Assessment of appropriate laboratory measurements to supplement the Crohn's disease activity index.

André, Chantal; Descos, L; Landais, Paul; Fermanian, Jacques

doi:10.1136/gut.22.7.571

Cited by 144 publications

(51 citation statements)

References 7 publications

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“…T hese observat ions need co be confirmed, and considered before incorporatmg any of the laboratory indices co a practical clinical index of C ro hn's disease activ ity as hns heen suggested (30).…”

Section: Discussionmentioning

confidence: 99%

“…However , both arc co nsidered co be relatively unsa tisfa ctory because they depend o n many subjecti ve cri teri a PEL T Ef. :lt\N et al (30). The authors' main criticism of the~c indices is thei r heavy reliance on Lhe number o f bowel movements without co nsideratio n fo r the presence o r extent of previo us intestinal resect io ns.…”

Section: Materials and Met Hodsmentioning

confidence: 99%

See 1 more Smart Citation

Open Trial of Cyclosporine in Patients with Severe Active Crohn's Disease Refractory to Conventional Therapy

Peltekian

Williams

Macdonald

et al. 1988

Canadian Journal of Gastroenterology

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Fifteen pat ients with severe active Crohn's disease, refra ccory to conventional therapy, were given a 16 week cou rse of cyclosporine ar an initial oral daily dose of 10 mg/kg, adjusted to ma intain cyclosporine scrum trough levels between 100 and 200 ng/m l. Five patients withdrew early because of side effects, poor absorption or noncompliance. T he remaining 10 patients all improved within four weeks as measured by three d iffe rent clinical indices: Crohn's Disease Activity Index, Simple Index of Crohn's Disease A ctivity and Mean Score of Therapeutic Goals (MSTG). Seven patients maintained th is initial improvement and prcdnisone was either reduced or discontinued. Four of these seven patients relapsed with in four wceb of stopping cyclosporine, and three remain in remission after 75 ± 2 weeks. S ide effects were minor and easily reversible. When the various clinical and labo ratory indices were compared, MSTG was found to be the most useful index fo r the assessment of therapy. Cyclosporine appears to be a safe and effective therapy in patients with severe active Crohn's disease refractory to conventional therapy. Ca n J Gastroenterol 1988; 2(1): 5-11

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Section: Discussionmentioning

confidence: 99%

Section: Materials and Met Hodsmentioning

confidence: 99%

Open Trial of Cyclosporine in Patients with Severe Active Crohn's Disease Refractory to Conventional Therapy

Peltekian

Williams

Macdonald

et al. 1988

Canadian Journal of Gastroenterology

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“…Many studies have demonstrated elevated CRP levels in patients with active CD [6][7][8][9]. It was suggested that CRP may better reflect the surface of active mucosal inflammation in CD than in ulcerative colitis [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…It was suggested that CRP may better reflect the surface of active mucosal inflammation in CD than in ulcerative colitis [7][8][9][10][11]. However, a recently published study denied any correlation between CRP level and endoscopically assessed mucosal status in CD patients [12].…”

Section: Introductionmentioning

confidence: 99%

Serum C-reactive protein level does not correlate with Crohn’s Disease Activity Index

Kohut¹,

Kozioł²,

Olek³

et al. 2010

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Introduction: Crohn's Disease Activity Index (CDAI) is a conventional, but poorly validated estimate of severity of Crohn's disease (CD). Similarly, the clinical significance of elevated levels of C-reactive protein (CRP) in CD patients is not well recognized. It is also unknown whether these two indices have similar informative value. Aim: To investigate the correlation between serum CRP level and CDAI. Material and methods: One hundred and forty-six patients (66 men and 80 women, mean age 37 ±12 years) with well established diagnosis of CD were included in the study. According to the admittance protocol in all patients the serum CRP was measured and all data necessary to calculate CDAI were collected. Results: There was no significant correlation between CRP and CDAI either in the entire population or in subgroups selected on the basis of CD severity, site of bowel involvement, kind of ongoing pharmacological therapy, past surgery or body mass. Conclusions: There is no correlation between serum CRP level and CDAI. These two indices reflect different aspects of CD severity.

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“…Routine laboratory and inflammatory marker assessments as well as faecal calprotectin measurement should be conducted in all patients to establish a baseline value for future comparison [36,37,38,39,40,41,42,43,44,45,46] (level D).…”

Section: Assessment At Diagnosismentioning

confidence: 99%

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

Sauter

Beglinger²,

Girardin³

et al. 2014

Digestion

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Background and Aims: The structured IBD Ahead ‘Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question ‘which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. Methods: The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead ‘Optimized Monitoring' Consensus. Results: A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. Conclusion: The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

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Assessment of appropriate laboratory measurements to supplement the Crohn's disease activity index.

Cited by 144 publications

References 7 publications

Open Trial of Cyclosporine in Patients with Severe Active Crohn's Disease Refractory to Conventional Therapy

Open Trial of Cyclosporine in Patients with Severe Active Crohn's Disease Refractory to Conventional Therapy

Serum C-reactive protein level does not correlate with Crohn’s Disease Activity Index

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

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