title: Current evidence supporting mucosal healing and deep remission as important treatment goals for inflammatory bowel disease.
abstract: 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.
authors.affiliation: a Department of Gastroenterology and Hepatology , Saint-Eloi Hospital, Montpellier University , Montpellier , France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pineton de Chambrun
authors.affiliation: a Department of Gastroenterology and Hepatology , Saint-Eloi Hospital, Montpellier University , Montpellier , France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Blanc
authors.affiliation: b Inserm U954 and Department of Gastroenterology , Université de Lorraine , Vandoeuvre-les-Nancy , France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D003106:Colon / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D003113:Colonoscopy; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents
keywords: Crohn’s disease; clinical remission; deep remission; endoscopic remission; inflammatory bowel disease; mucosal healing; treatment goals; ulcerative colitis