Mucosal healing in inflammatory bowel disease (IBD) may be an important sign of efficacy of treatment and a prognostic marker of long-term disease.
Dr Kathrine Frey Frøslie and colleagues from Norway examined both the possible predictors of mucosal healing and the impact of healing on subsequent course of disease.
The team assessed 740 incident patients with ulcerative colitis or Crohn's disease diagnosed between 1990 and 1994, before biologic therapy was available.
Demographics and symptoms were recorded.
|Fever at diagnosis was a significant predictor for mucosal healing|
Clinical and endoscopic evaluations were done at baseline before treatment and repeated after 1 and 5 years in 495 patients.
The team found in ulcerative colitis patients, education longer than 12 years and extensive disease at diagnosis were significant predictors of mucosal healing after 1 year.
The team noted that mucosal healing was significantly associated with a low risk of future colectomy.
In patients with Crohn's disease, fever at diagnosis and medical treatment without steroids were significant predictors for mucosal healing.
The researchers observed that mucosal healing was significantly associated with less inflammation after 5 years, and decreased future steroid treatmen.
Dr Frøslie's team concluded, "Several factors predicted subsequent mucosal healing."
"Education as predictor may implicate the importance of coping, compliance, or lifestyle."
"Mucosal healing after 1 year of treatment is predictive of reduced subsequent disease activity and decreased need for active treatment."
"The present results give further strength to the use of mucosal healing as a clinical indicator and treatment goal in inflammatory bowel disease."