Assessment of mucosal healing during biological therapy of small bowel Crohn’s disease by capsule endoscopy: a prospective observational study

Czech version

Authors: N. Machková ¹; D. Ďuricová ¹; M. Bortlík ^1,2; Luděk Hrdlička ¹; M. Lukáš Jr. ^1,2; M. Lukáš ^1,3
Authors‘ workplace: Klinické a výzkumné centrum pro střevní záněty ISCARE a 1. LF UK Praha ¹; Interní klinika 1. LF UK a ÚVN Praha ²; Ústav klinické biochemie a laboratorní diagnostiky 1. LF UK Praha ³
Published in: Gastroent Hepatol 2013; 67(1): 17-21
Category: IDB: Original Article

Overview

Background:
Efficacy of anti-TNFα therapy in mucosal healing of Crohn’s disease in the small bowel is examined less than in the large bowel due to more difficult detection of mucosal changes.

Aim and methods:
The aim of the prospective study was to assess the efficacy of anti-TNFα therapy in mucosal healing of small bowel CD using capsule endoscopy (CE). Patients with CD involving small (+/- large) bowel, who were indicated to anti-TNFα therapy were included.

Results:
25 patients (18 treated with infliximab, 7 with adalimumab) were examined by CE (Mirocam(R), IntroMedic, South Korea) at the start of biologic treatment and 19 of them during the maintenance phase of therapy. Mucosal inflammatory changes were assessed by the Lewis score (LS). The median LS at base line was 1,350 (range 337–7,840) with 28% having mild (LS 135–790) and 72% moderate to severe mucosal inflammation (LS > 790). A significant reduction of LS to 402.5 with the range of 0–4,432 (p < 0.001) was observed after median of 32 weeks of treatment, with 83% of patients having only mild mucosal inflammation or normal mucosal finding (LS < 135). Only one (2.3%) capsule retention was observed; other complications were not observed.

Conclusion:
Anti-TNFα therapy is effective in mucosal healing of small bowel CD. Capsule endoscopy detected mucosal changes effectively, was well tolerated and relatively safe.

Key words:
Crohn’s disease – small intestine – mucosal healing – capsule endoscopy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
7. 2. 2013

Accepted:
9. 2. 2013

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