Baseline MRI, scoring system predict Crohn’s outcomes
Click Here to Manage Email Alerts
SAN DIEGO — Baseline magnetic resonance index of activity score independently predicted the longer-term need for surgery, rescue corticosteroids or hospitalizations among patients with Crohn’s disease.
“Multiple methods have been developed to predict outcomes in Crohn's disease. ... The magnetic resonance index of activity, or MaRIA score, is used to quantify disease severity, it has been validated against the Crohn's disease endoscopic index of severity,” Alvin George, MD, internal medicine resident at Washington University School of Medicine in St. Louis, said at Digestive Disease Week. “We hypothesize that since endoscopic scores have been shown to predict Crohn's disease outcomes, and since the MaRIA score has been validated against endoscopic findings, that an increase in baseline MaRIA scores would be associated with poor clinical outcomes in Crohn's disease.”
To determine baseline predictors of CD outcomes, George and colleagues enrolled 311 patients with CD from a single center between June 2017 and May 2018. Patients underwent MRI, and researchers assessed MaRIA scores and proton density fat fraction (PDFF), defining nonalcoholic fatty liver disease as PDFF score greater than 5.5% and stratified by Fibrosis-4 scoring. The primary study endpoints were time to surgery, rescue corticosteroid use, hospitalization or death.
According to study results, there were 33 surgeries, 62 incidences of rescue corticosteroid use and 58 hospitalizations attributed to CD. Risk factors included BMI, prior biologic use, C-reactive protein greater than 10 mg/L, Simple Endoscopic Score for CD (SES-CD) greater than 7 and MaRIA score greater than 11; the presence of NAFLD did not affect complication-free survival.
Multivariable analysis revealed that a MaRIA score greater than 11 independently predicted complication-free survival (P = .002), while an SES-CD greater than 7 did not.
“A MaRIA score greater than or equal to 11 is an independent predictor of time to surgery, hospitalization and rescue corticosteroid use adjusted for a BMI of 30, a CRP of 10, which is the upper limit of normal in our lab, prior biologic use and SES-CD score of over seven,” George concluded. “Our data suggests that baseline radiologic evaluation can be used as a complementary tool to help predict clinical outcomes and even risk stratify patients starting with their baseline visit.”
Collapse
George A, et al. Abstract 17. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
Read more about
Click Here to Manage Email Alerts