Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease
Background The aim of the study was to identify factors associated with a radiological response and to assess the impact of radiological improvement in long-term outcomes in small bowel (SB) Crohn’s disease (CD) patients. Methods We performed a retrospective study from June 2011 to June 2017 in the...
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| Veröffentlicht in: | Digestive diseases and sciences 2020-09, Vol.65 (9), p.2664-2674 |
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| creator | Hallé, Eléonore Azahaf, Mustapha Duveau, Nicolas Lambin, Thomas Nachury, Maria Branche, Julien Gérard, Romain Lauriot Dit Prevost, Clémentine Wils, Pauline Desreumaux, Pierre Ernst, Olivier Pariente, Benjamin |
| description | Background
The aim of the study was to identify factors associated with a radiological response and to assess the impact of radiological improvement in long-term outcomes in small bowel (SB) Crohn’s disease (CD) patients.
Methods
We performed a retrospective study from June 2011 to June 2017 in the tertiary center, Claude Huriez Hospital in Lille, France. All SB CD patients, who underwent two magnetic resonance enterographies (MRE) 3–12 months apart, with at least 1-year follow-up after the second MRE, were included. Signs of radiological inflammation were identified by two expert radiologists in CD. Patients were classified as radiological responders (RR) and non-responders (NR). Hospitalization rates, adjustment of treatment, and surgical or endoscopic interventions were assessed and compared between RR and NR. Factors associated with a radiological response were also studied using the Cox model.
Results
One hundred and fifteen SB CD patients were included with a median follow-up of 17 months (IQR 11.6–28.3). There were 54 (47%) RR and 61 (53%) NR. The risk of surgical or endoscopic intervention was higher in NR than RR (
p
= 0.04), and the median delay until a surgical or endoscopic intervention was shorter in NR (
p
= 0.04). Multifocal disease, a hypersignal on diffusion-weighted or dynamic contrast-enhanced imaging, a stricture, or a fistula was significantly associated with a decreased probability of a radiological response (
p
|
| doi_str_mv | 10.1007/s10620-019-05979-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2322738535</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712936332</galeid><sourcerecordid>A712936332</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-16225950c09e7ea91e675553842765a29dc4e4f32e98b30f845428cff278bc783</originalsourceid><addsrcrecordid>eNp9kcuKFDEUhoMoTjv6Ai4k4MZNjblUbsu2vQ0MDIztOqRTp7ozVFXaJMUgbnwNX88nMW2PDorIWeSQ8_0_5_Aj9JSSM0qIepkpkYw0hJqGCKNMo--hBRWKN0xIfR8tCJW1p1SeoEc5XxNCjKLyITrhVFPacr1AX65cF-IQt8G7AV9B3scpAz7PeJlz9MEV6PBNKDv8CkqBhC_n4uMIGbupwx92cR66OsKrKgsdpEo7vN5BcnuYS_B47dIWCg4TXqW4m75__Zbx65DBZXiMHvRuyPDk9j1FH9--Wa_eNxeX785Xy4vGty0rDZWMCSOIJwYUOENBKiEE1y1TUjhmOt9C23MGRm846XUrWqZ93zOlN15pfopeHH33KX6aIRc7huxhGNwEcc6WccYU14KLij7_C72Oc5rqdpa1nEmtOOF31NYNYMPUx5KcP5japaLMcMk5q9TZP6haHYzBxwn6UP__ELCjwKeYc4Le7lMYXfpsKbGHxO0xcVsTtz8Tt4fjnt1uPG9G6H5LfkVcAX4Ech1NW0h3J_3H9geL0bR0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2432687303</pqid></control><display><type>article</type><title>Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hallé, Eléonore ; Azahaf, Mustapha ; Duveau, Nicolas ; Lambin, Thomas ; Nachury, Maria ; Branche, Julien ; Gérard, Romain ; Lauriot Dit Prevost, Clémentine ; Wils, Pauline ; Desreumaux, Pierre ; Ernst, Olivier ; Pariente, Benjamin</creator><creatorcontrib>Hallé, Eléonore ; Azahaf, Mustapha ; Duveau, Nicolas ; Lambin, Thomas ; Nachury, Maria ; Branche, Julien ; Gérard, Romain ; Lauriot Dit Prevost, Clémentine ; Wils, Pauline ; Desreumaux, Pierre ; Ernst, Olivier ; Pariente, Benjamin</creatorcontrib><description>Background
The aim of the study was to identify factors associated with a radiological response and to assess the impact of radiological improvement in long-term outcomes in small bowel (SB) Crohn’s disease (CD) patients.
Methods
We performed a retrospective study from June 2011 to June 2017 in the tertiary center, Claude Huriez Hospital in Lille, France. All SB CD patients, who underwent two magnetic resonance enterographies (MRE) 3–12 months apart, with at least 1-year follow-up after the second MRE, were included. Signs of radiological inflammation were identified by two expert radiologists in CD. Patients were classified as radiological responders (RR) and non-responders (NR). Hospitalization rates, adjustment of treatment, and surgical or endoscopic interventions were assessed and compared between RR and NR. Factors associated with a radiological response were also studied using the Cox model.
Results
One hundred and fifteen SB CD patients were included with a median follow-up of 17 months (IQR 11.6–28.3). There were 54 (47%) RR and 61 (53%) NR. The risk of surgical or endoscopic intervention was higher in NR than RR (
p
= 0.04), and the median delay until a surgical or endoscopic intervention was shorter in NR (
p
= 0.04). Multifocal disease, a hypersignal on diffusion-weighted or dynamic contrast-enhanced imaging, a stricture, or a fistula was significantly associated with a decreased probability of a radiological response (
p
< 0.05).
Conclusion
This study shows that a radiological response is associated with a decreased risk of surgical or endoscopic intervention and should be considered as a therapeutic target in CD patients.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-019-05979-8</identifier><identifier>PMID: 31811438</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adalimumab ; Adolescent ; Adult ; Biochemistry ; Crohn Disease - diagnostic imaging ; Crohn Disease - physiopathology ; Crohn Disease - therapy ; Crohn's disease ; Diffusion Magnetic Resonance Imaging ; Disease Progression ; Endoscopy ; Female ; France ; Gastroenterology ; Health aspects ; Hepatology ; Hospitalization ; Hospitals ; Humans ; Inflammation ; Inflammatory bowel disease ; Intervention ; Intestine, Small - diagnostic imaging ; Intestine, Small - physiopathology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original Article ; Patients ; Predictive Value of Tests ; Radiology ; Remission Induction ; Retrospective Studies ; Surgery ; Time Factors ; Transplant Surgery ; Treatment Outcome ; Tumor necrosis factor-TNF ; Wound Healing ; Young Adult</subject><ispartof>Digestive diseases and sciences, 2020-09, Vol.65 (9), p.2664-2674</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-16225950c09e7ea91e675553842765a29dc4e4f32e98b30f845428cff278bc783</citedby><cites>FETCH-LOGICAL-c442t-16225950c09e7ea91e675553842765a29dc4e4f32e98b30f845428cff278bc783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-019-05979-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-019-05979-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31811438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hallé, Eléonore</creatorcontrib><creatorcontrib>Azahaf, Mustapha</creatorcontrib><creatorcontrib>Duveau, Nicolas</creatorcontrib><creatorcontrib>Lambin, Thomas</creatorcontrib><creatorcontrib>Nachury, Maria</creatorcontrib><creatorcontrib>Branche, Julien</creatorcontrib><creatorcontrib>Gérard, Romain</creatorcontrib><creatorcontrib>Lauriot Dit Prevost, Clémentine</creatorcontrib><creatorcontrib>Wils, Pauline</creatorcontrib><creatorcontrib>Desreumaux, Pierre</creatorcontrib><creatorcontrib>Ernst, Olivier</creatorcontrib><creatorcontrib>Pariente, Benjamin</creatorcontrib><title>Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
The aim of the study was to identify factors associated with a radiological response and to assess the impact of radiological improvement in long-term outcomes in small bowel (SB) Crohn’s disease (CD) patients.
Methods
We performed a retrospective study from June 2011 to June 2017 in the tertiary center, Claude Huriez Hospital in Lille, France. All SB CD patients, who underwent two magnetic resonance enterographies (MRE) 3–12 months apart, with at least 1-year follow-up after the second MRE, were included. Signs of radiological inflammation were identified by two expert radiologists in CD. Patients were classified as radiological responders (RR) and non-responders (NR). Hospitalization rates, adjustment of treatment, and surgical or endoscopic interventions were assessed and compared between RR and NR. Factors associated with a radiological response were also studied using the Cox model.
Results
One hundred and fifteen SB CD patients were included with a median follow-up of 17 months (IQR 11.6–28.3). There were 54 (47%) RR and 61 (53%) NR. The risk of surgical or endoscopic intervention was higher in NR than RR (
p
= 0.04), and the median delay until a surgical or endoscopic intervention was shorter in NR (
p
= 0.04). Multifocal disease, a hypersignal on diffusion-weighted or dynamic contrast-enhanced imaging, a stricture, or a fistula was significantly associated with a decreased probability of a radiological response (
p
< 0.05).
Conclusion
This study shows that a radiological response is associated with a decreased risk of surgical or endoscopic intervention and should be considered as a therapeutic target in CD patients.</description><subject>Adalimumab</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biochemistry</subject><subject>Crohn Disease - diagnostic imaging</subject><subject>Crohn Disease - physiopathology</subject><subject>Crohn Disease - therapy</subject><subject>Crohn's disease</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Disease Progression</subject><subject>Endoscopy</subject><subject>Female</subject><subject>France</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inflammatory bowel disease</subject><subject>Intervention</subject><subject>Intestine, Small - diagnostic imaging</subject><subject>Intestine, Small - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Radiology</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor necrosis factor-TNF</subject><subject>Wound Healing</subject><subject>Young Adult</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kcuKFDEUhoMoTjv6Ai4k4MZNjblUbsu2vQ0MDIztOqRTp7ozVFXaJMUgbnwNX88nMW2PDorIWeSQ8_0_5_Aj9JSSM0qIepkpkYw0hJqGCKNMo--hBRWKN0xIfR8tCJW1p1SeoEc5XxNCjKLyITrhVFPacr1AX65cF-IQt8G7AV9B3scpAz7PeJlz9MEV6PBNKDv8CkqBhC_n4uMIGbupwx92cR66OsKrKgsdpEo7vN5BcnuYS_B47dIWCg4TXqW4m75__Zbx65DBZXiMHvRuyPDk9j1FH9--Wa_eNxeX785Xy4vGty0rDZWMCSOIJwYUOENBKiEE1y1TUjhmOt9C23MGRm846XUrWqZ93zOlN15pfopeHH33KX6aIRc7huxhGNwEcc6WccYU14KLij7_C72Oc5rqdpa1nEmtOOF31NYNYMPUx5KcP5japaLMcMk5q9TZP6haHYzBxwn6UP__ELCjwKeYc4Le7lMYXfpsKbGHxO0xcVsTtz8Tt4fjnt1uPG9G6H5LfkVcAX4Ech1NW0h3J_3H9geL0bR0</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Hallé, Eléonore</creator><creator>Azahaf, Mustapha</creator><creator>Duveau, Nicolas</creator><creator>Lambin, Thomas</creator><creator>Nachury, Maria</creator><creator>Branche, Julien</creator><creator>Gérard, Romain</creator><creator>Lauriot Dit Prevost, Clémentine</creator><creator>Wils, Pauline</creator><creator>Desreumaux, Pierre</creator><creator>Ernst, Olivier</creator><creator>Pariente, Benjamin</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200901</creationdate><title>Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease</title><author>Hallé, Eléonore ; Azahaf, Mustapha ; Duveau, Nicolas ; Lambin, Thomas ; Nachury, Maria ; Branche, Julien ; Gérard, Romain ; Lauriot Dit Prevost, Clémentine ; Wils, Pauline ; Desreumaux, Pierre ; Ernst, Olivier ; Pariente, Benjamin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-16225950c09e7ea91e675553842765a29dc4e4f32e98b30f845428cff278bc783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adalimumab</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biochemistry</topic><topic>Crohn Disease - diagnostic imaging</topic><topic>Crohn Disease - physiopathology</topic><topic>Crohn Disease - therapy</topic><topic>Crohn's disease</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Disease Progression</topic><topic>Endoscopy</topic><topic>Female</topic><topic>France</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Inflammatory bowel disease</topic><topic>Intervention</topic><topic>Intestine, Small - diagnostic imaging</topic><topic>Intestine, Small - physiopathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Radiology</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><topic>Tumor necrosis factor-TNF</topic><topic>Wound Healing</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hallé, Eléonore</creatorcontrib><creatorcontrib>Azahaf, Mustapha</creatorcontrib><creatorcontrib>Duveau, Nicolas</creatorcontrib><creatorcontrib>Lambin, Thomas</creatorcontrib><creatorcontrib>Nachury, Maria</creatorcontrib><creatorcontrib>Branche, Julien</creatorcontrib><creatorcontrib>Gérard, Romain</creatorcontrib><creatorcontrib>Lauriot Dit Prevost, Clémentine</creatorcontrib><creatorcontrib>Wils, Pauline</creatorcontrib><creatorcontrib>Desreumaux, Pierre</creatorcontrib><creatorcontrib>Ernst, Olivier</creatorcontrib><creatorcontrib>Pariente, Benjamin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hallé, Eléonore</au><au>Azahaf, Mustapha</au><au>Duveau, Nicolas</au><au>Lambin, Thomas</au><au>Nachury, Maria</au><au>Branche, Julien</au><au>Gérard, Romain</au><au>Lauriot Dit Prevost, Clémentine</au><au>Wils, Pauline</au><au>Desreumaux, Pierre</au><au>Ernst, Olivier</au><au>Pariente, Benjamin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>65</volume><issue>9</issue><spage>2664</spage><epage>2674</epage><pages>2664-2674</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
The aim of the study was to identify factors associated with a radiological response and to assess the impact of radiological improvement in long-term outcomes in small bowel (SB) Crohn’s disease (CD) patients.
Methods
We performed a retrospective study from June 2011 to June 2017 in the tertiary center, Claude Huriez Hospital in Lille, France. All SB CD patients, who underwent two magnetic resonance enterographies (MRE) 3–12 months apart, with at least 1-year follow-up after the second MRE, were included. Signs of radiological inflammation were identified by two expert radiologists in CD. Patients were classified as radiological responders (RR) and non-responders (NR). Hospitalization rates, adjustment of treatment, and surgical or endoscopic interventions were assessed and compared between RR and NR. Factors associated with a radiological response were also studied using the Cox model.
Results
One hundred and fifteen SB CD patients were included with a median follow-up of 17 months (IQR 11.6–28.3). There were 54 (47%) RR and 61 (53%) NR. The risk of surgical or endoscopic intervention was higher in NR than RR (
p
= 0.04), and the median delay until a surgical or endoscopic intervention was shorter in NR (
p
= 0.04). Multifocal disease, a hypersignal on diffusion-weighted or dynamic contrast-enhanced imaging, a stricture, or a fistula was significantly associated with a decreased probability of a radiological response (
p
< 0.05).
Conclusion
This study shows that a radiological response is associated with a decreased risk of surgical or endoscopic intervention and should be considered as a therapeutic target in CD patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31811438</pmid><doi>10.1007/s10620-019-05979-8</doi><tpages>11</tpages></addata></record> |
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| ispartof | Digestive diseases and sciences, 2020-09, Vol.65 (9), p.2664-2674 |
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| subjects | Adalimumab Adolescent Adult Biochemistry Crohn Disease - diagnostic imaging Crohn Disease - physiopathology Crohn Disease - therapy Crohn's disease Diffusion Magnetic Resonance Imaging Disease Progression Endoscopy Female France Gastroenterology Health aspects Hepatology Hospitalization Hospitals Humans Inflammation Inflammatory bowel disease Intervention Intestine, Small - diagnostic imaging Intestine, Small - physiopathology Male Medicine Medicine & Public Health Middle Aged Oncology Original Article Patients Predictive Value of Tests Radiology Remission Induction Retrospective Studies Surgery Time Factors Transplant Surgery Treatment Outcome Tumor necrosis factor-TNF Wound Healing Young Adult |
| title | Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease |
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