Performance of the Montreal classification for inflammatory bowel diseases

Spekhorst, Lieke M.; Visschedijk, Marijn C.; Alberts, Rudi; Festen, Eleonora A. M.; Woude, C. Janneke van der; Dijkstra, Gerard; Weersma, Rinse K.; Crohn, Dutch Initiative on; Colitis,

doi:10.3748/wjg.v20.i41.15374

Cited by 56 publications

(40 citation statements)

References 28 publications

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“…Demographic features of patients at inclusion are listed in Table 1. Montreal classification was used to define the behaviour and location of CD [18]. …”

Section: Resultsmentioning

confidence: 99%

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Rouiller-Braunschweig

Fournier

Pittet

et al. 2017

Digestion

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Background/Aims: Evidence for the effectiveness of methotrexate (MTX) in treating inflammatory bowel disease (IBD) is still incomplete. This study assessed the effectiveness, safety and mucosal healing in IBD patients treated with MTX in the Swiss IBD Cohort. Methods: Efficacy was defined by physician assessment or by CD activity index <150 points for Crohn’s disease (CD) or Modified Truelove and Witts activity index <4 points for ulcerative colitis (UC), measured at least after 3 months of MTX therapy. Mucosal healing was evaluated after 3 months or more of therapy. Results: MTX was administered to 341 patients (262 CD; 79 UC) out of 2,660 patients. MTX effectiveness was 59.5% (128/215) in CD and 40.0% (24/60) in UC (chi² = 7.2409, p = 0.007). Among patients on MTX therapy at the time of analysis, remission was obtained in 87.4% (76/87) and 69.2% (9/13) for CD and UC patients respectively. The median duration of MTX therapy was 40 months for CD and 15 months for UC. Occurrence of adverse events was the first reason for treatment discontinuation (39.4% of all cases). The rate of mucosal healing with MTX was 9.5% for CD and 25% for UC patients respectively. Conclusion: MTX therapy was effective for the induction and maintenance therapy in IBD patients, with only a modest mucosal healing ability.

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“…Demographic features of patients at inclusion are listed in Table 1. Montreal classification was used to define the behaviour and location of CD [18]. …”

Section: Resultsmentioning

confidence: 99%

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Rouiller-Braunschweig

Fournier

Pittet

et al. 2017

Digestion

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“…None of the cases was complicated with both CD and intestinal lymphoma or intestinal lymphoma in preexisting CD. Patients with CD were included in our final cohort if they met the following criteria: (1) newly diagnosed with CD with lower GI tract involvement; (2) aged >18 years; (3) with a definite diagnosis for at least 1 year; (4) had a Montreal classification of L1, L2, or L3 (with an involvement of the ileum, colon, or both)[14]; (5) underwent endoscopy and CTE at least once during hospitalization; and (6) had an exclusion of other concomitant GI diseases. Diagnosis of PIL was based on Dawson standards as follows[15]: (1) no enlargement of the peripheral or mediastinal lymph nodes; (2) normal white blood cell count; (3) predominance of alimentary tract lesions with only regional lymph node involvement; and (4) no involvement of the liver and spleen.…”

Section: Methodsmentioning

confidence: 99%

Potential model for differential diagnosis between Crohn's disease and primary intestinal lymphoma

Zhang

Fan

et al. 2016

WJG

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AIMTo evaluate the usefulness of different parameters to differentiate Crohn’s disease (CD) from primary intestinal lymphoma (PIL).METHODSThe medical records of 85 patients with CD and 56 patients with PIL were reviewed retrospectively. Demographic, clinical, laboratory, endoscopic, and computed tomographic enterography (CTE) parameters were collected. The univariate value of each parameter was analyzed. A differentiation model was established by pooling all the valuable parameters. Diagnostic efficacy was analyzed, and a receiver operating characteristic (ROC) curve was plotted.RESULTSThe demographic and clinical parameters that showed significant values for differentiating CD from PIL included age of onset, symptom duration, presence of diarrhea, abdominal mass, and perianal lesions (P < 0.05). Elevated lactate dehydrogenase and serum β2-microglobulin levels suggested a PIL diagnosis (P < 0.05). The endoscopic parameters that showed significant values for differentiating CD from PIL included multiple-site lesions, longitudinal ulcer, irregular ulcer, and intraluminal proliferative mass (P < 0.05). The CTE parameters that were useful in the identification of the two conditions included involvement of ≤ 3 segments, circular thickening of the bowel wall, wall thickness > 8 mm, aneurysmal dilation, stricture with proximal dilation, “comb sign”, mass showing the “sandwich sign”, and intussusceptions (P < 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the differentiation model were 91.8%, 96.4%, 93.6%, 97.5%, and 88.5%, respectively. The cutoff value was 0.5. The area under the ROC curve was 0.989.CONCLUSIONThe differentiation model that integrated the various parameters together may yield a high diagnostic efficacy in the differential diagnosis between CD and PIL.

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“…Moreover, the severity of IBD was assessed by determining the Montreal classification. 26 Additionally, it was established if patients were ever treated with immunosuppressive agents (azathioprine, 6-mercaptopurine, methotrexate, 6-thioguanine, cyclosporine, and tacrolimus) and/or anti-TNF-a therapy and whether they underwent surgical resection in the past.…”

Section: Ibd Evaluationmentioning

confidence: 99%

Identification of Clinical and Genetic Parameters Associated with Hidradenitis Suppurativa in Inflammatory Bowel Disease

Janse¹,

Koldijk²,

Spekhorst

et al. 2016

Inflammatory Bowel Diseases

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HS is present in 6.8% to 10.6% of IBD patients. Co-morbid HS is associated with an early onset of IBD in which anti-tumor necrosis factor-α therapy and surgical resections are often needed. We identified a suggestive protective association with ELOVL7 and suggestive risk association with the genes SULT1B1 and SULT1E1 for HS, in the context of IBD. These genetic associations need further exploration and replication in additional independent cohorts.

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Performance of the Montreal classification for inflammatory bowel diseases

Abstract: We found a good to excellent inter-observer agreement for all Montreal items except for disease severity in UC (poor).

Cited by 56 publications

References 28 publications

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Potential model for differential diagnosis between Crohn's disease and primary intestinal lymphoma

Identification of Clinical and Genetic Parameters Associated with Hidradenitis Suppurativa in Inflammatory Bowel Disease

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