Factors associated with the achievement of mucosal healing in Crohn's disease: The benefit of endoscopic monitoring in treating to target

Ren Mao, Yun Qiu, Bai Li Chen, Sheng Hong Zhang, Rui Feng, Yao He, Zhi Rong Zeng, Shomron Ben-Horin, Min Hu Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Mucosal healing (MH), the proposed treat to target in Crohn's disease (CD), is associated with improved disease outcomes. There are still scant data on factors associated with achieving MH in clinical practice. We evaluated the probability of achieving MH and identified factors predictive of subsequent MH in patients with CD. Methods: This was a retrospective, observational cohort study. A total of 272 patients with CD with serial endoscopy assessment and subsequent therapeutic management were reviewed. The primary outcome was MH. The cumulative incidence of MH and endoscopic improvement was estimated using the Kaplan-Meier method. Factors independently associated with MH were identified using the Cox proportional hazards model. Results: Of the 272 patients, 126 (46.32%) achieved MH after a median follow-up period of 33 months (interquartile range: 27-38 months). Factors independently associated with MH by multivariate analysis were time between endoscopic procedures within 26 weeks (hazard ratio [HR]: 1.56; 95% confidence interval [CI]: 1.05-3.39), adjustment of medical therapy when MH was not achieved (HR: 2.07; 95% CI: 1.26-2.33), prior enteric fistula (HR: 0.22; 95% CI: 0.06-0.91), perianal disease at CD diagnosis (HR: 0.58; 95% CI: 0.35-0.95), and C-reactive protein normalization within 12 weeks (HR: 3.23; 95% CI: 1.82-5.88). Similar factors have also been identified for endoscopic improvement. Conclusions: Performing serial endoscopic procedures at a 26-week interval and subsequent adjustment in medical treatment are helpful in achieving MH. Endoscopic monitoring plays an important role in the treating to target of CD.

Original languageEnglish
Pages (from-to)453-463
Number of pages11
JournalTherapeutic Advances in Gastroenterology
Issue number6
StatePublished - 2017


FundersFunder number
Ministry of Public Health, China303004269002
National Key Clinical Department
Scientific Project of Guangzhou
National Natural Science Foundation of China81270473, 81470821


    • Crohn's disease
    • endoscopic
    • mucosal healing
    • treat to target


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