Abstract Background The Clinical Decision Support Tool (CDST) is a clinical score developed to estimate the likelihood of response to vedolizumab in patients with Crohn’s Disease (CD), based on five baseline variables: prior anti-TNF failure, previous intestinal surgery, presence of fistulizing disease, serum albumin, and C-reactive protein levels. This study aimed to validate the CDST in a cohort of vedolizumab-treated CD patients from Hospital Alemán, Buenos Aires, and to assess its performance in predicting clinical and endoscopic outcomes. Methods We conducted a retrospective observational study at Hospital Alemán, Buenos Aires. Among 514 CD patients under follow-up, 50 received vedolizumab between 2017 and 2025, of whom 48 were included in the analysis. The CDST score was calculated prior to treatment initiation, classifying patients into low (13 points), intermediate (13–19 points), or high (19 points) probability of response. Clinical, endoscopic, and laboratory data were collected at baseline and throughout follow-up. Primary outcomes included clinical response, clinical remission, steroid-free remission, endoscopic improvement (defined as a reduction in SES-CD), mucosal healing (absence of ulcers on ileocolonoscopy), and deep remission (clinical remission plus mucosal healing). Results Of the 48 included patients (19 female; mean age 52 years; mean disease duration 14 years), 56.5% were classified as high CDST score, 32.6% as intermediate, and 10.8% as low. Clinical remission was achieved in 92% of high-score patients, 86.6% of the intermediate group, and 40% of the low group. Deep remission was observed in 46%, 26.6%, and 0%, respectively. Endoscopic improvement occurred in 90% of high-score, 54% of intermediate, and 0% of low-score patients. Mucosal healing was achieved in 70%, 36%, and 0%, respectively. Patients with high CDST scores required fewer treatment changes and experienced fewer clinical relapses during follow-up. Conclusion The CDST demonstrated strong predictive performance for both clinical and endoscopic response to vedolizumab in patients with Crohn’s disease. Patients with high CDST scores achieved higher rates of clinical remission, mucosal healing, and deep remission. This local validation supports the CDST as a practical tool to guide therapeutic decisions in routine clinical practice. Conflict of interest: Navar, Sofia: No conflict of interest Gómez, Estanislao Jesus: No conflict of interest Marturano, Maria Victoria: No conflict of interest Bentolila, Federico: No conflict of interest Vizcaíno, Beatriz: No conflict of interest Gonzalez, Raquel Analia: No conflict of interest
Navar et al. (Thu,) studied this question.