P0702Targetting deep remission in crohns disease - is there a role for histologic remission?

Abstract Background Crohn’s disease (CD) is a chronic and progressive immune-mediated condition. Targeting deeper forms of remission has been associated with optimized outcomes. The goal of histologic remission in this condition is not yet determined. Methods Retrospective analysis including 158 CD patients with two assessments performed by endoscopy and MRI enterography. We evaluated the rates of surgery, hospitalization, use of corticosteroids, and treatment change according to the presence of clinical, endoscopic, histologic and radiologic remission, and alternative groupings of these outcomes. Endoscopic remission was defined as a SES-CD (simplified endoscopic score for CD) ≤3. Radiologic remission was defined as a sMaria (simplified Maria score) ≤1. Histologic remission was characterized as an absence of intraepithelial neutrophils, erosions or ulcers. Results 135/158 patients achieved clinical remission, 83/158 endoscopic remission, 65 radiologic remission, and 47 histologic remission. In respect to the compound negative outcome, clear benefits were seen in patients obtaining endoscopic remission (33.7% vs 89.3%, P 0.001), radiologic remission (30.8% vs 80.6%, P 0.001), histologic remission (31.9% vs 72.1%, P 0.001), but not symptomatic remission (58.5% vs 69.6%, P = 0.364). Within the multivariate regression model solely endoscopic (HR 0.400 95%CI 0.161-0.998, P = 0.05) and radiologic remission (HR 0.079 95%CI 0.010-0.602, P = 0.014) were independently associated with lower risk of obtaining any negative outcome. Conclusion These findings indicate that endoscopic and radiologic remission are powerful predictors for better long-term outcomes. Clinical and histologic remission did not provide additional benefits. This further supports the importance of attaining transmural remission in CD. Conflict of interest: Dr. Neves, Andre: No conflict of interest Fernandes, Samuel Raimundo: No conflict of interest Tubal Bronze, Sérgio Manuel: No conflict of interest Rodrigues, Inês: No conflict of interest Saraiva, Sofia: No conflict of interest Valente, Ana Isabel: No conflict of interest Gonçalves Camilo, Ana Rita: No conflict of interest Correia, Luis: No conflict of interest