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
...gnosis...
...able 1. Consequences of Diagnostic Test Res...
...s with CD in symptomatic remission
...mendation 1In patients with CD in symp...
...ecommendation 2In patients with CD in symptoma...
Recommendation 3In patients with CD in symptomatic...
...In patients with CD in symptomatic remis...
...atients with symptomatically active C...
...5In patients with symptomatically active CD,...
...ommendation 6In patients with CD with...
...mendation 7In patients with CD with mi...
...ion 8In patients with CD with moderat...
...ation 9In patients with CD with moderate to sever...
...s with CD in surgically induced re...
...commendation 10In asymptomatic patients...
...dation 11In asymptomatic patients with CD after...
...ealing Index (EHI) (Monitr) in Pat...
...ion 12In patients with CD, the AGA suggests ne...
...ndoscopy-based Monitoring Strategy in Patien...
In patients with CD, the AGA makes no recomme...
...able 2. Key Considerations When Using Biomar...