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• W2977977589 abstract "Purpose: Capsule endoscopy has been demonstrated to be superior to standard endoscopic and radiographic modalities in diagnosing small bowel Crohn's disease (CD), especially for subtle mucosal lesions. However, its utility in tracking treatment response via mucosal healing has not been fully established. The aim of this study is to assess small bowel mucosal healing based on the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI, Dig Dis Sci (2008) 53:1933-27) after initiation or escalation of therapy.Table: Table. Change in CECDAI Pre- and Post-Treatment CEMethods: Retrospective review of CE in patients with suspected and known small bowel nonstricturing CD. CEs were read by two highly experienced readers who were not the managing IBD physicians at a tertiary referral center. Results: 2,190 capsule endoscopies were performed between October, 2001-October, 2012. One hundred fifty eight subjects underwent ≧ 2 capsule endoscopies during that time interval. Of those 158 subjects, 28 had known or suspected CD, for a total of 65 CE. Of those 28 subjects, 17 had known CD (60.7%), seven had suspected CD (25%), three had IBD-U (10.7%), and one had UC (3.6%). 7/11 (63.6%) with suspected CD or IBD-U were re-classified as CD and treated as such after pre-treatment CE. Indications for CE included abdominal pain (35%), extent of CD (20%), diarrhea (19%), growth failure (10%), anemia (8%), gastrointestinal bleed (4%), weight loss (2%), pouchitis (1%), and extraintestinal manifestations of CD (1%). The median age was 32 years old (range: 8-70), there were no capsule retentions, and 48/65 (73.8%) of capsules reached the cecum. The median time interval between pre- and post-treatment CE was 27 months (range: 1-81). CE results lead to escalation of therapy or switching of biologic agents in 15/28 (53.6%). There was a statistically significant difference in the CECDAI between the pre- and post-treatment CE (8.2 versus 4.1, p=0.0250.) However, there was no difference in pre- and post-treatment CRP (0.66 mg/dl vs 0.43 mg/dl, p=.21). Conclusion: CE was able to re-classify disease phenotype in >60% of those patients with suspected Crohn's disease or IBD-U, thereby potentially changing both the management and the natural outcome of small bowel Crohn's disease. More importantly, CE demonstrated mucosal healing in 70% of patients after escalation of therapy with a nonstricturing phenotype, positively changing disease outcomes and achieving a therapeutic goal. A prospective study is needed for confirmation. Disclosure - Neel K. Mann - Grant Support: Given Imaging." @default.
• W2977977589 created "2019-10-10" @default.
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• W2977977589 date "2013-10-01" @default.
• W2977977589 modified "2023-10-14" @default.
• W2977977589 title "Capsule Endoscopy (CE) Can Improve Outcomes in Crohnʼs Disease: An Evaluation of Pre- and Post-treatment CE" @default.
• W2977977589 doi "https://doi.org/10.14309/00000434-201310001-01834" @default.
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