Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context
Summary: Background: The Bowel Ultrasound Score (BUSS) accurately detects therapy-related changes by using the Simple Endoscopic Score for Crohn's disease (SES-CD) as the reference standard. We aimed to evaluate ultrasound remission as a treatment target and its prediction for long-term endosc...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S258953702400138X |
| _version_ | 1797249069449478144 |
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| author | Mariangela Allocca Cecilia Dell’Avalle Alessandra Zilli Federica Furfaro Ferdinando D'Amico Vipul Jairath David T. Rubin Laurent Peyrin-Biroulet Gionata Fiorino Silvio Danese |
| author_facet | Mariangela Allocca Cecilia Dell’Avalle Alessandra Zilli Federica Furfaro Ferdinando D'Amico Vipul Jairath David T. Rubin Laurent Peyrin-Biroulet Gionata Fiorino Silvio Danese |
| author_sort | Mariangela Allocca |
| collection | DOAJ |
| description | Summary: Background: The Bowel Ultrasound Score (BUSS) accurately detects therapy-related changes by using the Simple Endoscopic Score for Crohn's disease (SES-CD) as the reference standard. We aimed to evaluate ultrasound remission as a treatment target and its prediction for long-term endoscopic remission. Methods: This single-centre prospective observational study, based at a tertiary referral centre in Milan, Italy, enrolled, between March 1, 2018, and January 31, 2021, adult patients with active CD (SES-CD >2) who were starting biologics. Colonoscopy and IUS was performed at baseline and at 12 months (mean 12.8 ± 4.2). The primary outcome was the predictive value of ultrasound remission at week 12 (BUSS ≤3.52) for long-term endoscopic remission at 12 months. The International Bowel Ultrasound Segmental Activity Score (IBUS-SAS) was also calculated and optimal cut-point to detect endoscopic remission was identified through ROC analysis. Findings: 93 patients with CD were included. Of these, 22 patients (24%) achieved endoscopic remission. Week 12 ultrasound remission predicted endoscopic remission (59% compared with 41% of the patients who were not in ultrasound remission; OR 9.93, 95% CI 3.10–31.80; p < 0.001), while week 12 calprotectin values (<50, <100, <250 μg/g) did not. Week 12 ultrasound activity was associated with failure to achieve long-term endoscopic remission (NPV 87%, PPV 54%). IBUS-SAS cut-off to discriminate endoscopic remission was 22.8 (AUC 0.906). ROC curve comparison showed no-significant difference between BUSS and IBUS-SAS (p = 0.46) for detecting endoscopic remission. Interpretation: Early ultrasound remission predicts long-term endoscopic remission, making it a valuable early treatment target for clinical practice and in clinical trials. Larger multicentre validation studies are warranted to confirm these findings. Funding: None. |
| first_indexed | 2024-04-24T20:24:37Z |
| format | Article |
| id | doaj.art-3dafaa182ef347dd850d3069c668a430 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-24T20:24:37Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-3dafaa182ef347dd850d3069c668a4302024-03-22T05:40:28ZengElsevierEClinicalMedicine2589-53702024-05-0171102559Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in contextMariangela Allocca0Cecilia Dell’Avalle1Alessandra Zilli2Federica Furfaro3Ferdinando D'Amico4Vipul Jairath5David T. Rubin6Laurent Peyrin-Biroulet7Gionata Fiorino8Silvio Danese9IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy; Corresponding author. Department of Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, ItalyIRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, ItalyIRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, ItalyIRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy; Division of Colon and Rectal Surgery, Department of Biomedical Sciences, Humanitas University, Humanitas Clinical and Research Hospital IRCCS, Pieve Emanuele, Rozzano, Milan, ItalyDivision of Gastroenterology, Department of Medicine, Western University, London, ON, CanadaUniversity of Chicago Medicine Inflammatory Bowel Disease Centre, Chicago, IL, USADepartment of Gastroenterology and Inserm NGERE 1256, University Hospital of Nancy, University of Lorraine, Nancy, France; Groupe Hospitalier Privé Ambroise Paré - Hartmann, Paris IBD Centre, 92200, Neuilly sur Seine, FranceIRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy; Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, Rome, ItalyIRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, ItalySummary: Background: The Bowel Ultrasound Score (BUSS) accurately detects therapy-related changes by using the Simple Endoscopic Score for Crohn's disease (SES-CD) as the reference standard. We aimed to evaluate ultrasound remission as a treatment target and its prediction for long-term endoscopic remission. Methods: This single-centre prospective observational study, based at a tertiary referral centre in Milan, Italy, enrolled, between March 1, 2018, and January 31, 2021, adult patients with active CD (SES-CD >2) who were starting biologics. Colonoscopy and IUS was performed at baseline and at 12 months (mean 12.8 ± 4.2). The primary outcome was the predictive value of ultrasound remission at week 12 (BUSS ≤3.52) for long-term endoscopic remission at 12 months. The International Bowel Ultrasound Segmental Activity Score (IBUS-SAS) was also calculated and optimal cut-point to detect endoscopic remission was identified through ROC analysis. Findings: 93 patients with CD were included. Of these, 22 patients (24%) achieved endoscopic remission. Week 12 ultrasound remission predicted endoscopic remission (59% compared with 41% of the patients who were not in ultrasound remission; OR 9.93, 95% CI 3.10–31.80; p < 0.001), while week 12 calprotectin values (<50, <100, <250 μg/g) did not. Week 12 ultrasound activity was associated with failure to achieve long-term endoscopic remission (NPV 87%, PPV 54%). IBUS-SAS cut-off to discriminate endoscopic remission was 22.8 (AUC 0.906). ROC curve comparison showed no-significant difference between BUSS and IBUS-SAS (p = 0.46) for detecting endoscopic remission. Interpretation: Early ultrasound remission predicts long-term endoscopic remission, making it a valuable early treatment target for clinical practice and in clinical trials. Larger multicentre validation studies are warranted to confirm these findings. Funding: None.http://www.sciencedirect.com/science/article/pii/S258953702400138XCrohn's diseaseIntestinal ultrasoundBowel ultrasound scoreBUSSIBUS-SASTarget |
| spellingShingle | Mariangela Allocca Cecilia Dell’Avalle Alessandra Zilli Federica Furfaro Ferdinando D'Amico Vipul Jairath David T. Rubin Laurent Peyrin-Biroulet Gionata Fiorino Silvio Danese Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context EClinicalMedicine Crohn's disease Intestinal ultrasound Bowel ultrasound score BUSS IBUS-SAS Target |
| title | Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context |
| title_full | Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context |
| title_fullStr | Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context |
| title_full_unstemmed | Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context |
| title_short | Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort studyResearch in context |
| title_sort | ultrasound remission after biologic induction and long term endoscopic remission in crohn s disease a prospective cohort studyresearch in context |
| topic | Crohn's disease Intestinal ultrasound Bowel ultrasound score BUSS IBUS-SAS Target |
| url | http://www.sciencedirect.com/science/article/pii/S258953702400138X |
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