scholarly journals Usefulness of Endoscopic Indices in Determination of Disease Activity in Patients with Crohn’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Marcin Kucharski ◽  
Jacek Karczewski ◽  
Dorota Mańkowska-Wierzbicka ◽  
Katarzyna Karmelita-Katulska ◽  
Elżbieta Kaczmarek ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Histopathological Examination ◽  
Control Group ◽  
Endoscopic Score ◽  
Clinical Indices ◽  
Tract Disease ◽  
Severity Of The Disease

Background. Assessment of endoscopic activity of Crohn’s disease (CD) is of growing importance both in clinical practice and in clinical trials. The study aimed to assess which of the endoscopic indices used for evaluation of mucosal changes correlates with the currently used clinical indices for determination of disease activity and with the results of histopathological examination.Study. A group of 71 patients with CD and 52 individuals without a diagnosis of GI tract disease as a control group were investigated, considering clinical and histological severity of the disease and the severity of inflammatory changes in the bowel. Evaluation was conducted with the use of clinical, endoscopic, and histopathological indices. Endoscopic indices were then correlated with different clinical and histopathological indices with the aim of finding the strongest correlations.Results and Conclusions. Correlation between the clinical disease activity and the severity of endoscopic lesions in CD was shown in this study to be poor. The results also indicate that the optimal endoscopic index used in the diagnostic stage and in the assessment of treatment effects in CD is Simple Endoscopic Score for Crohn’s Disease (SES-CD).

Clinical Correlates of Urolithiasis in Ankylosing Spondylitis

2011 ◽  
Vol 38 (9) ◽  
pp. 1953-1956 ◽  
Author(s):  
NAI LEE LUI ◽  
ADELE CARTY ◽  
NIGIL HAROON ◽  
HUA SHEN ◽  
RICHARD J. COOK ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Ankylosing Spondylitis ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Functional Disability ◽  
Spinal Mobility ◽  
Joint Involvement ◽  
Control Group ◽  
Significant Difference ◽  
History Of

Objective.To determine the association between urolithiasis and syndesmophyte formation and the effect of urolithiasis on ankylosing spondylitis (AS) disease activity.Methods.In a longitudinal cohort of 504 patients with AS, we conducted an analysis of all patients with AS who have a history of urolithiasis. All patients met the modified New York criteria for AS. Demographics, clinical characteristics, extraarticular features, and comorbidities are systematically recorded in the database. We compared disease activity, functional indices, medical therapy and radiographic damage between AS patients with (Uro+) and without urolithiasis (Uro–) using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS).Results.Thirty-eight patients with AS (7.5%) had a history of urolithiasis in our cohort. Seventy-six patients with AS who did not have urolithiasis, matched for age, sex, and ethnicity, were selected as controls. Patients who were Uro+ were more likely to have more functional disability, based on the Bath AS Functional Index (BASFI; mean 5.3 vs 3.6 in control group, p = 0.003). Trends were noted in the Uro+ group toward higher Bath AS Disease Activity Index (BASDAI; mean 4.9 vs 4.0, p = 0.09), more peripheral joint involvement (p = 0.075), and higher frequency of biologic therapy (p = 0.09). No significant difference was detected in mSASSS or the Bath AS Metrology Index (BASMI). Significant association with diabetes mellitus (DM; p = 0.016) and Crohn’s disease (p = 0.006) was noted in the Uro+ group.Conclusion.Although there is no acceleration of syndesmophyte formation or spinal mobility restriction, more functional disability was detected in the urolithiasis group. The higher risk with concomitant DM or Crohn’s disease should alert clinicians to these comorbidities in Uro+ patients with AS.

Endoscopic Score Extracted From Scope Report Correlates With Crohn's Disease Activity and CT Enterography Findings

2011 ◽  
Vol 140 (5) ◽  
pp. S-426 ◽  
Author(s):  
Elan H. Green ◽  
Mahmoud M. Al-Hawary ◽  
Darashana Punglia ◽  
Ellen M. Zimmermann ◽  
Jeremy Adler
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Ct Enterography ◽  
Crohn’S Disease Activity ◽  
Endoscopic Score

B1a Lymphocytes (CD19+CD5+) Deficiency in Patients with Crohn’s Disease and Its Relation with Disease Severity

2018 ◽  
Vol 36 (3) ◽  
pp. 194-201 ◽  
Author(s):  
Rafael Gil-Borras ◽  
Carlos García-Ballesteros ◽  
Carmen Benet-Campos ◽  
Ignacio Catalán-Serra ◽  
Francisca López-Chuliá ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Severity ◽  
Peripheral Blood ◽  
Activity Index ◽  
Innate Immune ◽  
B1a Cells ◽  
Endoscopic Score ◽  
The Mean ◽  
Severity Of The Disease

Background/Aims: B1a cells (CD19+CD5+) are considered elements of the innate immune system. The aim of this study was to evaluate the frequency of B1a cells in the peripheral blood of patients with Crohn’s disease (CD) and its relation with disease severity. Methods: In this prospective study, a total of 128 subjects (64 CD patients and 64 healthy controls) were studied. B1a cells in peripheral blood, CD Activity Index, and Simple Endoscopic Score of B1a cells were studied. Results: A significant decrease of B1a cells in peripheral blood was observed in patients with CD versus controls (p = 0.002), especially in perforating or penetrating patterns (p = 0.017). A lower frequency of B1a cells is related to increased endoscopic severity (Spearman’s Rho: –0.559, p = 0.004). The mean frequency of B1a cells in patients with pre- and post-study surgery was significantly lower than that in patients who did not undergo surgery (p = 0.050 and p = 0.026, respectively). Conclusions: The B1a cell count in peripheral blood is lower in CD patients. This decrease is directly related to the severity of the disease (penetrating or perforating, Simple Endoscopy Score and surgery complication). These results pointed to the fact that B1a cells play an important role in immune protection in CD.

scholarly journals Serum Syndecan-1 Levels and Its Relationship to Disease Activity in Patients with Crohn’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Cem Çekiç ◽  
Adnan Kırcı ◽  
Sezgin Vatansever ◽  
Fatih Aslan ◽  
Huriye Erbak Yılmaz ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Activity Index ◽  
Normal Population ◽  
Disease Activity Index ◽  
Serum Levels ◽  
Control Group ◽  
Serum Samples ◽  
Reactive Protein

Background. Syndecan-1 (SDC-1), a member of the family of heparan sulfate proteoglycans, plays an important role in the resolution of inflammation. This study aimed to investigate the relationship between SDC-1 and disease activity in Crohn’s disease (CD).Methods. Serum samples of 54 patients with CD and 30 healthy controls were obtained. First, SDC-1 levels of the CD patients were compared to the control group. Subsequently, SDC-1 levels were analyzed in patients with CD in active and remission periods. Finally, SDC-1 efficacy in predicting disease activity was evaluated by performing correlation analysis between SDC-1 and C-reactive protein (CRP) and Crohn’s disease activity index (CDAI).Results. SDC-1 level was higher in the CD group (61.9 ± 42.6 ng/mL) compared with the control group (34.1 ± 8.0 ng/mL)p=0.03. SDC-1 levels were higher in active CD patients (97.1 ± 40.3 ng/mL) compared with those in remission (33.7 ± 13.5 ng/mL)p<0.001. A significant positive correlation was found between SDC-1 and CRP (r=0.687,p<0.001) and between SDC-1 and CDAI (r=0.747,p<0.001).Conclusion. Serum levels of SDC-1 are higher in CD compared to the normal population and can be an effective marker of disease severity.

scholarly journals Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

2014 ◽  
Vol 79 ◽  
pp. 70-74 ◽  
Author(s):  
Marcin Białecki ◽  
Agnieszka Białecka ◽  
Katarzyna Laskowska ◽  
Maria Kłopocka ◽  
Ariel Leibert ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Crohn’S Disease Activity

scholarly journals Correlation of Stool Frequency and Abdominal Pain Measures With Simple Endoscopic Score for Crohn’s Disease

2019 ◽  
Author(s):  
James D Lewis ◽  
Paul Rutgeerts ◽  
Brian G Feagan ◽  
Geert D’haens ◽  
Silvio Danese ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Linear Regression ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Stool Frequency ◽  
Endoscopic Score ◽  
Disease Location

Abstract Background The Crohn’s Disease Activity Index (CDAI) has been criticized for being weakly correlated with bowel inflammation. We assessed correlation between Simple Endoscopic Score for Crohn’s Disease (SES-CD) and individual CDAI items stratified by disease location to better understand this relationship. Methods We pooled patient-level data from 3 placebo-controlled Crohn’s disease (CD) trials that tested adalimumab, upadacitinib, and risankizumab. Disease location was defined as ileum only, colon only, or ileocolonic based upon colonoscopy at study entry. Pearson correlation coefficients and linear regression assessed correlations between items of the CDAI and SES-CD. Results A total of 353 patients were included (20.7% ileal, 30.6% colonic, 48.7% ileocolonic disease). Crohn’s Disease Activity Index and SES-CD scores were moderately correlated (R = 0.33; P < 0.001). Among CDAI items, the strongest correlations with SES-CD were seen with very soft or liquid stool frequency (SF) and patient-reported outcome 2 (PRO2; which includes SF and abdominal pain score; both R = 0.36; P < 0.001); these correlations were numerically stronger in colonic disease (SF: R = 0.46; P < 0.001; PRO2: R = 0.44; P < 0.001) than in ileal disease (SF: R = 0.14; P = 0.23; PRO2: R = 0.21; P = 0.07), although a test for interaction was not significant. In adjusted linear regression models, the proportion of mucosa that was inflamed and the proportion of mucosa with ulceration were positively correlated, whereas the presence of strictures was inversely correlated with SF. Conclusions The SF item of the CDAI is moderately correlated with SES-CD and independently correlated with mucosal ulceration, inflammation, and strictures. Understanding why bowel inflammation as measured endoscopically does not correlate more strongly with patients’ symptoms could help develop scales that link CD pathology to patient experience.

scholarly journals Lengthening adalimumab dosing interval in quiescent Crohn’s disease patients: protocol for the pragmatic randomised non-inferiority LADI study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035326
Author(s):  
L J T Smits ◽  
R W M Pauwels ◽  
W Kievit ◽  
D J de Jong ◽  
A C de Vries ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Cost Effectiveness ◽  
Crohn's Disease ◽  
Adverse Events ◽  
Disease Activity ◽  
Cumulative Incidence ◽  
Control Group ◽  
Physician Global Assessment ◽  
Dosing Interval

IntroductionAdalimumab is effective for maintenance of remission in patients with Crohn’s disease (CD) at a dose of 40 mg subcutaneously every 2 weeks. However, adalimumab is associated with (long-term) adverse events and is costly. The aim of this study is to demonstrate non-inferiority and cost-effectiveness of disease activity guided adalimumab interval lengthening compared to standard dosing of every other week (EOW).Methods and analysisThe Lengthening Adalimumab Dosing Interval (LADI) study is a pragmatic, multicentre, open label, randomised controlled non-inferiority trial. Non-inferiority is reached if the difference in cumulative incidence of persistent (>8 weeks) flares does not exceed the non-inferiority margin of 15%. 174 CD patients on adalimumab maintenance therapy in long-term (>9 months) clinical and biochemical remission will be included (C-reactive protein (CRP) <10 mg/L, faecal calprotectin (FC) <150 µg/g, Harvey-Bradshaw Index (HBI) <5). Patients will be randomised 2:1 into the intervention (adalimumab interval lengthening) or control group (adalimumab EOW). The intervention group will lengthen the adalimumab administration interval to every 3 weeks, and after 24 weeks to every 4 weeks. Clinical and biochemical disease activity will be monitored every 12 weeks by physician global assessment, HBI, CRP and FC. In case of disease flare, dosing will be increased. A flare is defined as two of three of the following criteria; FC>250 µg/g, CRP≥10 mg/l, HBI≥5. Secondary outcomes include cumulative incidence of transient flares, adverse events, predictors for successful dose reduction and cost-effectiveness.Ethics and disseminationThe study is approved by the Medical Ethics Committee Arnhem-Nijmegen, the Netherlands (registration number NL58948.091.16). Results will be published in peer-reviewed journals and presented at international conferences.Trial registration numbersEudraCT registry (2016-003321-42); Clinicaltrials.gov registry (NCT03172377); Dutch trial registry (NTRID6417).

scholarly journals Arthritis Associated with Crohn's Disease

1990 ◽  
Vol 4 (8) ◽  
pp. 497-502 ◽  
Author(s):  
JM Gilvarry ◽  
F Keeling ◽  
O Fitzgerald ◽  
JF Fielding
Keyword(s):  
Crohn’S Disease ◽  
Ankylosing Spondylitis ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Disease Onset ◽  
Close Correlation ◽  
Control Group ◽  
Hypertrophic Osteoarthropathy ◽  
Hla B27 ◽  
Peripheral Arthritis

A controlled prospective study was undertaken to determine the incidence and characteristic features of peripheral arthritis, sacroiliitis, ankylosing spondylitis and hypertrophic osteoarthropathy in a group of patients with Crohn's disease, and to define the relationship of such arthritides with disease site, duration and activity. Peripheral arthritis occurred in 14.5% of the patients; it was not seen in the control group. This arthritis, which tended to be pauciarticular, was more common in females with large bowel disease and post dated the bowel symptoms in all but one patient. There was close correlation with disease activity. Radiographic sacroiliitis occurred in 12.7% of the patients and ankylosing spondylitis in 7.3%; neither of these were seen in the control group. Sacroiliitis was more common in females and showed no correlation with either disease activity or human lymphocyte antigen (HLA) B27. Ankylosing spondylitis was seen equally in males and females and showed close correlation with both disease activity and HLA B27. Hypertrophic osteoarthropathy occurred in 9.1% of patients. It was not seen in the control group. All patients were asymptomatic. It showed no correlation with disease activity, finger clubbing, age of disease onset, or HLA B27.

scholarly journals The Relationship between Serum Bilirubin and Inflammatory Bowel Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaojing Zhao ◽  
Linzhen Li ◽  
Xueting Li ◽  
Jiajia Li ◽  
Di Wang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Control Group ◽  
Serum Total Bilirubin ◽  
Negatively Associated ◽  
Mayo Score ◽  
Inflammatory Bowel

The associations between serum total bilirubin (sTB) levels, inflammatory marker levels, and disease activity are not well understood in patients with inflammatory bowel disease (IBD). The present study investigated the association between sTB levels and disease activity in patients with IBD. We conducted a retrospective study with a total of 242 consecutive patients with Crohn’s disease (CD) and 211 consecutive patients with ulcerative colitis (UC). The Crohn’s Disease Activity Index (CDAI) score was used to assess disease activity in patients with CD and the Mayo score of patients with UC. 255 clinically healthy subjects comprised the control group, which come from the same geographic area as the IBD group. We retrieved the clinical and laboratory parameters of patients with IBD from the medical records. Patients with IBD displayed significantly lower sTB levels than controls. sTB levels were negatively associated with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin (FC), and hemoglobin (Hb) levels in patients with IBD. Additionally, there was a negative association between sTB levels and the CDAI score of patients with CD. sTB levels were also negatively associated with the Mayo score of patients with UC. IBD patients had lower sTB levels when compared with controls, and there was a negative correlation between sTB levels and disease activity in patients with IBD. Increased reactive oxygen species production in IBD is likely to be responsible for increased consumption of bilirubin in patients with IBD, leading to further intestinal injury. Reducing oxidative stress may be therapeutic for these patients.

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