Crohn’s disease is a chronic relapsing inflammatory bowel disorder (IBD).
Both biological and psychosocial factors may modulate the illness experience.
Dr Bitton and colleagues from Canada identified clinical, biological and psychosocial parameters as predictors of clinical relapse in quiescent Crohn’s disease.
The team followed patients in medically induced remission prospectively for 1 year, or less if they relapsed.
The team determined disease characteristics at baseline.
|C-reactive protein predicts earlier relapse|
Serum cytokines, anti-Saccharomyces cerevisiae antibodies, C-reactive protein, erythrocyte sedimentation rate and intestinal permeability were measured every 3 months.
Psychological distress, perceived stress, minor life stressors and coping strategies were measured monthly.
A time-dependent multivariate Cox regression model determined predictors of time to relapse.
The researchers recruited 101 patients, 14 withdrew and 37 relapsed.
The team found C-reactive protein, fistulising disease, colitis and the interaction between perceived stress and avoidance coping were predictors of earlier relapse.
Dr Bitton’s team concluded, “In quiescent Crohn’s disease, a higher C-reactive protein, fistulising disease behavior and disease confined to the colon were independent predictors of relapse.”
“Moreover, patients under conditions of low stress and who scored low on avoidance coping were least likely to relapse.”
“This study supports a biopsychosocial model of Crohn’s disease exacerbation.”