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Changes Over Time in the Lémann Index and the Inflammatory Bowel Disease Disability Index in a Prospective Cohort of
Laurine Cartier1,2, Apolline Loiez1, Maria Nachury1,3
1Department of Gastroenterology, Claude Huriez Hospital, University of Lille 2, Lille, France.
Insights
This study found that the Lémann index (LI) remained stable over four years in Crohn
Area of Science:
- Gastroenterology
- Clinical Medicine
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) is a chronic, debilitating condition.
- Assessing disease progression and patient-reported outcomes is crucial for managing CD.
- The Lémann index (LI) and Inflammatory Bowel Disease Disability Index (IBD-DI) are tools used to evaluate CD.
Purpose of the Study:
- To prospectively evaluate changes in the Lémann index (LI) and Inflammatory Bowel Disease Disability Index (IBD-DI) over time in a cohort of Crohn's disease patients.
- To determine the correlation between disease activity, bowel damage, and disability index scores in CD patients.
- To provide insights into the long-term impact of Crohn's disease on patient function and well-being.
Main Methods:
- A single-center prospective cohort study involving 130 consecutive CD patients.
- Assessment of LI and IBD-DI at baseline (2016) and follow-up (2020-2021), with a median follow-up of 4.2 years.
- Statistical analysis to compare LI and IBD-DI scores over time and assess their correlation with clinical factors.
Main Results:
- The median Lémann index (LI) remained stable over the follow-up period (9.6 vs 9.3; P=0.14).
- The median Inflammatory Bowel Disease Disability Index (IBD-DI) significantly decreased over time (23.2 vs 21.4; P=0.006).
- No significant correlation was found between the LI and IBD-DI over the study period.
Conclusions:
- This study represents the first prospective evaluation of longitudinal changes in both LI and IBD-DI in Crohn's disease patients.
- After approximately four years, the LI demonstrated stability, while the IBD-DI showed a significant decrease, indicating improved patient-reported function.
- The lack of correlation between the two indices suggests they capture distinct aspects of Crohn's disease impact.
Background:
Crohn's disease (CD) is a progressive, destructive, and disabling disorder. Our study aimed to assess changes over time in the Lémann index (LI) and the Inflammatory Bowel Disease Disability Index (IBD-DI) in a cohort of CD patients.
Methods:
This was a single-center prospective cohort study of 130 consecutive CD patients with a follow-up of at least 4 years. The LI 1 and the IBD-DI 1 questionnaires were assessed in 2016 and again between September 2020 and October 2021 (LI 2 and IBD-DI 2).
Results:
Of the 130 patients with assessment of both LI 1 and IBD-DI 1, 61 had calculation of the LI 2 and 98 patients answered the IBD-DI 2 questionnaire, with a median time between the 2 evaluations of 4.2 years. The LI increased for 16 (26%), decreased for 26 (43%), and remained unchanged for 19 (31%) patients. The median LI did not change over time (9.6 vs 9.3; P = .14). Clinical disease activity was significantly associated with bowel damage progression. A high initial LI (>7.9) was not associated with CD progression (surgery, drug dose escalation, or change of biologic). The IBD-DI decreased for 59 (60.2%), increased for 37 (37.8%), and remained unchanged for 2 (2%) patients. The median IBD-DI decreased significantly over time (23.2 vs 21.4; P = .006). There was no correlation between the 2 indexes.
Conclusions:
This is the first prospective cohort study assessing changes over time in both the LI and the IBD-DI in CD patients. After 4 years, the LI appeared to be stable and the IBD-DI decreased, with no correlation between the 2 indexes.
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