Römkens Tessa E H, Gijsbers Kim, Kievit Wietske, Hoentjen Frank, Drenth Joost P H
Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen; Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Gastrointestin Liver Dis. 2016 Dec;25(4):465-471. doi: 10.15403/jgld.2014.1121.254.ken.
Recently, treatment goals in inflammatory bowel disease (IBD) in clinical trials have shifted from mainly symptom-based to more mucosa-driven. Real world data on treatment priorities are lacking. We aimed to investigate the current practice and most commonly used definitions of IBD treatment targets among Dutch gastroenterologists.
Dutch gastroenterologists were asked to participate in a computer-based nation-wide survey. We asked questions on demographics, opinion and current practice regarding IBD treatment targets.
Twenty-four percent (134/556) of the respondents completed the survey. For both Crohn's disease (CD) (47.3%, 61/129) and ulcerative colitis (UC)(45%, 58/129) the main treatment goal was to achieve and maintain deep remission, defined as clinical, biochemical and endoscopic remission. Seventy-six percent of the participants use mucosal healing (MH) as a potential treatment target for IBD, whereas 22.6% use histological remission. There is no single definition for MH in IBD. The majority use Mayo score ≤ 1 in UC (52%) and 'macroscopic normal mucosa' in CD (66%).
More stringent and mucosa-driven treatment targets as 'deep remission' and 'mucosal healing' have found traction in clinical practice. The most commonly used definition for MH in routine practice is endoscopic MAYO score </= 1 in UC and 'macroscopic normal mucosa' in CD.
最近，临床试验中炎症性肠病（IBD）的治疗目标已从主要基于症状转向更多地由黏膜驱动。目前缺乏关于治疗优先级的真实世界数据。我们旨在调查荷兰胃肠病学家目前对IBD治疗目标的实践情况和最常用的定义。
邀请荷兰胃肠病学家参与一项基于计算机的全国性调查。我们询问了有关人口统计学、对IBD治疗目标的看法和当前实践的问题。
24%（134/556）的受访者完成了调查。对于克罗恩病（CD）（47.3%，61/129）和溃疡性结肠炎（UC）（45%，58/129），主要治疗目标都是实现并维持深度缓解，深度缓解定义为临床、生化和内镜缓解。76%的参与者将黏膜愈合（MH）作为IBD的潜在治疗目标，而22.6%的参与者使用组织学缓解。IBD中对于MH没有单一的定义。大多数人在UC中使用梅奥评分≤1（52%），在CD中使用“宏观正常黏膜”（66%）。
“深度缓解”和“黏膜愈合”等更严格且由黏膜驱动的治疗目标在临床实践中受到了关注。在常规实践中，对于MH最常用的定义是UC中内镜梅奥评分≤1，CD中是“宏观正常黏膜”。
