Editorial: Endoscopic Scoring Systems in Crohn's Disease for Evaluation of Responsiveness to Treatment: Are we Ready for the Prime Time of Endoscopic Assessment?

There are currently two validated endoscopic indices for evaluation of Crohn's disease (CD), the Crohn's disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's disease (SES-CD). The study by Khanna et al. evaluated the responsiveness of the SES-CD and CDEIS using data from a trial of adalimumab. The study used appropriate statistical methods to quantify responsiveness of the indices as assessed by blinded central readers. The SES-CD demonstrated numerically greater responsiveness to a treatment of known efficacy, suggestive that the SES-CD is more efficient outcome measure than the CDEIS. Removal of stenosis as an index item and adjusting for observed segments did not improve responsiveness. In the future, the implementation of the SES-CD into daily clinical practice may become a practical tool used by gastroenterologists when caring for patients with Crohn's disease. Further studies analyzing the responsiveness of the indices in combination with clinical and patients' driven outcomes are expected prior to the indices' use in "prime time".