ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Histologic Healing Is More Strongly Associated with Clinical Outcomes in Ileal Crohn's Disease than Endoscopic Healing.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn's Disease.Gastroenterology · 2025Guideline
- Second United Arab Emirates consensus guidance on the diagnosis and management of inflammatory bowel disease.World journal of gastroenterology · 2025Pooled it
- Maximizing the diagnostic information from biopsies in chronic inflammatory bowel diseases: recommendations from the Erlangen International Consensus Conference on Inflammatory Bowel Diseases and presentation of the IBD-DCA score as a proposal for a new index for histologic activity assessment in ulcerative colitis and Crohn's disease.Virchows Archiv : an international journal of pathology · 2021Guideline
- Mucosal p-STAT1/3 correlates with histologic disease activity in Crohn's disease and is responsive to filgotinib.Tissue barriers · 2023Trial
- Preventive and therapeutic effects of co-administration of Bacteroides thetaiotaomicron and infliximab on dextran sodium sulfate-induced colitis in mice.Intestinal research · 2026Article
- Article
- New Technologies for IBD Endoscopy.Journal of clinical medicine · 2026Review
- Non-invasive determination of disease activity in Crohn's disease by serum luminex profiling.Scientific reports · 2026Article
- Artificial intelligence in the management of inflammatory bowel disease: What's next?World journal of gastrointestinal pharmacology and therapeutics · 2026Review
- Knowledge and perspectives towards the use of histology in inflammatory bowel disease by gastroenterologists across the Asia-Pacific region.Intestinal research · 2025Article
- Integrating Proteomics into Personalized Medicine for Inflammatory Bowel Disease-Reality or Challenge?International journal of molecular sciences · 2025Review
- The Role of Histology Alongside Clinical and Endoscopic Evaluation in the Management of IBD-A Narrative Review.Journal of clinical medicine · 2025Review
- Advancing Therapeutic Targets in IBD: Emerging Goals and Precision Medicine Approaches.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases.Therapeutic advances in gastroenterology · 2025Article
- Real-World Impact of Uncontrolled Symptoms and Suboptimal Treatment Response in Patients With Crohn's Disease in the United States and Europe.Crohn's & colitis 360 · 2025Article
- Gastroenterologists' attitudes and challenges toward treat-to-target strategies in inflammatory bowel disease: a multinational survey.Therapeutic advances in gastroenterology · 2025Article
- Diagnostic Procedures for Inflammatory Bowel Disease: Laboratory, Endoscopy, Pathology, Imaging, and Beyond.Diagnostics (Basel, Switzerland) · 2024Review
- Managing Ulcerative Colitis and Crohn's Disease: Should the Target Be Endoscopy, Histology, or Both?Journal of the Canadian Association of Gastroenterology · 2024Article
- Crohn's disease management: translating STRIDE-II for UK clinical practice.Therapeutic advances in gastroenterology · 2024Review
- Effectiveness of transabdominal ultrasonography in predicting clinical relapse of Crohn's disease.Intestinal research · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsDeep remission, based on clinical remission and evidence of healing during endoscopic evaluation, are goals of medical treatments for Crohn's disease (CD). We investigated whether histologic healing is associated with outcomes of patients with CD ileitis.
methodsWe performed a retrospective study of 101 patients with CD (52% male) isolated to the terminal ileum who had a colonoscopy between September 2005 and June 2015. Our analysis included patients in clinical remission at colonoscopy who had biopsies collected from colon and ileum. The ileum was evaluated for endoscopic healing (no ulceration) and histologic evidence of healing (no active inflammation, erosions, ulceration, or neutrophil infiltration). We compared times of clinical relapse-free survival, medication escalation, corticosteroid use, or hospitalization secondary to disease activity between patients with and without histological and endoscopic healing, followed for a median 21 months. We identified factors associated with survival using Kaplan Meier analysis and Cox proportional hazard model.
resultsAt ileo-colonoscopy, 63% of patients had endoscopic healing and 55% had histologic evidence of healing. The level of agreement between endoscopic and histologic activity was fair (62%, K = 0.2250, P = .0064). Forty-two patients had clinical relapse, 45 had medication escalation, 30 required corticosteroids, and 17 were hospitalized (3 required surgery). On multivariate analysis, only histologic healing was associated with decreased risk of clinical relapse (hazard ratio [HR], 2.05; 95% CI, 1.07-3.94; P = .031), medication escalation (HR, 2.17; 95% CI, 1.2-3.96; P = .011), and corticosteroid use (HR, 2.44; 95% CI, 1.17-5.09; P = .018). No factors were associated with hospitalization.
conclusionsIn patients with ileal CD in clinical remission, histologic healing but not endoscopic healing is associated with decreased risk of clinical relapse, medication escalation, or corticosteroid use.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.