P0522 Transmural healing rate does not differ between Crohn’s disease patients with structural damage versus inflammatory behavior
Authors: Marques Garcia P , Albert Palomares S , Fquihi Chetouani M , Torrente Sánchez J , Pérez Ibáñez A A , Rabadán Mata A , Peiró García E , Blanc Garcia E , Martinez Perez M J , Paredes Arquiola J M ,   Transmural healing rate does not differ between crohn’s disease patients with structural damage versus inflammatory behavior
Published: January 2025

Abstract

Background
Crohn’s disease(CD) is a chronic inflammatory bowel disease, characterized by a progressive course that leads to structural bowel damage(SBD).There is no clear definition of SBD.However, the presence of detectable complications through imaging techniques, such as strictures, fistulas or abscesses is widely accepted to describe SBD.Therefore, reversing structural bowel damage is an emerging medical goal in the time of biological treatments

Methods
The main objective of this study was to assess the ability of biological treatments to reverse structural bowel damage monitored by intestinal ultrasound(IUS)and compare the disease course of patients with CD with inflammatory behavior vs complicated behavior. To achieve this objective, we compared the transmural healing(TH)at 12 weeks and one year after starting biological treatment.TH is defined as intestinal parietal thickness ≤3 mm, with no detectable Doppler signals and absence of complications Also we compared the need for medical treatment, hospital admission and surgery during the first year of biological treatment(Pearson’s Chi-squared test and Fisher’s exact test).IBM SPSS Statistics software was used for variable treatment and statistical calculations, with a statistical confidence level of 95% and a type I error rate of&lt;0.05
This was a longitudinal observational study, which included patients with CD who started a biological treatment in our center and that were monitored with IUS.Clinical, laboratory and ultrasound variables were collected at the beginning of biological treatment, after 12 weeks and after one year of treatment

Results
A total of 137 patients were included.At the beginning of biological treatment, 50 patients(36.5%) exhibited complicated behavior.After 12 weeks, TH was achieved in 22.9% of all evaluated patients,8.2% with complicated CD and 31.3% with inflammatory behavior achieved TH,being the last difference statistically significant (p 0.02)
After one year of treatment,TH on IUS was achieved in 46% patients. 31.8% had a complicated EC and 45.1% presented an inflammatory behavior, without reaching statistical significance (p 0.159). The group with complicated behavior exhibited a significantly higher need for corticosteroid therapy, hospital admission, and surgery

Conclusion
Patients with SBD showed a significantly lower rate of TH compared to patients with inflammatory behavior after 12 weeks of biological treatment. Additionally, the need for corticosteroid therapy, hospital admission, and surgery was significantly higher in patients with a complicated CD. However, after one year, the TH rate showed no differences between groups. This suggests that reversing structural bowel damage is possible but that the treatment of these patients is more complex

References
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