https://doi.org/10.55788/849dabf8
“Lewis scores of 350 and higher on VCE identify patients with a high risk of flares within the next 2 years, with a better predictive accuracy than faecal calprotectin,” explained Dr Shomron Ben-Horin (Tel-Aviv University, Israel) [1,2]. The current, prospective, randomised-controlled CURE-CD trial (NCT03555058) evaluated the efficacy of VCE as a guidance tool for patients with CD and small bowel involvement in clinical remission (n=60) [1].
At baseline, participants received VCE and those with a Lewis Score of 350 or higher (n=40) were randomised 1:1 to standard-of-care or to capsule endoscopy-guided proactive treatment for 24 months. “The proactive treatment regimen included biologic dose-escalation and initiating or swapping a biologic treatment,” added Dr Ben-Horin. Low-risk participants (n=20) continued on standard-of-care. The primary endpoint was the rate of relapse/disease complications in the high-risk population.
At 24 months, the clinical flare rate was 25% in the experimental arm and 70% in the control arm, meeting the primary endpoint (OR 0.14; 95% CI 0.04–0.57; P=0.006). “We also noted a trend towards fewer relapses in the low-risk standard-of-care group compared with the high-risk standard-of-care group (45% vs 70%; P=0.11), which was a secondary endpoint of the trial” (see Figure).
Figure: Main results of the CURE-CD trial at 24 months [2]
“High-risk patients with CD, as defined by baseline VCE scores, benefitted from a proactive treat-to-target strategy for the prevention of disease exacerbations,” concluded Dr Ben-Horin.
- Ben-Horin S, et al. Capsule endoscopy-guided proactive treatment versus standard care in patients with quiescent Crohn’s disease: the CURE-CD randomized controlled trial. DOP29, 19th Congress of ECCO, 21–24 February 2024, Stockholm, Sweden.
- Ben-Horin S, et al. Lancet Gastroenterol Hepatol. 2019;4(7):519-528.
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Table of Contents: ECCO 2024
Featured articles
Meet the Trialist: Dr Yasuharu Maeda on AI-assisted endoscopy
IL-23 Inhibitors on the Rise
VIVID-1: Mirikizumab meets expectations in Crohn’s disease
COMMAND: Long-term efficacy benefits of risankizumab in ulcerative colitis
SEQUENCE: Risankizumab versus ustekinumab across endpoints
QUASAR: Guselkumab improves QoL for patients with ulcerative colitis
Fatigue, urgency, and QoL improvements on mirikizumab in Crohn’s disease
Inspiring Drug Trials and Treatment Strategies
Novel agent VTX002 holds promise in ulcerative colitis
PROFILE: Top-down treatment strategy benefits patients with early Crohn’s disease
Biologicals and JAK inhibitors hold promise in microscopic colitis
Ustekinumab as alternative for anti-TNFs in HLA-DQA1*05-positive Crohn’s disease
How effective is dose escalation of biologicals in IBD?
Make Way for JAK Inhibitors
Promising data for JAK inhibitors in Crohn’s disease from phase 2 trial
U-ENDURE long-term extension: sustained efficacy of upadacitinib in Crohn’s disease
TRIUMPH: Tofacitinib as rescue option for acute severe ulcerative colitis
Focus on Endoscopy, Screening, and Risk Factors
Should we screen for metabolic bone disease at IBD diagnosis?
Predicting relapse in ulcerative colitis with AI-assisted endoscopy
Clear case for NUDT15 genetic testing in Asian patients with IBD
HELIOS: HD-WLE can yield similar neoplasia detection rates as HD-CE
CURE-CD: Capsule endoscopy-guided proactive treatment leads to fewer relapses in Crohn’s disease
Sharp Surgical Solutions
Extended mesenterectomy or mesenteric-sparing surgery in Crohn’s disease?
Similar outcomes for Kono-S and side-to-side anastomosis in Crohn’s terminal ileitis
Risk factors for re-resection in Crohn’s disease revealed
ADMIRE-CD-II: Darvadstrocel does not meet primary endpoint in complex peri-anal fistula
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