Predictors and Significance of Incomplete Mucosal Recovery in XXXX After 1 Year on a Gluten-Free Diet.

@entity1 @entity1593 @entity8884 @entity5 @entity16
OBJECTIVES: In @entity1593 , a follow-up biopsy taken 1 year after diagnosis is considered important in monitoring histological recovery. In many cases, recovery is incomplete, and the clinical significance of this is poorly understood. We now investigated associated factors and the significance of imperfect histological recovery in @entity1 in whom the follow-up had been completed. METHODS: Two hundred sixty-three biopsy-proven @entity1 were divided into two groups: histological recovery and incomplete recovery after 1 year on gluten-free diet. Serology, laboratory values, bone mineral density, and different clinical variables were measured at diagnosis and after 1 year. Gastrointestinal symptoms and quality of life were assessed by validated questionnaires. Further, long-term follow-up data on mortality, @entity5 , and other severe complications were collected. RESULTS: The incomplete recovery group had more severe @entity16 (P=0.003), higher antibody values (P=0.017), and more signs of @entity8884 (P<0.001) at diagnosis. There was no difference in gender, symptoms or quality of life, family history of @entity1593 , or comorbidities. At follow-up, there was still a difference in antibodies (P=0.018) and femoral T-scores (P=0.024). Histologically recovered @entity1 showed better dietary adherence, although it was excellent in both groups (97% vs. 87%, P<0.001). There was no difference in long-term outcomes between groups. CONCLUSIONS: The presence of more severe disease in terms of histology, serology, and signs of @entity8884 was associated with histological non-response. In @entity1 with high dietary adherence, incomplete villous recovery after 1 year does not affect the clinical response or long-term prognosis. A personalized approach is required to decide the optimal timing of the follow-up biopsy.
