Development of an index to define overall disease severity in IBD

被引：123

作者：

Siegel, Corey A. ^{[1
]}

Whitman, Cynthia B. ^{[2
]}

Spiegel, Brennan M. R. ^{[2
]}

Feagan, Brian ^{[3
]}

Sands, Bruce ^{[4
]}

Loftus, Edward V., Jr. ^{[5
]}

Panaccione, Remo ^{[6
]}

D'Haens, Geert ^{[7
]}

Bernstein, Charles N. ^{[8
]}

Gearry, Richard

Ng, Siew C. ^{[9
]}

Mantzaris, Gerassimos J. ^{[10
]}

Sartor, Balfour ^{[11
]}

Silverberg, Mark S. ^{[12
]}

Riddell, Robert ^{[12
]}

Koutroubakis, Ioannis E. ^{[13
]}

O'Morain, Colm ^{[14
]}

Lakatos, Peter L. ^{[15
]}

McGovern, Dermot P. B. ^{[16
]}

Halfvarson, Jonas ^{[17
]}

Reinisch, Walter ^{[18
]}

Rogler, Gerhard ^{[19
]}

Kruis, Wolfgang ^{[20
]}

Tysk, Curt ^{[17
]}

Schreiber, Stefan ^{[21
]}

Danese, Silvio ^{[22
]}

Sandborn, William ^{[23
]}

Griffiths, Anne ^{[24
]}

Moum, Bjorn ^{[25
,26
]}

Gasche, Christoph ^{[27
]}

Pallone, Francesco ^{[28
]}

Travis, Simon ^{[29
]}

Panes, Julian ^{[30
]}

Colombel, Jean-Frederic ^{[4
]}

Hanauer, Stephen ^{[31
]}

Peyrin-Biroulet, Laurent ^{[32
,33
]}

机构：

[1] Dartmouth Hitchcock Med Ctr, Dartmouth Hitchcock Inflammatory Bowel Dis Ctr, Lebanon, NH 03766 USA

[2] Cedars Sinai Med Ctr, Dept Hlth Serv, Los Angeles, CA 90048 USA

[3] Robarts Clin Trials, London, ON, Canada

[4] Icahn Sch Med Mt Sinai, New York, NY 10029 USA

[5] Mayo Clin, Rochester, MN USA

[6] Univ Calgary, Calgary, AB, Canada

[7] Acad Med Ctr, Amsterdam, Netherlands

[8] Univ Manitoba, Winnipeg, MB, Canada

[9] Chinese Univ Hong Kong, Inst Digest Dis, State Key Lab Digest Dis, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China

[10] Evangelismos PolyClin Ophthalmiatre Hosp, Athens, Greece

[11] Univ N Carolina, Chapel Hill, NC USA

[12] Mt Sinai Hosp, Toronto, ON, Canada

[13] Univ Hosp Heraklion, Iraklion, Greece

[14] Trinity Coll Dublin, Fac Hlth Sci, Dublin, Ireland

[15] Semmelweis Univ, Budapest, Hungary

[16] Cedars Sinai Med Ctr, Widjaja Inflammatory Bowel & Immunobiol Res Ins, Los Angeles, CA 90048 USA

[17] Orebro Univ, Fac Med & Hlth, Dept Gastroenterol, Orebro, Sweden

[18] McMaster Univ, Hamilton, ON, Canada

[19] Univ Zurich Hosp, Zurich, Switzerland

[20] Univ Cologne, Cologne, Germany

[21] Univ Hop Schleswig Holstein, Kiel, Germany

[22] Humanitas Univ, Milan, Italy

[23] Univ Calif San Diego, San Diego, CA USA

[24] Hosp Sick Children, Toronto, ON, Canada

[25] Oslo Univ Hosp, Oslo, Norway

[26] Univ Oslo, Oslo, Norway

[27] Med Univ, Gen Hosp Vienna, Vienna, Austria

[28] Univ Roma Tor Vergata, Rome, Italy

[29] Oxford Univ Hosp, Oxford, England

[30] Hosp Clin Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain

[31] Northwestern Feinberg Sch Med, Chicago, IL USA

[32] Lorraine Univ, Inserm U954, Nancy, France

[33] Lorraine Univ, CHU Nancy, Nancy, France

来源：

GUT | 2018年 / 67卷 / 02期

关键词：

CROHNS-DISEASE; ULCERATIVE-COLITIS; TREATMENT RISKS; PREFERENCES; MANAGEMENT; PREDICTORS; TOLERANT; THERAPY; DAMAGE;

D O I：

10.1136/gutjnl-2016-312648

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Background and aim Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC. Methods Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute. Results For CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities. Conclusions Based on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD.

引用

页码：244 / 254

页数：11

共 33 条

[1]

Allen PB, CURR OPIN GASTROENTE

[2]

Predictors of Crohn's disease [J].

Beaugerie, L ;

Seksik, P ;

Nion-Larmurier, I ;

Gendre, JP ;

Cosnes, J .

GASTROENTEROLOGY, 2006, 130 (03) :650-656

[3]

BEST WR, 1976, GASTROENTEROLOGY, V70, P439

[4]

Patient Preferences for Surgical Versus Medical Therapy for Ulcerative Colitis [J].

Bewtra, Meenakshi ;

Kilambi, Vikram ;

Fairchild, Angelyn O. ;

Siegel, Corey A. ;

Lewis, James D. ;

Johnson, F. Reed .

INFLAMMATORY BOWEL DISEASES, 2014, 20 (01) :103-114

[5]

Bridges JFP, 2008, PATIENT, V1, P273, DOI [10.2165/1312067-200801040-00009, 10.2165/01312067-200801040-00009]

[6]

Long-term evolution of disease behavior of Crohn's disease [J].

Cosnes, J ;

Cattan, S ;

Blain, A ;

Beaugerie, L ;

Carbonnel, F ;

Parc, R ;

Gendre, JP .

INFLAMMATORY BOWEL DISEASES, 2002, 8 (04) :244-250

[7]

Preventing Collateral Damage in Crohn's Disease: The L,mann Index [J].

Fiorino, Gionata ;

Bonifacio, Cristiana ;

Peyrin-Biroulet, Laurent ;

Danese, Silvio .

JOURNAL OF CROHNS & COLITIS, 2016, 10 (04) :495-500

[8]

FRIED BJ, 1993, J RHEUMATOL, V20, P548

[9]

Gower-Rousseau C, 2015, GUT

[10]

Crohn's disease patients' risk-benefit preferences:: Serious adverse event risks versus treatment efficacy [J].

Johnson, F. Reed ;

Oezdemir, Semra ;

Mansfield, Carol ;

Hass, Steven ;

Miller, David W. ;

Siegel, Corey A. ;

Sands, Bruce E. .

GASTROENTEROLOGY, 2007, 133 (03) :769-779

← 1 2 3 4 →