P182 Modified Multiplier SES-CD (MM-SES-CD) and laboratorial Crohn's disease activity parameters: is there any association?. (30th January 2023)

• Record Type: Journal Article
• Authors: Capela, T; Ferreira, A I; Macedo Silva, V; Freitas, M; Arieira, C; Cúrdia Gonçalves, T; Dias de Castro, F; Moreira, M J; Cotter, J
• Is Part Of: Journal of Crohn's and colitis. Volume 17(2023)Supplement 1
• Page Start: i335
• Page End: i336
• Publication Date: 2023-01-30
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjac190.0312
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Contrary to the Simple Endoscopic Score for Crohn's Disease (SES-CD), Modified Multiplier SES-CD (MM-SES-CD) is a new endoscopic severity assessment tool that was able to predict one-year endoscopic remission in patients with Crohn's Disease (CD) on active therapy. Unlike SES-CD, MM-SES-CD accounts for the number of segments affected and the different prognostic weight of individual SES-CD parameters according to disease location. Nevertheless, there is scarce information regarding its relationship with laboratorial parameters, namely C-reactive protein (CRP) and fecal calprotectin (FC). We aimed to analyze the association between MM-SES-CD and these laboratorial parameters. Methods: Retrospective cohort-study including all ileocolonoscopies performed in adult CD patients between January 2020 and October 2022 with CRP (mg/dL) and FC (ug/g) collected within one month. Patients with previous intestinal surgery or inadequate bowel preparation were excluded. MM-SES-CD, ranging from 0 to 130.5, was calculated and different severity categories were defined as follows: remission (<14), mild (≥14 to <31), moderate (≥31 to <45), and severe (≥45). MM-SES-CD values were correlated and compared, according to severity categories, with laboratorial biomarkers. Results: A total of 272 ileocolonoscopies from 218 CD patients were included, most females (54.1%) with a mean age of 41 years old. Most patients were A2 (72.8%), L1 (51.1%) and B1 (73.9%), according to Montreal classification. Median MM-SES-CD, CRP and FC was 12.0, 2.9 and 222.0, respectively. Despite MM-SES-CD values correlated weakly with CRP (r=0.376, P<0.001) and moderately with FC (r=0.531, P<0.001), patients with endoscopic remission had significantly lower median CRP (2.9 vs 7.7, P<0.001) and FC (128 vs 587, P<0.001) than patients with active disease. Additionally, median CRP (2.9 vs 6.0 vs 16.0 vs 30.7, P<0.001), and median FC (128 vs 531 vs 637 vs 877, P<0.001) were significantly different between MM-SES-CD severity categories (remission vs mild vs moderate vs severe), respectively. CRP and FC optimal cut-offs for endoscopic remission were 8.5 mg/dL (Sensitivity 74.7%, Specificity 43.6%, negative predictive value (NPV) 77.4%, positive predictive value (PPV) 40.0%) and 471.5 ug/g (Sensitivity 62.6%, Specificity 87.3%, NPV 82.3%, PPV 71.3%), respectively. Conclusion: To the best of our knowledge, this is the first study reporting an association between CRP and FC and increasing degrees of disease activity assessed by MM-SES-CD. A CRP <8.5 mg/dL and a FC <471.5 ug/g are suggested as cut-offs associated with endoscopic remission.