Post written by Gil Y. Melmed, MD, from the F Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA.
We aimed to determine the utility of using video capsule endoscopy for serial evaluations of Crohn’s disease activity. While the literature has demonstrated good correlation between WCE and colonoscopy at a single point in time, we wondered how well capsule endoscopy might correlate various indices of disease activity assessment including clinical, biochemical, and colonoscopic evaluations. Ultimately, we would like to know whether capsule endoscopy can be used as a valid and feasible tool for the longitudinal management of patients with Crohn’s disease as we move toward a ‘treat to target’ paradigm for treatment goals.
We demonstrated that capsule endoscopy correlated highly with colonoscopic evaluation but not with clinical assessments; we used a validated colonoscopy scoring index (CDEIS) and 2 different capsule endoscopy scoring indices (Lewis score and CE-CDEIS), as well as biochemical markers of inflammation and clinical assessments including the Crohn’s disease activity index and our primary endpoint, a physician global assessment score. The strong correlation with endoscopy suggests that capsule endoscopy is a valid and feasible tool to determine endoscopic disease activity over time in patients with Crohn’s disease. These findings should be reassuring to clinicians and patients by providing evidence for use of this modality to assess disease activity in a longitudinal fashion.
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