Depth of remission in Crohn's disease patients seen in a referral centre : associ- ated factors and impact on disease outcome

Introduction : Our goals were to assess the prevalence of biologi- cal and tissue remission in routine practice in Crohn's disease, and to evaluate the correlation between biological or tissue remission and clinical or demographic characteristics as well as their impact on disease outcome. Methods : We performed a retrospective monocenter study. Bio- logical remission was defined by a CRP < 5 mg/l. Tissue remission was defined by the absence of ulcer at endoscopy and/or absence of signs of acute inflammation at MRI. Association with demographic, clinical and laboratory markers was studied by logistic regression models and rates of relapses, hospitalizations and surgeries were compared using the logrank test. Results : Among the 263 patients included, 147 were in clinical remission ; 102/147 (69%) were in biological remission. Fifty-six patients also had morphological evaluation : 37 (66%) were in tissue remission. Biological remission was associated with older age, higher hemoglobin and lower BMI. Tissue remission was associated with older age, lower platelets count, absence of previ- ous surgery, and the use of immunosuppressant. Time-to-relapse was significantly longer in patients with biological remission and in patients with tissue remission as compared to patients without bio- logical or tissue remission. Conclusions : Among the patients in clinical remission seen as outpatients, two thirds were either in biological and/or tissue re- mission. Biological and/or tissue remission was associated with a better outcome than clinical remission alone. (Acta gastroenterol. belg., 2014, 77, 41-46).