Article (Scientific journals)
Defining biological remission in Crohn's disease: interest, challenges and future directions.
Pierre, Nicolas; Vieujean, Sophie; Peyrin-Biroulet, Laurent et al.
2023In Journal of Crohn's and Colitis
Peer Reviewed verified by ORBi
 

Files


Full Text
jjad086.docx
Author preprint (565.8 kB)
Download

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Crohn’s disease; biological remission; Gastroenterology; General Medicine
Abstract :
[en] In Crohn's disease, the treat-to-target strategy has been highly encouraged and became a standard of care. In this context, defining the target (remission) constitutes a major stake which fuels the literature. Currently, clinical remission (symptoms control) is no longer the only objective of treatments since it does not allow to well control inflammation-induced tissue damage. The introduction of endoscopic remission as a therapeutic target was clearly a progress but this examination remains invasive, costly, not well accepted by patients and does not allow a tight control of disease activity. More fundamentally, morphological techniques (eg, endoscopy, histology, ultrasonography) are limited since they do not evaluate the biological activity of the disease but only its consequences. Besides, emerging evidence suggest that biological signs of disease activity could better guide treatment decisions than clinical parameters. In this context, we stress the necessity to define a novel treatment target: biological remission. Based on our previous work, we propose a conceptual definition of biological remission which goes beyond the classical normalisation of inflammatory markers (C-reactive protein and faecal calprotectin): absence of biological signs associated with the risk of short-term relapse and mid/long-term relapse. The risk of short-term relapse seems essentially characterised by a persistent inflammatory state while the risk of mid/long-term relapse implicates a more heterogeneous biology. We discuss the interest of our proposal (guiding treatment maintenance, escalation or de-escalation) but also the fact that its clinical implementation would require overcoming major challenges. Finally, future directions are proposed to better define biological remission.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Pierre, Nicolas  ;  Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Vieujean, Sophie  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Peyrin-Biroulet, Laurent;  Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
Meuwis, Marie-Alice  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Louis, Edouard  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Language :
English
Title :
Defining biological remission in Crohn's disease: interest, challenges and future directions.
Publication date :
19 May 2023
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Oxford University Press (OUP), England
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 22 May 2023

Statistics


Number of views
128 (38 by ULiège)
Number of downloads
56 (2 by ULiège)

Scopus citations®
 
0
Scopus citations®
without self-citations
0
OpenCitations
 
0

Bibliography


Similar publications



Contact ORBi