P240 CDEIS score of 2 is optimal cut-off associated with lower risk of disease progression in early Crohn’s disease: Data from the CALM study
العنوان: | P240 CDEIS score of 2 is optimal cut-off associated with lower risk of disease progression in early Crohn’s disease: Data from the CALM study |
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المؤلفون: | G. D'Haens, G. Irina, John P. Wright, Carol Stanciu, Mathurin Fumery, Mircea Diculescu, L Peyrin-Biroulet, D. Laharie, Jonas Halfvarson, Grażyna Rydzewska, Clara Yzet, Satoshi Motoya, Marc Ferrante, Stefan Schreiber, O. Prymak, J.-F. Colombel, Alessandro Armuzzi, Gerhard Rogler, Adrian Goldis, Remo Panaccione, Simon Travis, Ryan C. Ungaro, Robyn Jordan, Oleksandr Golovchenko, P Bossuyt, F Baert, Fernando Gomollón, Walter Reinisch, Per M. Hellström, Silvio Danese, Gottfried Novacek, Benjamin Pariente, V. Wilhelmus Joustra, Erik Hertervig, Xavier Hébuterne, Tomas Vanasek, Mélanie Serrero |
المصدر: | Journal of Crohn's and Colitis. 14:S264-S266 |
بيانات النشر: | Oxford University Press (OUP), 2020. |
سنة النشر: | 2020 |
مصطلحات موضوعية: | medicine.medical_specialty, Crohn's disease, medicine.diagnostic_test, business.industry, Medical record, Disease progression, Gastroenterology, General Medicine, Disease, medicine.disease, Lower risk, Endoscopy, Internal medicine, medicine, Pathologic fistula, Abscess, business |
الوصف: | Background The optimal endoscopic target in early Crohn’s disease (CD) that limits long-term disease complications is unknown. Methods We analysed medical records from patients who had follow-up data since the end of CALM. Patients with Crohn’s disease endoscopic index of severity (CDEIS) scores at the end of CALM were included. The primary outcome was a composite of major adverse outcomes reflecting CD progression: new internal fistula/abscess, stricture, perianal fistula/abscess, CD hospitalisation, or CD surgery since the end of CALM. We compared median CDEIS and per cent improvement from baseline CDEIS. Youden index analysis was used to identify optimal CDEIS cut-off score associated with CD progression. Kaplan–Meier and Cox regression methods were used to compare rates of progression by different CDEIS targets. Multivariable models were adjusted for age, prior surgery, and stricturing behaviour. Results 110 patients with median age 28 (IQR 22–38) years, disease duration 0.2 (0.1–0.5) years, and median follow up of 3.1 (1.9–4.4) years were included. Eleven per cent had a history of stricture, 5.5% history of surgery, and 52% were originally in the tight control arm of the CALM study. Median CDEIS score at end of CALM was 3 (0–5.4) and 32 (29%) patients had disease progression. Baseline median CDEIS score was similar between those with and without progression [10.9 (7.5–15.5) vs. 11.9 (8–17.5)]. Median CDEIS score at the end of CALM was higher among those with progression [1.3 (0–5.1) vs. 4.9 (3–9.1), p < 0.001)]. Patients within higher quartiles of CDEIS score had higher rates of progression over time (Figure 1). Patients without disease progression had a greater median decrease in CDEIS score from baseline to end of CALM [90% (60–100%) vs. 50% (30–80%), p < 0.001]. The optimal CDEIS score cut-off was 2 with sensitivity 84%, specificity 60% and NPV 90% for progression. Patients with CDEIS ≤ 2 had less progression over time compared with patients with > 50% improvement from baseline CDEIS (not reaching CDEIS ≤ 2) and those not meeting either endpoint (Figure 2). On adjusted analysis, CDEIS score ≤ 2 was associated with a decreased risk of progression (aHR 0.23, 95% CI 0.09–0.56). Conclusion In early CD, a CDEIS score ≤ 2 is optimal cut-off associated with a lower risk of disease progression. |
تدمد: | 1876-4479 1873-9946 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::68c55b8eecb19b93c3a3b47c2555ca3a https://doi.org/10.1093/ecco-jcc/jjz203.369 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi...........68c55b8eecb19b93c3a3b47c2555ca3a |
قاعدة البيانات: | OpenAIRE |
تدمد: | 18764479 18739946 |
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