TOPLINE:

In patients with Crohn’s disease (CD) who were in endoscopic remission, achieving intestinal ultrasound (IUS) transmural healing was associated with decreased risks for CD relapse, hospitalization, and perianal complications. Absence of transmural healing was associated with relapse.

METHODOLOGY:

• Unlike studies demonstrating the benefits of endoscopic healing, prospective studies are lacking on whether transmural healing — measurable by MRI and increasingly by IUS — reduces CD-related disability.
• Researchers conducted a prospective observational study in France between September 2019 and January 2022, and enrolled 93 patients with CD (53% women) to determine whether the degree of healing predicted long‑term outcomes and if IUS transmural healing reduces short‑term disease-related disability.
• They analyzed data of patients who underwent colonoscopy for assessment of endoscopic healing and who were in endoscopic remission (CD Endoscopic Index of Severity score [CDEIS] < 4) and underwent an IUS within 4 weeks of colonoscopy.
• IUS transmural healing was defined as a bowel wall thickness of < 3 mm on all intestinal segments, and endoscopic healing was categorized as either complete (CDEIS = 0) or partial (CDEIS > 0 and < 4).
• The endpoint was relapse of CD, defined as a composite of intensification of current therapy (higher dose or shorter interval); initiation of corticosteroids, immunosuppressants, or advanced therapy; development of an intestinal stricture, fistula, or perianal disease; hospitalization for CD; or intestinal resection. The outcome was assessed over a median follow-up period of 22.5 months.

TAKEAWAY:

• Overall, 73% of patients had IUS transmural healing and 26% had disease relapse. Those with IUS transmural healing had a significantly lower cumulative risk for relapse than those without transmural healing (17% vs 48%; P = .007).
• Among patients with complete endoscopic healing, those achieving IUS transmural healing had a lower 12-month relapse rate than those without transmural healing (2% vs 33%; P = .030).
• Patients with IUS transmural healing had significantly lower risks for CD-related hospitalization and perianal CD than those without transmural healing (P = .040 for both).
• Absence of IUS transmural healing was independently associated with an increased risk for disease relapse in multivariate analysis (hazard ratio, 2.6; P = .031).

IN PRACTICE:

Intestinal ultrasound transmural healing “could become a new target in CD patients, reflecting a broader shift from endoscopic remission toward objective measures of deeper remission,” the authors wrote.

SOURCE:

This study was led by Clara Yzet, PhD, Amiens University Hospital, Amiens, France. It was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS:

The study was limited by the lack of centralized reading for endoscopies and IUS. Only patients with mucosal healing were included.

DISCLOSURES:

The study did not report any specific funding. Two authors reported receiving consultant and lecture fees from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.