Emma Calabrese1, Antonio Rispo2, Francesca Zorzi3, Elena De Cristofaro3, Anna Testa2, Giuseppe Costantino4, Anna Viola4, Cristina Bezzio5, Chiara Ricci6, Simonetta Prencipe7, Chiara Racchini8, Gianpiero Stefanelli9, Mariangela Allocca10, Salvatore Scotto di Santolo11, Mauro Valeriano D'Auria12, Paola Balestrieri13, Angelo Ricchiuti14, Maria Cappello15, Flaminia Cavallaro16, Alessia Dalila Guarino2, Giovanni Maconi17, Alessandra Spagnoli18, Giovanni Monteleone3, Fabiana Castiglione2. 1. Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome. Electronic address: emma.calabrese@uniroma2.it. 2. Gastroenterology, Department of Clinical Medicine and Surgery, Federico II, School of Medicine, Naples. 3. Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome. 4. Clinical Unit for Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina. 5. Gastroenterology Unit, ASST Rhodense, Rho Hospital, Rho. 6. Gastroenterology Unit, University and Spedali Civili of Brescia, Brescia. 7. Gastroenterology Unit, PO Barletta. 8. Santa Maria delle Croci Hospital, Ravenna. 9. Department of Life, Health and Environmental Sciences, Gastroenterology Unit, University of L'Aquila, L'Aquila. 10. Humanitas Clinical and Research Center, Humanitas University, Department of Biomedical Sciences, Milan. 11. PSI Napoli Est ASL NA1 UO Gastroenterologia, Naples. 12. Gastroenterology Unit "Umberto I" Hospital, Nocera Inferiore. 13. Unit of Digestive Disease, Campus Bio Medico University of Rome, Rome. 14. Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, Cisanello University Hospital of Pisa, Pisa. 15. Gastroenterology and Hepatology Unit, AOU Policlinico "P. Giaccone", Palermo. 16. Gastroenterology and Digestive Endoscopy, IRCCS Policlinico San Donato, San Donato Milanese, Milano. 17. Gastroenterology Unit, Department of Biomedical and Clinical Sciences, FBF-Sacco University Hospital, Milan. 18. Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Rome.
Abstract
BACKGROUND & AIMS: Bowel ultrasonography (BUS) is a noninvasive tool for evaluating bowel activity in Crohn's disease (CD) patients. Aim of our multicenter study was to assess whether BUS helps to monitor intestinal activity improvement/resolution following different biological therapies. METHODS: Adult CD patients were prospectively enrolled at 16 sites in Italy. Changes in BUS parameters [i.e. bowel wall thickening (BWT), lesion length, echo pattern, blood flow changes and transmural healing (TH: normalization of all BUS parameters)] were analyzed at baseline and after 3, 6 and 12 months of different biological therapies. RESULTS: One hundred eighty-eight out of 201 CD patients were enrolled and analyzed (116 males [62%]; median age 36 years). Fifty-five percent of patients were treated with adalimumab, 16% with infliximab, 13% with vedolizumab and 16% with ustekinumab. TH rates at 12 months were 27.5% with an NNT of 3.6. TH at 12 months after adalimumab was 26.8%, 37% after infliximab, 27.2% after vedolizumab and 20% after ustekinumab. Mean BWT improvement from baseline was statistically significant at 3 and 12 months (P < .0001). Median Harvey-Bradshaw index, C-reactive protein and fecal calprotectin decreased after 12 months from baseline (P < .0001). Logistic regression analysis showed colonic lesion was associated with a higher risk of TH at 3 months and a greater BWT at baseline was associated with a lower risk of TH at 3 months [P = .03 (OR 0.70, 95% CI 0.50-0.97)] and 12 months [P = .01 (OR 0.58, 95% CI 0.38-0.89)]. At 3 months therapy optimization during the study was the only independent factor associated with a higher risk of no ultrasonographic response [P = .02 (OR 3.34, 95% CI 1.18-9.47)] and at 12 months disease duration [P = .02 (OR 3.03, 95% CI 1.15-7.94)]. CONCLUSIONS: Data indicate that BUS is useful to monitor biologics-induced bowel activity improvement/resolution in CD.
BACKGROUND & AIMS: Bowel ultrasonography (BUS) is a noninvasive tool for evaluating bowel activity in Crohn's disease (CD) patients. Aim of our multicenter study was to assess whether BUS helps to monitor intestinal activity improvement/resolution following different biological therapies. METHODS: Adult CD patients were prospectively enrolled at 16 sites in Italy. Changes in BUS parameters [i.e. bowel wall thickening (BWT), lesion length, echo pattern, blood flow changes and transmural healing (TH: normalization of all BUS parameters)] were analyzed at baseline and after 3, 6 and 12 months of different biological therapies. RESULTS: One hundred eighty-eight out of 201 CD patients were enrolled and analyzed (116 males [62%]; median age 36 years). Fifty-five percent of patients were treated with adalimumab, 16% with infliximab, 13% with vedolizumab and 16% with ustekinumab. TH rates at 12 months were 27.5% with an NNT of 3.6. TH at 12 months after adalimumab was 26.8%, 37% after infliximab, 27.2% after vedolizumab and 20% after ustekinumab. Mean BWT improvement from baseline was statistically significant at 3 and 12 months (P < .0001). Median Harvey-Bradshaw index, C-reactive protein and fecal calprotectin decreased after 12 months from baseline (P < .0001). Logistic regression analysis showed colonic lesion was associated with a higher risk of TH at 3 months and a greater BWT at baseline was associated with a lower risk of TH at 3 months [P = .03 (OR 0.70, 95% CI 0.50-0.97)] and 12 months [P = .01 (OR 0.58, 95% CI 0.38-0.89)]. At 3 months therapy optimization during the study was the only independent factor associated with a higher risk of no ultrasonographic response [P = .02 (OR 3.34, 95% CI 1.18-9.47)] and at 12 months disease duration [P = .02 (OR 3.03, 95% CI 1.15-7.94)]. CONCLUSIONS: Data indicate that BUS is useful to monitor biologics-induced bowel activity improvement/resolution in CD.
Authors: Olga Maria Nardone; Giulio Calabrese; Anna Testa; Anna Caiazzo; Giuseppe Fierro; Antonio Rispo; Fabiana Castiglione Journal: Front Med (Lausanne) Date: 2022-05-23
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