PREDICTION OF RELAPSE IN PATIENTS WITH CROHNS-DISEASE IN REMISSION - A SIMPLIFIED INDEX USING LABORATORY TESTS, ENHANCED BY CLINICAL CHARACTERISTICS

Objective: To predict relapse in patients with Crohn's disease in clin ical remission. Design: A total of 107 consecutive outpatients in clin ical remission for at least 1 month were followed up without treatment for 18 months or until clinical relapse. Methods: Blood tests, Crohn' s Disease Activity Index and a series of clinical characteristics were measured on entry into the study. Results: Using the blood tests perf ormed on entry into the study, we were able to develop a simplified pr ognostic index (New Index) predictive of relapse within 18 months if a lpha-1-glycoprotein was > 130 mg/dl, alpha-2-globulins > 9.0 gm/l or e rythrocyte sedimentation rate > 40 mm/hr. Clinical characteristics wer e then used to identify two groups with different risks of relapse. Th e favourable group included all patients with more than 24 months sinc e last relapse and operated patients with no subsequent relapse (relap se rate 19%). The unfavourable group included all other patients (rela pse rate 65%). The New Index was predictive of relapse in the whole sa mple and in each of the risk groups. Blood tests and clinical characte ristics are complimentary predictors of risk. Conclusions: The suggest ed algorithm, using blood tests and clinical characteristics is simple and could be used to monitor patients with Crohn's disease in clinica l remission and to balance groups in multicentre trials.