Mucosal healing is not associated with better outcome during 7 years of follow-up in pediatric patients with Crohn's disease

Minerva Pediatr (Torino). 2024 Jun;76(3):381-387. doi: 10.23736/S2724-5276.21.06099-0. Epub 2021 Apr 12.

Abstract

Background: Mucosal healing (MH) has become a perspective treatment target in patients with Crohn's disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce.

Methods: Seventy-six pediatric patients with CD were evaluated retrospectively (2000-2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, N.=17; and No MH, N.=59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD.

Results: The number of hospitalized patients was 24% in the MH group and 42% in the No MH group (P=0.26). The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P=0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH (P>0.99). About 24% of the patients in the MH group and 39% patients in the No MH group underwent CD-related operation (P=0.39). Time to the first operation was 43 months for MH and 19 months for the No MH group (P=0.13). The follow-up period was 91 months in the MH group and 80 months in the No MH group (P=0.74). The use of infliximab was positively associated with MH (P=0.002).

Conclusions: MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.

MeSH terms

  • Adolescent
  • Child
  • Crohn Disease* / therapy
  • Female
  • Follow-Up Studies
  • Hospitalization* / statistics & numerical data
  • Humans
  • Infliximab / therapeutic use
  • Intestinal Mucosa* / pathology
  • Male
  • Retrospective Studies
  • Tertiary Care Centers
  • Time Factors
  • Treatment Outcome
  • Wound Healing

Substances

  • Infliximab

Supplementary concepts

  • Pediatric Crohn's disease