Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission
Introduction: Bowel ultrasound is a noninvasive alternative to endoscopy for assessing the disease activity of ulcerative colitis; however, it is unclear whether bowel ultrasound can predict subsequent relapse from remission. Materials and Methods: A retrospective cohort study enrolled patients with...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-07-01
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| Series: | Inflammatory Intestinal Diseases |
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| Online Access: | https://beta.karger.com/Article/FullText/532052 |
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| author | Masa Maeda Shintaro Sagami Moyu Tashima Yoko Yamana Ryo Karashima Yusuke Miyatani Aya Hojo Masaru Nakano Toshifumi Hibi Taku Kobayashi |
| author_facet | Masa Maeda Shintaro Sagami Moyu Tashima Yoko Yamana Ryo Karashima Yusuke Miyatani Aya Hojo Masaru Nakano Toshifumi Hibi Taku Kobayashi |
| author_sort | Masa Maeda |
| collection | DOAJ |
| description | Introduction: Bowel ultrasound is a noninvasive alternative to endoscopy for assessing the disease activity of ulcerative colitis; however, it is unclear whether bowel ultrasound can predict subsequent relapse from remission. Materials and Methods: A retrospective cohort study enrolled patients with ulcerative colitis who underwent bowel ultrasound between July 2018 and July 2021 during clinical remission (patient-reported outcome-2 ≤1 and no rectal bleeding) for at least 3 months and were followed up for 1 year. Ultrasonographic findings (bowel wall thickness, bowel wall flow, bowel wall stratification, and enlarged lymph nodes), Milan ultrasound criteria, Mayo endoscopic subscore, C-reactive protein, and fecal calprotectin levels and their association with subsequent clinical relapse were assessed. Relapse was defined as rectal bleeding score ≥1, stool frequency score ≥2, or treatment intensification for symptoms. Results: 31% of the patients (18/58) relapsed within 1 year. No single ultrasonographic finding predicted relapse, whereas Milan ultrasound criteria >6.2 (p = 0.019), Mayo endoscopic subscore ≥1 (p = 0.013), and fecal calprotectin ≥250 μg/g (p = 0.040) were associated with a shorter time to relapse in the log-rank test. Milan ultrasound criteria >6.2 (hazard ratio 3.22; 95% confidence interval 1.14–9.08, p = 0.027) and Mayo endoscopic subscore ≥1 (hazard ratio 8.70; 95% confidence interval 1.11–68.1, p = 0.039) showed a higher risk of relapse according to a Cox proportional hazards model. Conclusion: Bowel ultrasound can predict subsequent clinical relapse from remission in patients with ulcerative colitis using the Milan ultrasound criteria. |
| first_indexed | 2024-03-12T13:31:53Z |
| format | Article |
| id | doaj.art-e15cc0fd445d460fac560cbe1bbe42a0 |
| institution | Directory Open Access Journal |
| issn | 2296-9365 |
| language | English |
| last_indexed | 2024-03-12T13:31:53Z |
| publishDate | 2023-07-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Inflammatory Intestinal Diseases |
| spelling | doaj.art-e15cc0fd445d460fac560cbe1bbe42a02023-08-24T09:41:55ZengKarger PublishersInflammatory Intestinal Diseases2296-93652023-07-011110.1159/000532052532052Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in RemissionMasa Maeda0Shintaro Sagami1Moyu Tashima2Yoko Yamana3Ryo Karashima4Yusuke Miyatani5Aya Hojo6Masaru Nakano7Toshifumi Hibi8Taku Kobayashi9Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanCenter for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, JapanIntroduction: Bowel ultrasound is a noninvasive alternative to endoscopy for assessing the disease activity of ulcerative colitis; however, it is unclear whether bowel ultrasound can predict subsequent relapse from remission. Materials and Methods: A retrospective cohort study enrolled patients with ulcerative colitis who underwent bowel ultrasound between July 2018 and July 2021 during clinical remission (patient-reported outcome-2 ≤1 and no rectal bleeding) for at least 3 months and were followed up for 1 year. Ultrasonographic findings (bowel wall thickness, bowel wall flow, bowel wall stratification, and enlarged lymph nodes), Milan ultrasound criteria, Mayo endoscopic subscore, C-reactive protein, and fecal calprotectin levels and their association with subsequent clinical relapse were assessed. Relapse was defined as rectal bleeding score ≥1, stool frequency score ≥2, or treatment intensification for symptoms. Results: 31% of the patients (18/58) relapsed within 1 year. No single ultrasonographic finding predicted relapse, whereas Milan ultrasound criteria >6.2 (p = 0.019), Mayo endoscopic subscore ≥1 (p = 0.013), and fecal calprotectin ≥250 μg/g (p = 0.040) were associated with a shorter time to relapse in the log-rank test. Milan ultrasound criteria >6.2 (hazard ratio 3.22; 95% confidence interval 1.14–9.08, p = 0.027) and Mayo endoscopic subscore ≥1 (hazard ratio 8.70; 95% confidence interval 1.11–68.1, p = 0.039) showed a higher risk of relapse according to a Cox proportional hazards model. Conclusion: Bowel ultrasound can predict subsequent clinical relapse from remission in patients with ulcerative colitis using the Milan ultrasound criteria.https://beta.karger.com/Article/FullText/532052ulcerative colitisultrasoundinflammatory bowel diseasepredictionfecal calprotectin |
| spellingShingle | Masa Maeda Shintaro Sagami Moyu Tashima Yoko Yamana Ryo Karashima Yusuke Miyatani Aya Hojo Masaru Nakano Toshifumi Hibi Taku Kobayashi Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission Inflammatory Intestinal Diseases ulcerative colitis ultrasound inflammatory bowel disease prediction fecal calprotectin |
| title | Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission |
| title_full | Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission |
| title_fullStr | Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission |
| title_full_unstemmed | Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission |
| title_short | Milan Ultrasound Criteria Predict Relapse of Ulcerative Colitis in Remission |
| title_sort | milan ultrasound criteria predict relapse of ulcerative colitis in remission |
| topic | ulcerative colitis ultrasound inflammatory bowel disease prediction fecal calprotectin |
| url | https://beta.karger.com/Article/FullText/532052 |
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