Correlation between the Crohn's disease activity and Harvey-Bradshaw indices in assessing Crohn's disease severity.

Severine Vermeire, Stefan Schreiber, William J Sandborn, Cécile Dubois, Paul Rutgeerts
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Clinical gastroenterology and hepatology the official clinical practice journal of the American Gastroenterological Association
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Clinical trials of Crohn''s disease generally use the Crohn''s Disease Activity Index to assess disease activity; these calculations are complex, time-consuming, and impracticable. We investigated whether a simpler tool, the Harvey-Bradshaw Index, was equally effective in assessing disease severity.Crohn''s Disease Activity and Harvey-Bradshaw Index scores were collected from 2 large multicenter Crohn''s disease studies. The PEGylated antibody fragment evaluation in Crohn''s disease: safety and efficacy (PRECiSE) 1 and 2 trials assessed efficacy and tolerability of certolizumab pegol (PEGylated, humanized, Fab'' fragment of an antitumor necrosis factor alpha antibody). PRECiSE 1 and 2 data were analyzed to determine if results from the Crohn''s Disease Activity Index correlated with those from the Harvey-Bradshaw Index criteria for defining response and remission.Analysis of almost 1000 data pairs showed a positive correlation between scores. The correlation between the indices for pooled data from PRECiSE 1 and PRECiSE 2 was 0.800 (Spearman correlation coefficient). The correlations between indices for the PRECiSE 1 or PRECiSE 2 were 20.698 and 0.716, respectively (Kronecker product variance). A 3-point change in the Harvey-Bradshaw Index score corresponded to a 100-point change in the Crohn''s Disease Activity Index (clinical response); scores < or =4 points corresponded to a Crohn''s Disease Activity Index score < or =150 points (clinical remission).Results from the Crohn''s Disease Activity Index correlate with those from the Harvey-Bradshaw Index; use of the Harvey-Bradshaw Index might permit simpler Crohn''s disease activity assessment in long-term clinical trials, and facilitate standardized disease activity measurements and cross-center comparisons.