Correlation between Crohn's disease activity index and the severity of disease flare-up

Aims Several clinico-biological indices have been advanced to evaluate the severity of Crohn 's disease (CD) flare-up, but only the Crohn's disease activity index(CDAI) has been validated. This study aims to evaluate the contribution of the CDAI in assessing the severity of the flare of Crohn's disease.

Methods We report a retrospective comparative study from January 2013 to December 2023, including 151 patients suffering from CD.The patients were divided into four groups (Gps) : Gp 1 (CDAI<150 : n=54), Gp 2 (CDAI between 150-350 : n=84), Gp 3 (CDAI between 350 and 450 : n=10), Gp 4 (CDAI>450: n=3) [1] [2].

Results In univariate analysis,a statistically significant difference between groups was found in the necessity of oral corticosteroid to induce remission (Gp 1: 22% ; Gp 2: 85%; Gp 3: 90%; Gp 4: 0%) (p<0.0001) and the use of intravenous corticotherapy (Gp 1: 3.7% ; Gp 2: 59% ; Gp 3: 80% ; Gp 4: 100%) (p<0.0001).No statistically significant difference was found between groups regarding the indication of surgery for complicated CD or severe flare-up with medical therapies failure (Gp 1: 29.62% ; Gp 2: 36% ; Gp 3: 50% and Gp 4: 66%).

Conclusions In the group of patients with quiescent or mild-to-moderate disease according to CDAI,the necessity of corticosteroid therapy and surgery was common.This highlights that this index may underestimate disease activity.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Thia K, Faubion WA. et al. Short CDAI: Development and validation of a shortened and simplified Crohn's disease activity index Inflammatory Bowel Diseases. 17 (Issue 1). 2011
• 2 https://www.snfcp.org/questionnaires-outils/maladies-inflammatoires/cdai-crohn-disease-activity-index-score-de-best