Table 4

Potential monitoring of a patient with clinically active CD

QuestionMonitoring toolPrediction
Are there endoscopic active lesions?CRP ≤5 mg/l and faecal calprotectin ≤200 μg/g
MR enterocolonography (MaRIA score)
Predicts CDEIS ≤6 with a sensitivity of 83% and specificity of 71%57

Predicts active endoscopic ileocolonic lesions with a sensitivity of 87% and a specificity of 89%30 31
Is the patient going to respond to anti-TNF therapy (before induction)?CRP >5 mg/l
Presence of any ulcer at ileocolonoscopy
76% response rate after first anti-TNF (compared with 46% when normal CRP)54
61% steroid-free remission with azathioprine+infliximab combination therapy (compared with 40% without endoscopic lesion)13
Is the patient going to respond to anti-TNF therapy (after induction)?Faecal calprotectin decrease
Absence of sustained CRP normalisation
Increased proportion of endoscopic healing58
Increased risk of anti-TNF loss of response59
  • CD, Crohn's disease; CDEIS, CD Endoscopic Index of Severity; CRP, C-reactive protein; MaRIA, Magnetic Resonance Index of Activity; TNF, tumour necrosis factor.