Clin Gastroenterology H: Histological healing is more closely related to the clinical outcomes of intestinal Crohn's disease.

In patients with Crohn's disease (CD), persistent inflammation can lead to intestinal damage, and the conventional view is that CD treatment is designed to control clinical symptoms.
, however, the correlation between clinical symptoms and endoscopic mucosa disease activity is poor, and the natural process and cumulative intestinal damage of CD cannot be altered by the relief of symptoms alone.
, mucous membrane healing is associated with better long-term prognosis.
patients who had reached mucous membrane healing had lower rates of hospitalization and surgery, and were less likely to have a clinical onset of the disease.
, however, histological inflammation may also persist in mucous membrane healing environments, so in this study we investigated whether histological healing was associated with prognosis in patients with CD enteritis.
researchers conducted a retrospective study of 101 CD patients (52 per cent male) who underscopyed between September 2005 and June 2015.
researchers assessed endoscopic healing (no ulcers) and histological changes (with or without active inflammation, erosion, ulcers, or neural granulocytosic immersion) in CD patients.
Finally, the researchers compared the non-recurring period between patients with or without histology and endoscopic cures, drug escalation, the use of corticosteroid hormones or the duration of hospitalization due to disease activity, and used Kaplan Meier analysis and Cox proportional risk models to identify survival-related factors.
endoscopy, 63% of patients had endoscopic healing and 55% had histological healing.
level of consistency between endoscopic and histological activities is verified (K s 0.2250, P s .0064).
42 patients had clinical relapses, 45 patients had progressive drug treatment, 30 needed corticosteroid hormone therapy, and 17 were hospitalized (3 patients required surgery).
in the multivarivariable analysis, only histological cures were associated with reduced risk of clinical recurrence (risk ratio, HR, 2.05; 95% CI, 1.07-3.94; P s.031), but also with drug escalation (HR, 2.17; 95% CI, 1.2-3.96; P - .011) and the use of corticosteroids (HR, 2.44; 95% CI, 1.17 - 5.09; P - .018) decreased.
, the researchers said that in patients with echo hdicose CD during clinical remission, histological cures rather than endoscopic cures were associated with a reduced risk of clinical recurrence, drug escalation or corticosteroid use.
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