P3549 - The Utility of Patency Capsule in Non-Stricturing Crohn’s Disease

Tuesday, October 24, 2023

10:30 AM – 4:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Tarek Odah, MD

Mayo Clinic
Jacksonville, FL

Tarek Odah, MD¹, Christian Karime, MD¹, Jami Kinnucan, MD, FACG², Michael F.. Picco, MD, PhD, FACG², Jana G.. Hashash, MD, MSc, FACG¹, Francis A. Farraye, MD, MSc, MACG¹
¹Mayo Clinic, Jacksonville, FL; ²Mayo Clinic Florida, Jacksonville, FL

Introduction: Video capsule endoscopy retention is a complication that can have serious consequences in patients with small bowel Crohn’s disease (CD). The patency capsule is a radiopaque dissolvable capsule that was developed to evaluate for the presence of small bowel strictures before standard video capsule endoscopy is performed. The usefulness of patency capsule in patients with CD who do not have evidence of small bowel disease on imaging is uncertain. Our study aims to evaluate the usefulness of the patency capsule in patients with CD.

Methods: This is a multicenter retrospective study of patients with suspected or confirmed diagnosis of CD who underwent a patency capsule between January 2017 and February 2023. We excluded patients who were lost to follow up or did not have CT or MRI of the abdomen within six months of the patency capsule procedure. The fisher exact test was used to compare categorical variables.

Results: A total of 126 patients with suspected or confirmed diagnosis of CD were identified who had an order for a patency capsule procedure. Fifty patients were excluded as they were lost to follow up or did not have abdominal imaging within 6 months of the patency capsule. Of the remaining 76 patients, 27.6% (n=21) had a small bowel stricture or wall thickening on imaging while the remaining 72.4% (n=55) had normal small bowel imaging. Of the 21 patients with abnormal imaging, 19.0% (n=4/21) did not pass the patency capsule into the colon. In comparison 3.6% (n=2/55) of patients without a stricture or wall thickening on imaging did not pass the patency capsule (p=0.046). One of the 2 patients in which the patency capsule did not enter the colon despite normal small bowel imaging subsequently underwent and successfully passed a video capsule while the other patient had mild small bowel strictures requiring endoscopic dilation. Small bowel stricture or wall thickening on imaging had a positive and negative predictive value of 19% (n=4/21) and 96.4% (n=53/55), respectively for successful passage of patency capsule.

Discussion: The usefulness of the patency capsule in patients with CD without imaging findings to suggesting stricture or wall thickening is questionable. Our study shows that there is a statistically significant association between small bowel disease on imaging and retention of patency capsule while normal small bowel imaging had a negative predictive value of 96.4% of patency capsule retention in the small bowel.

Disclosures:

Tarek Odah indicated no relevant financial relationships.

Christian Karime indicated no relevant financial relationships.

Jami Kinnucan: Abbvie – Advisory Committee/Board Member, Consultant. BMS – Advisory Committee/Board Member, Consultant. Fresinius kabi – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant.

Michael Picco indicated no relevant financial relationships.

Jana Hashash: Iterative Health – Grant/Research Support.

Francis Farraye: AbbVie – Advisory Committee/Board Member. Avalo Therapeutics – Advisory Committee/Board Member. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. Fresenius Kabi – Advisory Committee/Board Member. GI Reviewers – Independent Contractor. GSK – Advisory Committee/Board Member. IBD Educational Group – Independent Contractor. Iterative Health – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member. Pharmacosmos – Advisory Committee/Board Member. Sandoz Immunology – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Viatris – Advisory Committee/Board Member.

Tarek Odah, MD¹, Christian Karime, MD¹, Jami Kinnucan, MD, FACG², Michael F.. Picco, MD, PhD, FACG², Jana G.. Hashash, MD, MSc, FACG¹, Francis A. Farraye, MD, MSc, MACG¹. P3549 - The Utility of Patency Capsule in Non-Stricturing Crohn’s Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.