Early rheumatoid arthritis | Criterion | Early Crohn disease |
≥6 of 66 swollen joints, ≥6 of 68 tender joints | Active disease | Crohn disease Activity Index (CDAI)>220 |
Erythrocyte sedimentation rate ≥28 mm/h or a global health score of ≥20 mm | Active disease | C-reactive protein >10 mg/l or significant endoscopic (large coalescent and deep ulcerations covering more than 10% of the mucosal area of at least one segment of the colorectum) or radiological evidence (CT or MRI bowel enhancement) of disease activity or positive faecal markers |
≥18 years | Age | No limit of age (both paediatric and adult patients can be included) |
Immunomodulators (azathioprine, 6-mercaptopurine, methotrexate), biologics, corticosteroids (previously steroid-dependent with oral steroids or any treatment with intravenous steroids)* | No previous or current use | |
Bowel damage | No fistula (including perianal fistulas), abscess, stricture (wall thickening and luminal narrowing with prestenotic dilatation—defined as a diameter greater than the normal diameter of the small bowel or colon) on CT or MRI† | |
Surgery | No history of Crohn disease-related surgery (minor or major surgical procedures) | |
Endoscopy procedures | No history of endoscopic balloon dilation of a stricture | |
Impaired GI functioning | Normal faecal continence, no previous or current use of oral or parenteral substitution (vitamins, minerals), no enteral or parenteral nutrition since diagnosis | |
≤2 years | Disease duration | ≤2 years |
The patient must fulfil all inclusion criteria without any exception.
As a prerequisite, the previous diagnosis of Crohn disease has to be confirmed according to the criteria adopted by Lennard-Jones.48
↵* All 5-aminosalicylate formulations permitted (previous or current use).
↵† When available, MRI is preferred.