Bowel ultrasound score is accurate in assessing response to therapy in patients with Crohn's disease. Issue 4 (15th November 2021)

• Record Type: Journal Article
• Authors: Allocca, Mariangela; Craviotto, Vincenzo; Dell'Avalle, Cecilia; Furfaro, Federica; Zilli, Alessandra; D'Amico, Ferdinando; Bonovas, Stefanos; Peyrin‐Biroulet, Laurent; Fiorino, Gionata; Danese, Silvio
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 55:Issue 4(2022)
• Page Start: 446
• Page End: 454
• Publication Date: 2021-11-15
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.16700
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: We developed a non‐invasive bowel ultrasound score (BUSS) to assess disease activity in Crohn's disease (CD). BUSS >3.52 is an indicator of endoscopic activity (SES‐CD>2). Aim: To assess whether BUSS, in addition to detecting inflammatory lesions, also detects relevant changes of these lesions over time. Methods: This was a prospective observational study of 49 patients with active CD. All patients underwent bowel ultrasound and colonoscopy at baseline and at re‐assessment after treatment with biologics and/or immunosuppressants. The primary objective was to assess the sensitivity to change of BUSS in patients treated for active CD, using the SES‐CD as reference standard. Results: BUSS changed significantly from baseline to re‐assessment in patients achieving endoscopic response (a reduction of SES‐CD of at least 50% vs baseline: 4.87 [3.78‐6.0] vs 2.47 [2.25‐3.36], P < 0.001) and endoscopic remission (SES‐CD ≤ 2: 4.65 [3.58‐6.03] vs 2.25 [2.25‐3.46], P = 0.003). A change of −1.2 in BUSS over time predicted endoscopic response (AUC 0.786, 95% CI 0.645‐0.890; sensitivity 74%, specificity 83%). BUSS determined endoscopic response with 80% accuracy, and endoscopic remission with 78% accuracy. BUSS accurately detected changes in lesion severity (Guyatt score: 1.41 and standardized effect score: 1.74). BUSS did not change significantly in patients who did not achieve endoscopic response (5.62 [5.26‐6.15] vs 5.70 [4.97‐6.19], P = 0.53) or endoscopic remission (5.62 [5.18‐6.14] vs 5.10 [4.58‐6.05]; P = 0.10). Conclusion: BUSS is sensitive to change in CD. Abstract : A change of −1.2 in BUSS overtime predicts endoscopic response with a sensitivity of 74% and specificity of 83%. BUSS determines endoscopic response with 80% accuracy. BUSS accurately detects changes in lesion severity (Guyattscore: 1.41 and standardized effect score: 1.74).