Development of a Radiological Index for Peri-anal Crohn’s Disease

Perianal fistulas affect approximately one-third of patients with Crohn’s disease (CD) during their lifetime and are associated with considerable morbidity and impaired quality of life. Few clinical trials have specifically addressed fistula healing, thus identification of new treatments for fistulizing perianal CD is a large unmet clinical need. Magnetic resonance imaging (MRI) is the only modality capable of detecting/monitoring all manifestations of CD activity as well as transmural complications including perianal fistula. Although MRI is considered the gold standard for assessment of perianal fistulas, the lack of a validated outcome measure to assess disease activity and response to therapy was seen as a barrier to drug development. To address this need, we developed the Magnetic Resonance Novel Index for Fistula Imaging in CD (MAGNIFI-CD) using rigorous methods for index development. MAGNIFI-CD is a more reliable and responsiveness index compared to the commonly used Van Assche Index. The use of MAGNIFI-CD in future clinical trials will help facilitate research and development of novel therapies for a patient group with a large unmet need and burden of illness.