Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Validation of endoscopic activity scores in patients with Crohn's disease

A post hoc analysis reported in November's issue of Gastroenterology validates endoscopic activity scores in patients with Crohn's disease.

News image

Mucosal healing might alter midterm and long-term outcomes of patients with Crohn's disease (CD) and has become an important end point in clinical trials.

However, the minimal degree of mucosal improvement (endoscopic response) required to alter midterm outcomes is not known.

Dr Marc Ferrante and colleagues from Belgium determined the best definition of endoscopic response by evaluating data on the Simple Endoscopic Score for Crohn's Disease (SES-CD), and the Crohn's Disease Endoscopic Index of Severity (CDEIS) from the Study of Biologic and Immunomodulator Naive Patients in Crohn's Disease (SONIC trial).

The researchers analyzed data from 172 patients who participated in the SONIC trial, were found to have endoscopic lesions at baseline, and underwent a second endoscopic examination at week 26 of treatment with infliximab, azathioprine, or both.

The team defined mucosal healing as absence of ulcers.

The relative risk was 0.80 for an increment of 1 cup of coffee per day
Gastroenterology

A central reader calculated SES-CD and CDEIS results.

Different cutoff values were set for endoscopic response based on the SES-CD or CDEIS.

The diagnostic ability of these different cutoff values was evaluated using receiver operating characteristic curves, positive likelihood ratios, and negative likelihood ratios.

Corticosteroid-free clinical remission (CFREM) at week 50 was used as a binary classifier.

Based on analyses of ROC curves, positive likelihood ratios, and negative likelihood ratios, endoscopic response was defined as a decrease from baseline in SES-CD of at least 50%.

The research team found that at week 26, mucosal healing and endoscopic response were achieved in 48% and 65% of patients, respectively.

Mucosal healing at week 26 was associated with CFREM at week 50, with 56% sensitivity, 65% specificity, a positive likelihood ratios of 1.60, and an negative likelihood ratios of 0.67.

Endoscopic response at week 26 was associated with CFREM at week 50, with 74% sensitivity, 48% specificity, a positive likelihood ratios of 1.42, and an negative likelihood ratios of 0.54.

The team observed that endoscopic response, defined as a decrease from baseline in CDEIS of at least 50%, yielded similar results.

Dr Ferrante's team concludes, "In patients with Crohn's disease, mucosal healing and endoscopic response at week 26 of treatment identified those most likely to be in CFREM at week 50."

"The ability of the proposed endoscopic response cutoff value to predict midterm CFREM should be validated in an independent, prospective cohort."

"Its correlation with changes in long-term disease progression still needs to be demonstration."

Gastroenterol 2013: 145(5): 978-986.e5
25 October 2013

Go to top of page Email this page Email this page to a colleague

 01 October 2014

Advanced search
 01 October 2014 
Cecal intubation time during colonoscopy
 01 October 2014 
Anti-TNFa therapies during pregnancy in IBD
 01 October 2014 
Prevention of postop Crohn's
 30 September 2014 
Medication use in patients with chronic Hep C
 30 September 2014 
Gastric cancer according to H pylori infection status
 30 September 2014 
Autoimmune hepatitis
 29 September 2014 
Peptic ulcer bleeding after PPI treatment
 29 September 2014 
Intestinal tuberculosis vs Crohn's disease
 29 September 2014 
Drug exposure and microscopic colitis
 26 September 2014 
Ondansetron for IBS with diarrhea
 26 September 2014 
5-aminosalicylates for the treatment of Crohn's
 26 September 2014 
Response to infliximab in paediatric perianal Crohn's
 25 September 2014 
Colorectal neoplasia among family members of patients with colorectal cancer
 25 September 2014 
Medical treatment and surgery rates in IBD
 25 September 2014 
Liver transplants for liver cancer
 24 September 2014 
PPIs after antireflux surgery
 24 September 2014 
Antidepressants in chronic liver disease
 24 September 2014 
Health services burden of IBD
 23 September 2014 
Upper GI bleeding with drug combinations
 23 September 2014 
Recurrence of Barrett's neoplasia after resection
 23 September 2014 
Abnormal prion protein in appendixes
 22 September 2014 
Anorectal function after low anterior resection
 22 September 2014 

Anorectal stricture in Crohn's

 22 September 2014 
Malignancies in celiac disease
 19 September 2014 
Adhesions in abdominal and pelvic surgery
 19 September 2014 
Repeat colonoscopy among US Medicare
 19 September 2014 
Progression to liver cancer in HCV-infected Veterans
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 12 September 2014 
Management of complex colon polyps
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us