Couto Sousa Diogo, Fernandes Samuel Raimundo, Bernardo Sónia, Correia Luís, Cortez-Pinto Helena, Magro Fernando
Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.
Clínica Universitária de Gastrenterologia da Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
GE Port J Gastroenterol. 2024 Nov 5;32(4):273-280. doi: 10.1159/000541867. eCollection 2025 Jul.
In 2018, the authors surveyed the clinical practices among Portuguese gastroenterologists (PGEs) regarding treatment targets in Crohn's disease (CD) and ulcerative colitis (UC). Since then, new evidence has emerged supporting additional targets, such as transmural remission and histological remission. This study provides an updated assessment of treatment practices among PGE with special emphasis on these new targets.
Using the Portuguese Inflammatory bowel disease Study Group (GEDII) physician database, we invited PGE to participate in an anonymous online survey.
Fifty-six physicians agreed to participate in the study. Deep remission, steroid-free clinical remission, endoscopic remission, and biomarker remission were ranked among the most important treatment targets in CD (89%, 80%, 89%, and 84%, respectively) and UC (82%, 84%, 79%, and 84%, respectively). In CD, transmural remission was considered a target by 70% of participants, with 48% agreeing to intensify treatment to achieve it. In UC, histological remission was aimed by only 45% of PGE with most (88%) being unwilling to intensify treatment to achieve this goal. Physicians were more likely to seek endoscopic remission in CD and UC in younger and healthier patients, compared to older patients with comorbidities.
PGEs are increasingly pursuing tougher treatment targets such as transmural remission in CD and, to a lesser extent, histological remission in UC. Physicians are more willing to escalate treatment to achieve endoscopic remission in younger patients.
2018年，作者对葡萄牙胃肠病学家（PGEs）关于克罗恩病（CD）和溃疡性结肠炎（UC）治疗目标的临床实践进行了调查。自那时以来，出现了支持其他治疗目标的新证据，如透壁缓解和组织学缓解。本研究对PGEs的治疗实践进行了更新评估，特别强调了这些新目标。
利用葡萄牙炎症性肠病研究组（GEDII）医生数据库，我们邀请PGEs参与一项匿名在线调查。
56名医生同意参与该研究。深度缓解、无类固醇临床缓解、内镜缓解和生物标志物缓解在CD（分别为89%、80%、89%和84%）和UC（分别为82%、84%、79%和84%）中被列为最重要的治疗目标。在CD中，70%的参与者将透壁缓解视为一个目标，48%的人同意加强治疗以实现这一目标。在UC中，只有45%的PGEs将组织学缓解作为目标，大多数（88%）人不愿意加强治疗以实现这一目标。与患有合并症的老年患者相比，医生在年轻且健康的CD和UC患者中更倾向于寻求内镜缓解。
PGEs越来越追求更严格的治疗目标，如CD中的透壁缓解，以及在较小程度上UC中的组织学缓解。医生更愿意加强治疗以在年轻患者中实现内镜缓解。
