IDENTIFYING PATIENTS WITH A HIGH-RISK OF RELAPSE IN QUIESCENT CROHNS-DISEASE

No reliable identification of quiescent Crohn's disease (CD) patients with a high risk of relapse is available. The aim of this study was to develop a prognostic index to identify those patients. Untreated adul t patients with quiescent disease (not induced by surgery) included in three phase III clinical trials were analysed retrospectively with re spect to time to relapse. Nineteen factors related to biology, disease history, and topography were investigated. A relapse was defined as e ither a CD Activity Index (CDAI) greater than or equal to 200, a CDAI greater than or equal to 150 but over the baseline value by more than 100, or acute complications requiring surgery. The inclusion criteria were fulfilled by 178 patients. The median follow up was 23 months. Th e Cox model retained the following bad prognostic factors: age less th an or equal to 25 years, interval since first symptoms >5 years, inter val since previous relapse less than or equal to 6 months, and colonic involvement (p < 0.001). Bootstrapping confirmed the variable selecti on. Patients were classified into three groups with an increasing risk of relapse (p < 0.001). The worst risk group was composed of patients presenting at least three of the four bad prognostic factors. These r esults make possible the design of clinical trials in quiescent CD pat ients with a high risk of relapse.