Steroid-free remission in Crohn’s disease does not equate to less progression

For Crohn’s disease (CD) patients, achieving a complete and sustained clinical remission off steroids does not necessarily translate to a lower likelihood of experiencing progression, according to data from the TAILORIX trial.

The analysis included 95 CD patients (median disease duration 4.5 months, interquartile range [IQR] 1.0–56.6) who participated in the TAILORIX trial and received infliximab in combination with an immunosuppressant for 1 year.

Researchers followed the patients for a median of 64.2 months (IQR, 57.6–69.9) after the end of treatment to assess multiple outcomes, including the progression-free survival of CD defined by anal or major abdominal surgery, CD-related hospitalization, or the need for a new systemic CD treatment.

Of the patients, 45 (47 percent) achieved the primary endpoint of sustained corticosteroid-free clinical remission from weeks 22 through 54, without any evidence of ulcers on ileo-colonoscopy at week 54.

Patients who did vs did not achieve the primary endpoint had similar CD progression-free survival at 1, 3, and 5 years (p=0.64). Moreover, there were no significant between-group differences in each component of CD progression, namely anal surgery, major abdominal surgery, CD-related hospitalization, and the need for a new systemic CD treatment.

Additional prospective trials are needed to define the therapeutic goals required to change the natural course of CD and prevent complications.