Assessing Long-Term Outcomes of Crohn’s Disease Following Mucosal and Transmural Healing

Patients with Crohn’s disease who achieved transmural and mucosal healing had the best long-term outcomes, investigators reported in the Inflammatory Bowel Disease Journal.

The authors noted, “Healing in Crohn’s disease is complex and difficult to measure due to incongruencies between clinical symptoms and disease states.” Definitions of mucosal and transmural healing are inconsistent among studies and their relationship to long-term outcomes has been unclear, they added.

The researchers conducted a systematic literature review of databases containing real-world reports and clinical studies that measuried mucosal and transmural healing in Crohn’s disease from 2012 to 2022 that reported clinical, economic, or quality of life outcomes of adult patients with Crohn’s disease who achieved mucosal and/or transmural healing.

Among 46 studies involving 5530 participants, 39 reported mucosal healing with 14 reporting endoscopic assessment with validated scales, while 13 studies reported outcomes of patients found to achieve transmural healing. Those studies that assessed outcomes of patients who did and did not achieve either mucosal or transmural healing found that the patients who healed experienced better fewer hospitalizations, fewer surgeries, and higher rates of clinical remission, along with lower rates of health care resource use. The investigators observed that these better outcomes were particularly associated with transmural healing.

Reference:

Sands BE, Danese S, Chapman JC, et al. Mucosal and transmural healing and long-term outcomes in Crohn’s disease. Inflamm Bowel Dis. 2025; 31(3): 857–877