Looking beyond mucosal healing: Effect of biologic therapy on transmural healing in pediatric Crohn's disease

Civitelli, Fortunata; Nuti, Federica; Oliva, Salvatore; Nardo, Giovanni Di; Murciano, Manuel; Messina, Lorena; Aloi, Marina; Viola, Franca; Cucchiara, Salvatore

doi:10.1016/j.dld.2014.07.053

Cited by 27 publications

(47 citation statements)

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“…37,38 However, other recent studies indicated that transmural healing is achieved only in the minority of treated patients. 39,40 There are limited data on the predictive value of calprotectin in determining transmural healing, especially in children. Studies have shown that calprotectin correlates with transmural inflammation measured by MRE, with a correlation coefficient range of 0.46-0.72.…”

Section: Discussionmentioning

confidence: 99%

Associations Among Mucosal and Transmural Healing and Fecal Level of Calprotectin in Children With Crohn’s Disease

Weinstein-Nakar

Focht

Church

et al. 2018

Clinical Gastroenterology and Hepatology

104

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Section: Discussionmentioning

confidence: 99%

Associations Among Mucosal and Transmural Healing and Fecal Level of Calprotectin in Children With Crohn’s Disease

Weinstein-Nakar

Focht

Church

et al. 2018

Clinical Gastroenterology and Hepatology

104

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“…GIUS has high diagnostic accuracy for detecting CD [11], where increased bowel wall thickness (BWT) is the most important and common ultrasonographic parameter [12]. Previous studies showed that ultrasonographic changes during medical treatment correlate with endoscopic response and may provide measurements of MH [13][14][15]. These studies evaluate post-therapeutic changes in patients with active CD, thus, the usefulness of ultrasonography in different disease statuses remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Ultrasound Can Predict Endoscopic Activity in Crohn’s Disease

2020

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Purpose To explore the ability of gastrointestinal ultrasound (GIUS) to separate patients in endoscopic remission from patients with active disease in a heterogeneous hospital cohort with Crohn’s disease (CD). Materials and Methods 145 CD patients scheduled for ileocolonoscopy were prospectively included. The endoscopic disease activity was quantified using the Simple Endoscopic Score for Crohn’s disease (SES-CD), and mucosal healing was strictly defined as SES-CD = 0. Ultrasound remission was defined as wall thickness < 3 mm (< 4 mm in the rectum). Additionally, SES-CD was compared to color Doppler, Harvey Bradshaw’s index (HBI), C-reactive protein (CRP) and calprotectin. 23 patients were examined by two investigators for interobserver assessment. Results 102 had active disease and 43 patients were in remission. GIUS yielded a sensitivity of 92.2 % and a specificity of 86 % for wall thickness and a sensitivity of 66.7 % and a specificity of 97.7 % for color Doppler. The sensitivity and specificity were 34.3 % and 88.4 %, respectively, for HBI, 35.7 % and 82.9 %, respectively, for CRP and 55.9 % and 82.1 %, respectively, for calprotectin. The interobserver analysis revealed excellent agreement for wall thickness (k = 0.90) and color Doppler (k = 0.91) measurements. Conclusion GIUS has a high sensitivity for detecting endoscopic activity. Accordingly, bowel ultrasound has the potential to reduce the number of routine ileocolonoscopies in patients with CD.

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“…It avoids radiation exposure and is, furthermore, available at bedside and associated with low costs. US techniques include Doppler US [56], with contrast agents such as contrast-enhanced US [90] and small-intestine contrast US [91,92], and ultrasound elasticity imaging [93].…”

Section: Ultrasonographymentioning

confidence: 99%

Objective evaluation for treat to target in Crohn’s disease

et al. 2020

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Background Crohn's disease (CD) is a chronic and destructive bowel disease; continued disease activity can lead to penetrating complications. With the recent advent of effective medications, the importance of using a treat-totarget approach to guide therapy is becoming important. Methods In this review, we reviewed the previous evidence for evaluating CD lesions. Results We describe ileocolonoscopy's role in assessing disease activity, as well as recent progress in modalities, such as balloon-assisted endoscopy, capsule endoscopy, magnetic resonance enterography, computed tomography enterography, and ultrasonography. Advances in modalities have changed CD assessment, with small-bowel involvement becoming more important. Conclusions Proper optimization is necessary in clinical practice.

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Looking beyond mucosal healing: Effect of biologic therapy on transmural healing in pediatric Crohn's disease

Cited by 27 publications

References 0 publications

Associations Among Mucosal and Transmural Healing and Fecal Level of Calprotectin in Children With Crohn’s Disease

Associations Among Mucosal and Transmural Healing and Fecal Level of Calprotectin in Children With Crohn’s Disease

Gastrointestinal Ultrasound Can Predict Endoscopic Activity in Crohn’s Disease

Objective evaluation for treat to target in Crohn’s disease

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