in clinical trials. Although a validated definition of mucosal healing still does not exist, its use is also assuming an increasingly important role in the follow-up of individual patients in clinical practice. Corticosteroids induce mucosal healing in a small proportion of patients with Crohn's disease and are of no benefit to maintain it. By contrast, mucosal healing in Crohn's disease can be achieved and maintained, with varying degrees of evidence and success, with thiopurines and biological agents. In ulcerative colitis, the ability of corticosteroids to induce mucosal healing is well recognized. 5-aminosalicylates, thiopurines and biological agents are also able to induce mucosal healing and, additionally, to maintain it. Mucosal healing assessment should be considered in clinical practice when symptoms persist despite therapy or when treatment discontinuation is being considered. Conversely, in patients whose clinical remission is not associated with mucosal healing, intensification of treatment is not currently recommended because of lack of evidence.
authors.affiliation: Internal Medicine and Gastroenterology Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.forename: Walter
authors.initials: W
authors.lastname: Reinisch
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pineton de Chambrun
authors.forename: Anne
authors.initials: A
authors.lastname: Griffiths
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Sladek
authors.forename: Jan C
authors.initials: JC
authors.lastname: Preiss
authors.forename: Milan
authors.initials: M
authors.lastname: Lukas
authors.forename: Geert
authors.initials: G
authors.lastname: D'Haens
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000503:physiopathology; D000069285:Infliximab; D007413:Intestinal Mucosa / Q000187:drug effects; D015122:Mercaptopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019804:Mesalamine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; C488629:azathiopurine; D019804:Mesalamine; D000069285:Infliximab; D015122:Mercaptopurine; D008727:Methotrexate