MM-SES-CD and SES-CD Threshold Scores and Risk of Disease Progression

Patients with ileocolonic or colonic Crohn’s disease (CD) who achieve multiplier Simple Endoscopic Score for Crohn’s Disease (MM-SES-CD) <22.5 or Simple Endoscopic Score for Crohn’s Disease (SES-CD) <4 have a low risk of disease progression, according to a study published in Clinical Gastroenterology and Hepatology.

Researchers aimed to identify the optimal thresholds for the MM-SES-CD and the SES-CD that are associated with a low likelihood of long-term disease progression in patients with CD. The analysis used data from 61 patients in the CALM long-term extension study as the derivation cohort and validated these findings using the McMaster inflammatory bowel disease database (99 patients). The primary outcome assessed was disease progression, defined as new internal fistula or abscess, stricture, perianal fistula or abscess, or CD-related hospitalization or surgery.

The study identified that an MM-SES-CD score below 22.5 and an SES-CD score below 4 were the optimal thresholds associated with a low risk of disease progression. Patients in the derivation cohort with MM-SES-CD scores of 22.5 or higher had a significantly greater likelihood of disease progression (58.8%) compared to those with scores below 22.5 (6.8%). Similarly, a greater number of patients with SES-CD scores of 4 or higher experienced disease progression (44.0%) compared to those with scores below 4 (5.6%). The MM-SES-CD <22.5 threshold was found to be the most accurate predictor of disease progression, with an area under the curve of 0.81, indicating good predictive performance.

These findings were validated in an independent cohort, confirming that achieving MM-SES-CD <22.5 or SES-CD <4 is associated with a low risk of disease progression in patients with ileocolonic or colonic CD. These thresholds may serve as valuable targets for endoscopic healing in both clinical practice and trials.

Reference
Narula N, Wong ECL, Dulai PS, et al. Defining endoscopic remission in crohn's disease: MM-SES-CD and SES-CD thresholds associated with low risk of disease progression. Clin Gastroenterol Hepatol. 2024;22(8):1687-1696.e6. doi:10.1016/j.cgh.2024.02.009