Faecal Calprotectin and Magnetic Resonance Enterography in Ileal Crohn’s Disease: Correlations Between Disease Activity and Long-Term Follow-Up

Abstract Background Real-life long-term evidence on ustekinumab treatment response in patients with Crohn’s disease (CD) is scarce. We performed a retrospective non-interventional nationwide chart review study of dosing and long-term clinical outcomes in Finnish CD patients treated with ustekinumab (FINUSTE2, EUPAS30920). Methods FINUSTE2 involved 17 Finnish centres. Eligible patients were adults with CD, receiving an intravenous first dose of ustekinumab during 2017 or 2018. Disease activity data, such as C-reactive protein (CRP), faecal calprotectin (fCal), and the Simple Endoscopic Score for Crohn’s disease (SES-CD) were collected at baseline, 16 weeks, and one year from treatment initiation. A local gastroenterologist at each centre collected the data from health records in an electronic standardised health questionnaire. Results One hundred and fofty-five patients (48% female) with a mean age of 44 and disease duration of 14 years initiated ustekinumab treatment for CD. Table 1 summarises patient characteristics at baseline. After induction consisting of one intravenous dose and one to two subcutaneous doses at 8 to 16 weeks, 140 patients (93%) continued to maintenance treatment with subcutaneous ustekinumab. Of 93 patients with a follow-up of at least one year, 77 were still on ustekinumab. During ustekinumab treatment, SES-CD (10 at baseline, 3 at 1 year, medians, p = 0.033) and CRP (7 mg/l at baseline, 5 mg/l at 1 year, medians, p < 0.001) and fCal (776 μg/g at baseline, 305 μg/g at 1 year, medians, p < 0.001) decreased significantly in those patients with data available. Figure 1 describes changes in fCal levels over time. Conclusion In this nationwide real-life long-term follow-up study, covering all major centres in Finland, ustekinumab treatment of patients with highly refractory and long-standing CD effectively reduced inflammatory activity, assessed by endoscopy, CRP, and fCal.

Download Full-text

Evaluation of Crohn’s disease activity: Initial validation of a magnetic resonance enterography global score (MEGS) against faecal calprotectin

European Radiology ◽

10.1007/s00330-013-3010-z ◽

2013 ◽

Vol 24 (2) ◽

pp. 277-287 ◽

Cited By ~ 71

Author(s):

Jesica C. Makanyanga ◽

Doug Pendsé ◽

Nikolaos Dikaios ◽

Stuart Bloom ◽

Sara McCartney ◽

...

Keyword(s):

Crohn’S Disease ◽

Magnetic Resonance ◽

Crohn's Disease ◽

Disease Activity ◽

Magnetic Resonance Enterography ◽

Global Score ◽

Faecal Calprotectin ◽

Initial Validation ◽

Crohn’S Disease Activity

Download Full-text

Changes in the Management of Patients with Crohn’s Disease Based on Magnetic Resonance Enterography Patterns

Gastroenterology Research and Practice ◽

10.1155/2019/3467316 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Evelyn Sayuri S. Chinem ◽

Barbara C. Esberard ◽

Andre da L. Moreira ◽

Tatiana G. Barbassa ◽

Guilherme M. da Cunha ◽

...

Keyword(s):

Crohn’S Disease ◽

Magnetic Resonance ◽

Crohn's Disease ◽

Disease Activity ◽

Magnetic Resonance Enterography ◽

Medical Decisions ◽

Cross Sectional ◽

Therapeutic Decisions ◽

The Impact

Background and Aims. Magnetic resonance enterography (MRE) has become an important modality of radiological imaging in the evaluation of Crohn’s disease (CD). The aim of this study was to investigate the impact of MRE in the assessment of disease activity and abdominal complications and in the making of therapeutic decisions for patients with CD. Methods. In a cross-sectional retrospective study, we selected 74 patients with CD who underwent MRE and ileocolonoscopy with an interval between the two exams of up to 30 days between January 2011 and December 2017. We assessed the parameters of the images obtained by MRE and investigated the agreement with the level of disease activity and complications determined by a clinical evaluation, inflammatory biomarkers, and endoscopy, as well as the resulting changes in medical and surgical management. Results. Changes in medical management were detected in 41.9% of patients. Significant changes in medical decisions were observed in individuals with a purely penetrating (P=.012) or a mixed (P=.024) MRE pattern. Patients with normal MRE patterns had a correlation with unchanged medical decisions (P=.001). There were statistically significant agreements between the absence of inflammatory criteria on MRE and remission according to the Harvey and Bradshaw index (HBI) (P=.037), the presence of inflammatory criteria on MRE and positive results for calprotectin (P=.005), and penetrating criteria on MRE and the scoring endoscopic system for Crohn’s disease (SES-CD), indicating active disease (P=.048). Finally, there was significant agreement between the presence of fibrostenotic criteria and a long disease duration (P=.027). Conclusion. MRE discloses disease activity and complications not apparent with other modalities and results in changes in therapeutic decisions. In addition to being used for diagnosis, MRE should be routinely used in the follow-up of CD patients.

Download Full-text

Long term follow up of through the endoscope balloon dilatation as compared to strictureplasty and bowel resection of intestinal strictures in crohn's disease

Zeitschrift für Gastroenterologie ◽

10.1055/s-0031-1285149 ◽

2011 ◽

Vol 49 (08) ◽

Author(s):

E Krauss ◽

H Kessler ◽

A Gottfried ◽

W Hohenberger ◽

M Neurath ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Balloon Dilatation ◽

Bowel Resection ◽

Long Term Follow Up

Download Full-text

W1260 Maintenance of Clinical Benefit in Crohn's Disease Patients After Discontinuation of Infliximab: Long Term Follow-up of a Single Center Cohort

Gastroenterology ◽

10.1016/s0016-5085(10)63151-4 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-685

Author(s):

Alistair W. Waugh ◽

Karen Wong ◽

Richard N. Fedorak

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Clinical Benefit ◽

Single Center ◽

Long Term Follow Up

Download Full-text

Mo1806 Natural History of Perianal Crohn's Disease: Long-Term Follow-Up on a Population-Based Cohort

Gastroenterology ◽

10.1016/s0016-5085(16)32649-x ◽

2016 ◽

Vol 150 (4) ◽

pp. S781-S782

Author(s):

Rabilloud Marie-Laure ◽

Charlène Brochard ◽

Emma Bajeux ◽

Siproudhis Laurent ◽

Jean-François Viel ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Natural History ◽

Population Based ◽

Perianal Crohn’S Disease ◽

Long Term Follow Up ◽

History Of ◽

Perianal Crohn's Disease

Download Full-text

Improved Biochemical Parameters in Patients Who Undergo Early Resection in Isolated Ileocaecal Crohn’s Disease

Surgery Research and Practice ◽

10.1155/2017/4396573 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Mirzafaraz Saeed ◽

Hari Hullur ◽

Amro Salem ◽

Abbas Ali ◽

Yousif Sahib ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Surgical Resection ◽

Complete Blood Count ◽

Long Term Results ◽

Number Of Patients ◽

Long Term Follow Up ◽

One Year

Introduction. The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Methods. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results. There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F=19.8, p<0.001 and F=8.9, p=0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F=8.5, p=0.019 and F=8.3, p=0.013, resp.). Conclusion. Early surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.

Download Full-text