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The following is a summary of “Physiological Data Collected from Wearable Devices Identify and Predict Inflammatory Bowel Disease Flares,” published in the January 2025 issue of Gastroenterology by Hirten et al.

Wearable devices, which capture physiological signals non-invasively and passively, have shown promise in monitoring various health conditions, including inflammatory bowel disease (IBD). Many physiological metrics derived from these devices have been linked to IBD activity, yet their predictive ability regarding flare-ups remains underexplored. This study aimed to assess the associations between multiple physiological parameters and IBD flare activity, focusing on how these metrics change prior to flare development. 

Participants from across the United States wore an Apple Watch, Fitbit, or Oura Ring and provided daily responses to disease activity surveys. These devices continuously monitored heart rate (HR), resting heart rate (RHR), heart rate variability (HRV), daily step count, and oxygen saturation (SpO2), while C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin levels were also recorded as part of standard clinical care. To analyze the data, linear mixed-effects models were employed for HR, RHR, steps, and SpO2, while cosinor mixed-effects models were applied to HRV circadian rhythms. Mixed-effects logistic regression was used to evaluate the predictive power of the physiological metrics. A total of 309 participants from 36 states were enrolled in the study. The analysis revealed that circadian patterns of HRV significantly differed between periods of inflammatory flare and remission, as well as between symptomatic flare and remission. 

Additionally, both HR and RHR were found to be higher during inflammatory and symptomatic flare periods, while the daily step count decreased during inflammatory flare periods. The study demonstrated that HRV, HR, and RHR could distinguish between symptomatic participants with or without inflammation and that HRV, HR, RHR, steps, and SpO2 significantly changed up to seven weeks before the onset of both inflammatory and symptomatic flares. These findings suggest that physiological metrics collected longitudinally via wearable devices can not only detect but also predict the onset of IBD flare-ups, offering a non-invasive approach for continuous monitoring and early intervention in IBD management. Further studies are needed to refine these metrics and improve their clinical utility in IBD prediction.

Source: sciencedirect.com/science/article/abs/pii/S0016508525000137