Steroid-free endoscopic remission does not link to less disease progression
Among patients with Crohn’s disease, achieving a sustained clinical remission off steroids with complete endoscopic remission did not correlate with less disease progression, according to study results.
“[We] observed that neither the association of clinical and endoscopic remission nor complete mucosal healing were associated with better disease outcomes,” David Laharie, MD, PhD, of Centre Hospitalier Universitaire de Bordeaux in France, and colleagues wrote. “Our data support the early use of powerful treatments to modify the history of CD and also suggest that a more flexible approach of the treat-to-target concept should be taken in daily practice.”
During the TAILORIX trial, Laharie and colleagues identified 95 patients with CD. Sustained corticosteroid-free clinical remission from weeks 22 through 54, with no ulcers on ileo-colonoscopy at week 54, served as the primary endpoint. Investigators compared patients who did or did not reach the endpoint. The progression-free survival of CD based on anal or major abdominal surgery, CD-related hospitalization or the need for a new systemic CD treatment served as the primary outcome.
Laharie and colleagues noted of the 95 patients, 45 patients achieved the primary endpoint. These patients were followed for a median duration of 64.2 months.
Results showed at 1, 3 and 5 years, no significant difference was observed in CD progression-free survival between patients who achieved the primary endpoint and those who did not. In addition, there was no difference noted between the two groups for each part of CD progression including: anal surgery, major abdominal surgery, CD-related hospitalization or the need for a new systemic CD treatment.