{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:00:27Z","timestamp":1769158827374,"version":"3.49.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The Modified Multiplier of the Simple Endoscopic Score for Crohn\u2019s Disease (MM-SES-CD) refines the assessment of endoscopic CD severity by differentially weighting parameters in the original SES-CD. A threshold of &amp;lt;22.5 for MM-SES-CD suggests endoscopic remission (ER) and correlates with a low risk of long-term disease progression. This study examines whether MM-SES-CD-defined ER and response criteria are more sensitive to treatment effects compared to conventional SES-CD definitions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This post hoc analysis of the EXTEND (extend the safety and\u00a0efficacy\u00a0of\u00a0adalimumab\u00a0through endoscopic healing) trial compared various SES-CD and MM-SES-CD definitions of ER and endoscopic response in CD patients treated with adalimumab or placebo. The study included participants with moderate\u2013severe CD and a baseline MM-SES-CD score\u2005\u2265\u200522.5. The primary outcome of ER, defined as MM-SES-CD\u2005&amp;lt;\u200522.5, was evaluated at Weeks 12 and 52. Area under the curve (AUC) analyses compared thresholds for predicting Week 52 ER.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 100 participants (77.5% of the EXTEND population), 51 received adalimumab and 49 received placebo. At Week 12, 62% achieved MM-SES-CD\u2005\u2265\u200520% reduction from baseline, compared to 39% with SES-CD\u2005\u2265\u200550% reduction. At Week 52, 56.9% of adalimumab-treated participants achieved MM-SES-CD\u2005&amp;lt;\u200522.5, compared to 10.2% in the placebo group. Modified Multiplier of the Simple Endoscopic Score for Crohn\u2019s Disease\u2005\u2265\u200520% reduction at Week 12 better predicted Week 52 ER than SES-CD\u2005\u2265\u200550% reduction (AUC: 0.73 vs 0.62, p\u2005=\u20050.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>MM-SES-CD definitions improved discrimination between treatment and placebo and offered superior predictive accuracy for Week 52 ER. Its use may enhance trial efficiency and better predict long-term disease outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjae171","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T06:22:41Z","timestamp":1731392561000},"source":"Crossref","is-referenced-by-count":3,"title":["Use of Modified Multiplier of the Simple Endoscopic Score for Crohn\u2019s Disease Endoscopic Improvement Thresholds Enhances Effect Size Differentiation Between Adalimumab Versus Placebo: A Post Hoc Analysis of the EXTEND Trial"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9472-201X","authenticated-orcid":false,"given":"Emily C L","family":"Wong","sequence":"first","affiliation":[{"name":"Farncombe Family Digestive Health Research Institute, McMaster University Department of Medicine (Division of Gastroenterology), , Hamilton, ON ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parambir S","family":"Dulai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Northwestern University , Chicago, IL ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John K","family":"Marshall","sequence":"additional","affiliation":[{"name":"Farncombe Family Digestive Health Research Institute, McMaster University Department of Medicine (Division of Gastroenterology), , Hamilton, ON ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Laroux","sequence":"additional","affiliation":[{"name":"AbbVie Bioresearch Center , Worcester, MA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Western University Department of Medicine, , London, ON ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2088-091X","authenticated-orcid":false,"given":"Walter","family":"Reinisch","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Medical University of Vienna Department of Internal Medicine III, , Vienna ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1536-8436","authenticated-orcid":false,"given":"Neeraj","family":"Narula","sequence":"additional","affiliation":[{"name":"Farncombe Family Digestive Health Research Institute, McMaster University Department of Medicine (Division of Gastroenterology), , Hamilton, ON 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