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DOI: 10.1055/s-0039-1681800
ENDOSCOPIC AND CLINICAL OUTCOMES IN CD PATIENTS: RESULTS OF A PROSPECTIVE STUDY
Publikationsverlauf
Publikationsdatum:
18. März 2019 (online)
Aims:
Our aim was to assess clinical and endoscopic outcomes in CD (Crohn's disease) patients enrolled in an IBD prospective cohort and to identify predictors of persistent inflammatory activity at follow-up.
Methods:
CD patients prospectively enrolled in an IBD cohort from a tertiary care center in Bucharest were followed annually, collecting clinical (CDAI, SIBDQ), endoscopic (SES-CD), biologic (CRP) data at each study visit.
Results:
Analysed data from 62 CD patients (visits (22% ileal, 46% colonic, 29% ileo-colonic disease extension) were included, totalling 143 study visits. In the final analysis, at baseline 43% of patients had clinical activity, 82% had active endoscopic disease and reported a poor quality of life (median SIBDQ score 4.7). Enrolled patients had mild endoscopic activity (median SES-CD score 5) and a low prevalence of stenosis (median SES-CD stenosis subscore 0). SES-CD scores improved significantly at first follow up visit (median SES-CD 3, p = 0.013, Mann-Whitney U test), as well as quality of life scores (median SIBDQ score at baseline 4.7 vs. 5.5 at first follow-up visit, p = 0.001, Mann-Whitney U test) and clinical remission rates (43% at baseline vs. 28% at follow-up, p = 0.04). In addition, we found a weak correlation for the SES-CD score with SIBDQ scores (r =-0.27, p = 0.019) and with CRP levels (r = 0.38, p < 0.01, Spearman's correlation).
Conclusions:
Under medical treatment, endoscopic and clinical parameters of CD patients improve at 12 months of follow-up. As there is no consensus regarding SES-CD cut-off scores for endoscopic remission it's difficult to interpret the significance of SES-CD score improvement. However, according to some authors [1], we could consider that a significant percent of enrolled patients achieved endoscopic remission at one year of follow-up, with 58% having SESCD ≤3.
References:
[1] Efstratios Koutroumpakis and Konstantinos H. Katsanos1. Implementation of the Simple Endoscopic Activity Score in Crohn's Disease. Saudi J Gastroenterol. 2016 May-Jun;22 (3):183 – 191.doi: [10.4103/1319 – 3767.182455]
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