دورية أكاديمية
أعرض في EDS

Evaluation of the modified Van Assche index for assessing response to anti-TNF therapy with MRI in perianal fistulizing Crohn's disease.

التفاصيل البيبلوغرافية
العنوان: Evaluation of the modified Van Assche index for assessing response to anti-TNF therapy with MRI in perianal fistulizing Crohn's disease.
المؤلفون: van Rijn KL; Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: k.l.vanrijn@amsterdamumc.nl., Lansdorp CA; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., Tielbeek JAW; Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands., Nio CY; Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands., Buskens CJ; Amsterdam UMC, University of Amsterdam, Department of Surgery, Meibergdreef 9, the Netherlands., D'Haens GRAM; Amsterdam UMC, University of Amsterdam, Department of Gastroenterology and Hepatology, Meibergdreef 9, Amsterdam, the Netherlands., Löwenberg M; Amsterdam UMC, University of Amsterdam, Department of Gastroenterology and Hepatology, Meibergdreef 9, Amsterdam, the Netherlands., Stoker J; Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, the Netherlands.
المصدر: Clinical imaging [Clin Imaging] 2020 Feb; Vol. 59 (2), pp. 179-187. Date of Electronic Publication: 2019 Nov 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8911831 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4499 (Electronic) Linking ISSN: 08997071 NLM ISO Abbreviation: Clin Imaging Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, NY] : Elsevier, [c1989-
مواضيع طبية MeSH: Adalimumab/*therapeutic use , Crohn Disease/*diagnostic imaging , Crohn Disease/*drug therapy , Infliximab/*therapeutic use , Magnetic Resonance Imaging/*methods , Rectal Fistula/*drug therapy, Adult ; Crohn Disease/complications ; Female ; Follow-Up Studies ; Gastrointestinal Agents/therapeutic use ; Humans ; Male ; Rectal Fistula/complications ; Retrospective Studies ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; Young Adult
مستخلص: Background: Structured evaluation of magnetic resonance imaging (MRI) is important to guide clinical decisions of perianal fistulas in Crohn's disease (CD) patients.
Purpose: To evaluate the recently developed modified Van Assche index to assess clinical responses to anti-tumor necrosis factor (TNF) therapy in patients with perianal fistulizing CD.
Methods: A search of medical records identified patients with fistulizing perianal CD who underwent baseline and follow-up MRI while receiving anti-TNF treatment. Patients were divided into clinical responders and non-responders based on physician's assessment. MRI-scans were scored using the original and modified Van Assche index and scores between baseline and follow-up were compared within clinical responders and non-responders.
Results: Thirty cases were included (48% female, median age 27 years). Clinical responders (n = 16) had a median modified Van Assche score of 9.6 (IQR 5.8-12.7) at baseline and 5.8 (IQR 3.5-8.5) at follow-up (p = 0.008). In non-responders (n = 14), corresponding scores were 7.7 (IQR 5.8-13.5) and 8.2 (IQR 5.8-11.5) (p = 0.624). In clinical responders, 6/16 showed no drop in modified Van Assche score at follow-up. Scores obtained with the original Van Assche index dropped between baseline and follow-up in clinical responders (13.0 vs. 9.6, p = 0.011), whereas no decrease was observed in non-responders (11.5 vs. 11.5, p = 0.324).
Conclusions: While the modified Van Assche index overall decreases significantly in patients with perianal fistulas responding to anti-TNF treatment, one third of responders had unaltered scores at follow-up. Also, outcomes were comparable to the original Van Assche index. Further optimization of the modified Van Assche index is needed before application in larger studies.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Anti-TNF therapy; Crohn's disease; Magnetic resonance imaging; Perianal fistula
المشرفين على المادة: 0 (Gastrointestinal Agents)
0 (Tumor Necrosis Factor-alpha)
B72HH48FLU (Infliximab)
FYS6T7F842 (Adalimumab)
تواريخ الأحداث: Date Created: 20191211 Date Completed: 20200330 Latest Revision: 20200330
رمز التحديث: 20231215
DOI: 10.1016/j.clinimag.2019.10.007
PMID: 31821976
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-4499
DOI:10.1016/j.clinimag.2019.10.007