Adalimumab in prevention of postoperative recurrence of Crohn's disease in high-risk patients

Table 1 Rutgeerts and magnetic resonance score for classification of postoperative recurrence in Crohn's disease

Rutgeerts score	Description	MR score	Description
i0	No lesions	MR0	No findings
i1	Less than 5 aphthous lesions	MR1	Minor mucosal irregularities: Slight wall thickening Slight mural contrast enhancement No stenosis
i2	More than 5 aphthous lesions with normal mucosa between the lesions or skip areas or larger lesions or lesions confined to ileocolonic anastomosis
i3	Diffuse aphthous ileitis with diffusely-inflamed mucosa	MR2	Major mucosal abnormalities: Distinct bowel wall thickening Distinct mural contrast enhancement Low grade stenosis without prestenotic dilatation
i4	Diffuse inflammation with already large ulcers, nodules and/or narrowing	MR3	Same finding as MR 2 plus: Transmural edema with T2w signal increase and contrast enhancement of the perienteric fat High grade stenosis without prestenotic dilatation Extramural complications (fistula, abscess, conglomeration of bowel loops)

MR: Magnetic resonance; MR0-MR3: A 4-point MR-enteroclysis-based score; i0-i4: A 5-point score to measure the presence and severity of endoscopic lesions in the neoterminal ileum and anastomosis.

Table 2 Patient characteristics at baseline (n = 29) (%)

Patient characteristics	Value
Gender
Female	13 (44.8)
Age (yr), mean (range)	42.3 (19.8-61.1)
Duration of the disease (mo), median (range)	166 (7-365)
Montreal classification:
A1 (< 17 yr)	6 (20.7)
A2 (17-40 yr)	17 (58.6)
A3 (> 40 yr)	6 (20.7)
L1 (ileal)	15 (51.7)
L3 (ileocolonic)	9 (31.0)
L1 + L4 (ileal + upper gastrointestinal)	5 (17.2)
B1 (non-stricturing/penetrating)	9 (31.0)
B2 (stricturing)	14 (48.3)
B3 (penetrating)	6 (20.6)
Perianal disease	10 (34.4 )
Extensive resection	11 (37.9)
Immunomodulators (AZA, 6-MP) concomitant to adalimumab	5 (17.2)
Concomitant enteral nutrition	6 (20.7)
Previous infliximab	15 (51.7)
Previous resections (including index operation)
1	15 (51.7)
2	7 (24.1)
3	6 (20.7)
4	1 (3.4)
Smoking status at diagnosis
Smokers	14 (48.3)
Ex-smokers	2 (6.9)
Non-smokers	13 (44.8)
Smoking status after the index operation
Smokers	4 (13.8 )
Ex-smokers	12 (41.4)
Non-smokers	13 (44.8)

AZA: Azathioprine; 6-MP: 6-mercaptopurine.

Table 3 Correlation between endoscopic and radiological findings n (%)

Rutgeerts score	MR score
	MR0	MR1	MR2	MR3
i0	9 (100)	0	0	0
i1	3 (75)	1 (25)	0	0
i2	0	1 (50)	1 (50)	0
i3	0	1 (50)	1 (50)	0
i4	0	0	1 (50)	1 (50)

MR: Magnetic resonance; MR0-MR3: A 4-point MR-enteroclysis-based score; i0-i4: A 5-point score to measure the presence and severity of endoscopic lesions in the neoterminal ileum and anastomosis.

Table 4 Univariate analysis for endoscopic recurrence n (%)

Endoscopic recurrence		Yes	No	P value
Gender	Female	3 (23.1)	10 (76.9)	0.775
	Male	3 (18.8)	13 (81.3)
Duration of the disease	≤ 10 yr	3 (23.1)	10 (76.9)	0.775
	> 10 yr	3 (18.8)	13 (81.3)
Pattern	Non-stricturing, non-penetrating	2 (22.2)	7 (77.8)	0.318
	Stricturing	4 (28.6)	10 (71.4)
	Penetrating	0 (0)	6 (100)
Extensive resection	Yes	5 (45.5)	6 (54.5)	0.026
	No	1 (5.6)	17 (94.4)
Immunomodulators concomitant to ADA	Yes	1 (20)	4 (80)	0.967
	No	5 (20.8)	19 (79.2)
Prior infliximab	Yes	5 (33.3)	10 (66.7)	0.111
	No	1 (7.1)	13 (92.9)
Previous resections	≤ 2	2 (9.1)	20 (90.9)	0.015
	> 2	4 (57.1)	3 (42.9)
Smoking status at diagnosis	Smokers	3 (21.4)	11 (78.6)	0.516
	Non-smokers	3 (23.1)	10 (76.9)
	Ex-smokers	0 (0)	2 (100)
Smoking status after the index operation	Smokers	2 (50)	2 (50)	0.119
	Non-smokers	4 (16)	21 (84)
Adverse events	Yes	0 (0)	1 (100)	0.454
	No	6 (22.2)	21 (77.8)

ADA: Adalimumab.