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P277. Assessment of the performance of the colonic PillCam PCC2 in Crohn's patients

A. Van Gossum1, D. Franchimont1, L. Amininejad1, G. D'Haens2, 1Hôpital Erasme, Gastroenterology, Brussels, Belgium, 2AMC, Gastroenterology, Amsterdam, Netherlands

Background

The goals of treatment in Crohn's disease have evolved from symptoms control to mucosal healing, usually visualised by endoscopies.

This pilot exploratory study was designed to investigate the value of the PillCam colon capsule endoscope (PCC2-Given Imaging, Israël) in patients with Crohn'disease.

Methods

A cohort of patients with active CD was studied with serial PCC2 and optical colonoscopy.

Inclusion criteria: Patients with CDAI >200, serum CRP> mg/l and faecal calprotectin >200, colonoscopy clinically indicated; prior documentation of colonic involvement by CD.

Exclusion criteria: Any contraindication for optical colonoscopy or colon capsule examination.

Evaluation: CDEI-s; SES-CD; Global severity assessment (GSA); serum CRP; CDAI; PCC passage Time; side effect.

Colon preparation was used as previously described for PCC endoscope.

The RAPID 6 software was used for reviewing recordings. PCC2 and colonoscopies were performed by independent investigators.

Statistics: Pearson test was used for correlation.

Results

Forty-three patients were enrolled with a baseline CDAI of 277.8±97. The average capsule passage time was 07:20 hours (±05:43). The mean CDEI-s, SES-CD and GSA were 8.1±7.1, 3.7±5.7 and 5.9±14.2 for PCC2, respectively and 10.2±7.5, 9.9±7.9, 7.8±16 for optimal colonoscopy, respectively. High correlation was found between the two CDEI-s (Pearson correlation 0.76) as well for the SGA (correlation 0.963).

Poor correlation has been found between the two SES-CD scores.

Low correlation between PCC2 CDEI-s and serum CRP (0.144) and CDAI score (0.069) were observed. Now capsule rétention was reported. Colon preparation was good to excellent in 80% of the patients.

Conclusion

This pilot study comparing PCC2 to optimal colonoscopy in CD patients showed a good correlation for assessing the CDEI-s and global severity assessment but not for SES-CD. Colon preparation was good to excellent in 80% of the patients. There was no capsule retention. The use of PCC2 for assessing colonic mucosal alterations in CD patients should be confirmed in further large trials.