European Cooperative Crohn’s Disease Study (ECCDS): Colonoscopy

Lorenz-Meyer, H; Malchow, H; Miller, B.; Stock, Heather; Brandes, J W

doi:10.1159/000199187

Cited by 24 publications

(13 citation statements)

References 8 publications

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“…The distribution of clinical manifestations in patients with different ana tomical involvement reported from other se ries [1,12] was largely confirmed by our results, although, with the exception of the association of perianal disease with colonic involvement, no specific pattern of clinical manifestations in patients with different ana tomical involvement was found. Endoscopic and histologic findings in the ECCDS pa tients are discussed in a separate paper [13],…”

Section: Discussionmentioning

confidence: 99%

European Cooperative Crohn’s Disease Study (ECCDS): Clinical Features and Natural History

Steinhardt¹,

Loeschke²,

Kasper³

et al. 1985

Digestion

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In the European Cooperative Crohn’s Disease Study patients from 14 centers were included in whom diagnosis was made within 2 years before study entry on the basis of generally accepted radiological, endoscopical and/or histological criteria or a combination of all. Reasons for exclusion were: diagnosis older than 2 years in patients who did not require active treatment, age less than 18 years, duration of symptoms less than 3 months, presence of complications which potentially required emergency surgery. Data on clinical features were obtained in 633 patients, of whom 452 were eligible to participate in the study. In 110 patients randomized to placebo the natural course of Crohn’s disease was studied. Patients with ileocolonic involvement were younger than patients with either colonic or small intestinal involvement only. Classic ileitis terminalis was present in 14% of the patients. 49% of the patients had combined involvement of both the small and large intestine. 30% of patients had only small intestinal involvement, and in 21 % colonic disease was present. Small intestinal involvement was associated with a significantly lower Crohn’s Disease Activity Index (CDAI) than other anatomical locations of the disease. Perianal disease was more often associated with colonic than with small intestinal involvement. 60% of placebo patients with active disease at entry achieved at least a transient remission within the initial 5 months of study. After 2 years, 23% of patients with active disease at entry and 68% of patients with quiescent disease had reached or maintained a remission, respectively. By stepwise multiple linear regression analysis long duration of disease between diagnosis and randomization, normal serum albumin and combined involvement of small intestine and colon were identified as predictors of a more favorable outcome of patients treated with placebo. In contrast, extensive small bowel disease, treatment with steroids and bowel resection prior to study entry correlated with a less favorable outcome. However, by life table analysis outcome of previously untreated and treated patients in the placebo group was similar.

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Section: Discussionmentioning

confidence: 99%

European Cooperative Crohn’s Disease Study (ECCDS): Clinical Features and Natural History

Steinhardt¹,

Loeschke²,

Kasper³

et al. 1985

Digestion

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“…7 The exception is smoking, which is associated with an increased susceptibility for relapse and surgical intervention. 29,30 The endoscopic appearance of the mucosa seems to be of limited prognostic value after medically induced remission, 31 and repeated colonoscopy is an invasive procedure that is not indicated for CD patients on a regular basis. 31 In our previous studies in patients with steroidinduced remission, we found a weak correlation between splanchnic blood flow and endoscopic severity of disease in UC patients, but not in CD patients.…”

Section: Discussionmentioning

confidence: 99%

“…29,30 The endoscopic appearance of the mucosa seems to be of limited prognostic value after medically induced remission, 31 and repeated colonoscopy is an invasive procedure that is not indicated for CD patients on a regular basis. 31 In our previous studies in patients with steroidinduced remission, we found a weak correlation between splanchnic blood flow and endoscopic severity of disease in UC patients, but not in CD patients. 12,13 This difference has been confirmed in the current investigation of chronically active patients and may arise from the anatomic extent of inflammation in both diseases.…”

Section: Discussionmentioning

confidence: 99%

Mesenteric Pulsatility Index Analysis Predicts Response to Azathioprine in Patients with Crohnʼs Disease

Homann

Klarmann

Fellermann

et al. 2005

Inflammatory Bowel Diseases

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“…Some studies, among them the large multicenter studies of the European Cooperative Crohn's Disease Study (ECCDS) and National Cooperative Crohn's Disease Study (NCCDS), observed that the pattern of anatomical involvement has implications on the overall course of disease. The impression was given that colonic involvement, particularly with disease restricted to the colon, caused a worse overall outcome with more severe disease (1,2,(48)(49)(50)(51)(52).…”

Section: Clinical and Serologic Factorsmentioning

confidence: 99%

Prediction of treatment refractoriness in ulcerative colitis and Crohn's disease-do we have reliable markers?

Gelbmann

2007

Inflamm Bowel Dis

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Treatment refractoriness is a severe problem in the management of patients with ulcerative colitis and Crohn's disease. Despite some promising new therapeutic approaches, corticosteroids are still the preferential primary treatment for moderate to severe Crohn's disease and of severe ulcerative colitis. However, clinical response to corticosteroids varies, and many patients are resistant to such treatment. Since corticosteroids have frequent and even severe side effects, and toxicity increases with chronic steroid intake, factors predictive of response to such treatment would be very helpful for decisions on further management of these patients. At least in severe attacks of ulcerative colitis, the consensus seems to be that a high frequency of bowel movements as well as a high C‐reactive protein and low serum albumin recorded after a few days of intensive medical treatment are important signs for early prediction of treatment failure in the majority of the patients. In Crohn's disease thus far, data on predictive factors are conflicting. No reliable marker with sufficient predictive value for treatment refractoriness could be identified. This might be due to the tremendous heterogeneity of Crohn's disease with many clinical phenotypes, which requires subgroup analysis with sufficient numbers of patients. Corticosteroids as well as other immunomodulating and immunosuppressive medications interfere with the immune system, which plays a central role in the mediation of intestinal inflammation. Treatment refractoriness might have its origin in specific immunological peculiarities eventually reflected in abnormal immunological, biochemical, and clinical parameters. Further exploration of those parameters to predict treatment refractoriness in patients with ulcerative colitis or Crohn's disease is of great clinical importance for safe and efficient management of patients.

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European Cooperative Crohn’s Disease Study (ECCDS): Colonoscopy

Cited by 24 publications

References 8 publications

European Cooperative Crohn’s Disease Study (ECCDS): Clinical Features and Natural History

European Cooperative Crohn’s Disease Study (ECCDS): Clinical Features and Natural History

Mesenteric Pulsatility Index Analysis Predicts Response to Azathioprine in Patients with Crohnʼs Disease

Prediction of treatment refractoriness in ulcerative colitis and Crohn's disease-do we have reliable markers?

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