Abstract | BACKGROUND AND AIMS: Studies performed on patient and disease characteristics predicting the treatment response in tumor necrosis factor alpha antibody (anti-TNF)-treated Crohn's disease (CD) have generally been based on clinical data. Only a few studies have assessed the role of endoscopy as a predictor for long-term response for anti-TNF therapy. Our aim was to evaluate the role of early endoscopy in predicting the long-term endoscopic response to anti-TNF in active luminal CD in a clinical setting. PATIENTS AND METHODS: Forty-two patients with active luminal CD, treated for at least 3 months with anti-TNF, either adalimumab (52%) or infliximab (48%), were included in this prospective study. Data on the simple endoscopic score for Crohn's disease (SES-CD) at 3 months after therapy commencement, and either data on the SES-CD or surgery after 1 year, were available for all patients. Endoscopic remission was defined as SES-CD 0-2. RESULTS: At 3 months after commencing anti-TNF therapy, 10 patients (24%) were in endoscopic remission. Thirty-three patients continued anti-TNF as maintenance therapy. At 1 year, endoscopic remission (11/33, 33%) was significantly more common in those patients who had been in endoscopic remission at 3 months, compared with those with endoscopically active disease at 3 months (7/10, 70% vs. 4/23, 17%, p = 0.01). The 3-month SES-CD had a sensitivity of 88%, and specificity of 64%, to predict 1-year endoscopic remission in patients who received anti-TNF maintenance therapy. CONCLUSIONS: In anti-TNF-treated active luminal CD mucosal healing at 3 months is a strong predictor for long-term endoscopic response.
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Authors | Clas-Göran af Björkesten, Urpo Nieminen, Taina Sipponen, Ulla Turunen, Perttu Arkkila, Martti Färkkilä |
Journal | Scandinavian journal of gastroenterology
(Scand J Gastroenterol)
Vol. 48
Issue 5
Pg. 543-51
(May 2013)
ISSN: 1502-7708 [Electronic] England |
PMID | 23477356
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Tumor Necrosis Factor-alpha
- Infliximab
- Adalimumab
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Topics |
- Adalimumab
- Adult
- Aged
- Anti-Inflammatory Agents
(therapeutic use)
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Crohn Disease
(diagnosis, drug therapy)
- Endoscopy, Gastrointestinal
- Female
- Follow-Up Studies
- Humans
- Infliximab
- Intestinal Mucosa
(pathology)
- Male
- Middle Aged
- Prospective Studies
- Remission Induction
- Sensitivity and Specificity
- Severity of Illness Index
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
- Young Adult
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