Abstract
[IOIBD] even suggested that transmural healing in Crohn’s disease [CD] and histological healing in ulcerative colitis
[UC], although not formal targets, should be assessed as measures of remission depth. 2 Thus, a new concept has been proposed, namely disease clearance, histological remission for UC and transmural remission for CD. 3 The latter is typically evaluated by cross-sectional imaging including magnetic resonance enterography [MRE], computed tomography [CT] enterography or intestinal ultrasound [IUS]. Although data are still scare, accumulating evidence suggests that transmural remission is associated with favourable clinical outcomes and
can prevent complications including hospitalizations and surgeries. 1,4–7 It is important to highlight that transmural healing is a stringent endpoint and difficult to achieve. A systematic review of 17 studies reported rates of transmural healing with MRE, bowel US or CT enterography of 14–42.4% of patients with CD. 4 Therapeutic drug monitoring [TDM], which involves measuring serum drug and anti-drug antibody concentrations, has been recognized as a useful tool for biological therapy optimization along with early and scheduled disease assessment to ensure maintenance of remission in IBD. 8 Several exposure–outcome studies have consistently demonstrated that higher biological drug concentration are associated with increased rates of therapeutic outcomes including more stringent outcomes, such as fistula closure and histological remission. 8 However, there are only limited data regarding the relationship of biological drug concentrations
and transmural healing.
