Steroid-free endoscopic remission not linked to less disease progression in Crohn's Disease: Study

France: Achieving prolonged clinical remission off steroids with full endoscopic remission in patients with early Crohn's disease (CD) was not related to decreased disease progression, according to a recent study. The findings of this study were published in Clinical Gastroenterology and Hepatology on 26th November, 2021.

Patients with CD who participated in the TAILORIX study were given infliximab in conjunction with an immunosuppressant for one year. The current study's goal was to assess the long-term illness course after the study period.

For the following randomized, double-blind, controlled, multicenter study, David Laharie and the team analyzed the outcomes of patients who did or did not complete the TAILORIX trial's primary endpoint, defined as prolonged corticosteroid-free clinical remission from weeks 22 through 54, with no ulcers on ileocolonoscopy at week 54, in the following study. The primary goal of this follow-up research was to determine CD progression-free survival as determined by anal or major abdominal surgery, CD-related hospitalization, or the requirement for a new systemic CD medication.

The key findings of this study are as follow:

1. The 95 patients studied (median illness duration, 4.5 months), including 45 (47%) who met the primary endpoint, were followed up for a median of 64.2 months after the research period ended.

2. At 1, 3, and 5 years, there was no significant difference in CD progression-free survival between patients who met the TAILORIX primary endpoint and those who did not.

3. There was no difference between the two groups for any of the following aspects of CD progression: anal surgery, major abdominal surgery, CD-related hospitalization, or the necessity for a new systemic CD therapy.

In conclusion, more research into individualized illness management concepts is required across a range of disease-monitoring systems with various targeted immunomodulation medications. To reframe treatment aims, prospective studies are necessary.

Reference:

Laharie, D., D'Haens, G., Nachury, M., Lambrecht, G., Bossuyt, P., Bouhnik, Y., Louis, E., Janneke van der Woude, C., Buisson, A., Van Hootegem, P., Allez, M., Filippi, J., Brixi, H., Gilletta, C., Picon, L., Baert, F., Vermeire, S., Duveau, N., & Peyrin-Biroulet, L. (2021). Steroid-Free Deep Remission at One Year Does Not Prevent Crohn's Disease Progression: Long-Term Data From the TAILORIX Trial. In Clinical Gastroenterology and Hepatology. Elsevier BV. https://doi.org/10.1016/j.cgh.2021.11.030