クローン病の試験および臨床における使用のための国際磁気共鳴画像コンセンサス
Bénédicte Caron1, Vipul Jairath2, Bruce E Sands3
1University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, F-54000 Nancy France.
まとめ
マグネット共振エンテログラフィ (MRE) を用いたクローン病の反応と寛解の標準化された定義が確立された. これらのガイドラインは,治療の有効性を評価するための臨床試験と実践の一貫性を改善することを目的としています.
科学分野:
- 胃腸内科
- 放射線科
- 医療用イメージング
背景:
- 横断画像,特にMREは,クローン病の活動と合併症の評価に不可欠です.
- MREを用いたクローン病の治療の有効性を評価するための既存のガイドラインは標準化されていない.
- MREに基づく応答,寛解,およびトランスムラルヒーリングの定義について合意が必要である.
研究 の 目的:
- クローン病におけるMRE応答と寛解の標準化された定義のためのコンセンサス声明を開発する.
- MREを用いて治療反応と寛解を評価するための最適なタイミングを確立する.
- クローン病の臨床試験および臨床実務におけるMREの適用に関するガイドラインを提供すること.
主な方法:
- 33人の国際専門家 (胃腸科医と放射線科医) が参加した改良されたデルフィー法が採用されました.
- 体系的な文献レビューが,最初のコンセンサス声明を基にした.
- 合意は参加者の間で少なくとも75%の合意と定義された.
主要な成果:
- マリアスコアと簡略化されたマリアスコアは,中等から重度のクローン病の応答と寛解を評価するために推奨されます.
- 応答 (MaRIA < 11 または ≥25%の改善) と寛解 (MaRIA < 7 または簡略化された MaRIA < 1) のための特定の基準が定義されました.
- 提案された評価のタイミングは,応答の24週,寛解の24週から54週,そして経口治癒の52週から104週です.
結論:
- クローン病の応答と寛解のための標準化されたMRE定義は,専門家パネルによって確立されています.
- 開発されたガイドラインは,臨床実務と試験における治療効果の評価の一貫性を高めることを目的としています.
- MREによるトランスムラルヒーリングの測定方法を精錬するには,さらなる研究が必要です.
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