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Journal of Crohn's and Colitis: 9 (5)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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Published on behalf of

Results from the 2nd Scientific Workshop of the ECCO (I): Impact of mucosal healing on the course of inflammatory bowel disease

Laurent Peyrin-Biroulet , Marc Ferrante , Fernando Magro , Simon Campbell , Denis Franchimont , Herma Fidder , Hans Strid , Sandro Ardizzone , Gigi Veereman-Wauters , Jean-Baptiste Chevaux , Mathieu Allez , Silvio Danese , Andreas Sturm
DOI: http://dx.doi.org/10.1016/j.crohns.2011.06.009 477-483 First published online: 1 October 2011

Abstract

Over the past years, mucosal healing has emerged as a major therapeutic goal in clinical trials in inflammatory bowel diseases. Accumulating evidence indicates that mucosal healing may change the natural course of the disease by decreasing the need for surgery and reducing hospitalization rates in both ulcerative colitis and Crohn's disease. Mucosal healing may also prevent the development of long-term disease complications, such as bowel damage in Crohn's disease and colorectal cancer in ulcerative colitis. Histologic healing may be the ultimate therapeutic goal in ulcerative colitis, whereas its impact on the course of Crohn's disease is unknown. Complete mucosal healing may be required before considering drug withdrawal. Targeting early Crohn's disease is more effective than approaches aimed at healing mucosa in longstanding disease. Several questions remain to be answered: should mucosal healing be systematically used in clinical practice? Should we optimize therapies to achieve mucosal healing? What is the degree of intestinal healing that is required to change the disease course? Large prospective studies addressing these issues are needed.

Highlights: ► Mucosal healing is associated with greater response and remission rates in CD. ► Mucosal healing is associated with a better long-term outcome in CD. ► Mucosal lesions predict postoperative clinical recurrence in CD. ► Mucosal healing is associated with lower risk of colorectal cancer in UC. ► Mucosal healing is associated with lower relapse rates following anti-TNF-a withdrawal.

Keywords
  • Inflammatory Bowel Disease
  • Ulcerative colitis
  • Crohn's disease
  • Mucosal healing
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