Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy

Detalhes bibliográficos
Autor(a) principal: Cotter, José de Almeida Berkeley
Data de Publicação: 2014
Outros Autores: Castro, Francisca Dias de, Moreira, Maria João, Rosa, Bruno
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/1822/32373
Resumo: "Article in Press"; "Epub 2014 Mar 14"
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spelling Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopyCapsule endoscopyCrohn's diseaseSmall bowelLewis scoreScience & Technology"Article in Press"; "Epub 2014 Mar 14"BACKGROUND AND AIMS: Small bowel capsule endoscopy (SBCE) may detect proximal small bowel lesions that have been previously missed by ileocolonoscopy and small bowel imaging in patients with known ileal and/or colonic Crohn's disease (CD). We aimed to evaluate whether the therapeutic management is influenced by SBCE findings. METHODS: Retrospective single center study. Inclusion of consecutive patients with known non-stricturing and non-penetrating ileal and/or colonic CD, submitted to SBCE to evaluate disease extension and activity, with ≥ 1year follow-up. Lesions were classified with the Lewis score (LS) as non-significant (LS<135), mild (135≤LS≤790), or moderate-to-severe (LS>790). Therapeutic changes were assessed three months after SBCE. RESULTS: Fifty consecutive patients (35±13years, 52% females) were included. At ileocolonoscopy, disease location was ileal (L1) in 60%, colonic (L2) in 10% and ileocolonic (L3) in 30% of the patients. In 33 patients (66%) SBCE detected significant proximal lesions previously missed by other modalities. The proportion of patients on thiopurines and/or biologics before SBCE was 2/50 (4%); this was significantly higher three months after SBCE, 15/50 (30%), p=0.023. Treatment with thiopurines and/or biologics was started more often in patients with proximal small bowel lesions [13/33 (39%) vs. 1/17 (6%), p=0.011, relative risk (RR) 6.5], particularly when severe (6%, 36% and 45% of patients with non-significant, mild and moderate-to-severe inflammation, respectively). CONCLUSIONS: SBCE diagnoses previously undetected lesions and it influences therapeutic management of CD, triggering an earlier introduction of immunomodulators and/or biological therapy.ElsevierUniversidade do MinhoCotter, José de Almeida BerkeleyCastro, Francisca Dias deMoreira, Maria JoãoRosa, Bruno20142014-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/32373eng1873-994610.1016/j.crohns.2014.02.01824631311www.elsevier.cominfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:43:25Zoai:repositorium.sdum.uminho.pt:1822/32373Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:40:54.166353Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
title Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
spellingShingle Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
Cotter, José de Almeida Berkeley
Capsule endoscopy
Crohn's disease
Small bowel
Lewis score
Science & Technology
title_short Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
title_full Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
title_fullStr Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
title_full_unstemmed Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
title_sort Tailoring Crohn's disease treatment : the impact of small bowel capsule endoscopy
author Cotter, José de Almeida Berkeley
author_facet Cotter, José de Almeida Berkeley
Castro, Francisca Dias de
Moreira, Maria João
Rosa, Bruno
author_role author
author2 Castro, Francisca Dias de
Moreira, Maria João
Rosa, Bruno
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Cotter, José de Almeida Berkeley
Castro, Francisca Dias de
Moreira, Maria João
Rosa, Bruno
dc.subject.por.fl_str_mv Capsule endoscopy
Crohn's disease
Small bowel
Lewis score
Science & Technology
topic Capsule endoscopy
Crohn's disease
Small bowel
Lewis score
Science & Technology
description "Article in Press"; "Epub 2014 Mar 14"
publishDate 2014
dc.date.none.fl_str_mv 2014
2014-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1822/32373
url http://hdl.handle.net/1822/32373
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1873-9946
10.1016/j.crohns.2014.02.018
24631311
www.elsevier.com
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dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
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