European evidence based consensus for endoscopy in inflammatory bowel disease

Annese, Vito; Daperno, Marco; Rutter, Matthew D.; Amiot, Aurélien; Bossuyt, Peter; East, James E.; Ferrante, Marc; Götz, Martín; Κατσάνος, Κωνσταντίνος; Kießlich, Ralf; Ordás, Íngrid; Repici, Alessandro; Rosa, Bruno; Sebastian, Shaji; Kucharzik, Torsten; Eliakim, Rami

doi:10.1016/j.crohns.2013.09.016

Cited by 738 publications

(701 citation statements)

References 402 publications

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“…Several guidelines and consensus documents by different organizations such as the European Society of Gastrointestinal Endoscopy (ESGE), the European Crohn's and Colitis Organisation (ECCO) and the American Society of Gastrointestinal Endoscopy (ASGE) have recommended CE in patients with suspected CD after a negative ileocolonoscopy and in absence of obstructive symptoms (1,(19)(20)(21)(22). In 2005, during the International Conference on Capsule Endoscopy (ICCE), it was established in a consensus document that suspicion of SB-CD should be based on the presence of clinical data (abdominal pain, diarrhea, weight loss, extra-intestinal conditions, etc.…”

Section: Discussionmentioning

confidence: 99%

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Valenzuela¹,

López²,

Fernández³

et al. 2016

Rev Esp Enferm Dig

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Background and aims:Capsule endoscopy is an extended tool for the diagnosis of small bowel Crohn's disease. However, factors associated with positive findings of this technique have not been well established. Our aim is to asses which factors are associated with a better diagnostic yield of capsule endoscopy in suspected small bowel Crohn's disease.Material and methods: This was a retrospective study including patients under capsule endoscopy because of suspected small bowel Crohn's disease. Demographic data of these patients, as well as symptoms and laboratory data including hemoglobin levels, count of leucocytes and platelets, and levels of C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected. Capsule endoscopy studies were classified as negative (no lesions) or positive (lesions suggestive of Crohn's disease). Descriptive, univariate and multivariate analysis were done, as well as diagnostic yield tests of the different markers for predicting lesions in capsule studies.Results: One hundred and twenty-four patients were included (85 women and 39 men). The average age was 38.21 years. Levels of C-reactive protein and fecal calprotectin were the markers more frequently associated with positive findings in capsule endoscopy. Calprotectin presented the best sensitivity as isolated marker. The association of altered levels of C-reactive protein and calprotectin showed the best specificity and predictive values.Conclusions: C-reactive protein and fecal calprotectin are appropriate biomarkers for selecting patients with suspected Crohn's disease of the small bowel for capsule endoscopy studies.

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Section: Discussionmentioning

confidence: 99%

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Valenzuela¹,

López²,

Fernández³

et al. 2016

Rev Esp Enferm Dig

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“…Ileo-colonoscopy with a biopsy is considered to be the "gold standard" for assessing intestinal inflammation, yet it is costly, not widely available and can cause complications (4)(5)(6). Although a series of specific endoscopic indices have been developed, such as the Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD), which can classify degrees of activity and correlate to a considerable degree (7), they are difficult to calculate and interpret in daily medical practice, although the SES-CD is simpler and easier to use (8).…”

Section: Introductionmentioning

confidence: 99%

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Morón¹,

Manrique²,

Machancoses³

et al. 2017

Rev Esp Enferm Dig

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Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing.Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test.Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores.Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

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“…However, patients are unlikely to agree to new endoscopic procedures for research into IBD symptoms such as fatigue, they may not have undergone recent endoscopy and there is the need for a sufficiently large sample size in studies in order to have adequately powered studies exploring relationships. The measurement of faecal calprotectin levels is emerging as surrogate marker of mucosal healing 4 and has been found to correlate significantly with endoscopic disease activity. 5,6 The growing use of such markers in routine clinical practice and in research may reduce the need for endoscopy, while still providing us with a reliable characterisation of disease activity in patients with IBD.…”

Section: Acknowledgementmentioning

confidence: 99%

Letter: causes of fatigue in inflammatory bowel disease remain uncertain – authors’ reply

Artom

Czuber‐Dochan

Norton

2017

Aliment Pharmacol Ther

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European evidence based consensus for endoscopy in inflammatory bowel disease

Cited by 738 publications

References 402 publications

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Letter: causes of fatigue in inflammatory bowel disease remain uncertain – authors’ reply

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European evidence based consensus for endoscopy in inflammatory bowel disease

Cited by 738 publications

References 402 publications

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Letter: causes of fatigue in inflammatory bowel disease remain uncertain – authors’ reply

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Resources

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Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin