Assessment of Treatment Response in Known Crohn's Disease-A Prospective Blinded Study Comparing the Diagnostic Accuracy of Intestinal Ultrasound, Magnetic Resonance Enterocolonography, Panenteric Capsule Endoscopy, and Fecal Calprotectin.

Autor:	Brodersen JB; Department of Internal Medicine, Section of Gastroenterology, Esbjerg Hospital - University Hospital of Southern Denmark, Esbjerg, Denmark.; Department of Regional Health Research, University of Southern Denmark, Region of Southern Denmark, Denmark., Rafaelsen SR; Department of Regional Health Research, University of Southern Denmark, Region of Southern Denmark, Denmark.; Department of Radiology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark., Juel MA; Department of Internal Medicine, Section of Gastroenterology, Esbjerg Hospital - University Hospital of Southern Denmark, Esbjerg, Denmark., Knudsen T; Department of Internal Medicine, Section of Gastroenterology, Esbjerg Hospital - University Hospital of Southern Denmark, Esbjerg, Denmark.; Department of Regional Health Research, University of Southern Denmark, Region of Southern Denmark, Denmark., Kjeldsen J; Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.; Research Unit of Medical Gastroenterology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark., Jensen MD; Department of Internal Medicine, Section of Gastroenterology, Esbjerg Hospital - University Hospital of Southern Denmark, Esbjerg, Denmark.; Department of Regional Health Research, University of Southern Denmark, Region of Southern Denmark, Denmark.
Jazyk:	angličtina
Zdroj:	Inflammatory bowel diseases [Inflamm Bowel Dis] 2024 Nov 04. Date of Electronic Publication: 2024 Nov 04.
DOI:	10.1093/ibd/izae254
Abstrakt:	Background: Minimally invasive modalities may replace ileocolonoscopy (IC) in the follow-up of Crohn's disease (CD). The aim of this study was to evaluate intestinal ultrasound (IUS), magnetic resonance enterocolonography (MREC), panenteric capsule endoscopy (PCE), and fecal calprotectin (FC) for determining response to medical treatment in patients with ileocolonic CD. Methods: This prospective, blinded, multicenter study included patients with endoscopically active CD. Patients were scheduled for IC, MREC, IUS, PCE, and FC before and 12 weeks after treatment with corticosteroids or biological therapy. A ≥50% reduction of the Simple Endoscopic Score for Crohn's Disease (SES-CD) with IC defined treatment response. Results: Fifty patients completed the pre- and posttreatment evaluation with IC, and endoscopic response was achieved in 25 (50.0%). PCE was omitted in 12 (24.0%) patients because of stricturing CD. All activity scores decreased in patients achieving endoscopic response: The Simple Ultrasound Score for Crohn's Disease 2.2 vs 6.1 (P < .001), Magnetic Resonance Index of Activity 29.0 vs 37.1 (P = .05), SES-CD with PCE 3.1 vs 12.8 (P < .001), and FC 115.3 vs 1339.9 mg/kg (P < .001). The sensitivity and specificity of IUS, MREC, PCE, and FC were 80.0% (95% CI, 56.3-94.3)/77.8% (95% CI, 52.4-93.6), 65.2% (95% CI, 42.7-83.6)/87.0% (95% CI, 66.4-97.2), 87.5% (95% CI, 61.7-98.4)/86.7% (95% CI, 59.5-98.3), and 90.0% (95% CI, 68.3-98.8)/86.4% (95% CI, 65.1-97.1), respectively. Conclusions: IUS and FC are equally effective for determining treatment response in patients with active CD. PCE is limited by the occurrence of strictures in this group of patients. (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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