Ongoing inflammation in the gastrointestinal tract and loss of the mucosal barrier are key components of Crohn's disease. Current treatment paradigms, including treat-to-target, are based on improvement of both clinical and endoscopic symptoms. Endoscopy is an essential tool for the evaluation of mucosal healing, but patients may be reluctant to undergo repeated procedures. Surrogate markers of inflammation, such as C-reactive protein and fecal calprotectin, are being used, yet they have several limitations in the assessment of mucosal healing. A new strategy, known as the Monitr test, assesses mucosal healing status by evaluating serum levels of 13 biomarkers in patients with Crohn's disease. The 13 biomarkers are associated with cell adhesion, inflammation, angiogenesis, extracellular matrix remodeling, cell proliferation and repair, and immune cell recruitment. Monitr testing yields a mucosal healing index score that reflects disease severity. Validation of the test showed an overall accuracy of 90%, with a negative predictive value of 92% and a positive predictive value of 87% for identifying patients with endoscopic evidence of Crohn's disease. Use of this noninvasive test may aid in the monitoring and management of patients with Crohn's disease, while potentially reducing the need for repeated endoscopy.
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