title: Mucosal healing in inflammatory bowel disease: treatment efficacy and predictive factors.
abstract: In recent years mucosal healing has emerged as an important therapeutic goal for patients with inflammatory bowel disease. Growing evidence suggests that achieving mucosal healing can improve patient outcomes and, potentially, alter the course of the disease. Drugs currently used in the management of inflammatory bowel disease are potentially able of inducing and maintaining mucosal healing, but the effect size is difficult to assess because of different definitions of mucosal healing, differences in study designs, and timing of endoscopic evaluation. Mucosal healing has been studied extensively in the biologic era. Data available from different sources, such as controlled trials and observational studies, show that anti-TNFα therapies can induce rapid and sustained mucosal healing in a variable percentage of patients with Crohn's disease and ulcerative colits. No controlled study has been designed to identify possible predictors of mucosal healing. Some clinical characteristics such as extensive disease, young age at diagnosis, and smoking status may be predictive of a more aggressive clinical course and, presumably, of a reduced clinical and endoscopic response to therapy. Changes and normalization of C-reactive protein and faecal calprotectin may be useful tools to predict outcomes, guide the timing for endoscopic evaluation and, possibly, reduce the need of endoscopic evaluation in assessing mucosal healing.
authors.affiliation: Gastroenterology & Hepatology Unit, San Filippo Neri Hospital, Rome, Italy. Electronic address: c.papi@sanfilipponeri.roma.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Papi
authors.forename: Federica
authors.initials: F
authors.lastname: Fascì-Spurio
authors.forename: Francesca
authors.initials: F
authors.lastname: Rogai
authors.forename: Alessia
authors.initials: A
authors.lastname: Settesoldi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Margagnoni
authors.forename: Vito
authors.initials: V
authors.lastname: Annese
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001781:Blood Component Removal; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D005243:Feces / Q000737:chemistry; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007413:Intestinal Mucosa / Q000473:pathology*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D019804:Mesalamine / Q000627:therapeutic use; D012074:Remission Induction; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014945:Wound Healing
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D007155:Immunologic Factors; D039841:Leukocyte L1 Antigen Complex; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine; D002097:C-Reactive Protein
keywords: Crohn's disease; Mucosal healing; Predictive factors; Ulcerative colitis