STRIDE-II treatment target achievement in inflammatory bowel disease: a cross-sectional study from a tertiary IBD centre in the United Arab Emirates

Abstract

Background:
Data on STRIDE-II treatment target achievement in Middle Eastern inflammatory bowel disease (IBD) populations remain limited. We assessed the prevalence and predictors of deep remission at a tertiary IBD center in the United Arab Emirates.


Methods:
A cross-sectional analysis was conducted on 389 IBD patients (242 Crohn’s disease [CD], 147 ulcerative colitis [UC]) on stable treatment for ≥6 months. Deep remission required concurrent clinical, biochemical, and endoscopic remission. Predictors were identified using logistic regression.


Results:

Complete STRIDE-II assessment was available in 264 patients (67.9%). Deep remission was achieved in 164 patients (62.1% available-case; 42.2% conservative, treating incomplete assessments as failure). In the advanced therapy subgroup (
n
= 182), deep remission was 64.3% available-case and 43.8% conservative. Clinical remission was 78.7%, biochemical remission 72.4%, and endoscopic remission 69.2%. Rates were similar between CD and UC, and complicated CD phenotypes achieved equivalent deep remission to non-complicated disease (62.7% vs 63.9%,
P
= 0.85). Disease duration was the strongest overall predictor (OR 1.06 per year, 95% CI 1.02–1.10,
P
= 0.009). CD-specific predictors included B3 penetrating behavior (OR 5.49,
P
= 0.027) and male sex (OR 0.47,
P
= 0.039). In UC, older age and male sex were independently associated with remission. Higher advanced therapy exposure predicted lower remission odds in CD (adjusted OR 0.70,
P
= 0.034). No individual therapy demonstrated significant superiority in adjusted drug comparisons. Efficacy was preserved at second-line (67.4%) with decline at third-line (50.0%).



Conclusion:
Deep remission rates in this UAE tertiary center cohort were comparable to or numerically higher than international reports. Further validation in prospective, geographically diverse populations is warranted.