Disease Activity Indices for Pouchitis: A Systematic Review.

C-Reactive Protein Feces Humans Leukocyte L1 Antigen Complex Pouchitis / diagnosis Reproducibility of Results
index development operating properties pouchitis disease systematic review

Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
30 03 2022
Historique:
received: 22 01 2021
pubmed: 29 6 2021
medline: 5 4 2022
entrez: 28 6 2021
Statut: ppublish

Résumé

Several indices exist to measure pouchitis disease activity; however, none are fully validated. As an initial step toward creating a validated instrument, we identified pouchitis disease activity indices, examined their operating properties, and assessed their value as outcome measures in clinical trials. Electronic databases were searched to identify randomized controlled trials including indices that evaluated clinical, endoscopic, or histologic pouchitis disease activity. A second search identified studies that assessed the operating properties of pouchitis indices. Eighteen randomized controlled trials utilizing 4 composite pouchitis disease activity indices were identified. The Pouchitis Disease Activity Index (PDAI) was most commonly used (12 of 18; 66.7%) to define both trial eligibility (8 of 12; 66.7%), and outcome measures (12 of 12; 100%). In a separate search, 21 studies evaluated the operating properties of 3 pouchitis indices; 90.5% (19 of 21) evaluated validity, of which 42.1% (8 of 19) evaluated the construct validity of the PDAI. Criterion validity (73.7%; 14 of 19) was evaluated through correlation of the PDAI with fecal calprotectin (FCP; r = 0.188 to 0.71), fecal lactoferrin (r = 0.570 to 0.582), and C-reactive protein (CRP; r = 0.584). Two studies assessed correlation of the modified PDAI (mPDAI) with FCP (r = 0.476 and r = 0.565, respectively). Fair to moderate inter-rater reliability of the PDAI (k = 0.440) and mPDAI (k = 0.389) was reported in a single study. Responsiveness of the PDAI pre-antibiotic and postantibiotic treatment was partially evaluated in a single study of 12 patients. Development and validation of a specific pouchitis disease activity index is needed given that existing instruments are not valid, reliable, or responsive.

Sections du résumé

BACKGROUND
Several indices exist to measure pouchitis disease activity; however, none are fully validated. As an initial step toward creating a validated instrument, we identified pouchitis disease activity indices, examined their operating properties, and assessed their value as outcome measures in clinical trials.
METHODS
Electronic databases were searched to identify randomized controlled trials including indices that evaluated clinical, endoscopic, or histologic pouchitis disease activity. A second search identified studies that assessed the operating properties of pouchitis indices.
RESULTS
Eighteen randomized controlled trials utilizing 4 composite pouchitis disease activity indices were identified. The Pouchitis Disease Activity Index (PDAI) was most commonly used (12 of 18; 66.7%) to define both trial eligibility (8 of 12; 66.7%), and outcome measures (12 of 12; 100%). In a separate search, 21 studies evaluated the operating properties of 3 pouchitis indices; 90.5% (19 of 21) evaluated validity, of which 42.1% (8 of 19) evaluated the construct validity of the PDAI. Criterion validity (73.7%; 14 of 19) was evaluated through correlation of the PDAI with fecal calprotectin (FCP; r = 0.188 to 0.71), fecal lactoferrin (r = 0.570 to 0.582), and C-reactive protein (CRP; r = 0.584). Two studies assessed correlation of the modified PDAI (mPDAI) with FCP (r = 0.476 and r = 0.565, respectively). Fair to moderate inter-rater reliability of the PDAI (k = 0.440) and mPDAI (k = 0.389) was reported in a single study. Responsiveness of the PDAI pre-antibiotic and postantibiotic treatment was partially evaluated in a single study of 12 patients.
CONCLUSIONS
Development and validation of a specific pouchitis disease activity index is needed given that existing instruments are not valid, reliable, or responsive.

Identifiants

DOI: 10.1093/ibd/izab124 PMID: 34180986 PMC: PMC8972820
pubmed: 34180986
pii: 6310706
doi: 10.1093/ibd/izab124
pmc: PMC8972820
doi:

Substances chimiques

Leukocyte L1 Antigen Complex 0
C-Reactive Protein 9007-41-4

Types de publication

Journal Article Systematic Review Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

622-638

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK120515
Pays : United States
Organisme : NIDDK NIH HHS
ID : K08 DK110415
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK123233
Pays : United States

Informations de copyright

© 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Rocio Sedano (R)

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
Alimentiv Inc., London, Ontario, Canada.

Tran M Nguyen (TM)

Alimentiv Inc., London, Ontario, Canada.

Ahmed Almradi (A)

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
Alimentiv Inc., London, Ontario, Canada.

Florian Rieder (F)

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Claire E Parker (CE)

Alimentiv Inc., London, Ontario, Canada.

Lisa M Shackelton (LM)

Alimentiv Inc., London, Ontario, Canada.

Geert D'Haens (G)

Alimentiv Inc., London, Ontario, Canada.
Department of Gastroenterology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.

William J Sandborn (WJ)

Alimentiv Inc., London, Ontario, Canada.
Division of Gastroenterology, University of California, San Diego, La Jolla, California, USA.

Brian G Feagan (BG)

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
Alimentiv Inc., London, Ontario, Canada.
Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.

Christopher Ma (C)

Alimentiv Inc., London, Ontario, Canada.
Division of Gastroenterology and Hepatology, Cumming School of Medicine, Departments of Medicine & Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Vipul Jairath (V)

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
Alimentiv Inc., London, Ontario, Canada.
Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
ORCID: 0000-0001-8603-898X

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Classifications MeSH

questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines du sang › Immunoprotéines › Protéine C-réactive › Disease Activity Indices for Pouchitis: A...
questionsmedicales.fr › Liquides et sécrétions biologiques › Fèces › Disease Activity Indices for Pouchitis: A...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Disease Activity Indices for Pouchitis: A...
questionsmedicales.fr › Facteurs biologiques › Antigènes › Antigènes de surface › Complexe antigénique L1 leucocytaire › Disease Activity Indices for Pouchitis: A...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies de l'iléon › Iléite › Pochite › Disease Activity Indices for Pouchitis: A...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Reproductibilité des résultats › Disease Activity Indices for Pouchitis: A...