A Review of the Modified Multiplier of Simple Endoscopic Score for Crohn's Disease and How to Use It in Clinical Trials and Practice

Endoscopic evaluation is valuable in the diagnosis, assessment, and management of Crohn's disease (CD). The Simple Endoscopic Score for CD (SES-CD) was created using a uniform, linear scoring scale of 0-3 for each of its 4 parameters at 5 anatomic locations and was designed to accurately indicate disease severity rather than predicting disease progression. There is evidence to suggest that all disease segments and parameters of the SES-CD do not have equal prognostic value for likelihood of achieving endoscopic remission. The Modified Multiplier SES-CD, developed by multivariable logistic regression modeling, weighs the individual parameters of the SES-CD including disease distribution based on their prognostic values for achieving endoscopic remission. The objective of this qualitative review is to provide guidance to clinicians and clinical trialists for how to use and interpret the Modified Multiplier SES-CD.