Predictive Factors of Endoscopic Mucosal Healing in Patients with Chronic Inflammatory Bowel Diseases on Biotherapy

Abstract

Achieving mucosal healing is the main goal in the treatment of patients with chronic inflammatory bowel diseases (Crohn's disease and Ulcerative Colitis). Nevertheless, mucosal healing predictors after medical treatment remain unknown. The purpose of this study was to determine the rates of mucosal healing and to characterize its predictive factors in patients with IBD treated with Anti-TNF alpha. We conducted a retrospective descriptive and analytical study between January 2019 and March 2022 in the hepato-gastroenterology I department, within the Mohamed V Military Instruction Hospital in Rabat. We collected demographic, clinical, and biological data of patients being treated for IBD with anti TNF alpha therapy, and who have undergone a colonoscopy before initiating treatment and after 1-year of treatment. In this study, mucosal healing was defined as the absence of ulcerated lesions during the 1-year follow-up colonoscopy. Among 60 patients on anti TNF-alfa therapy for IBD; 43 were included in our study with 10 patients having Ulcerative Colitis and 33 having Crohn’s Disease. Overall, 22 patients had mucosal healing (approximatively 51%): 60% in the UC group and 48,50% in the CD group. Regarding associated factors, in all patients, fecal calprotectin was retained as the only significant predictive factor of mucosal healing. The overall rate of endoscopic mucosal healing in our study was of 51,20% with faecal calprotectin being identified at follow-up coloscopy as a predictive factor. Nevertheless, none of the studied factors were retained when the two groups were analyzed separately.