In the era of biological drugs, healing of severe endoscopic lesions has become a key therapeutic objective in Crohn’s disease (CD) as achieving this goal is associated with improved long-term clinical outcomes, including higher rates of sustained clinical remission, decreased hospitalization requirements, and reduced need for surgery .
Recent studies exploring the role of MRE as a tool for detecting the response to medical treatment [2–6] found good agreement between ileocolonoscopy and MRE for assessing response after induction treatment. Moreover, recent evidence suggests that patients...
Methods and materials
Study design and patients:
Patients were recruited for this prospective observational study from January 2013 to January 2018.
The study was approved by the local ethics committee. All patients provided written informed consent before inclusion.
Inclusion and exclusion criteria:
We included patients with 1) confirmed diagnosis of CD, 2) clinically active luminal CD with severe inflammation in at least one segment of the colon and/or terminal ileum on MRE (segmental MaRIA≥11), 3) clinical indications for TNF-α inhibitors for induction of remission, and 4) MRE before...
58 patients with a total of 86 intestinal segments with segmental MaRIA≥11 were included in the analyses. Figure 3 shows the flow chart of patients included in the analysis.
Figure 4 summarizes patients’ demographic and baseline clinical data and their associations with outcomes.
Figure 5 provides detailed information about the MRE characteristics of the 86 intestinal segments included in the study and their associations with outcomes.
At week-46 after TNF-α inhibitor treatment initiation, 51/86 (59.3%) segments with severe inflammatory lesions detected at baseline...
MRE is a reliable tool for monitoring the response to TNF-α inhibitors in patients with CD, and baseline MRE findings are independent predictors of remission after 46 weeks of treatment. Early healing of severe inflammatory lesions (MaRIA
Personal information and conflict of interest
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Conflict of interest:
J. Rimola; Barcelona/ES - Consultant at Robarts clinical Research - Grant Recipient at Abbvie - Advisory Board at Takeda, Gilead N. Capozzi; Bologna/IT - nothing to disclose A. Fernandez-Clotet; Barcelona/ES - nothing to disclose C. Pérez Serrano; Barcelona/ES - nothing to disclose I. Ordás; Barcelona/ES - nothing to disclose J. Panes; Barcelona/ES - nothing to disclose
1 Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting Therapeutic Targets in Infl ammatory Bowel Disease ( STRIDE ): Determining Therapeutic Goals for. Am J Gastroenterol 2015;110:1324–38. doi:10.1038/ajg.2015.233
2 Ordás I, Rimola J, Rodríguez S, et al. Accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn’s disease. Gastroenterology 2014;146. doi:10.1053/j.gastro.2013.10.055
3 Ordás I, Rimola J, Alfaro I, et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn’s Disease. Gastroenterology 2019;157:432–439.e1. doi:10.1053/j.gastro.2019.03.051...