[en] Endoscopic remission is the cornerstone of drug development and the guidance for daily clinical practice in Crohn's disease [CD]. However, although scoring systems for endoscopic activity in CD have been available for more than three decades, no consensus exists on the definition of endoscopic remission. In this viewpoint we describe the shortcomings of the current definition of endoscopic remission in ileocolonic CD and the essential requirements for a newly developed endoscopic scoring tool for endoscopic remission in CD.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Bossuyt, Peter
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Mary, Jean-Yves
Vermeire, Severine
Bouhnik, Yoram
Language :
English
Title :
Defining Endoscopic Remission in Ileocolonic Crohn's Disease: Let's Start from Scratch.
Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis; a pathologic and clinical entity. Am J Med 1952;13:583-90.
Nagasako K, Yazawa C, Takemoto T. Biopsy of the terminal ileum. Gastrointest Endosc 1972;19:7-10.
Elliott PR, Williams CB, Lennard-Jones JE, et al. Colonoscopic diagnosis of minimal change colitis in patients with a normal sigmoidoscopy and normal air-contrast barium enema. Lancet 1982;1:650-1.
Coremans G, Rutgeerts P, Geboes K, Van den Oord J, Ponette E, Vantrappen G. The value of ileoscopy with biopsy in the diagnosis of intestinal Crohn's disease. Gastrointest Endosc 1984;30:167-72.
Gaisford WD. Fiberendoscopy of the cecum and terminal ileum. Gastrointest Endosc 1974;21:13-8.
Lorenz-Meyer H, Malchow H, Miller B, Stock H, Brandes JW. European cooperative Crohn's disease study (ECCDS): colonoscopy. Digestion 1985;31:109-19.
Reproducibility of colonoscopic findings in Crohn's disease: A prospective multicenter study of interobserver variation. Groupe d'Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Dig Dis Sci 1987;32:1370-9.
Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Groupe d'Etudes Thérapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Gut 1989;30:983-9.
Modigliani R, Mary JY, Simon JF, et al. Clinical, biological, and endoscopic picture of attacks of Crohn's disease. Evolution on prednisolone. Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives. Gastroenterology 1990;98:811-8.
Hindryckx P, Baert F, Hart A, et al. Clinical trials in luminal Crohn's disease: a historical perspective. J Crohns Colitis 2014;8:1339-50.
Sostegni R, Daperno M, Scaglione N, Lavagna A, Rocca R, Pera A. Review article: Crohn's disease: monitoring disease activity. Aliment Pharmacol Ther 2003;17:11-7.
Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc 2004;60:505-12.
Van Deventer SJ. Tumour necrosis factor and Crohn's disease. Gut 1997;40:443-8.
Baert F, Moortgat L, Van Assche G, et al.; Belgian Inflammatory Bowel Disease Research Group; North-Holland Gut Club. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn's disease. Gastroenterology 2010;138:463-468; quiz e10-1.
Schnitzler F, Fidder H, Ferrante M, et al. Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn's disease. Inflamm Bowel Dis 2009;15:1295-301.
Frøslie KF, Jahnsen J, Moum BA, Vatn MH; IBSEN Group. Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology 2007;133:412-22.
af Björkesten CG, Nieminen U, Sipponen T, Turunen U, Arkkila P, Färkkilä M. Mucosal healing at 3 months predicts long-term endoscopic remission in anti-TNF-treated luminal Crohn's disease. Scand J Gastroenterol 2013;48:543-51.
Rutgeerts P, Van Assche G, Sandborn WJ, et al.; EXTEND Investigators. Adalimumab induces and maintains mucosal healing in patients with Crohn's disease: data from the EXTEND trial. Gastroenterology 2012;142:1102-1111.e2.
Hébuterne X, Lémann M, Bouhnik Y, et al. Endoscopic improvement of mucosal lesions in patients with moderate to severe ileocolonic Crohn's disease following treatment with certolizumab pegol. Gut 2013;62:201-8.
Mazzuoli S, Guglielmi FW, Antonelli E, et al. Definition and evaluation of mucosal healing in clinical practice. Dig Liver Dis 2013;45:969-77.
Papi C, Aratari A. Mucosal healing as a treatment for IBD? Expert Rev Gastroenterol Hepatol 2014;8:457-9.
Vuitton L, Marteau P, Sandborn WJ, et al. IOIBD technical review on endoscopic indices for Crohn's disease clinical trials. Gut 2016;65:1447-55.
Gottlieb K, Travis S, Feagan B, Hussain F, Sandborn WJ, Rutgeerts P. Central reading of endoscopy endpoints in inflammatory bowel disease trials. Inflamm Bowel Dis 2015;21:2475-82.
Feagan BG, Sandborn WJ, D'Haens G, et al. The role of centralized reading of endoscopy in a randomized controlled trial of mesalamine for ulcer-ative colitis. Gastroenterology 2013;145:149-157.e2.
Daperno M, Comberlato M, Bossa F, et al. Inter-observer agreement in endoscopic scoring systems: preliminary report of an ongoing study from the Italian group for inflammatory bowel disease (IG-IBD). Dig Liver Dis 2014;46:969-73.
Rutgeerts P, Reinisch W, Colombel JF, et al. Agreement of site and central readings of ileocolonoscopic scores in Crohn's disease: comparison using data from the EXTEND trial. Gastrointest Endosc 2016;83:188-97. e1-3.
Khanna R, Zou G, D'Haens G, et al. Reliability among central readers in the evaluation of endoscopic findings from patients with Crohn's disease. Gut 2016;65:1119-25.
Dubcenco E, Zou G, Stitt L, et al. Effect of standardised scoring conventions on inter-rater reliability in the endoscopic evaluation of Crohn's disease. J Crohns Colitis 2016;10:1006-14.
Pineton de Chambrun G, Blanc P, Peyrin-Biroulet L. Current evidence supporting mucosal healing and deep remission as important treatment goals for inflammatory bowel disease. Expert Rev Gastroenterol Hepatol 2016;10:915-27.
Bossuyt P, Vermeire S. Treat to target in inflammatory bowel disease. Curr Treat Options Gastroenterol 2016;14:61-72.
Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting therapeutic targets in inflammatory bowel disease (stride): determining therapeutic goals for treat-to-target. Am J Gastroenterol 2015;110:1324-38.
Lazarev M, Huang C, Bitton A, et al. Relationship between proximal Crohn's disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium. Am J Gastroenterol 2013;108:106-12.
Flamant M, Trang C, Maillard O, et al. The prevalence and outcome of jejunal lesions visualized by small bowel capsule endoscopy in Crohn's disease. Inflamm Bowel Dis 2013;19:1390-6.
Kopylov U, Yung DE, Engel T, et al. Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohn's disease: systematic review and meta-analysis. Dig Liver Dis 2017;49:854-63.
