F Dias de Castro1, Pedro Boal Carvalho2, Sara Monteiro2, Bruno Rosa2, João Firmino-Machado3, Maria João Moreira2, José Cotter4. 1. Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal franciscacastro@chaa.min-saude.pt. 2. Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal. 3. Unidade de Saúde Pública, ACES Porto Ocidental, Porto, Portugal. 4. Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal. ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal.
Abstract
BACKGROUND AND AIMS: Small bowel capsule endoscopy (SBCE) allows mapping of small bowel inflammation in Crohn's disease (CD). We aimed to assess the prognostic value of the severity of inflammatory lesions, quantified by the Lewis score (LS), in patients with isolated small bowel CD. METHODS: A retrospective study was performed in which 53 patients with isolated small bowel CD were submitted to SBCE at the time of diagnosis. The Lewis score was calculated and patients had at least 12 months of follow-up after diagnosis. As adverse events we defined disease flare requiring systemic corticosteroid therapy, hospitalization and/or surgery during follow-up. We compared the incidence of adverse events in 2 patient subgroups, i.e. those with moderate or severe inflammatory activity (LS ≥790) and those with mild inflammatory activity (135 ≤ LS < 790). RESULTS: The LS was ≥790 in 22 patients (41.5%), while 58.5% presented with LS between 135 and 790. Patients with a higher LS were more frequently smokers (p = 0.01), males (p = 0017) and under immunosuppressive therapy (p = 0.004). In multivariate analysis, moderate to severe disease at SBCE was independently associated with corticosteroid therapy during follow-up, with a relative risk (RR) of 5 (p = 0.011; 95% confidence interval [CI] 1.5-17.8), and for hospitalization, with an RR of 13.7 (p = 0 .028; 95% CI 1.3-141.9). CONCLUSION: In patients with moderate to severe inflammatory activity there were higher prevalences of corticosteroid therapy demand and hospitalization during follow-up. Thus, stratifying the degree of small bowel inflammatory activity with SBCE and LS calculation at the time of diagnosis provided relevant prognostic value in patients with isolated small bowel CD.
BACKGROUND AND AIMS: Small bowel capsule endoscopy (SBCE) allows mapping of small bowel inflammation in Crohn's disease (CD). We aimed to assess the prognostic value of the severity of inflammatory lesions, quantified by the Lewis score (LS), in patients with isolated small bowel CD. METHODS: A retrospective study was performed in which 53 patients with isolated small bowel CD were submitted to SBCE at the time of diagnosis. The Lewis score was calculated and patients had at least 12 months of follow-up after diagnosis. As adverse events we defined disease flare requiring systemic corticosteroid therapy, hospitalization and/or surgery during follow-up. We compared the incidence of adverse events in 2 patient subgroups, i.e. those with moderate or severe inflammatory activity (LS ≥790) and those with mild inflammatory activity (135 ≤ LS < 790). RESULTS: The LS was ≥790 in 22 patients (41.5%), while 58.5% presented with LS between 135 and 790. Patients with a higher LS were more frequently smokers (p = 0.01), males (p = 0017) and under immunosuppressive therapy (p = 0.004). In multivariate analysis, moderate to severe disease at SBCE was independently associated with corticosteroid therapy during follow-up, with a relative risk (RR) of 5 (p = 0.011; 95% confidence interval [CI] 1.5-17.8), and for hospitalization, with an RR of 13.7 (p = 0 .028; 95% CI 1.3-141.9). CONCLUSION: In patients with moderate to severe inflammatory activity there were higher prevalences of corticosteroid therapy demand and hospitalization during follow-up. Thus, stratifying the degree of small bowel inflammatory activity with SBCE and LS calculation at the time of diagnosis provided relevant prognostic value in patients with isolated small bowel CD.
Authors: Marisol Luján-Sanchis; Laura Sanchis-Artero; Laura Larrey-Ruiz; Laura Peño-Muñoz; Paola Núñez-Martínez; Génesis Castillo-López; Lara González-González; Carlos Boix Clemente; Cecilia Albert Antequera; Ana Durá-Ayet; Javier Sempere-Garcia-Argüelles Journal: World J Gastrointest Endosc Date: 2016-09-16
Authors: Foong Way D Tai; Pierre Ellul; Alfonso Elosua; Ignacio Fernandez-Urien; Gian E Tontini; Luca Elli; Rami Eliakim; Uri Kopylov; Sara Koo; Clare Parker; Simon Panter; Reena Sidhu; Mark McAlindon Journal: United European Gastroenterol J Date: 2021-03-19 Impact factor: 4.623
Authors: Bruno Rosa; Rolando Pinho; Susana Mão de Ferro; Nuno Almeida; José Cotter; Miguel Mascarenhas Saraiva Journal: GE Port J Gastroenterol Date: 2015-10-01