Evolution of Treatment Targets in Inflammatory Bowel Disease
Main Article Content
Abstract
Inflammatory Bowel Disease (IBD), which encompasses Crohn's disease and ulcerative colitis, represents a chronic and progressive condition characterised by periods of active inflammation interspersed with periods of remission. The resulting disease burden, arising from patient symptoms and complications, leads to a diminished quality of life for individuals with IBD. Despite significant advancements in the management of IBD, the ideal treatment targets are uncertain. The evolution of treatment targets in IBD signifies a paradigm shift from mere symptom control to a more holistic approach that aims at achieving deeper remission and improving patients' quality of life. The “treat-to-target” paradigm, guided by international consensus and expert insights, emphasises the importance of tailoring therapeutic goals to individual patient needs and disease severity. As our understanding of IBD's underlying mechanisms deepens and therapeutic options expand, treatment goals have evolved to include not only clinical response but also the pursuit of more objective endpoints such as endoscopic healing. Emerging targets, such as the assessment of transmural healing through cross-sectional imaging and the focus on histologic remission as a predictor of long-term outcomes, hold great promise in further refining IBD management strategies. However, further research is needed to recommend these treatment targets in clinical practice. In the review we explore the ongoing evolution of treatment targets in IBD aimed at optimising patient outcomes and ultimately improving quality of life (QoL).
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How to Cite
KYRIACOU, Maro; VUYYURU, Sudheer Kumar; MORAN, Gordon William.
Evolution of Treatment Targets in Inflammatory Bowel Disease.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4662>. Date accessed: 03 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i11.4662.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Zhang YZ, Li YY. Inflammatory bowel disease: pathogenesis. World J Gastroenterol. 2014;20(1):91-99.
2. Collaborators GBDIBD. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(1):17-30.
3. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769-2778.
4. Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ Open. 2023;13(3):e065186.
5. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial. Br Med J. 1954;2(4884):375-378.
6. Vermeire S, van Assche G, Rutgeerts P. Review article: Altering the natural history of Crohn's disease--evidence for and against current therapies. Aliment Pharmacol Ther. 2007;25(1):3-12.
7. Wilson A, Choi B, Sey M, Ponich T, Beaton M, Kim RB. High infliximab trough concentrations are associated with sustained histologic remission in inflammatory bowel disease: a prospective cohort study. BMC Gastroenterol. 2021;21(1):77.
8. Gracie DJ, Williams CJ, Sood R, et al. Poor Correlation Between Clinical Disease Activity and Mucosal Inflammation, and the Role of Psychological Comorbidity, in Inflammatory Bowel Disease. Am J Gastroenterol. 2016;111(4):541-551.
9. Cellier C, Sahmoud T, Froguel E, et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn's disease. A prospective multicentre study of 121 cases. The Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives. Gut. 1994;35(2):231-235.
10. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021;160(5):1570-1583.
11. Cohen ER, Melmed GY. Making a Case for Patient-Reported Outcomes in Clinical Inflammatory Bowel Disease Practice. Clin Gastroenterol Hepatol. 2018;16(5):603-607.
12. Irvine EJ, Zhou Q, Thompson AK. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. Am J Gastroenterol. 1996;91(8):1571-1578.
13. Best WR, Becktel JM, Singleton JW, Kern F, Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976;70(3):439-444.
14. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955;2(4947):1041-1048.
15. Baars JE, Nuij VJ, Oldenburg B, Kuipers EJ, van der Woude CJ. Majority of patients with inflammatory bowel disease in clinical remission have mucosal inflammation. Inflamm Bowel Dis. 2012;18(9):1634-1640.
16. Laterza L, Piscaglia AC, Minordi LM, et al. Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn's Disease. Dig Dis. 2018;36(3):184-193.
17. Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet. 2017;390(10114):2779-2789.
18. White JR, Jairath V, Moran GW. Evolution of treatment targets in Crohn's disease. Best Pract Res Clin Gastroenterol. 2019;38-39:101599.
19. Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn's disease (SES-CD) than CRP, blood leukocytes, and the CDAI. Am J Gastroenterol. 2010;105(1):162-169.
20. Stjernman H, Tysk C, Almer S, Strom M, Hjortswang H. Factors predicting the outcome of disease activity assessment in Crohn's disease. Inflamm Bowel Dis. 2009;15(12):1859-1866.
21. Arias MT, Vande Casteele N, Vermeire S, et al. A panel to predict long-term outcome of infliximab therapy for patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2015;13(3):531-538.
22. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625-1629.
23. Restellini S, Chao CY, Martel M, et al. Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review. Clin Gastroenterol Hepatol. 2019;17(7):1265-1275 e1268.
24. Rochelle TL, Fidler H. The importance of illness perceptions, quality of life and psychological status in patients with ulcerative colitis and Crohn's disease. J Health Psychol. 2013;18(7):972-983.
25. Khanna R, Wilson AS, Gregor JC, Prowse KL, Afif W. Clinical Guidelines for the Management of IBD. Gastroenterology. 2021;161(6):2059-2062.
26. Le Berre C, Ricciuto A, Peyrin-Biroulet L, Turner D. Evolving Short- and Long-Term Goals of Management of Inflammatory Bowel Diseases: Getting It Right, Making It Last. Gastroenterology. 2022;162(5):1424-1438.
27. Colombel JF, Rutgeerts PJ, Sandborn WJ, et al. Adalimumab induces deep remission in patients with Crohn's disease. Clin Gastroenterol Hepatol. 2014;12(3):414-422 e415.
28. Colombel JF, Rutgeerts P, Reinisch W, et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141(4):1194-1201.
29. Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Groupe d'Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Gut. 1989;30(7):983-989.
30. Koutroumpakis E, Katsanos KH. Implementation of the simple endoscopic activity score in crohn's disease. Saudi J Gastroenterol. 2016;22(3):183-191.
31. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-512.
32. Spiceland CM, Lodhia N. Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment. World J Gastroenterol. 2018;24(35):4014-4020.
33. Annese V, Daperno M, Rutter MD, et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis. 2013;7(12):982-1018.
34. Yamamoto H, Kita H, Sunada K, et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol. 2004;2(11):1010-1016.
35. Melmed GY, Dubinsky MC, Rubin DT, et al. Utility of video capsule endoscopy for longitudinal monitoring of Crohn's disease activity in the small bowel: a prospective study. Gastrointest Endosc. 2018;88(6):947-955 e942.
36. Travis SP, Schnell D, Krzeski P, et al. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut. 2012;61(4):535-542.
37. Travis SP, Schnell D, Krzeski P, et al. Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology. 2013;145(5):987-995.
38. Xie T, Zhang T, Ding C, et al. Ulcerative Colitis Endoscopic Index of Severity (UCEIS) versus Mayo Endoscopic Score (MES) in guiding the need for colectomy in patients with acute severe colitis. Gastroenterol Rep (Oxf). 2018;6(1):38-44.
39. Corte C, Fernandopulle N, Catuneanu AM, et al. Association between the ulcerative colitis endoscopic index of severity (UCEIS) and outcomes in acute severe ulcerative colitis. J Crohns Colitis. 2015;9(5):376-381.
40. Manginot C, Baumann C, Peyrin-Biroulet L. An endoscopic Mayo score of 0 is associated with a lower risk of colectomy than a score of 1 in ulcerative colitis. Gut. 2015;64(7):1181-1182.
41. Yoon H, Jangi S, Dulai PS, et al. Incremental Benefit of Achieving Endoscopic and Histologic Remission in Patients With Ulcerative Colitis: A Systematic Review and Meta-Analysis. Gastroenterology. 2020;159(4):1262-1275 e1267.
42. Wright E. Non-invasive biomarkers as treatment targets: What do we all need to know? J Gastroenterol Hepatol. 2021;36 Suppl 1:12-13.
43. Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target. Am J Gastroenterol. 2015;110(9):1324-1338.
44. Dulai PS, Levesque BG, Feagan BG, D'Haens G, Sandborn WJ. Assessment of mucosal healing in inflammatory bowel disease: review. Gastrointest Endosc. 2015;82(2):246-255.
45. Reinisch W, Panaccione R, Bossuyt P, et al. Association of Biomarker Cutoffs and Endoscopic Outcomes in Crohn's Disease: A Post Hoc Analysis From the CALM Study. Inflamm Bowel Dis. 2020;26(10):1562-1571.
46. Yzet C UR, Bossuyt P, et al. OP35 Endoscopic and deep remission at 1 year prevents disease pro- gression in early Crohn’s disease: long-term data from CALM. J Crohns Colitis. 2019;13:(Suppl 1):S24–S025.
47. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
48. Wagatsuma K, Yokoyama Y, Nakase H. Role of Biomarkers in the Diagnosis and Treatment of Inflammatory Bowel Disease. Life (Basel). 2021;11(12).
49. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006;55(3):426-431.
50. Mosli MH, Zou G, Garg SK, et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2015;110(6):802-819; quiz 820.
51. Benitez JM, Meuwis MA, Reenaers C, Van Kemseke C, Meunier P, Louis E. Role of endoscopy, cross-sectional imaging and biomarkers in Crohn's disease monitoring. Gut. 2013;62(12):1806-1816.
52. Denis MA, Reenaers C, Fontaine F, Belaiche J, Louis E. Assessment of endoscopic activity index and biological inflammatory markers in clinically active Crohn's disease with normal C-reactive protein serum level. Inflamm Bowel Dis. 2007;13(9):1100-1105.
53. Poncin M, Reenaers C, Van Kemseke C, et al. Depth of remission in Crohn's disease patients seen in a referral centre : associated factors and impact on disease outcome. Acta Gastroenterol Belg. 2014;77(1):41-46.
54. Kostas A, Siakavellas SI, Kosmidis C, et al. Fecal calprotectin measurement is a marker of short-term clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease. World J Gastroenterol. 2017;23(41):7387-7396.
55. Roblin X, Marotte H, Leclerc M, et al. Combination of C-reactive protein, infliximab trough levels, and stable but not transient antibodies to infliximab are associated with loss of response to infliximab in inflammatory bowel disease. J Crohns Colitis. 2015;9(7):525-531.
56. Reinisch W, Wang Y, Oddens BJ, Link R. C-reactive protein, an indicator for maintained response or remission to infliximab in patients with Crohn's disease: a post-hoc analysis from ACCENT I. Aliment Pharmacol Ther. 2012;35(5):568-576.
57. Magro F, Rodrigues-Pinto E, Santos-Antunes J, et al. High C-reactive protein in Crohn's disease patients predicts nonresponse to infliximab treatment. J Crohns Colitis. 2014;8(2):129-136.
58. Sakurai T, Saruta M. Positioning and Usefulness of Biomarkers in Inflammatory Bowel Disease. Digestion. 2023;104(1):30-41.
59. Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci. 2014;59(4):829-837.
60. Abraham BP, Kane S. Fecal markers: calprotectin and lactoferrin. Gastroenterol Clin North Am. 2012;41(2):483-495.
61. Lin JF, Chen JM, Zuo JH, et al. Meta-analysis: fecal calprotectin for assessment of inflammatory bowel disease activity. Inflamm Bowel Dis. 2014;20(8):1407-1415.
62. Cremer A, Ku J, Amininejad L, et al. Variability of Faecal Calprotectin in Inflammatory Bowel Disease Patients: An Observational Case-control Study. J Crohns Colitis. 2019;13(11):1372-1379.
63. Roseth AG, Aadland E, Jahnsen J, Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion. 1997;58(2):176-180.
64. Sipponen T, Savilahti E, Kolho KL, Nuutinen H, Turunen U, Farkkila M. Crohn's disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn's disease activity index and endoscopic findings. Inflamm Bowel Dis. 2008;14(1):40-46.
65. Schoepfer AM, Beglinger C, Straumann A, Trummler M, Renzulli P, Seibold F. Ulcerative colitis: correlation of the Rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009;15(12):1851-1858.
66. Roseth AG, Aadland E, Grzyb K. Normalization of faecal calprotectin: a predictor of mucosal healing in patients with inflammatory bowel disease. Scand J Gastroenterol. 2004;39(10):1017-1020.
67. Shi JT, Chen N, Xu J, et al. Diagnostic Accuracy of Fecal Calprotectin for Predicting Relapse in Inflammatory Bowel Disease: A Meta-Analysis. J Clin Med. 2023;12(3).
68. Hart L, Chavannes M, Kherad O, et al. Faecal Calprotectin Predicts Endoscopic and Histological Activity in Clinically Quiescent Ulcerative Colitis. J Crohns Colitis. 2020;14(1):46-52.
69. Mak WY, Buisson A, Andersen MJ, Jr., et al. Fecal Calprotectin in Assessing Endoscopic and Histological Remission in Patients with Ulcerative Colitis. Dig Dis Sci. 2018;63(5):1294-1301.
70. Dhaliwal A, Zeino Z, Tomkins C, et al. Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply? Frontline Gastroenterol. 2015;6(1):14-19.
71. Hirten RP, Shah S, Sachar DB, Colombel JF. The Management of Intestinal Penetrating Crohn's Disease. Inflamm Bowel Dis. 2018;24(4):752-765.
72. Fernandes SR, Rodrigues RV, Bernardo S, et al. Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn's Disease. Inflamm Bowel Dis. 2017;23(8):1403-1409.
73. Civitelli F, Nuti F, Oliva S, et al. Looking Beyond Mucosal Healing: Effect of Biologic Therapy on Transmural Healing in Pediatric Crohn's Disease. Inflamm Bowel Dis. 2016;22(10):2418-2424.
74. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013;7(7):556-585.
75. Liu W, Liu J, Xiao W, Luo G. A Diagnostic Accuracy Meta-analysis of CT and MRI for the Evaluation of Small Bowel Crohn Disease. Acad Radiol. 2017;24(10):1216-1225.
76. Rimola J, Rodriguez S, Garcia-Bosch O, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. 2009;58(8):1113-1120.
77. Ordas I, Rimola J, Alfaro I, et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn's Disease. Gastroenterology. 2019;157(2):432-439 e431.
78. Deepak P, Fletcher JG, Fidler JL, et al. Radiological Response Is Associated With Better Long-Term Outcomes and Is a Potential Treatment Target in Patients With Small Bowel Crohn's Disease. Am J Gastroenterol. 2016;111(7):997-1006.
79. Rimola J, Torres J, Kumar S, Taylor SA, Kucharzik T. Recent advances in clinical practice: advances in cross-sectional imaging in inflammatory bowel disease. Gut. 2022;71(12):2587-2597.
80. Plevris N, Lees CW. Disease Monitoring in Inflammatory Bowel Disease: Evolving Principles and Possibilities. Gastroenterology. 2022;162(5):1456-1475 e1451.
81. Shaban N, Hoad CL, Naim I, et al. Imaging in inflammatory bowel disease: current and future perspectives. Frontline Gastroenterol. 2022;13(e1):e28-e34.
82. Kucharzik T, Wittig BM, Helwig U, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol. 2017;15(4):535-542 e532.
83. Taylor SA, Mallett S, Bhatnagar G, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn's disease (METRIC): a multicentre trial. Lancet Gastroenterol Hepatol. 2018;3(8):548-558.
84. Radford SJ, Taylor S, Moran G. Ultrasound use to assess Crohn's disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members. Frontline Gastroenterol. 2022;13(6):471-476.
85. Rubin DT. Transmural Healing in Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y). 2023;19(2):101-103.
86. Geyl S, Guillo L, Laurent V, D'Amico F, Danese S, Peyrin-Biroulet L. Transmural healing as a therapeutic goal in Crohn's disease: a systematic review. Lancet Gastroenterol Hepatol. 2021;6(8):659-667.
87. Vaughan R, Tjandra D, Patwardhan A, et al. Toward transmural healing: Sonographic healing is associated with improved long-term outcomes in patients with Crohn's disease. Aliment Pharmacol Ther. 2022;56(1):84-94.
88. Shehab M, Al Akram S, Hassan A, Alrashed F, Jairath V, Bessissow T. Histological Disease Activity as Predictor of Clinical Relapse, Hospitalization, and Surgery in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Inflamm Bowel Dis. 2023.
89. Neri B, Mossa M, Scucchi L, Sena G, Palmieri G, Biancone L. Histological scores in inflammatory bowel disease. J Dig Dis. 2021;22(1):9-22.
90. Tursi A, Elisei W, Picchio M, et al. Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres. Eur J Intern Med. 2014;25(5):485-490.
91. Mikocka-Walus A, Knowles SR, Keefer L, Graff L. Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2016;22(3):752-762.
92. Knowles SR, Keefer L, Wilding H, Hewitt C, Graff LA, Mikocka-Walus A. Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses-Part II. Inflamm Bowel Dis. 2018;24(5):966-976.
93. Holko P, Kawalec P, Mossakowska M, Pilc A. Health-Related Quality of Life Impairment and Indirect Cost of Crohn's Disease: A Self-Report Study in Poland. PLoS One. 2016;11(12):e0168586.
2. Collaborators GBDIBD. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(1):17-30.
3. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769-2778.
4. Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ Open. 2023;13(3):e065186.
5. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial. Br Med J. 1954;2(4884):375-378.
6. Vermeire S, van Assche G, Rutgeerts P. Review article: Altering the natural history of Crohn's disease--evidence for and against current therapies. Aliment Pharmacol Ther. 2007;25(1):3-12.
7. Wilson A, Choi B, Sey M, Ponich T, Beaton M, Kim RB. High infliximab trough concentrations are associated with sustained histologic remission in inflammatory bowel disease: a prospective cohort study. BMC Gastroenterol. 2021;21(1):77.
8. Gracie DJ, Williams CJ, Sood R, et al. Poor Correlation Between Clinical Disease Activity and Mucosal Inflammation, and the Role of Psychological Comorbidity, in Inflammatory Bowel Disease. Am J Gastroenterol. 2016;111(4):541-551.
9. Cellier C, Sahmoud T, Froguel E, et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn's disease. A prospective multicentre study of 121 cases. The Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives. Gut. 1994;35(2):231-235.
10. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021;160(5):1570-1583.
11. Cohen ER, Melmed GY. Making a Case for Patient-Reported Outcomes in Clinical Inflammatory Bowel Disease Practice. Clin Gastroenterol Hepatol. 2018;16(5):603-607.
12. Irvine EJ, Zhou Q, Thompson AK. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. Am J Gastroenterol. 1996;91(8):1571-1578.
13. Best WR, Becktel JM, Singleton JW, Kern F, Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976;70(3):439-444.
14. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955;2(4947):1041-1048.
15. Baars JE, Nuij VJ, Oldenburg B, Kuipers EJ, van der Woude CJ. Majority of patients with inflammatory bowel disease in clinical remission have mucosal inflammation. Inflamm Bowel Dis. 2012;18(9):1634-1640.
16. Laterza L, Piscaglia AC, Minordi LM, et al. Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn's Disease. Dig Dis. 2018;36(3):184-193.
17. Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet. 2017;390(10114):2779-2789.
18. White JR, Jairath V, Moran GW. Evolution of treatment targets in Crohn's disease. Best Pract Res Clin Gastroenterol. 2019;38-39:101599.
19. Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn's disease (SES-CD) than CRP, blood leukocytes, and the CDAI. Am J Gastroenterol. 2010;105(1):162-169.
20. Stjernman H, Tysk C, Almer S, Strom M, Hjortswang H. Factors predicting the outcome of disease activity assessment in Crohn's disease. Inflamm Bowel Dis. 2009;15(12):1859-1866.
21. Arias MT, Vande Casteele N, Vermeire S, et al. A panel to predict long-term outcome of infliximab therapy for patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2015;13(3):531-538.
22. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625-1629.
23. Restellini S, Chao CY, Martel M, et al. Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review. Clin Gastroenterol Hepatol. 2019;17(7):1265-1275 e1268.
24. Rochelle TL, Fidler H. The importance of illness perceptions, quality of life and psychological status in patients with ulcerative colitis and Crohn's disease. J Health Psychol. 2013;18(7):972-983.
25. Khanna R, Wilson AS, Gregor JC, Prowse KL, Afif W. Clinical Guidelines for the Management of IBD. Gastroenterology. 2021;161(6):2059-2062.
26. Le Berre C, Ricciuto A, Peyrin-Biroulet L, Turner D. Evolving Short- and Long-Term Goals of Management of Inflammatory Bowel Diseases: Getting It Right, Making It Last. Gastroenterology. 2022;162(5):1424-1438.
27. Colombel JF, Rutgeerts PJ, Sandborn WJ, et al. Adalimumab induces deep remission in patients with Crohn's disease. Clin Gastroenterol Hepatol. 2014;12(3):414-422 e415.
28. Colombel JF, Rutgeerts P, Reinisch W, et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141(4):1194-1201.
29. Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Groupe d'Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Gut. 1989;30(7):983-989.
30. Koutroumpakis E, Katsanos KH. Implementation of the simple endoscopic activity score in crohn's disease. Saudi J Gastroenterol. 2016;22(3):183-191.
31. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-512.
32. Spiceland CM, Lodhia N. Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment. World J Gastroenterol. 2018;24(35):4014-4020.
33. Annese V, Daperno M, Rutter MD, et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis. 2013;7(12):982-1018.
34. Yamamoto H, Kita H, Sunada K, et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol. 2004;2(11):1010-1016.
35. Melmed GY, Dubinsky MC, Rubin DT, et al. Utility of video capsule endoscopy for longitudinal monitoring of Crohn's disease activity in the small bowel: a prospective study. Gastrointest Endosc. 2018;88(6):947-955 e942.
36. Travis SP, Schnell D, Krzeski P, et al. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut. 2012;61(4):535-542.
37. Travis SP, Schnell D, Krzeski P, et al. Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology. 2013;145(5):987-995.
38. Xie T, Zhang T, Ding C, et al. Ulcerative Colitis Endoscopic Index of Severity (UCEIS) versus Mayo Endoscopic Score (MES) in guiding the need for colectomy in patients with acute severe colitis. Gastroenterol Rep (Oxf). 2018;6(1):38-44.
39. Corte C, Fernandopulle N, Catuneanu AM, et al. Association between the ulcerative colitis endoscopic index of severity (UCEIS) and outcomes in acute severe ulcerative colitis. J Crohns Colitis. 2015;9(5):376-381.
40. Manginot C, Baumann C, Peyrin-Biroulet L. An endoscopic Mayo score of 0 is associated with a lower risk of colectomy than a score of 1 in ulcerative colitis. Gut. 2015;64(7):1181-1182.
41. Yoon H, Jangi S, Dulai PS, et al. Incremental Benefit of Achieving Endoscopic and Histologic Remission in Patients With Ulcerative Colitis: A Systematic Review and Meta-Analysis. Gastroenterology. 2020;159(4):1262-1275 e1267.
42. Wright E. Non-invasive biomarkers as treatment targets: What do we all need to know? J Gastroenterol Hepatol. 2021;36 Suppl 1:12-13.
43. Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target. Am J Gastroenterol. 2015;110(9):1324-1338.
44. Dulai PS, Levesque BG, Feagan BG, D'Haens G, Sandborn WJ. Assessment of mucosal healing in inflammatory bowel disease: review. Gastrointest Endosc. 2015;82(2):246-255.
45. Reinisch W, Panaccione R, Bossuyt P, et al. Association of Biomarker Cutoffs and Endoscopic Outcomes in Crohn's Disease: A Post Hoc Analysis From the CALM Study. Inflamm Bowel Dis. 2020;26(10):1562-1571.
46. Yzet C UR, Bossuyt P, et al. OP35 Endoscopic and deep remission at 1 year prevents disease pro- gression in early Crohn’s disease: long-term data from CALM. J Crohns Colitis. 2019;13:(Suppl 1):S24–S025.
47. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
48. Wagatsuma K, Yokoyama Y, Nakase H. Role of Biomarkers in the Diagnosis and Treatment of Inflammatory Bowel Disease. Life (Basel). 2021;11(12).
49. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006;55(3):426-431.
50. Mosli MH, Zou G, Garg SK, et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2015;110(6):802-819; quiz 820.
51. Benitez JM, Meuwis MA, Reenaers C, Van Kemseke C, Meunier P, Louis E. Role of endoscopy, cross-sectional imaging and biomarkers in Crohn's disease monitoring. Gut. 2013;62(12):1806-1816.
52. Denis MA, Reenaers C, Fontaine F, Belaiche J, Louis E. Assessment of endoscopic activity index and biological inflammatory markers in clinically active Crohn's disease with normal C-reactive protein serum level. Inflamm Bowel Dis. 2007;13(9):1100-1105.
53. Poncin M, Reenaers C, Van Kemseke C, et al. Depth of remission in Crohn's disease patients seen in a referral centre : associated factors and impact on disease outcome. Acta Gastroenterol Belg. 2014;77(1):41-46.
54. Kostas A, Siakavellas SI, Kosmidis C, et al. Fecal calprotectin measurement is a marker of short-term clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease. World J Gastroenterol. 2017;23(41):7387-7396.
55. Roblin X, Marotte H, Leclerc M, et al. Combination of C-reactive protein, infliximab trough levels, and stable but not transient antibodies to infliximab are associated with loss of response to infliximab in inflammatory bowel disease. J Crohns Colitis. 2015;9(7):525-531.
56. Reinisch W, Wang Y, Oddens BJ, Link R. C-reactive protein, an indicator for maintained response or remission to infliximab in patients with Crohn's disease: a post-hoc analysis from ACCENT I. Aliment Pharmacol Ther. 2012;35(5):568-576.
57. Magro F, Rodrigues-Pinto E, Santos-Antunes J, et al. High C-reactive protein in Crohn's disease patients predicts nonresponse to infliximab treatment. J Crohns Colitis. 2014;8(2):129-136.
58. Sakurai T, Saruta M. Positioning and Usefulness of Biomarkers in Inflammatory Bowel Disease. Digestion. 2023;104(1):30-41.
59. Yoon JY, Park SJ, Hong SP, Kim TI, Kim WH, Cheon JH. Correlations of C-reactive protein levels and erythrocyte sedimentation rates with endoscopic activity indices in patients with ulcerative colitis. Dig Dis Sci. 2014;59(4):829-837.
60. Abraham BP, Kane S. Fecal markers: calprotectin and lactoferrin. Gastroenterol Clin North Am. 2012;41(2):483-495.
61. Lin JF, Chen JM, Zuo JH, et al. Meta-analysis: fecal calprotectin for assessment of inflammatory bowel disease activity. Inflamm Bowel Dis. 2014;20(8):1407-1415.
62. Cremer A, Ku J, Amininejad L, et al. Variability of Faecal Calprotectin in Inflammatory Bowel Disease Patients: An Observational Case-control Study. J Crohns Colitis. 2019;13(11):1372-1379.
63. Roseth AG, Aadland E, Jahnsen J, Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion. 1997;58(2):176-180.
64. Sipponen T, Savilahti E, Kolho KL, Nuutinen H, Turunen U, Farkkila M. Crohn's disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn's disease activity index and endoscopic findings. Inflamm Bowel Dis. 2008;14(1):40-46.
65. Schoepfer AM, Beglinger C, Straumann A, Trummler M, Renzulli P, Seibold F. Ulcerative colitis: correlation of the Rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009;15(12):1851-1858.
66. Roseth AG, Aadland E, Grzyb K. Normalization of faecal calprotectin: a predictor of mucosal healing in patients with inflammatory bowel disease. Scand J Gastroenterol. 2004;39(10):1017-1020.
67. Shi JT, Chen N, Xu J, et al. Diagnostic Accuracy of Fecal Calprotectin for Predicting Relapse in Inflammatory Bowel Disease: A Meta-Analysis. J Clin Med. 2023;12(3).
68. Hart L, Chavannes M, Kherad O, et al. Faecal Calprotectin Predicts Endoscopic and Histological Activity in Clinically Quiescent Ulcerative Colitis. J Crohns Colitis. 2020;14(1):46-52.
69. Mak WY, Buisson A, Andersen MJ, Jr., et al. Fecal Calprotectin in Assessing Endoscopic and Histological Remission in Patients with Ulcerative Colitis. Dig Dis Sci. 2018;63(5):1294-1301.
70. Dhaliwal A, Zeino Z, Tomkins C, et al. Utility of faecal calprotectin in inflammatory bowel disease (IBD): what cut-offs should we apply? Frontline Gastroenterol. 2015;6(1):14-19.
71. Hirten RP, Shah S, Sachar DB, Colombel JF. The Management of Intestinal Penetrating Crohn's Disease. Inflamm Bowel Dis. 2018;24(4):752-765.
72. Fernandes SR, Rodrigues RV, Bernardo S, et al. Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn's Disease. Inflamm Bowel Dis. 2017;23(8):1403-1409.
73. Civitelli F, Nuti F, Oliva S, et al. Looking Beyond Mucosal Healing: Effect of Biologic Therapy on Transmural Healing in Pediatric Crohn's Disease. Inflamm Bowel Dis. 2016;22(10):2418-2424.
74. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013;7(7):556-585.
75. Liu W, Liu J, Xiao W, Luo G. A Diagnostic Accuracy Meta-analysis of CT and MRI for the Evaluation of Small Bowel Crohn Disease. Acad Radiol. 2017;24(10):1216-1225.
76. Rimola J, Rodriguez S, Garcia-Bosch O, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. 2009;58(8):1113-1120.
77. Ordas I, Rimola J, Alfaro I, et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn's Disease. Gastroenterology. 2019;157(2):432-439 e431.
78. Deepak P, Fletcher JG, Fidler JL, et al. Radiological Response Is Associated With Better Long-Term Outcomes and Is a Potential Treatment Target in Patients With Small Bowel Crohn's Disease. Am J Gastroenterol. 2016;111(7):997-1006.
79. Rimola J, Torres J, Kumar S, Taylor SA, Kucharzik T. Recent advances in clinical practice: advances in cross-sectional imaging in inflammatory bowel disease. Gut. 2022;71(12):2587-2597.
80. Plevris N, Lees CW. Disease Monitoring in Inflammatory Bowel Disease: Evolving Principles and Possibilities. Gastroenterology. 2022;162(5):1456-1475 e1451.
81. Shaban N, Hoad CL, Naim I, et al. Imaging in inflammatory bowel disease: current and future perspectives. Frontline Gastroenterol. 2022;13(e1):e28-e34.
82. Kucharzik T, Wittig BM, Helwig U, et al. Use of Intestinal Ultrasound to Monitor Crohn's Disease Activity. Clin Gastroenterol Hepatol. 2017;15(4):535-542 e532.
83. Taylor SA, Mallett S, Bhatnagar G, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn's disease (METRIC): a multicentre trial. Lancet Gastroenterol Hepatol. 2018;3(8):548-558.
84. Radford SJ, Taylor S, Moran G. Ultrasound use to assess Crohn's disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members. Frontline Gastroenterol. 2022;13(6):471-476.
85. Rubin DT. Transmural Healing in Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y). 2023;19(2):101-103.
86. Geyl S, Guillo L, Laurent V, D'Amico F, Danese S, Peyrin-Biroulet L. Transmural healing as a therapeutic goal in Crohn's disease: a systematic review. Lancet Gastroenterol Hepatol. 2021;6(8):659-667.
87. Vaughan R, Tjandra D, Patwardhan A, et al. Toward transmural healing: Sonographic healing is associated with improved long-term outcomes in patients with Crohn's disease. Aliment Pharmacol Ther. 2022;56(1):84-94.
88. Shehab M, Al Akram S, Hassan A, Alrashed F, Jairath V, Bessissow T. Histological Disease Activity as Predictor of Clinical Relapse, Hospitalization, and Surgery in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Inflamm Bowel Dis. 2023.
89. Neri B, Mossa M, Scucchi L, Sena G, Palmieri G, Biancone L. Histological scores in inflammatory bowel disease. J Dig Dis. 2021;22(1):9-22.
90. Tursi A, Elisei W, Picchio M, et al. Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres. Eur J Intern Med. 2014;25(5):485-490.
91. Mikocka-Walus A, Knowles SR, Keefer L, Graff L. Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2016;22(3):752-762.
92. Knowles SR, Keefer L, Wilding H, Hewitt C, Graff LA, Mikocka-Walus A. Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses-Part II. Inflamm Bowel Dis. 2018;24(5):966-976.
93. Holko P, Kawalec P, Mossakowska M, Pilc A. Health-Related Quality of Life Impairment and Indirect Cost of Crohn's Disease: A Self-Report Study in Poland. PLoS One. 2016;11(12):e0168586.