Francesca Zorzi1, Elisa Stasi1, Gerolamo Bevivino1, Patrizio Scarozza1, Livia Biancone1, Sara Zuzzi2, Carla Rossi2, Francesco Pallone1, Emma Calabrese3. 1. Gastrointestinal Unit, Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy. 2. Interdepartmental Center of Biostatistics and Bioinformatics, University of Rome "Tor Vergata," Rome, Italy. 3. Gastrointestinal Unit, Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy. Electronic address: emma.calabrese@uniroma2.it.
Abstract
BACKGROUND & AIMS: Therapeutic antibodies against tumor necrosis factor α (anti-TNF) are effective in patients with Crohn's disease (CD). Mucosal healing is a surrogate marker of efficacy, but little is known about the effects of anti-TNF agents on structural damage in the intestine. Small-intestine contrast ultrasonography (SICUS) is a valuable tool for assessing CD lesions. A new sonographic quantitative index (the sonographic lesion index for CD [SLIC]) was developed to quantify changes in CD lesions detected by SICUS. We explored whether the SLIC can be used to monitor transmural bowel damage in CD patients during anti-TNF therapy. METHODS: We performed a prospective study of 29 patients with ileal or ileocolonic CD treated with anti-TNF agents; patients underwent SICUS before and after scheduled induction and maintenance therapy. To determine whether changes that can be detected by SICUS occur independently of anti-TNF therapy, 7 patients with ileal CD treated with mesalamine were enrolled as controls. A clinical response was defined as steroid-free remission, with CD activity index scores less than 150. RESULTS: We observed significant improvements in SLIC scores and subscores after induction and maintenance therapy with anti-TNFs, compared with before therapy. SLIC scores and subscores and index classes were improved significantly in patients with vs without clinical responses. Controls had no improvements in terms of CD activity index or SLIC scores, or index classes. CONCLUSIONS: Sonographic assessment using the quantitative index SLIC can be used to monitor changes in transmural bowel damage during anti-TNF therapy for CD.
BACKGROUND & AIMS: Therapeutic antibodies against tumor necrosis factor α (anti-TNF) are effective in patients with Crohn's disease (CD). Mucosal healing is a surrogate marker of efficacy, but little is known about the effects of anti-TNF agents on structural damage in the intestine. Small-intestine contrast ultrasonography (SICUS) is a valuable tool for assessing CD lesions. A new sonographic quantitative index (the sonographic lesion index for CD [SLIC]) was developed to quantify changes in CD lesions detected by SICUS. We explored whether the SLIC can be used to monitor transmural bowel damage in CD patients during anti-TNF therapy. METHODS: We performed a prospective study of 29 patients with ileal or ileocolonic CD treated with anti-TNF agents; patients underwent SICUS before and after scheduled induction and maintenance therapy. To determine whether changes that can be detected by SICUS occur independently of anti-TNF therapy, 7 patients with ileal CD treated with mesalamine were enrolled as controls. A clinical response was defined as steroid-free remission, with CD activity index scores less than 150. RESULTS: We observed significant improvements in SLIC scores and subscores after induction and maintenance therapy with anti-TNFs, compared with before therapy. SLIC scores and subscores and index classes were improved significantly in patients with vs without clinical responses. Controls had no improvements in terms of CD activity index or SLIC scores, or index classes. CONCLUSIONS: Sonographic assessment using the quantitative index SLIC can be used to monitor changes in transmural bowel damage during anti-TNF therapy for CD.
Authors: Parakkal Deepak; Amy B Kolbe; Jeff L Fidler; Joel G Fletcher; John M Knudsen; David H Bruining Journal: Gastroenterol Hepatol (N Y) Date: 2016-04
Authors: Nathan S S Atkinson; Robert V Bryant; Yi Dong; Christian Maaser; Torsten Kucharzik; Giovanni Maconi; Anil K Asthana; Michael Blaivas; Adrian Goudie; Odd Helge Gilja; Dieter Nuernberg; Dagmar Schreiber-Dietrich; Christoph F Dietrich Journal: World J Gastroenterol Date: 2017-10-14 Impact factor: 5.742