연구성과 홍보

Scand J Gastroenterol. 2025 Oct;60(10):999-1010.

Title : Tight monitoring with colonoscopy and magnetic resonance enterography improves outcomes in patients with Crohn's disease

Authors : Soyun Lim1, Kwang Woo Kim2, Jin Soo Moon3, Se Hyung Kim4, Seungbum Ryoo5, Kyu Joo Park5, Hyun Jung Lee6, Jong Pil Im6, Byeong Gwan Kim6, Joo Sung Kim6, Seong-Joon Koh6*

Affiliations :

1Seoul National University College of Medicine, Seoul, Republic of Korea.

2Division of Gastroenterology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.

3Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.

4Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.

5Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.

6Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.

DOI: 10.1080/00365521.2025.2544307.

Abstract :

Background and aims: This study evaluated the impact of monitoring with colonoscopy and magnetic resonance enterography on clinical decision-making and long-term outcomes in advanced therapy-naïve Crohn's disease patients with moderate-to-severe disease.

Methods: A retrospective review was conducted on 157 biologic-naïve Crohn's disease patients with moderate-to-severe disease at the initiation of advanced therapy between 2006 and 2023. Participants were categorized into three groups according to monitoring method within two years post-treatment: (1) tight monitoring (colonoscopy and magnetic resonance enterography), (2) semi-tight monitoring (either colonoscopy or magnetic resonance enterography), and (3) conventional monitoring (clinical outcomes including laboratory tests only). Treatment adjustments and long-term outcomes were compared.

Results: Of 157 patients (69.4% male, median age 31 years), tight monitoring was associated with increased immunomodulator use (27.2% vs. 3.8%; p < 0.001) and reduced hospitalizations compared to conventional monitoring (5.4% vs. 38.8%; p < 0.001). The incidence of strictures was 0% in the tight monitoring group, compared to 21.3% in the conventional monitoring group, respectively (p = 0.011).

Conclusion: Tight monitoring with both colonoscopy and magnetic resonance enterography within 2 years after advanced therapy initiation in patients with moderate-to-severe Crohn's disease is associated with timely treatment adjustments and improved long-term outcomes, particularly through better detection of residual inflammation.