Rate and predictors of endoscopic mucosal healing among IBD patients on medical therapy at Tikur Anbessa Specialized Hospital: Institution Based Prospective Cross-sectional study
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Date
2023-10
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Addis Ababa University
Abstract
Introduction
Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the intestinal
mucosa resulting from strong interaction between genetic, environmental, immunologic and
intestinal microbial factors. Medical treatment for inflammatory bowel disease (IBD) has
undergone a complete transformation over the last several decades due to the advent of different
drugs. Clinical remission and endoscopic healing are integral components of the treat to target
strategy in IBD therapy. Endoscopic healing is associated with significant reduction in
complications of IBD and/or need for surgery.
Objective
The objectives of this study are to determine the rates of clinical remission and endoscopic
mucosal healing among IBD patients on treatment and to sort out predictors of endoscopic
healing.
Methodology
A prospective cross-sectional study was conducted at Tikur Anbesa Specialized Hospital from
January, 2023 to October 2023. The study included all consecutive IBD patients on treatment for
six months or more who showed up for a regular follow up at TASH GI clinic in the study period
and who were willing to consent and undergo follow up colonoscopy.
Results
Overall Clinical remission rate from this Cross-sectional study is 69 /106, including 62/87,
(71.3%) of CD, 7/17 (41.2%) of UC and 0 /2 Unclassified. Thirty-five (33%) of IBD patients in
the study achieved endoscopic healing. Twenty-six of the 87 (29%) patients with CD, 8 of the
17(47%) UC, and one of the two with indeterminate colitis achieved endoscopic mucosal
healing. Only 10 of the 32 CD patients with previous history of bowel resection achieved
endoscopic healing. Higher ESR value (P = 0.040, AOR 0.946 with 95% CI 0.898-0.997) and
younger age at diagnosis (P = 0.046, AOR 1.322 with 95% CI 1.005-1.739) predicted absence of
endoscopic healing.
Conclusion
Sixty-nine of the one hundred six IBD patients (65.1%, 70% for CD, 41.2% for UC) were in
clinical remission. The overall endoscopic mucosal healing rate from this study is 33% (29.1%
CD, 47.1% UC). Elevated ESR and younger age at the diagnosis predicted absence of
endoscopic healing within the study period.
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Keywords
Inflammatory bowel diseases