Derivation and Validation of a classification system for defining Response and Remission to Gluten-free diet in patients with Celiac Disease

We are developing a Disease Activity Index and a classification system for defining Response and Remission to Gluten-free diet in patients with Celiac Disease.

A classification system for assessing the response to Gluten-free diet which is the only available treatment to Celiac Disease does not exist. The definition of remission is unclear, whether to look at clinical remission, serological remission or histological remission or a combination of all three; how much improvement in the patient can be called remission, how much improvement can we expect in the patient and after how much time of beginning of gluten-free diet should we expect remission. All these questions require consensus from experts in the field of celiac disease and should come through a systematic study. The monitoring and follow-up protocol of patients with Celiac Disease is not uniform globally and there are variations in the monitoring practices and therefore there is a need to standardise them as well.

Purpose“The enemy of medical progress is hypothetical or speculative reasoning of physicians”. With the development of a classification system, the response of patient to gluten-free diet will be assessed using a standard, objective tool that forms its basis on the subjective reasoning of the physicians. This will lead to improvement in patient-care, by looking at the grey area, between Non-responsive Celiac Disease and Responsive Celiac Disease, and help to provide personalised care. The score will also provide a universal approach to assess response and remission in patients with Celiac Disease but also at the same time being precise enough for an individual patient. A classification system will also be useful after drug discovery during clinical trials to define response and remission and a measure of Disease Activity. The study will be one of the initial steps to form the basis of monitoring practices owing to its regular follow-up method and assessment of dynamics of recovery.