Impact of timing on mucosal healing during restaging endoscopy in pediatric Crohn's disease: A retrospective cohort study

While endoscopic remission is an important target in pediatric Crohn's disease (CD), no consensus for restaging timing exists. This retrospective cohort study assessed the timing and impact of restaging endoscopy in children with new CD in remission, comparing earlier ( ≤ 9 months) versus later endoscopy. Twenty-five patients were included (median: 12.6 years, range: 5-17). Endoscopic remission (no ulcerations) was achieved in 72% (<i>n</i> = 18/25). Thirteen patients (52%) had earlier endoscopy (median: 7 months, interquartile range [IQR]: 6-9, range: 3-9) while 12 (48%) had later (median: 14.5 months, IQR: 13-17, range: 11-20). There were no differences in endoscopic remission (earlier 77% vs. later 67%; <i>p</i> = 0.69) or therapy escalation after restaging (earlier 23% vs. later 42%; <i>p</i> = 0.44). This study demonstrates that one in four pediatric Crohn's disease patients in clinical and biochemical remission were not in endoscopic remission, regardless of the timing of restaging endoscopy. This indicates potential benefit to earlier restaging endoscopy in clinical decision-making.