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Crohn's disease (CD) is a chronic autoimmune disease in the gastrointestinal tract that, over time, can lead to the accumulation of intestinal damage and the occurrence of intestinal cramps, as well as complications such as abscesses and fistula.
despite advances in the treatment of CD, such as the introduction of biologics, many patients are still in progress and require surgery and hospitalization.
in other immunocompromised diseases, such as rheumatoid arthritis, that studies have shown that early and effective treatment can improve long-term outcomes in patients, in post-mortem analysis of CD clinical trials, researchers found that early intervention with anti-tumor necrosis factor biologics (anti-TNF) was associated with higher clinical response and remission rates in patients with moderate to severe CDs and shorter duration of the disease.
addition, a well-known STRIDE ("Choice of Treatment Targets for Inflammatory Bowel Disease") program has reached expert consensus on CD treatment strategies and highlighted the treatment of deep intestinal remission as the treatment goal.
this study is designed to explore the effects of prolonged intestinal deep remission on disease development.
researchers tested 122 CD patients who were under strictly controlled management, all of whom were moderate to severe CD patients.
50% of patients (n s 61) were randomly assigned to a strict control strategy (increased treatment based on the level of calcin in the feces, serum levels and symptoms of C-reactive protein) and 50% of the patients were assigned to routine treatment.
patients who did not achieve deep remission at the end of the follow-up period were defined as cd endoscopy severity score of less than 4, without deep ulceroration or steroid therapy, lasting 8 weeks or more.
the main outcome is a combination of major adverse outcomes: new internal fistula or abscesses, stenosis, fistula or abscess or CD hospitalization or surgery.
results showed that a total of 34 serious adverse consequences (27.9 per cent) occurred during follow-up.
end of the study, patients with deep remission experienced a significant reduction in severe adverse prognosis during follow-up (P .01).
When we adjust for potential mixing factors, deep mitigation (adjusted risk ratio of 0.19; 95% confidence interval of 0.07-0.31) is significantly associated with a lower risk of significant adverse consequences."
study confirmed that induced deep mitigation of moderate to severe CD was associated with a reduction in the risk of disease progression within three years.
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