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Factors predicting the outcome of disease activity assessment in Crohn's disease

Henrik Stjernman1, Curt Tysk, Sven Almer

  • 1Division of Gastroenterology, Department of Medicine, County Hospital Ryhov, Jönköping, Sweden. henrik.stjernman@lj.se

Inflammatory Bowel Diseases
|July 4, 2009
PubMed

Insights

The Crohn's Disease Activity Index (CDAI) moderately correlates with physician assessment, but is heavily influenced by subjective symptoms. Objective markers better predict disease activity in Crohn's disease trials.

Area of Science:

  • Gastroenterology
  • Clinical Research
  • Inflammatory Bowel Disease

Background:

  • The Crohn's Disease Activity Index (CDAI) is the standard for assessing Crohn's disease (CD) activity.
  • This study examined the relationship between CDAI and physician global assessment (PGA).

Purpose of the Study:

  • To investigate the correlation between CDAI and PGA in CD patients.
  • To identify demographic and disease-related factors predicting CDAI and PGA outcomes.

Main Methods:

  • Multiple linear regression analysis was performed on data from 405 CD patients.
  • The study analyzed the relationship between CDAI and PGA, identifying predictors for each.

Main Results:

  • A moderate correlation was found between CDAI and PGA.
  • Subjective variables constituted 72% of the CDAI score in patients with CDAI >150.
  • C-reactive protein (CRP), stenosis, smoking, bowel resection, gender, and concomitant disease predicted CDAI; CRP, stenosis, and fistula predicted PGA.

Conclusions:

  • CDAI and PGA showed moderate correlation, with subjective factors significantly impacting CDAI.
  • Factors unrelated to inflammation predicted CDAI but not PGA.
  • Future CD therapy trials should differentiate subjective and objective variables for disease activity assessment.
Abstract

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