In Crohn’s disease (CD), objective assessment of disease activity is critical for selecting the best treatment and monitoring the response to drug therapy.
Cross-sectional imaging enables the assessment of transmural lesions and extramural complications, providing additional information to complement ileocolonoscopy.
In clinical reserach of drug therapies, it is important to be able to identify and quantify the severity of gastrointestinal inflammation and disease-related complications, namely stenosing and penetrating lesions. Ileocolonoscopy is still considered the gold standard for CD lesion assessment. However, ileocolonoscopy has various drawbacks....
Methods and materials
We prospectively included patients with diagnosed CD that presented at least one intestinal segment with active and severe inflammation (defined as the presece of ulcers at the endoscopy).
Inclusion criteria for the substudy were age >18 years; established diagnosis of CD; presence of active disease on ileocolonoscopy (defined as Crohn’s Disease Endoscopic Index of Severity [CDEIS]> 3.5); presence of severe disease (ulcers) in at least one segment examined by ileocolonoscopy, and MRE and ileocolonoscopy before treatment initiation. Exclusion criteria were pregnancy; intolerance to or contraindications...
Data from 50 patients at baseline and 39 at week 46 were available; 11 patients were missing at the follow-up because 6 underwent surgey within the 46 weeks, 3 refused assesment by both techniques and 2 were lost during the follow-up. On a segment-by-segment analysis, at baseline, both sets had similar sensitivity (86% vs. 89%; p=0.6) and specificity for detecting active disease (92% vs. 93%; p=0.6) and similar sensitivity (87% vs. 85%; p=0.99) and specificity (95% vs. 94%; p=0.5) for detecting severe inflammation [Table 1]....
The sMaRIA can be applied without the use of gadolinium maintaining high accuracy and reliability for grading luminal inflammation and detecting therapeutic response.
Personal information and conflict of interest
N. Capozzi; Bologna/IT - nothing to disclose J. Rimola; Barcelona/ES - nothing to disclose A. Fernandez-Clotet; Barcelona/ES - nothing to disclose I. Ordás; Barcelona/ES - nothing to disclose J. Panes; Barcelona/ES - nothing to disclose E. Ricart; Barcelona/ES - nothing to disclose
Medicines Agency E. Committee for Medicinal Products for Human Use (CHMP) Guideline on the development of new medicinal products for the treatment of Crohn’s Disease Guideline on the development of new medicinal products for the treatment of Crohn’s Disease 2018;44(June 2018):1–19
Maaser C., Sturm A., Vavricka SR., Kucharzik T., Fiorino G., Annese V., et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohn’s Colitis 2019;13(2):144–64. Doi: 10.1093/ecco-jcc/jjy113
Bruining DH., Zimmermann EM., Loftus EV.,...