Journal article
Crohn's Disease Activity Index Does Not Correlate with Endoscopic Recurrence One Year After Ileocolonic Resection
Inflammatory bowel diseases, Vol.17(1), pp.118-126
01 Jan 2011
PMID: 20848538
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Crohn's disease clinical trials utilize the Crohn's Disease Activity Index (CDAI) to measure primary endpoint assessments of clinical recurrence and remission. We evaluated the extent of agreement between clinical recurrence/remission as defined by the CDAI and endoscopic recurrence 1 year after intestinal resection for Crohn's disease (CD).
Methods: Twenty-four CD patients who had been randomly assigned to a postoperative clinical trial had 1 year clinical, endoscopic, and histological assessment for disease recurrence. The primary endpoint was the extent of agreement between endoscopic recurrence and clinical recurrence 1 year after intestinal resection for CD. Secondary endpoints were extent of agreement between endoscopic recurrence and the surrogate markers of CD activity, i.e., histological activity, sedimentation rate, and C-reactive protein (CRP).
Results: Twelve of the 24 patients (50%) were in endoscopic remission (i0, i1) and 12 (50%) had endoscopic recurrence (i2, i3, or i4). There was good agreement between endoscopy and histological activity scores (intraclass correlation coefficient = 0.53, kappa coefficient = 0.58). In contrast, there was little to no relationship between endoscopy and CDAI scores; median CDAI scores for endoscopy scores of i0/i1, i2, i3, and i4 were 118, 76, 156, and 78, respectively (P for trend = 0.88). The kappa coefficient (of agreement) between endoscopy score +/- 2 and CDAI score +/- 150 was 0.12 (exact P = 0.68), indicating poor agreement. Similarly, there was no consistent association observed between endoscopy scores and mean CRP and ESR values at week 54.
Conclusions: The CDAI shows poor agreement with endoscopic recurrence 1 year after intestinal resection. Endoscopic recurrence should be the primary endpoint of future postoperative studies and ileocolonoscopy the gold standard test to detect postoperative recurrence.
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Details
- Title
- Crohn's Disease Activity Index Does Not Correlate with Endoscopic Recurrence One Year After Ileocolonic Resection
- Creators
- Miguel Regueiro - University of PittsburghKevin E. Kip - University of South FloridaWolfgang Schraut - University of PittsburghLeonard Baidoo - University of PittsburghAntonia R. Sepulveda - Hospital of the University of PennsylvaniaMarilyn Pesci - University of PittsburghSandra El-Hachem - University of PittsburghJanet Harrison - University of PittsburghDavid Binion - University of Pittsburgh
- Publication Details
- Inflammatory bowel diseases, Vol.17(1), pp.118-126
- Publisher
- Oxford Univ Press
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000285258500019
- Scopus ID
- 2-s2.0-78650135645
- Other Identifier
- 991022054321704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology