Modified Multiplier Simple Endoscopic Score for Crohn's Disease (MM-SES-CD) Thresholds as Predictors of Delayed Clinical Response to Upadacitinib in Patients with Crohn’s Disease

Crohn’s disease (CD) is a long-term condition that causes inflammation in the digestive system, leading to symptoms such as severe stomach pain, diarrhea, weight loss, and fatigue. It is a chronic illness, meaning it persists over time and can affect a person's quality of life. Many people with CD are treated with medications such as corticosteroids, immune system-modulating drugs, or biologics.

Corticosteroids are a class of synthetic hormones that mimic natural hormones produced by the body and are widely used to reduce inflammation.
Immune system-modulating drugs alter the way the immune system works, either enhancing or suppressing its activity to control inflammation.
Biologics are a type of medication made from living organisms or their components (like proteins) and are designed to target specific parts of the immune system involved in inflammation.

These medications aim to reduce inflammation by targeting the immune system, but not all patients respond well to these treatments. This creates a need for better treatments and ways to personalize care for each patient.

One medication that has shown promise in treating CD is upadacitinib, which works by blocking proteins called Janus Kinases (JAKs). JAKs are enzymes that act as messengers, transmitting signals from outside the cell to the inside. In CD, these signals can lead to an overactive immune response and chronic inflammation in the digestive tract. By blocking JAKs, upadacitinib helps reduce this immune system overactivity and the associated inflammation.

Although upadacitinib helps many patients feel better by the 12th week of treatment, some people take longer to see improvements. These individuals are referred to as “delayed responders.” Understanding why some people respond more slowly to treatment could help doctors decide on the best course of action, ensuring that patients receive the most effective care.

Recent evidence suggests that improvements in a specific endoscopic score, the Modified Multiplier of the Simple Endoscopic Score for Crohn’s Disease (MM-SES-CD), may help predict delayed response. This study will focus on whether changes in MM-SES-CD at week 12 can reliably identify patients who will experience clinical improvement by week 24, even if they haven’t yet shown symptomatic response.

To conduct this research, we will collect data from a group of patients who are receiving upadacitinib for CD. We will track their responses to treatment over time and compare those who respond quickly with those who take longer. This comparison will help us identify patterns and factors that might influence how well a patient responds to the medication