Clinical implications of mucosal healing for the management of IBD
- 1 December 2009
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Gastroenterology & Hepatology
- Vol. 7 (1), 15-29
- https://doi.org/10.1038/nrgastro.2009.203
Abstract
Mucosal healing (MH) has emerged as an important treatment goal for patients with IBD. Historically, the therapeutic goals of induction and maintenance of clinical remission seemed insufficient to change the natural history of IBD. Evidence has now accumulated to show that MH can alter the course of IBD, as it is associated with sustained clinical remission, and reduced rates of hospitalization and surgical resection. In patients with ulcerative colitis, MH may represent the ultimate therapeutic goal because inflammation is limited to the mucosa. In patients with Crohn's disease, which is a transmural disease, MH could be considered as a minimum therapeutic goal. This Review focuses on the definition of MH and discusses the ability of each available IBD medication to induce and maintain MH. The importance of achieving MH is also discussed and literature that demonstrates improvement of disease course with MH is reviewed. Finally, we discuss how best to integrate the treatment end point of MH into clinical practice for the management of patients with IBD.Keywords
This publication has 109 references indexed in Scilit:
- Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, non-inferiority trialGut, 2008
- Randomised trial of once- or twice-daily MMX mesalazine for maintenance of remission in ulcerative colitisGut, 2008
- Assessment and Validation of the New Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI)Digestive Diseases and Sciences, 2007
- Histologic Inflammation Is a Risk Factor for Progression to Colorectal Neoplasia in Ulcerative Colitis: A Cohort StudyGastroenterology, 2007
- Mucosal Healing in Inflammatory Bowel Disease: Results From a Norwegian Population-Based CohortGastroenterology, 2007
- Mucosal healing in inflammatory bowel disease: impossible ideal or therapeutic target?Gut, 2007
- Nuclear factor-κB in cancer development and progressionNature, 2006
- Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's diseaseGastrointestinal Endoscopy, 2006
- Infliximab for Induction and Maintenance Therapy for Ulcerative ColitisNew England Journal of Medicine, 2005
- Coated Oral 5-Aminosalicylic Acid Therapy for Mildly to Moderately Active Ulcerative ColitisNew England Journal of Medicine, 1987