A Belgian-Dutch study examined the rate of relapse of Crohn's disease in patients in the early stages of the disease, as a function of mucosal healing. This prospective study which included 133 patients demonstrated that stable remission was observed during the 4 years of follow-up in 71% of patients presenting with complete healing after 2 years of treatment. This percentage dropped to 27% in patients presenting with incomplete healing. This study suggests that the goal of therapeutic management of patients should be to obtain complete mucosal healing whatever the stage of the disease. These data lend support to a therapeutic strategy known as “top-down”, i.e. highly aggressive (in the favorable sense of the word) at the beginning of treatment, and which could be reduced once mucosal healing is attained.

Reference:

Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, Vos MD, Stokkers P, Hommes D, Rutgeerts P, Vermeire S, D'Haens G; BELGIAN INFLAMMATORY BOWEL DISEASE RESEARCH GROUP; NORTH-HOLLAND GUT CLUB. Mucosal Healing Predicts Sustained Clinical Remission in Patients with Early-Stage Crohn's Disease. Gastroenterology. 2009 Oct 8. [Epub ahead of print]