Crohn’s Disease Biomarkers
Key Points
Key Points
- Inflammatory bowel diseases (IBDs), comprising Crohn’s disease (CD) and ulcerative colitis (UC), are rising in incidence and prevalence worldwide. They often have an onset in young adulthood and are characterized by a protracted relapsing–remitting course with progressive permanent bowel damage.
- To durably modify the natural history of CD, an important concept that has emerged is the need for early institution of effective treatment followed by confirmation of attainment of therapeutic target in order to improve long-term outcomes and prevent disease-related disability.
- Four methods are available to assess disease activity:
- Endoscopy is costly, invasive and uncomfortable.
- Radiology is costly but may be a reasonable alternative to endoscopic assessment for patients with predominantly small bowel involvement.
- Symptoms correlate poorly with endoscopic disease activity.
- Serum and fecal disease markers are promising as surrogates for endoscopic disease activity but have yet to be standardized.
- Because optimal treatment requires accurate longitudinal patient monitoring, this Guideline represents the current official recommendations of the AGA for incorporating widely used biomarkers in the management of CD.
Diagnosis
Diagnosi...
...onsequences of Diagnostic Test Results on Patient...
...ts with CD in symptomatic remissio...
...endation 1In patients with CD in sy...
...n 2In patients with CD in symptomatic r...
...dation 3In patients with CD in symptomatic...
...ommendation 4In patients with CD in symptomati...
...th symptomatically active CD
...endation 5In patients with symptomati...
...ion 6In patients with CD with mild symptoms...
...commendation 7In patients with CD with m...
...ation 8In patients with CD with mo...
Recommendation 9In patients with CD with modera...
...h CD in surgically induced remission...
...ommendation 10In asymptomatic patien...
...11In asymptomatic patients with CD afte...
...ng Index (EHI) (Monitr) in Patients With CD...
...2In patients with CD, the AGA suggests nei...
...iomarker- vs Endoscopy-based Monitoring Strat...
...n patients with CD, the AGA makes no reco...
...le 2. Key Considerations When Using Biomarkers...