Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 04 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 04 May 2016 
Anti-TNF therapy for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
PPIs and gut microbiota
 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 29 April 2016 
Crohn's disease associated genes
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 28 April 2016 
Racial disparities in survival from colon cancer
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 27 April 2016 
Dust mite and human GI tract
 27 April 2016 
Ultra-short celiac disease
 27 April 2016 
Celiac disease in adults
 26 April 2016 
Polyp detection during colonoscopy
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
IBS and microscopic colitis
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Acceptance of Liver transplant center organ offers
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naïve children
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 07 April 2016 
HBV during immunosuppressive therapies
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 05 April 2016 
Colorectal cancer risk with serrated polyps
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 31 March 2016 
Management of Barrett’s esophagus
 30 March 2016 
Depression and symptoms in IBS
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 29 March 2016 
Statins and survival in esophageal cancer
 29 March 2016 
Infant feeding practices and celiac disease
 25 March 2016 
Medical therapy and neoplasia regression in familial adenomatous polyposis
 25 March 2016 
Medical therapy compliance and ulcerative colitis recurrence
 25 March 2016 
Predicting outcomes of drug-induced acute liver failure
 24 March 2016 
Thrombocytopenia and multi-organ system failure in acute liver failure

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us