Predictive factors for an uncomplicated long-term course of Crohn's disease: A retrospective analysis

W. Kruis*, A. Katalinic, T. Klugmann, G. R. Franke, J. Weismüller, L. Leifeld, S. Ceplis-Kastner, B. Reimers, B. Bokemeyer

*Corresponding author for this work
10 Citations (Scopus)


Background: Predictive factors for a mild course of Crohn's disease (CD) may have therapeutic consequences, but as yet have not been identified. Aims: To identify baseline factors that predict mild CD and design a predictive scoring system. Methods: A retrospective, multicenter study of newly diagnosed CD patients allocated to mild CD (no therapy, mesalazine only, or mesalazine with a single initial short course of low-dose prednisone) or moderate CD (all other patients including resected patients). Results: 162 patients (median follow-up 43. months) were analyzed: 47 mild CD and 115 moderate CD. For mild CD versus moderate CD, mean age at first diagnosis was higher (41.1 versus 33.9. years, p=0.02), mean C-reactive protein (CRP) concentration was lower (1.6 versus 3.6. mg/L, p < 0.01), and perianal lesions were less frequent (0% versus 10.4%, p=0.02). The combined incidence of complications (stenosis, any type of fistula, extraintestinal complications or fever) was 21.3% in mild CD versus 35.7% in moderate CD (p=0.07). A scoring system based on age, CRP, endoscopic severity (adapted Rutgeert's score), perianal lesions and combined incidence of complications was developed which can predict a mild prognosis at the initial diagnosis, giving patients the chance of simplified therapy and accelerated step-up in the event of treatment failure. Conclusions: Approximately a third of CD patients experience a mild disease course and require only basic therapy. A possible scoring system to predict mild CD which may avoid overtreatment and unnecessary risks for the patient and costs is suggested.

Original languageEnglish
JournalJournal of Crohn's and Colitis
Issue number7
Publication statusPublished - 11.06.2013


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