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Prospective study of capsule endoscopy for evaluating the therapeutic effects in patients with Crohn’s disease
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Masanao Nakamura1,
Takeshi Yamamura2,
Yoshiki Hirooka2 |
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1Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 2Department of Endoscopy, Nagoya University Hospital |
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| Introduction: Mucosal healing (MH) in Crohn’s disease (CD) can be evaluated by capsule endoscopy (CE). However, few studies have demonstrated the therapeutic effect of medical treatment. We aimed to evaluate the therapeutic effects of medical treatment for CD patients by using CE. Patients and methods: This prospective, multicentre study was conducted at our hospital and affiliated institutions from September 2012 to April 2016. Key inclusion criteria were patients with CD who were more than 10 years old and were scheduled to receive the PillCam patency capsule and undergo CE. Two expert CE readers reviewed independently the CE videos and determined the Lewis score (LS). Patients with Lewis score (LS) ≤135 on CE were excluded from the study. In those with an LS >135 (active CD group), additional treatment was provided regardless of the presence of any symptoms, as per the treating physicians’ advice. These patients underwent follow- up CE 6 months later. LSs were evaluated between CEs. Results: One hundred patients with CD were enrolled. Of 92 patients who had confirmed gastrointestinal patency and underwent CE, 40 (43.4%) had findings of active inflammation. Of 29 patients with an LS >135 who received additional medications and underwent follow-up CE, improvement of the LS was noted in 23 (79.3%) patients. Of 11 patients with an asymptomatic status who received additional medications, 8 (72.7%) had improvement in the LS, however, none of 11 patients achieved MH. Conclusion: This study demonstrates that additional treatment for even patients with CD in clinical remission and active small-bowel inflammation on CE can reduce mucosal damage. |
Index Term 1: Crohn's disease
Index Term 2: capsule endoscopy |
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