The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome
Summary Background While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non‐inflammatory has been questioned. Aim T...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2013-04, Vol.37 (8), p.786-794 |
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| creator | Lahiff, C. Safaie, P. Awais, A. Akbari, M. Gashin, L. Sheth, S. Lembo, A. Leffler, D. Moss, A. C. Cheifetz, A. S. |
| description | Summary
Background
While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non‐inflammatory has been questioned.
Aim
To compare CDAI scores in patients with Crohn's and those with Irritable Bowel Syndrome (IBS).
Methods
This was a prospective, cross‐sectional cohort study of 91 patients with either Crohn's (n = 44) or IBS (n = 47). Total CDAI and individual component scores were recorded and comparisons were made between Crohn's and IBS patients.
Results
Mean CDAI scores were higher in the IBS patients (183 vs. 157, P = 0.1). Sixty‐two per cent (n = 29) of IBS patients had CDAI scores greater than 150. Mean CDAI haematocrit score (35.9 vs. 23.0, P = 0.02) and CRP level (6.8 vs. 2.0, P = 0.002) were higher in the Crohn's group. Analysis of CDAI sub‐scores demonstrated that IBS patients had significantly higher pain (mean 1.7 vs. 0.8, P = 0.0007) and well‐being scores (mean 1.2 vs. 0.8, P = 0.04) relative to patients with Crohn's. Specifically evaluating patients with CDAI greater than 150 (n = 51), IBS patients had higher pain sub‐scores (mean 2.4 vs. 1.4, P = 0.002), whereas patients with Crohn's had higher CRP (mean 8.4 vs. 1.8, P = 0.001).
Conclusions
Our study demonstrates that the CDAI does not discriminate patients with symptoms due to active Crohn's from patients with IBS. Patients with IBS can have CDAI scores in the clinically meaningful range. Objective measures, such as CDAI haematocrit score and CRP, are more specific markers of inflammation. |
| doi_str_mv | 10.1111/apt.12262 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1317847007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1317847007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3902-da68b255d91b297cf368717caac7afe5f27306eb6c3015a1978692fc8eaaabd13</originalsourceid><addsrcrecordid>eNp10L1u2zAUBWAiSNG4aYe8QMElSDIo4Y9FSqPh_gUI0A7uLFxRVzALSnJ46Th6iTxzldpth6Z3ucuHc4DD2JkU13K6G9ika6mUUUdsJrXJMyW0OWYzoUyZqULqE_aG6IcQwlihXrMTpeda6XI-Y0-rNfJlHNb9BfHGEwIhB5f8g08j932Dj_xy-WFxe8U9cfKdDxDDyDHgAyRsJsI3kDz2ifjOp_W_Yf0LyMfoE9QBeT3sMHAa-yYOHb5lr1oIhO8O_5R9__RxtfyS3X39fLtc3GVOl0JlDZiiVnnelLJWpXWtNoWV1gE4Cy3mrbJaGKyN00LmIEtbmFK1rkAAqBupT9nlPncTh_stUqo6Tw5DgB6HLVVSS1vMrRB2old76uJAFLGtNtF3EMdKiup5_mqav_o1_2TfH2K3dYfNH_l77wmcHwCQg9BG6J2nv87Kea71c-nN3u18wPH_jdXi22pf_RO8l50s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1317847007</pqid></control><display><type>article</type><title>The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library (Open Access Collection)</source><creator>Lahiff, C. ; Safaie, P. ; Awais, A. ; Akbari, M. ; Gashin, L. ; Sheth, S. ; Lembo, A. ; Leffler, D. ; Moss, A. C. ; Cheifetz, A. S.</creator><creatorcontrib>Lahiff, C. ; Safaie, P. ; Awais, A. ; Akbari, M. ; Gashin, L. ; Sheth, S. ; Lembo, A. ; Leffler, D. ; Moss, A. C. ; Cheifetz, A. S.</creatorcontrib><description>Summary
Background
While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non‐inflammatory has been questioned.
Aim
To compare CDAI scores in patients with Crohn's and those with Irritable Bowel Syndrome (IBS).
Methods
This was a prospective, cross‐sectional cohort study of 91 patients with either Crohn's (n = 44) or IBS (n = 47). Total CDAI and individual component scores were recorded and comparisons were made between Crohn's and IBS patients.
Results
Mean CDAI scores were higher in the IBS patients (183 vs. 157, P = 0.1). Sixty‐two per cent (n = 29) of IBS patients had CDAI scores greater than 150. Mean CDAI haematocrit score (35.9 vs. 23.0, P = 0.02) and CRP level (6.8 vs. 2.0, P = 0.002) were higher in the Crohn's group. Analysis of CDAI sub‐scores demonstrated that IBS patients had significantly higher pain (mean 1.7 vs. 0.8, P = 0.0007) and well‐being scores (mean 1.2 vs. 0.8, P = 0.04) relative to patients with Crohn's. Specifically evaluating patients with CDAI greater than 150 (n = 51), IBS patients had higher pain sub‐scores (mean 2.4 vs. 1.4, P = 0.002), whereas patients with Crohn's had higher CRP (mean 8.4 vs. 1.8, P = 0.001).
Conclusions
Our study demonstrates that the CDAI does not discriminate patients with symptoms due to active Crohn's from patients with IBS. Patients with IBS can have CDAI scores in the clinically meaningful range. Objective measures, such as CDAI haematocrit score and CRP, are more specific markers of inflammation.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.12262</identifier><identifier>PMID: 23432394</identifier><language>eng</language><publisher>Oxford: Blackwell</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Biomarkers - metabolism ; Cohort Studies ; Crohn Disease - diagnosis ; Crohn Disease - metabolism ; Diagnosis, Differential ; Digestive system ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hematocrit ; Humans ; Irritable Bowel Syndrome - diagnosis ; Irritable Bowel Syndrome - metabolism ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Prospective Studies ; Severity of Illness Index ; Sickness Impact Profile ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Young Adult</subject><ispartof>Alimentary pharmacology & therapeutics, 2013-04, Vol.37 (8), p.786-794</ispartof><rights>2013 Blackwell Publishing Ltd</rights><rights>2014 INIST-CNRS</rights><rights>2013 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3902-da68b255d91b297cf368717caac7afe5f27306eb6c3015a1978692fc8eaaabd13</citedby><cites>FETCH-LOGICAL-c3902-da68b255d91b297cf368717caac7afe5f27306eb6c3015a1978692fc8eaaabd13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.12262$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.12262$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,1435,27931,27932,45581,45582,46416,46840</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27145337$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23432394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lahiff, C.</creatorcontrib><creatorcontrib>Safaie, P.</creatorcontrib><creatorcontrib>Awais, A.</creatorcontrib><creatorcontrib>Akbari, M.</creatorcontrib><creatorcontrib>Gashin, L.</creatorcontrib><creatorcontrib>Sheth, S.</creatorcontrib><creatorcontrib>Lembo, A.</creatorcontrib><creatorcontrib>Leffler, D.</creatorcontrib><creatorcontrib>Moss, A. C.</creatorcontrib><creatorcontrib>Cheifetz, A. S.</creatorcontrib><title>The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non‐inflammatory has been questioned.
Aim
To compare CDAI scores in patients with Crohn's and those with Irritable Bowel Syndrome (IBS).
Methods
This was a prospective, cross‐sectional cohort study of 91 patients with either Crohn's (n = 44) or IBS (n = 47). Total CDAI and individual component scores were recorded and comparisons were made between Crohn's and IBS patients.
Results
Mean CDAI scores were higher in the IBS patients (183 vs. 157, P = 0.1). Sixty‐two per cent (n = 29) of IBS patients had CDAI scores greater than 150. Mean CDAI haematocrit score (35.9 vs. 23.0, P = 0.02) and CRP level (6.8 vs. 2.0, P = 0.002) were higher in the Crohn's group. Analysis of CDAI sub‐scores demonstrated that IBS patients had significantly higher pain (mean 1.7 vs. 0.8, P = 0.0007) and well‐being scores (mean 1.2 vs. 0.8, P = 0.04) relative to patients with Crohn's. Specifically evaluating patients with CDAI greater than 150 (n = 51), IBS patients had higher pain sub‐scores (mean 2.4 vs. 1.4, P = 0.002), whereas patients with Crohn's had higher CRP (mean 8.4 vs. 1.8, P = 0.001).
Conclusions
Our study demonstrates that the CDAI does not discriminate patients with symptoms due to active Crohn's from patients with IBS. Patients with IBS can have CDAI scores in the clinically meaningful range. Objective measures, such as CDAI haematocrit score and CRP, are more specific markers of inflammation.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>Cohort Studies</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - metabolism</subject><subject>Diagnosis, Differential</subject><subject>Digestive system</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hematocrit</subject><subject>Humans</subject><subject>Irritable Bowel Syndrome - diagnosis</subject><subject>Irritable Bowel Syndrome - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Sickness Impact Profile</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Young Adult</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10L1u2zAUBWAiSNG4aYe8QMElSDIo4Y9FSqPh_gUI0A7uLFxRVzALSnJ46Th6iTxzldpth6Z3ucuHc4DD2JkU13K6G9ika6mUUUdsJrXJMyW0OWYzoUyZqULqE_aG6IcQwlihXrMTpeda6XI-Y0-rNfJlHNb9BfHGEwIhB5f8g08j932Dj_xy-WFxe8U9cfKdDxDDyDHgAyRsJsI3kDz2ifjOp_W_Yf0LyMfoE9QBeT3sMHAa-yYOHb5lr1oIhO8O_5R9__RxtfyS3X39fLtc3GVOl0JlDZiiVnnelLJWpXWtNoWV1gE4Cy3mrbJaGKyN00LmIEtbmFK1rkAAqBupT9nlPncTh_stUqo6Tw5DgB6HLVVSS1vMrRB2old76uJAFLGtNtF3EMdKiup5_mqav_o1_2TfH2K3dYfNH_l77wmcHwCQg9BG6J2nv87Kea71c-nN3u18wPH_jdXi22pf_RO8l50s</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Lahiff, C.</creator><creator>Safaie, P.</creator><creator>Awais, A.</creator><creator>Akbari, M.</creator><creator>Gashin, L.</creator><creator>Sheth, S.</creator><creator>Lembo, A.</creator><creator>Leffler, D.</creator><creator>Moss, A. C.</creator><creator>Cheifetz, A. S.</creator><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201304</creationdate><title>The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome</title><author>Lahiff, C. ; Safaie, P. ; Awais, A. ; Akbari, M. ; Gashin, L. ; Sheth, S. ; Lembo, A. ; Leffler, D. ; Moss, A. C. ; Cheifetz, A. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3902-da68b255d91b297cf368717caac7afe5f27306eb6c3015a1978692fc8eaaabd13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>Cohort Studies</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - metabolism</topic><topic>Diagnosis, Differential</topic><topic>Digestive system</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hematocrit</topic><topic>Humans</topic><topic>Irritable Bowel Syndrome - diagnosis</topic><topic>Irritable Bowel Syndrome - metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Sickness Impact Profile</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lahiff, C.</creatorcontrib><creatorcontrib>Safaie, P.</creatorcontrib><creatorcontrib>Awais, A.</creatorcontrib><creatorcontrib>Akbari, M.</creatorcontrib><creatorcontrib>Gashin, L.</creatorcontrib><creatorcontrib>Sheth, S.</creatorcontrib><creatorcontrib>Lembo, A.</creatorcontrib><creatorcontrib>Leffler, D.</creatorcontrib><creatorcontrib>Moss, A. C.</creatorcontrib><creatorcontrib>Cheifetz, A. S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lahiff, C.</au><au>Safaie, P.</au><au>Awais, A.</au><au>Akbari, M.</au><au>Gashin, L.</au><au>Sheth, S.</au><au>Lembo, A.</au><au>Leffler, D.</au><au>Moss, A. C.</au><au>Cheifetz, A. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2013-04</date><risdate>2013</risdate><volume>37</volume><issue>8</issue><spage>786</spage><epage>794</epage><pages>786-794</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non‐inflammatory has been questioned.
Aim
To compare CDAI scores in patients with Crohn's and those with Irritable Bowel Syndrome (IBS).
Methods
This was a prospective, cross‐sectional cohort study of 91 patients with either Crohn's (n = 44) or IBS (n = 47). Total CDAI and individual component scores were recorded and comparisons were made between Crohn's and IBS patients.
Results
Mean CDAI scores were higher in the IBS patients (183 vs. 157, P = 0.1). Sixty‐two per cent (n = 29) of IBS patients had CDAI scores greater than 150. Mean CDAI haematocrit score (35.9 vs. 23.0, P = 0.02) and CRP level (6.8 vs. 2.0, P = 0.002) were higher in the Crohn's group. Analysis of CDAI sub‐scores demonstrated that IBS patients had significantly higher pain (mean 1.7 vs. 0.8, P = 0.0007) and well‐being scores (mean 1.2 vs. 0.8, P = 0.04) relative to patients with Crohn's. Specifically evaluating patients with CDAI greater than 150 (n = 51), IBS patients had higher pain sub‐scores (mean 2.4 vs. 1.4, P = 0.002), whereas patients with Crohn's had higher CRP (mean 8.4 vs. 1.8, P = 0.001).
Conclusions
Our study demonstrates that the CDAI does not discriminate patients with symptoms due to active Crohn's from patients with IBS. Patients with IBS can have CDAI scores in the clinically meaningful range. Objective measures, such as CDAI haematocrit score and CRP, are more specific markers of inflammation.</abstract><cop>Oxford</cop><pub>Blackwell</pub><pmid>23432394</pmid><doi>10.1111/apt.12262</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection) |
| subjects | Adolescent Adult Aged Biological and medical sciences Biomarkers - metabolism Cohort Studies Crohn Disease - diagnosis Crohn Disease - metabolism Diagnosis, Differential Digestive system Female Gastroenterology. Liver. Pancreas. Abdomen Hematocrit Humans Irritable Bowel Syndrome - diagnosis Irritable Bowel Syndrome - metabolism Male Medical sciences Middle Aged Other diseases. Semiology Pharmacology. Drug treatments Prospective Studies Severity of Illness Index Sickness Impact Profile Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Young Adult |
| title | The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome |
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