Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission

Makoto Naganuma, Tadakazu Hisamatsu, Katsuyoshi Matsuoka, Hiroki Kiyohara, Mari Arai, Shinya Sugimoto, Kiyoto Mori, Kosaku Nanki, Keiko Ohno, Makoto Mutaguchi, Shinta Mizuno, Rieko Bessho, Yoshihiro Nakazato, Naoki Hosoe, Nagamu Inoue, Yasushi Iwao, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Mucosal healing has emerged as a desirable treatment goal in clinical practice for patients with Crohn's disease (CD). The aim of this study was to assess the relationship between endoscopic activity and the long-term prognosis of CD using simple endoscopic score for Crohn's disease (SESCD) and Rutgeerts' score. Methods: We conducted a cohort study in clinical practice at a single center. Among CD patients who underwent colonoscopy between July 2008 and June 2011 at our hospital, 131 patients with clinical remission were selected, and the patients were divided into 2 groups: a non-surgical group (n = 84) and a surgical group (n = 47). The primary endpoint of this study was to assess the associations between variables and clinical relapse after endoscopic procedures. The cut-off levels of SESCD or Rutgeerts' score for the prediction of relapse were also assessed in patients with clinical remission. Results: In the non-surgical group, SESCD and C-reactive protein at baseline were significantly higher in patients who had clinical recurrence than in patients who maintained remission. A factor of SESCD ≤2 was independently associated with sustained remission, even in patients with clinical remission. In the surgical group, patients with Rutgeerts' scores ≤1 had significantly prolonged clinical remission compared to patients with Rutgeerts' scores ≥3. Conclusion: A cut-off value of SESCD ≤2 and a Rutgeerts' score ≤1 enabled the prediction of long-term prognosis. These cut-off values could be used in clinical trials of endoscopic remission from the point of view of the clinical outcomes of CD.

Original languageEnglish
Pages (from-to)66-71
Number of pages6
JournalDigestion
Volume93
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Crohn Disease
Recurrence
Colonoscopy
C-Reactive Protein
Cohort Studies
Clinical Trials

Keywords

  • Crohn's disease
  • Rutgeerts' score
  • SESCD

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission. / Naganuma, Makoto; Hisamatsu, Tadakazu; Matsuoka, Katsuyoshi; Kiyohara, Hiroki; Arai, Mari; Sugimoto, Shinya; Mori, Kiyoto; Nanki, Kosaku; Ohno, Keiko; Mutaguchi, Makoto; Mizuno, Shinta; Bessho, Rieko; Nakazato, Yoshihiro; Hosoe, Naoki; Inoue, Nagamu; Iwao, Yasushi; Ogata, Haruhiko; Kanai, Takanori.

In: Digestion, Vol. 93, No. 1, 01.01.2016, p. 66-71.

Research output: Contribution to journalArticle

Naganuma, Makoto ; Hisamatsu, Tadakazu ; Matsuoka, Katsuyoshi ; Kiyohara, Hiroki ; Arai, Mari ; Sugimoto, Shinya ; Mori, Kiyoto ; Nanki, Kosaku ; Ohno, Keiko ; Mutaguchi, Makoto ; Mizuno, Shinta ; Bessho, Rieko ; Nakazato, Yoshihiro ; Hosoe, Naoki ; Inoue, Nagamu ; Iwao, Yasushi ; Ogata, Haruhiko ; Kanai, Takanori. / Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission. In: Digestion. 2016 ; Vol. 93, No. 1. pp. 66-71.
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AU - Naganuma, Makoto

AU - Hisamatsu, Tadakazu

AU - Matsuoka, Katsuyoshi

AU - Kiyohara, Hiroki

AU - Arai, Mari

AU - Sugimoto, Shinya

AU - Mori, Kiyoto

AU - Nanki, Kosaku

AU - Ohno, Keiko

AU - Mutaguchi, Makoto

AU - Mizuno, Shinta

AU - Bessho, Rieko

AU - Nakazato, Yoshihiro

AU - Hosoe, Naoki

AU - Inoue, Nagamu

AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Kanai, Takanori

PY - 2016/1/1

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N2 - Introduction: Mucosal healing has emerged as a desirable treatment goal in clinical practice for patients with Crohn's disease (CD). The aim of this study was to assess the relationship between endoscopic activity and the long-term prognosis of CD using simple endoscopic score for Crohn's disease (SESCD) and Rutgeerts' score. Methods: We conducted a cohort study in clinical practice at a single center. Among CD patients who underwent colonoscopy between July 2008 and June 2011 at our hospital, 131 patients with clinical remission were selected, and the patients were divided into 2 groups: a non-surgical group (n = 84) and a surgical group (n = 47). The primary endpoint of this study was to assess the associations between variables and clinical relapse after endoscopic procedures. The cut-off levels of SESCD or Rutgeerts' score for the prediction of relapse were also assessed in patients with clinical remission. Results: In the non-surgical group, SESCD and C-reactive protein at baseline were significantly higher in patients who had clinical recurrence than in patients who maintained remission. A factor of SESCD ≤2 was independently associated with sustained remission, even in patients with clinical remission. In the surgical group, patients with Rutgeerts' scores ≤1 had significantly prolonged clinical remission compared to patients with Rutgeerts' scores ≥3. Conclusion: A cut-off value of SESCD ≤2 and a Rutgeerts' score ≤1 enabled the prediction of long-term prognosis. These cut-off values could be used in clinical trials of endoscopic remission from the point of view of the clinical outcomes of CD.

AB - Introduction: Mucosal healing has emerged as a desirable treatment goal in clinical practice for patients with Crohn's disease (CD). The aim of this study was to assess the relationship between endoscopic activity and the long-term prognosis of CD using simple endoscopic score for Crohn's disease (SESCD) and Rutgeerts' score. Methods: We conducted a cohort study in clinical practice at a single center. Among CD patients who underwent colonoscopy between July 2008 and June 2011 at our hospital, 131 patients with clinical remission were selected, and the patients were divided into 2 groups: a non-surgical group (n = 84) and a surgical group (n = 47). The primary endpoint of this study was to assess the associations between variables and clinical relapse after endoscopic procedures. The cut-off levels of SESCD or Rutgeerts' score for the prediction of relapse were also assessed in patients with clinical remission. Results: In the non-surgical group, SESCD and C-reactive protein at baseline were significantly higher in patients who had clinical recurrence than in patients who maintained remission. A factor of SESCD ≤2 was independently associated with sustained remission, even in patients with clinical remission. In the surgical group, patients with Rutgeerts' scores ≤1 had significantly prolonged clinical remission compared to patients with Rutgeerts' scores ≥3. Conclusion: A cut-off value of SESCD ≤2 and a Rutgeerts' score ≤1 enabled the prediction of long-term prognosis. These cut-off values could be used in clinical trials of endoscopic remission from the point of view of the clinical outcomes of CD.

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KW - Rutgeerts' score

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