New Crohn's disease damage index tool could help minimize complications

Kathleen Blanchard's picture
New index developed by international team to measure Crohn's disease damage

Crohn's disease affects everyone differently. Sometimes the damage causes by the form of inflammatory bowel disease is difficult to measure, making it difficult to minimize complications. A new scoring index has now been created by researchers that measures the total damage to the intestines caused by Crohn's disease.

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The scoring tool, known as the Lémann Index, was developed by the International Program to Develop New Indexes in Crohn’s Disease (IPNIC) group and is the first tool to take into account the extent and depth of Crohn's disease intestinal damage. What that means is physicians can more easily identify different phenotypes of the disease to deliver better care.

Jacques Cosnes, MD, from the gastroenterology and nutrition department at Hôpital Saint-Antoine in Paris explains: “By measuring the damage index at different time points in one individual we will be able to identify different phenotypes of the disease according to the speed of damage progression, according to Healio Gastroenterology.

New Crohn's disease tool helps control damage

Rather than focus on controlling symptoms of Crohn's disease, Cosnes said the index will help identify patients whose disease seems to be progressing rapidly. Aggressive treatment in the first few months of diagnosis can help prevent more damage including strictures that can lead to surgery and lesions that can cause bleeding. The index tool also provides a way to find out what treatments are working.

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Researchers validated the index by performing an international, prospective, cross-sectional, observational study from August 2008 to December 2010. Investigators analyzed data from 138 patients with Crohn's disease from 24 health care location centers, in 15 countries. All patients underwent a clinical exam, abdominal MRI and colonoscopy and pelvic MRI according to disease location.

An accompanying editorial highlights the challenges in using the index. Ashwin N. Ananthakrishnan, MD, from Massachusetts General Hospital and Harvard Medical School, and Stephen B. Hanauer, MD, from the Feinberg School of Medicine at Northwestern University note that validation of how well the index performs for IBD is still needed. They also note many experts were involved in the study, including radiologists with much expertise in interpreting MRIs. Moving the index from clinical trial into the "real world" of clinical practice could be difficult, given its complexity.

The study authors concluded, "The Lémann Index ...should be used to evaluate progression of CD and efficacy of treatment."

Citations:
Gastroenterology
DOI: http://dx.doi.org/10.1053/j.gastro.2014.09.015
http://dx.doi.org/10.1053/j.gastro.2014.11.022
January, 2015

Image credit: Wikimedia Commons

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Comments

Please correct - should be inflammatory bowel disease, not irritable bowel disease.
Thanks Julie. I think I am always going to make that mistake - it is so easy to type the wrong thing even though I know better. I appreciate the head's up.
Would like to know who you consider as the leading Canadian GI Specialist. Thanks
Hi Bryan. I removed your e-mail just for the sake of your privacy. I am in the U.S. I wonder if someone in a Facebook Crohn's disease group might have some information that would answer that question?