Review article: Measuring disease severity in inflammatory bowel disease - Beyond treat to target.

Autor: Swaminathan A; Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.; Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand., Day AS; Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand., Sparrow MP; Department of Gastroenterology, Alfred Health and School of Translational Medicine, Monash University, Australia., Peyrin-Biroulet L; Department of Gastroenterology, Nancy University Hospital, Vandoevre-les-Nancy, France.; Department of Gastroenterology, INFINY Institute, FHU-CURE, INSERM NGERE, Nancy University Hospital, Vandoeuvre-les-Nancy, France.; Groupe Hospitalier privé Ambroise Paré - Hartmann, Paris IBD Center, Neuilly sur Seine, France.; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada., Siegel CA; Center for Digestive Health, Section of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Centre, Lebanon, New Hampshire, USA., Gearry RB; Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.; Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2024 Nov; Vol. 60 (9), pp. 1176-1199.
DOI: 10.1111/apt.18231
Abstrakt: Background: Inflammatory bowel disease (IBD) follows a heterogenous disease course and predicting a patient's prognosis is challenging. There is a wide burden of illness in IBD and existing tools measure disease activity at a snapshot in time. Comprehensive assessment of IBD severity should incorporate disease activity, prognosis, and the impacts of disease on a patient. This review investigates the concept of disease severity in adults with IBD to highlight key components contributing to this.
Methods: To perform this narrative review, a Medline search was conducted for full-text articles available at 1st March 2024 using search terms which encompassed disease activity assessment, disease severity, prognosis, natural history of Crohn's disease (CD) and ulcerative colitis (UC), and the burden of IBD.
Results: Current methods of disease assessment in IBD have evolved from a focus on the burden of symptoms to one that includes inflammatory targets, genetic, serological, and proteomic profiles, and assessments of quality-of-life (QoL), disability, and psychosocial health. Longitudinal studies of IBD suggest that the burden of illness is driven by disease phenotype, clinical markers of complicated disease course (previous intestinal resection, corticosteroid use, perianal disease in CD, recent hospitalisations in UC), gut inflammation, and the impact of IBD on the patient.
Conclusions: Disease severity in IBD can be difficult to conceptualise due to the multitude of factors that contribute to IBD outcomes. Measurement of IBD severity may better encapsulate the full burden of illness rather than gut inflammation alone at a single timepoint and may be associated with longitudinal outcomes.
(© 2024 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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