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A Simple Endoscopic Score for Crohn's Disease (SES-CD) ≥ 7 Predicts Disease Progression

Title: A Simple Endoscopic Score for Crohn's Disease (SES-CD) ≥ 7 Predicts Disease Progression
Authors: Peraza, Jellyana; Kaper, Marco Emilio; Bargas, Andre; Kim, Iris; Agrawal, Manasi; Larsen, Lone; Jacobsen, Henrik Albaek; Jess, Tine; Colombel, Jean-Frederic; Torres, Joana; Ungaro, Ryan C.; Ananthakrishnan, Ashwin N.
Source: Peraza, J, Kaper, M E, Bargas, A, Kim, I, Agrawal, M, Larsen, L, Jacobsen, H A, Jess, T, Colombel, J-F, Torres, J, Ungaro, R C & Ananthakrishnan, A N 2025, 'A Simple Endoscopic Score for Crohn's Disease (SES-CD) ≥ 7 Predicts Disease Progression', Alimentary Pharmacology & Therapeutics, vol. 61, no. 6, pp. 1011-1018. https://doi.org/10.1111/apt.18492
Publication Year: 2025
Collection: Aalborg University (AAU): Publications / Aalborg Universitet: Publikationer
Subject Terms: Crohn's disease; SES-CD; endoscopic severity; inflammatory bowel disease
Description: BACKGROUND: Up to 30% of patients with Crohn's disease (CD) will experience a mild disease course. However, there is no consensus definition for mild CD. AIM: To examine the Simple Endoscopic Score for Crohn's disease (SES-CD) thresholds best associated with low likelihood of long-term disease progression. METHODS: We conducted a multicentre retrospective cohort study at three tertiary care centres in United States and Europe. We analysed data from 177 surgery-naïve patients with CD who had endoscopic assessment while not on immunosuppressive therapy. The primary outcome was disease progression (systemic steroids, biologic or immunomodulator therapy initiation; new stricturing or penetrating complications; or CD-related hospitalisation or surgery). Univariable and multivariable Cox proportional hazards modelling identified predictors of the primary outcome at 2 and 5 years following endoscopy. RESULTS: Disease progression occurred in 23% and 35% of patients at years two and five, respectively. Endoscopic severity at enrolment independently predicted disease progression. Compared to those with an SES-CD of 0, an SES-CD ≥ 7 had a greater risk of progression at 2 years (HR 2.50, 95% CI 1.09-5.72) and 5 years (HR 2.89, 95% CI 1.41-5.91). SES-CD > 7 remained independently predictive of disease progression among the 129 immunosuppression-naïve patients (HR 5.65, 95% CI 1.49-21.52) and after excluding patients with prior penetrating disease (HR 2.32, 95% CI 1.00-5.45). CONCLUSIONS: SES-CD ≥ 7 predicts disease progression in mild CD. A score ≤ 6 may help identify patients less likely to progress and be part of the definition of mild CD.
Document Type: article in journal/newspaper
Language: English
ISSN: 0269-2813; 0953-0673
Relation: info:eu-repo/semantics/altIdentifier/pmid/39757503; info:eu-repo/semantics/altIdentifier/pissn/0269-2813; info:eu-repo/semantics/altIdentifier/eissn/0953-0673
DOI: 10.1111/apt.18492
Availability: https://vbn.aau.dk/da/publications/76952b3b-b20e-448a-a9e4-1e8fb42052cf; https://doi.org/10.1111/apt.18492; https://www.scopus.com/pages/publications/85214410536
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.9CBE9E20
Database: BASE