METRIC-EF: Magnetic Resonance Enterography and Small Bowel Ultrasound as predictors of disabling disease in newly-diagnosed Crohn’s disease

Summary

Crohn's disease (CD) is a painful, debilitating bowel condition that usually affects young adults. It can be mild and require little treatment, or very severe ("disabling"), requiring powerful drugs or surgery. It is important to treat patients with disabling disease as early as possible, because this improves long term health. It is not possible to give the most powerful drugs to all patients, because they have side-effects & risks.

Patients and doctors need a reliable way to predict who will develop disabling CD. We completed a NIHR HTA-funded study (called METRIC) to test the accuracy of a scan of the bowel called magnetic resonance enterography (MRE) when diagnosing CD.

We want to extend this work and determine if MRE scans can be used not only for diagnosis,  but also to predict who will get disabling disease. To date there are no long-term studies comparing MRE findings at the time of diagnosis with long term health, so the idea is unproven.

Because METRIC has already identified patients & arranged for them to have MRE scans, there is an excellent opportunity to investigate if MRE abnormalities can predict health 5 years later. The patients have already been scanned, so there is little additional patient inconvenience - all we need to do is look at their medical records.

To make sure we have enough patients in the study to give meaningful answers, we will also study around 100 more patients who have had MRE scans as part of normal clinical care when they were diagnosed. We will use medical records to find out how many patients develop severe (disabling) CD during this time. We will develop a statistical model that combines all of the currently known predictive  factors, and then tests if the addition of MRE helps make better predictions about future health. 

Organisation: This study is organised by Professor Stewart Taylor from University College London.