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Definition of "remission" by IBD experts

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Ulcerative Colitis
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Posted 1/2/2014 5:35 PM (GMT 0)
Since it's been discussed here it might be interesting to hear how top GI's define it

Dr. Regueiro: Most of us define “clinical remission” as a patient who does not require steroids and whose quality of life and physical function is essentially normal. More recently, the term “remission” has evolved to include more objective criteria—specifically mucosal healing—and that has been generally defined by endoscopic or “deep” remission.

this is from this article which discusses whether people can stop taking biologics after they reach remission.
www.gastroendonews.com/ViewArticle.aspx?d=Expert+Roundtable&d_id=233&i=June+2013&i_id=961&a_id=23380

Tell me whether you can access this article without a login using this link. Otherwise I don't know how to give access to this article. It is a roundtable discussion by 3 GI's: Reguiro (U of Pittsburgh Medical Ctr), Sandborn (UC San Diego Sch Medicine) and Rubin (Inflammatory Bowel Disease Ctr, U Chicago)

Short answer to whether people can stop biologics after remission: they prefer not stopping but admit that for UC the answer is unclear without studies having more participants. For CD they do not recommend stopping because that disease is progressive.
Posted 1/2/2014 5:44 PM (GMT 0)
ima, I couldn't access the article.

I'm going to copy and paste a post I made a while back, which is about an article comparing clinical and endoscopic remission. I thought it was interesting, and it really relates to this post.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665176/

It's a pretty small study, but I think it's interesting. They only looked at people who were in clinical remission (i.e., no symptoms) and did a c-scope at the beginning of the study. They used a score of 0-3 to classify disease severity based on what was seen during the scope. There are pics and explanations in the article, but 0 is no disease evident, 1 is mild, 2 is moderate, and 3 is severe.

They found that only 24% of people in clinical remission had completely clear scopes (group A). 40% were in the "mild" category (group B), 26% in the moderate (group C), and 10% in the severe (group D). I was surprised that the majority of the patients had at least some disease activity.

They followed the patients to see if they stayed in remission or not. In 6 months, 100% of group A were, 93% of group B, 70% in group c, and 50% in group D.

In 5 years, 78% of group A were, 40% of group B, 10% of group C, and 0% of group D.

So, this basically shows that it IS important to achieve endoscopic remission in addition to clinical remission, if you want to stay in remission long-term.

They also note that patients in the study stayed on their meds. ;)
Posted 1/2/2014 5:51 PM (GMT 0)
I've been in endoscopic remission since 2007, except for one tiny rectal ulcer in 2009. I will go off my Remicade when it stops working, when I develop an allergy to it, when my insurance stops covering it or when I can't find a doctor to prescribe it for me. I hope none of those things ever happens. I was just too sick for too long to risk going back there.
Posted 1/2/2014 5:51 PM (GMT 0)
Anyone know how I can upload this article somewhere?
Posted 1/2/2014 5:52 PM (GMT 0)
I just signed up -- I'll see if I can figure something out.
Posted 1/2/2014 6:14 PM (GMT 0)
Try this:

I emailed myself the article, and got this link. It opened in firefox, and I'd logged into the site using IE, so I'm hoping it'll work.


http://www.gastroendonews.com/ViewArticle.aspx?d=Expert+Roundtable&d_id=233&i=June+2013&i_id=961&a_id=23380&ses=ogst
Posted 1/2/2014 6:18 PM (GMT 0)
Yes that worked when I pasted your link in. Hope it works for others.
I'm on that websites mailing list but there's rarely "hot" news.

here's a live link to your workaround
www.gastroendonews.com/ViewArticle.aspx?d=Expert+Roundtable&d_id=233&i=June+2013&i_id=961&a_id=23380&ses=ogst
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