A64 VALIDATION OF THE MODIFIED MULTIPLIER OF SES-CD (MM-SES-CD) TO PREDICT ENDOSCOPIC REMISSION IN CROHN’S DISEASE: A POST HOC ANALYSIS OF THE SEAVUE TRIAL

TL;DR

This study validates a new scoring system to predict endoscopic healing in Crohn’s disease patients based on disease severity at baseline.

Contribution

The MM-SES-CD score is validated as a predictor of endoscopic healing and other outcomes in Crohn’s disease.

Findings

Patients with mild baseline disease had the highest rate of endoscopic healing (62.0%) at one year.

Baseline MM-SES-CD severity was significantly associated with fecal calprotectin normalization (p=0.008).

Trends suggest higher baseline severity correlates with lower clinical remission rates based on patient-reported outcomes.

Abstract

The modified multiplier of the SES-CD (MM-SES-CD) has been shown to have prognostic value for predicting endoscopic healing (EH) in patients with Crohn’s disease.

The purpose of this analysis was to validate baseline categories of endoscopic disease severity using the MM-SES-CD and determine their prognostic value for predicting one-year EH.

Participants in the SEAVUE trial (n = 386) were categorized based on baseline endoscopic disease severity using MM-SES-CD cut-offs into mild (≥22.5 to < 31), moderate (≥ 31 to < 45) and severe (≥45) disease. The primary outcome was achievement of endoscopic healing (EH) based on MM-SES-CD score (< 22.5) at one year. Secondary outcomes included achieving clinical remission based on patient-reported outcomes and normalization of fecal calprotectin in patients with raised baseline levels at one year.

MM-SES-CD < 22.5 at one year was achieved in 62.0% of patients with baseline mild endoscopic disease, 48.6% with moderate disease and 33.8% with severe disease (p <0.001). Similarly, a trend was observed for patient-reported outcome (PRO-2) clinical remission, which was achieved in 78.9% of patients with baseline mild endoscopic disease, 72.9% of those with moderate and 66.2% of those with severe disease (p=0.09). Likelihood of fecal calprotectin (FCP) normalization was significantly associated with baseline endoscopic disease severity (p=0.008).

Baseline MM-SES-CD-based cutoffs for endoscopic disease severity demonstrate prognostic value for achieving one-year EH, PRO2 remission, and FCP normalization. These findings suggest that the MM-SES-CD can be used both to measure baseline endoscopic disease severity and predicts post-maintenance outcomes in patients with CD.

Figure 1: Percentage of patients in MM-SES-CD remission (<22.5) at week 52 stratified by baseline MM-SES-CD categories (Mild ≥ 22.5 to < 31, moderate ≥ 31 to < 45, severe ≥ 45)

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