Small Bowel Motility Quantified by Cine MRI to Predict Longer-Term Response in Patients with Crohn's Disease Commencing Biological Therapy: The Motility Study

被引：3

作者：

Plumb, Andrew A. ^{[1
,2
]}

Moran, Gordon ^{[3
]}

Chowdhury, Kashfia ^{[4
]}

Ahmed, Norin ^{[4
]}

Philpott, Sue ^{[4
]}

Ahmad, Tariq ^{[5
]}

Bloom, Stuart ^{[6
]}

Hart, Ailsa ^{[7
]}

Jacobs, Ilan ^{[8
]}

Menys, Alex ^{[9
]}

Mooney, Peter ^{[10
]}

Tolan, Damian ^{[11
]}

Travis, Simon ^{[12
]}

Bhagwanani, Anisha ^{[13
]}

Bhatnagar, Gauraang ^{[9
]}

Boone, Darren ^{[1
,2
]}

Franklin, James ^{[14
]}

Gangi-Burton, Anmol ^{[13
,15
]}

Hameed, Maira ^{[1
,2
]}

Helbren, Emma ^{[16
]}

Hosseini-Ardehali, Faraz ^{[1
]}

Hyland, Rachel ^{[11
]}

Kilic, Yakup ^{[1
]}

Kumar, Shankar ^{[1
,2
]}

Lambie, Hannah ^{[11
]}

Mohsin, Maryam ^{[11
]}

Patel, Anisha ^{[17
]}

Rahman, Safi ^{[11
]}

Sakai, Naomi ^{[1
,2
]}

Sidhu, Harbir ^{[1
,2
]}

Thomson, Elen ^{[11
]}

Ahmed, Saiam ^{[4
]}

Bannur Chikkeragowda, Uday ^{[15
]}

Barratt, Nina ^{[18
]}

Beeston, Teresita ^{[1
,2
]}

Fitzke, Heather ^{[2
]}

Gibbons, Nicola ^{[19
]}

Godfrey, Edmund ^{[20
]}

Gupta, Arun ^{[21
]}

Higginson, Antony ^{[19
]}

Isaac, Elizabeth ^{[1
,2
]}

Kok, Klaartje Bel ^{[22
]}

Langlands, Sarah ^{[23
]}

Parkes, Miles ^{[24
]}

Patel, Jaymin ^{[25
,27
]}

Patel, Kamal ^{[25
]}

Patel, Kamini ^{[26
]}

Patodi, Nishant

Pollok, Richard ^{[28
]}

Przemiosolo, Robert ^{[29
]}

机构：

[1] Univ Coll London Hosp, Dept Radiol, London, England

[2] UCL, Ctr Med Imaging, Div Med, London, England

[3] Univ Nottingham, Queens Med Ctr, Nottingham, England

[4] UCL, Comprehens Clin Trials Unit, London, England

[5] Royal Devon & Exeter Hosp, Dept Gastroenterol, Exeter, England

[6] Univ Coll London Hosp, Dept Gastroenterol, London, England

[7] St Marks Hosp, Dept Gastroenterol, London, England

[8] Patient Representat, London, England

[9] Motilent, London, England

[10] St James Hosp, Dept Gastroenterol, Leeds, England

[11] St James Hosp, Dept Radiol, Leeds, England

[12] Oxford Radcliffe Hosp, Dept Gastroenterol, Oxford, England

[13] Frimley Hlth NHS Trust, Dept Radiol, Frimley, England

[14] Univ Hosp Dorset NHS Fdn Trust, Dept Cardiol, Bournemouth, England

[15] Nottingham Univ Hosp, Dept Radiol, Nottingham, England

[16] Hull Univ Teaching Hosp NHS Trust, Dept Radiol, Kingston Upon Hull, England

[17] Western Gen Hosp, Dept Radiol, Edinburgh, Scotland

[18] Wessex Hlth Partners, Southampton, England

[19] Portsmouth Hosp Univ NHS Trust, Dept Radiol, Portsmouth, England

[20] Addenbrookes Hosp, Dept Radiol, Cambridge, England

[21] St Marks Hosp, Dept Radiol, London, England

[22] Barts Hlth NHS Trust, Dept Gastroenterol, London, England

[23] Frimley Hlth NHS Trust, Dept Gastroenterol, Frimley, England

[24] Addenbrookes Hosp, Dept Gastroenterol, Cambridge, England

[25] St Georges Univ Hosp NHS Trust, Dept Radiol, London, England

[26] Homerton Healthcare NHS Trust, Dept Radiol, London, England

[27] Royal Berkshire NHS Trust, Dept Gastroenterol, Reading, England

[28] St Georges Univ Hosp NHS Trust, Dept Gastroenterol, London, England

[29] North Bristol NHS Trust, Dept Gastroenterol, Bristol, England

[30] Royal Berkshire NHS Trust, Dept Radiol, Reading, England

[31] Homerton Healthcare NHS Trust, Dept Gastroenterol, London, England

来源：

INFLAMMATORY BOWEL DISEASES | 2025年

关键词：

biologics (IBD); Crohn's disease; inflammatory bowel disease; radiology/imaging; small intestine; C-REACTIVE PROTEIN; POST-HOC ANALYSIS; QUALITY-OF-LIFE; ENDOSCOPIC ACTIVITY; FECAL CALPROTECTIN; VALIDATION; INFLIXIMAB; ENTEROGRAPHY; REMISSION;

D O I：

10.1093/ibd/izaf023

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Small bowel Crohn's disease (SBCD) is increasingly treated with biological therapies. Predicting response or remission (RoR) for individual patients is difficult and complicates treatment strategy. We aimed to determine if motility magnetic resonance imaging (mMRI) is superior to CRP and fecal calprotectin (FC) for the prediction of RoR at 1 year in patients commencing biologics for SBCD. Methods Prospective, multicenter (n = 13) cohort study of patients with active non-stricturing SBCD requiring anti-TNF alpha or anti-IL-12/23 treatment. We measured mMRI and CRP at baseline and post-induction (visit 2: 12-30 weeks), and FC in a subset. RoR was assessed at 1 year using clinical and structural magnetic resonance enterography parameters. We compared sensitivity, specificity, and area under the receiver operating characteristic curve (ROC-AUC) of changes in mMRI and CRP to predict RoR at 1 year. Secondary outcomes compared mMRI with FC, and prediction of improved quality of life (QoL). Results Eighty-six participants completed all assessments. Stable or improved mMRI at visit 2 was more sensitive than normalization of CRP for RoR (mMRI:71.0%, 95%CI 52.0-85.8; CRP:45.2%, 95%CI 27.3-64.0%, P = .008) but less specific (mMRI:30.9%, 95%CI 19.1-44.8; CRP:67.3%, 95%CI 53.3-79.3%, P < .001). There was no significant difference in ROC-AUC (mMRI:0.48; CRP:0.53, P = .65). Similar results were obtained for FC. None of mMRI, CRP, or FC predicted patient QoL at 1 year. Conclusions Although improved mMRI is more sensitive than CRP and FC to predict RoR at 1 year, it is less specific. No factor predicted patient QoL. Motility MRI remains a marker of disease activity at given timepoints.

引用

页数：13

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