Background and Aims

This prospective, multicenter study evaluated small-bowel capsule endoscopy (CE) for the longitudinal assessment of mucosal inflammation in subjects with Crohn’s disease (CD).

Methods

Subjects with known CD underwent clinical evaluation with ileocolonoscopy and CE at baseline and 6-month follow-up. Small-bowel patency was confirmed before CE at both time points. The Simple Endoscopic Score for CD (SES-CD) was used for ileocolonoscopy, and the Lewis score and the CE CD Endoscopic Index of Severity (CECDEIS) were used for CE. Clinical scoring indices included the Physician Global Assessment (PGA), CD Activity Index (CDAI), and Harvey-Bradshaw Index (HBI). Laboratory markers including C-reactive protein, fecal calprotectin, and erythrocyte sedimentation rate were collected at baseline and follow-up. Correlation between endoscopic scores and clinical parameters were measured using Spearman tests.

Results

A total of 74 subjects were enrolled, of whom 53 (72%) completed endoscopic procedures at baseline and 6-month follow-up. The SES-CD ileocolonoscopy score correlated with the Lewis score (P < .001, ρ = .59) and CECDEIS capsule score (P = .002, ρ = .48). None of the 3 endoscopic scores correlated with PGA, CDAI, HBI, C-reactive protein, erythrocyte sedimentation rate, or fecal calprotectin. Approximately 85% of subjects had proximal small-bowel inflammation identified on CE. There were no CE-related adverse events.

Conclusions

There was high correlation between CE and ileocolonoscopy scores for the assessment of mucosal disease activity over time; however, there were no correlations between endoscopic scores and clinical parameters. The use of serial CE for the assessment of small-bowel CD is feasible and valid. (Clinical trial registration number: NCT01942720.)

中文翻译：

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视频胶囊内窥镜用于纵向监测小肠克罗恩病活动的一项前瞻性研究

背景和目标

这项前瞻性，多中心研究评估了小肠内窥镜（CE）对克罗恩病（CD）患者粘膜炎症的纵向评估。

方法

在基线期和6个月的随访中，患有已知CD的受试者接受了回肠结肠镜检查和CE的临床评估。CE在两个时间点之前均已确认小肠通畅。回肠结肠镜检查采用CD的简单内镜评分（SES-CD），CE评分采用Lewis评分和CE CD内镜严重度指标（CECDEIS）。临床评分指数包括医师全球评估（PGA），CD活动指数（CDAI）和Harvey-Bradshaw指数（HBI）。在基线和随访时收集包括C反应蛋白，粪便钙卫蛋白和红细胞沉降率在内的实验室标记物。内窥镜评分与临床参数之间的相关性使用Spearman检验进行了测量。

结果

总共招募了74名受试者，其中53名（72％）在基线和6个月的随访中完成了内窥镜检查程序。SES-CD回肠结肠镜检查评分与Lewis评分（P  <.001，ρ= .59）和CECDEIS胶囊评分（P  = .002，ρ= .48）相关。3个内镜评分均与PGA，CDAI，HBI，C反应蛋白，红细胞沉降率或粪钙卫蛋白无关。大约85％的受试者在CE上发现了近端小肠炎症。没有CE相关的不良事件。

结论

CE和回肠结肠镜检查得分之间的相关性随时间的推移在评估粘膜疾病活动方面有很高的相关性。但是，内窥镜评分与临床参数之间没有相关性。使用串行CE评估小瓶CD是可行和有效的。（临床试验注册号：NCT01942720。）