The following is a summary of “Monitoring Inflammatory Bowel Disease (IBD) by intestinal ultrasound decreases time to treatment change and time to remission in comparison to conventional management: Analysis of patients with IBD on multiple IBD therapies,” published in the January 2024 issue of Gastroenterology by Cleveland et al.
A previous study (ACG 2023) showed intestinal ultrasound (IUS) sped up treatment changes and remission in patients with inflammatory bowel disease (IBD).
Researchers started a retrospective study to evaluate the broader impact of IUS on management and outcomes in IBD patients undergoing diverse treatment regimens.
They involved patients who completed induction therapy according to drug labels but had active disease (SCCAI >2 or HBI >4) (October 2021 to October 2023). The time to treatment change (from positive clinical index to medical decision) and time to clinical remission (from positive clinical index to normalization) were analyzed, comparing IUS-monitored and conventionally managed patients. Patients matched by provider and disease type; active disease assessed via FCP (>150 mcg/g) and MES (>0) pre-positive clinical index. An abnormal IUS included BWT >3 mm and any CDS hyperemia (modified Limberg score >0). A chi-square analysis was conducted (P<0.10 significance).
The results showed 54 patients (63 encounters), 33 in the IUS cohort and 30 in conventional management, from 3 different providers. Upon inclusion, 27% of patients in the IUS group and 33.3% in the conventional group had elevated FCP, while 15.2% in the IUS group and 96% had endoscopic disease. In the IUS group, the average time to treatment change was 2.2 (±1.2) days, compared to 25.6 (±14.5) days in conventional management (P=0.050). Clinical remission was achieved by 44 patients (22 in each group), with an average time to remission of 128.1 days (±22.3) in the IUS group versus 230.6 (±38.2) days in conventional management (P=0.035). Drug class had no impact on the time to treatment change or remission. The primary reason for the delay in the conventional group was awaiting endoscopy and FCP results.
Investigators concluded that IUS-guided monitoring in IBD led to faster treatment adjustments and remission, regardless of therapy, supporting its broader use in IBD management.
Source: academic.oup.com/ecco-jcc/article/18/Supplement_1/i1767/7587086