title: A simple biological score for predicting low risk of short-term relapse in Crohn's disease.
abstract: BACKGROUND
  In Crohn's disease, studies have evaluated the ability of biological markers to predict relapse in the next 12 to 18 months, without differentiating early from late relapses. The aim of this study was to look for biological markers of short-term relapse.
  
  
  METHODS
  In a previous therapeutic trial, patients with a medically induced clinical remission had biological markers evaluated and updated every 6 weeks. A Cox model with time-dependent covariates was used for analysis.
  
  
  RESULTS
  Among the 71 patients, 38 had a relapse. Multivariate analysis selected 2 markers predictive of relapse: C-reactive protein >20 mg/L and erythrocyte sedimentation rate >15 mm. A binary biological predictive score was derived: "negative" when both were lower than their limits, "positive" when otherwise. The relative risk of short-term relapse for patients with a positive score compared to those with a negative score was 8.0 (95% confidence interval 2.8-22.9). Sensitivity of the score was 89% and specificity was 43%. Assuming a 10% relapse rate every 6 weeks, negative and positive predictive values were 97% and 15%, respectively.
  
  
  CONCLUSIONS
  This simple biological score can predict short-term maintenance of remission in Crohn's disease and may help physicians in the follow-up of patients in clinical remission.
authors.affiliation: Unité de Biostatistique et Epidémiologie Clinique, INSERM U 717, Université Paris 7, Paris, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Consigny
authors.forename: Robert
authors.initials: R
authors.lastname: Modigliani
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Colombel
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Dupas
authors.forename: Marc
authors.initials: M
authors.lastname: Lémann
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mary
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D004311:Double-Blind Method; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012008:Recurrence; D012074:Remission Induction; D012306:Risk; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein