Apex Score: Predicting Flares in Small-Bowel Crohn’s Disease After Mucosal Healing

2021 ◽  
Author(s):  
Vítor Macedo Silva ◽  
Marta Freitas ◽  
Pedro Boal Carvalho ◽  
Francisca Dias de Castro ◽  
Tiago Cúrdia Gonçalves ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Mucosal Healing

Higher concentrations of cytokine blockers are needed to obtain small bowel mucosal healing during maintenance therapy in Crohn's disease

2021 ◽  
Author(s):  
Kento Takenaka ◽  
Ami Kawamoto ◽  
Shuji Hibiya ◽  
Kohei Suzuki ◽  
Toshimitsu Fujii ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Maintenance Therapy ◽  
Mucosal Healing

Su1224 Small Bowel Mucosal Healing and Deep Remission in Patients With Known Small Bowel Crohn's Disease

2015 ◽  
Vol 148 (4) ◽  
pp. S-443-S-444
Author(s):  
Uri Kopylov ◽  
Doron Yablecovitch ◽  
Adi Lahat ◽  
Sandra Neuman ◽  
Nina Levhar ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Mucosal Healing

scholarly journals P138 Platelet-to-lymphocyte ratio index: a reliable tool for non-invasive assessment of endoscopic activity in small bowel Crohn’s Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S225-S225
Author(s):  
V Macedo Silva ◽  
M Freitas ◽  
S Xavier ◽  
T Cúrdia Gonçalves ◽  
P Boal Carvalho ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Fecal Calprotectin ◽  
Mucosal Healing ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Non Invasive

Abstract Background The platelet-to-lymphocyte ratio (PLR) index has been a recent focus of investigation as a reliable marker of inflammation. This score was recently shown to have a good accuracy upon predicting endoscopic remission in patients with colonic Crohn’s Disease (CD). We aimed to assess the discriminative power of PLR index in patients with isolated small bowel CD. Methods Single center study of consecutive patients with isolated small bowel CD (L1 ± L4 disease according to Montreal classification) who underwent small bowel capsule endoscopy (SBCE) for assessment of endoscopic activity between January 2019 and December 2020. Only complete SBCEs were considered. CD endoscopic activity was classified according to the Lewis score (LS) value. Complete blood count, C-reactive protein and fecal calprotectin values were collected within 1 month of SBCE. Results Final sample included 49 patients, 35 (71.4%) of them females, with a mean age of 35.1±11.8 years. SBCE reported mucosal healing (LS<135) in 30.6% of the patients; mild activity (135≤LS<790) in 42.9% and moderate-to-severe activity (LS≥790) in 26.5% of the patients. PLR index positive correlation with LS was significant and moderate (k=0.597; p<0.001). This correlation was stronger than the one seen between fecal calprotectin (k=0.525; p=0.001) or C-reactive protein (k=0.321; p=0.029) and the LS score. In particular, PLR index presented an excellent accuracy for predicting patients with a moderate-to-severe endoscopic activity (AUC=0.908; 95%CI=0.816–0.999; p<0.001), with an optimal cut-off of PLR above 157 (sensitivity 92.3%; specificity 82.9%). The accuracy for prediction of mucosal healing was good (AUC=0.743; 95%CI=0.600–0.887; p=0.007), with an optimal cut-off of PLR below 126 (sensitivity 66.7%; specificity 80.0%). Conclusion PLR index demonstrated an excellent acuity for predicting patients with moderate to severe disease in small bowel CD. Moreover, it also demonstrated good acuity for predicting mucosal healing on this set of patients. These results come from a significant correlation of PLR index with endoscopic activity in small bowel CD. Our findings establish this index as a promising and easy-to-apply tool for non-invasive and regular follow-up of patients with small bowel CD.

scholarly journals Panenteric capsule endoscopy identifies proximal small bowel disease guiding upstaging and treatment intensification in Crohn’s disease: A European multicentre observational cohort study

2020 ◽  
pp. 205064062094866 ◽  
Author(s):  
Foong Way D Tai ◽  
Pierre Ellul ◽  
Alfonso Elosua ◽  
Ignacio Fernandez-Urien ◽  
Gian E Tontini ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Bowel Disease ◽  
Mucosal Healing ◽  
Small Bowel Disease ◽  
Treatment Intensification ◽  
Non Invasive ◽  
Proximal Small Bowel

Background Endoscopically defined mucosal healing in Crohn’s disease is associated with improved outcomes. Panenteric capsule endoscopy enables a single non-invasive assessment of small and large bowel mucosal inflammation. Aims and methods: This multicentre observational study of patients with suspected and established Crohn’s disease examined the feasibility, safety and impact on patient outcomes of panenteric capsule endoscopy in routine clinical practice. The potential role in assessment of disease severity and extent by a comparison with existing clinical and biochemical markers is examined. Results Panenteric capsule endoscopy was performed on 93 patients (71 with established and 22 with suspected Crohn’s disease). A complete examination occurred in 85% (79/93). Two cases (2.8%) of capsule retention occurred in patients with established Crohn’s disease. Panenteric capsule resulted in management change in 38.7% (36/93) patients, including 64.6% (32/48) of those with an established diagnosis whose disease was active, and all three patients with newly diagnosed Crohn’s disease. Montreal classification was upstaged in 33.8% of patients with established Crohn’s disease and mucosal healing was demonstrated in 15.5%. Proximal small bowel disease upstaged disease in 12.7% and predicted escalation of therapy (odds ratio 40.3, 95% confidence interval 3.6–450.2). Raised C-reactive protein and faecal calprotectin were poorly sensitive in detecting active disease (0.48 and 0.59 respectively). Conclusions Panenteric capsule endoscopy was feasible in routine practice and the ability to detect proximal small bowel disease may allow better estimation of prognosis and guide treatment intensification. Panenteric capsule endoscopy may be a suitable non-invasive endoscopic investigation in determining disease activity and supporting management decisions.

Tu1141 Mucosal Healing of Small Bowel Crohn's Disease After Anti-TNFα Therapy Assessed by Capsule Endoscopy

2013 ◽  
Vol 144 (5) ◽  
pp. S-773 ◽  
Author(s):  
Nadezda Machkova ◽  
Dana Duricova ◽  
Martin Bortlik ◽  
Ludek Hrdlicka ◽  
Martin Lukas ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Mucosal Healing
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