Prospective Evaluation of Mucosal Changes in the Small Bowel by Capsule Endoscopy in Patients with Crohn’s Disease Treated with Infliximab and Adalimumab

Ladislav Kuzela, Marian Oltman, Jarolim Sutka, Barbora Zacharova, Peter Paulen, Beata Repakova, Miroslava Rajska


AIM: The aim of the proposed study was to evaluate mucosal lesions in the small bowel by means of capsule endoscopy (CE) in patients with Crohn’s disease (CD) before administration of infliximab(IFX) or adalimumab (ADA) and following maintenance treatment.Secondary endpoint was to assess the tolerance of CE by the patient,possible adverse events and also the diagnostic efficacy in patients with CD. METHODS: The group of 50 patients with CD treated with IFX(n=25) or ADA (n=25), were prospectively monitored. CE using was performed in each patient before the treatment and after one year of maintenance treatment. RESULTS: 42 patients concluded the study. In ADA treated patients(n=23) after one year we observed changes in CE from conclusive to normal in 2 patients, in 1 patient impairment from inconclusive to conclusive. All the other patients remained their findings without change. In IFX treated patients (n=19) after one year we have observed changes from conclusive to normal in 2 patients. All the other patients remained their findings without change. CONCLUSION: Despite the fact that we have not observed statistical significant effect of ADA or IFX treatment on small bowel MH, we have noticed improvement by means of drop in CDAI after 1 year maintenance treatment. CE could be helpful in selecting the right patient with mucosal lesions in terms of achievement of best clinical results for the biological treatment.

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