John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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New therapeutic objectives in Inflammatory Bowel Disease – Histological remission in ulcerative colitis and Crohn's disease Volume 27, supplement 4, Novembre 2020

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Authors
CHRU – Université de Lille, Hôpital Claude-Huriez, Service des maladies de l’appareil digestif, Rue Michel Polonowski, 59037 Lille
* Correspondance

Therapeutic goals are constantly evolving in chronic Inflammatory Bowel Disease (IBD), with the ultimate goal of in-depth control of inflammation and prevention of disease-related complications. Thus, over the past 20 years, the objectives have evolved from obtaining simple clinical remission to “deep” remission (clinical remission associated with improvement, or even normalization of biological and endoscopic parameters).

In 2015, an international consensus defined the targets to be achieved in IBD. With regard to ulcerative colitis (UC), it is on the one hand the clinical remission evaluated at least 3 months after the outbreak of the disease and, on the other hand, endoscopic remission evaluated by rectosigmoidoscopy or colonoscopy 3 at 6 months after the outbreak of the disease. With regard to Crohn's disease (CD), this also involves the association of a clinical remission evaluated at least 3 months after the outbreak of the disease and, on the other hand, the absence of ulceration evaluated in 9 to 12 months after starting treatment with endoscopy, or sectional imaging techniques when the endoscopy cannot assess inflammation adequately. In this consensus, some parameters, such as histological remission, were considered as so-called adjuvant measures but not as real therapeutic objectives to be achieved, due to a lack of robust data.

The objective of this short review is to discuss the evolution of therapeutic objectives in IBD, in particular to assess the benefit of obtaining histological healing in UC and CD.