Sands Bruce E, Danese Silvio, Chapman J Casey, Gurjar Khushboo, Grieve Stacy, Thakur Deepika, Griffith Jenny, Joshi Namita, Kligys Kristina, Dignass Axel
The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Athos Therapeutics, Milan, Italy.
Inflamm Bowel Dis. 2025 Mar 3;31(3):857-877. doi: 10.1093/ibd/izae159.
Healing in Crohn's disease is complex and difficult to measure due to incongruencies between clinical symptoms and disease states. Mucosal healing (MH) and transmural healing (TH) are increasingly used to measure clinical improvement in Crohn's disease, but definitions of MH and TH can vary across studies, and their relationship to long-term outcomes is not clear. To address this knowledge gap, we performed a systematic literature review (SLR) to examine studies measuring MH and TH in Crohn's disease.
Database records from 2012 to 2022 were searched for real-world evidence and interventional studies that reported the association of MH or TH with clinical, economic, or quality of life outcomes of adult patients with Crohn's disease.
A total of 46 studies were identified in the systematic literature review, representing a combined patient population of 5530. Outcomes of patients with MH were reported by 39 studies; of these, 14 used validated scales for endoscopic assessment. Thirteen studies reported outcomes of patients with TH. Among studies that examined the outcomes of patients with and without MH or TH, patients with healing generally experienced improved clinical outcomes and reduced healthcare resource utilization, including fewer hospitalizations and surgeries and improved rates of clinical remission. This was especially true for patients with TH.
Mucosal and transmural healing are associated with positive long-term outcomes for adult patients with Crohn's disease. The adoption of standardized measures and less invasive assessment tools will maximize the benefits of patient monitoring.
由于临床症状与疾病状态之间存在不一致性，克罗恩病的愈合过程复杂且难以衡量。黏膜愈合（MH）和透壁愈合（TH）越来越多地用于衡量克罗恩病的临床改善情况，但MH和TH的定义在不同研究中可能有所不同，并且它们与长期结局的关系尚不清楚。为了填补这一知识空白，我们进行了一项系统文献综述（SLR），以审查测量克罗恩病中MH和TH的研究。
检索2012年至2022年的数据库记录，以获取关于成年克罗恩病患者中报告MH或TH与临床、经济或生活质量结局之间关联的真实世界证据和干预性研究。
在系统文献综述中总共鉴定出46项研究，代表了总计5530名患者。39项研究报告了MH患者的结局；其中，14项使用了经过验证的内镜评估量表。13项研究报告了TH患者的结局。在检查有或没有MH或TH的患者结局的研究中，愈合的患者通常经历了更好的临床结局和更低的医疗资源利用，包括更少的住院和手术以及更高的临床缓解率。对于TH患者尤其如此。
黏膜愈合和透壁愈合与成年克罗恩病患者的积极长期结局相关。采用标准化测量方法和侵入性较小的评估工具将使患者监测的益处最大化。
