TOpCLASS Expert Consensus Classification of Perianal Fistulising Crohn’s Disease: A Real-world Application in a Serial Fistula MRI Cohort
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Le résumé fourni par la source
BACKGROUND AND AIMS: Perianal fistuliing Crohn's disease [PFCD] is an aggressive phenotype of Crohn's disease defined by frequent relapses and disabling symptoms. A novel consensus classification system was recently outlined by the TOpCLASS consortium, which seeks to unify disease severity with patient-centred goals but has not yet been validated. We aimed to apply this to a real-world cohort and to identify factors that predict transition between classes over time. METHODS: We identified all patients with PFCD and at least one baseline and one follow-up pelvic MRI [pMRI]. TOpCLASS classification, disease characteristics, and imaging indices were collected retrospectively at time periods corresponding with respective MRIs. RESULTS: We identified 100 patients with PFCD, of whom 96 were assigned TOpCLASS Classes 1-2c at baseline. Most patients [78.1%] started in Class 2b, but changes in classification were observed in 52.1% of all patients. Male sex [72.0%, 46.6%, 40.0%, p = 0.03] and prior perianal surgery [52.0% vs 44.6% vs 40.0%, p = 0.02] were more frequently observed in those with improved class compared to unchanged and worsened class. Baseline pMRI indices were not associated with changes in classification; however, greater improvements in mVAI, MODIFI-CD, and PEMPAC were seen among those who improved. Linear mixed effect modelling identified only male sex [-0.31, 95% CI -0.60 to -0.02] with improvement in class. CONCLUSION: The TOpCLASS classification highlights the dynamic nature of PFCD over time. However, our ability to predict transitions between classes remains limited and requires prospective assessment. Improvement in MRI index scores over time was associated with a transition to lower TOpCLASS classification.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- TOpCLASS Expert Consensus Classification of Perianal Fistulising Crohn’s Disease: A Real-world Application in a Serial Fistula MRI Cohort
- Date Crossref
- 20/04/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
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Washington University in St. Louis pays non établi dans la noticeUniversité ou école supérieure
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Cleveland Clinic Division of Gastroenterology pays non établi dans la noticeÉtablissement de santé
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St. Mary Medical Center OSF Health pays non établi dans la noticeÉtablissement de santé
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University of Virginia Division of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
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Mallinckrodt (United States) pays non établi dans la noticeEntreprise
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Mayo Clinic in Arizona pays non établi dans la noticeÉtablissement de santé
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Washington University School of Medicine in Saint Louis Division of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
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Mayo Clinic Arizona Department of Radiology pays non établi dans la noticeÉtablissement de santé
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Washington University in St. Louis, Division of Gastroenterology — Cleveland Clinic et OSF Health — St. Mary Medical Center, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.