Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12208-12220
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12208
Predictors of bowel damage in the long-term progression of Crohn’s disease
Agnes Fernández-Clotet, Julian Panés, Elena Ricart, Jesús Castro-Poceiro, Maria Carme Masamunt, Sonia Rodríguez, Berta Caballol, Ingrid Ordás, Jordi Rimola
Agnes Fernández-Clotet, Julian Panés, Elena Ricart, Jesús Castro-Poceiro, Maria Carme Masamunt, Berta Caballol, Ingrid Ordás, Department of Gastroenterology, Hospital Clinic, Barcelona 08036, Spain
Agnes Fernández-Clotet, Julian Panés, Elena Ricart, Jesús Castro-Poceiro, Maria Carme Masamunt, Berta Caballol, Ingrid Ordás, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
Agnes Fernández-Clotet, Julian Panés, Elena Ricart, Jesús Castro-Poceiro, Maria Carme Masamunt, Berta Caballol, Ingrid Ordás, Jordi Rimola, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid 28029, Spain
Sonia Rodríguez, Jordi Rimola, Department of Radiology, Hospital Clinic, Barcelona 08036, Spain
Author contributions: Fernández-Clotet A contributed to study design, study conduction, patient recruitment, data collection, data analysis, data interpretation, and drafting the article; Panés J, Ordás I, and Rimola J contributed to study design, patient recruitment, data collection, data interpretation, and drafting the article; Ricart E, Castro-Poceiro J, Masamunt MC, and Caballol B contributed to patient recruitment and data collection; Rodríguez S contributed to data collection; all authors critically reviewed the article and approved the final manuscript.
Supported by the Helmsley Charitable Trust Grant, No. 2015PG-IBD005.
Institutional review board statement: This study was evaluated and approved by the Local Ethics Committee (Approval No. HCB/2018/0160).
Clinical trial registration statement: This study is registered at the clinical hospital center “Hospital Clinic de Barcelona”. The registration identification number is HCB/2018/0160.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Dr. Rimola reports grants from Abbvie, personal fees from Alimentiv, personal fees from Janssen, personal fees from Takeda, non-financial support from Gilead and from Agumab during the conduct of the study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jordi Rimola, MD, PhD, Consultant Physician-Scientist, Department of Radiology, Hospital Clinic, 170 Villarroel, Barcelona 08036, Spain. jrimola@clinic.cat
Received: September 14, 2022
Peer-review started: September 14, 2022
First decision: September 26, 2022
Revised: October 6, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 26, 2022
Core Tip

Core Tip: The aim of the study was to characterize the long-term progression of bowel damage (BD) in patients with Crohn’s disease based on changes in the Lémann index. Predictors of BD progression were a baseline stricturing and fistulizing Crohn’s disease phenotype, ileal location, disease duration of more than 10 years, and a higher Lémann index stricturing score. Strict monitoring of BD-associated lesions during treatment, especially in those patients with a higher baseline Lémann index score, may help clinicians to improve treatment strategies in order to halt BD progression, adapting treatment based on risk factors identified in this study.