Bowel ultrasound score is accurate in assessing response to therapy in patients with Crohn’s disease
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 change...
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| Published in | Alimentary Pharmacology & Therapeutics (Suppl) Vol. 55; no. 4; pp. 446 - 454 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Wiley Subscription Services, Inc
01.02.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0269-2813 1365-2036 0953-0673 1365-2036 |
| DOI | 10.1111/apt.16700 |
Cover
| 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.
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). |
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| AbstractList | 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.
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). 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). To assess whether BUSS, in addition to detecting inflammatory lesions, also detects relevant changes of these lesions over time. 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. 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). BUSS is sensitive to change in CD. BackgroundWe 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).AimTo assess whether BUSS, in addition to detecting inflammatory lesions, also detects relevant changes of these lesions over time.MethodsThis 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.ResultsBUSS 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).ConclusionBUSS is sensitive to change in CD. 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. 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).BACKGROUNDWe 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).To assess whether BUSS, in addition to detecting inflammatory lesions, also detects relevant changes of these lesions over time.AIMTo assess whether BUSS, in addition to detecting inflammatory lesions, also detects relevant changes of these lesions over time.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.METHODSThis 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.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).RESULTSBUSS 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).BUSS is sensitive to change in CD.CONCLUSIONBUSS is sensitive to change in CD. |
| Author | D’Amico, Ferdinando Bonovas, Stefanos Peyrin‐Biroulet, Laurent Zilli, Alessandra Danese, Silvio Fiorino, Gionata Allocca, Mariangela Dell’Avalle, Cecilia Furfaro, Federica Craviotto, Vincenzo |
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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... 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... BackgroundWe developed a non‐invasive bowel ultrasound score (BUSS) to assess disease activity in Crohn’s disease (CD). BUSS >3.52 is an indicator of... 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... |
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| SubjectTerms | Colon Colonoscopy Crohn Disease Crohn Disease - diagnostic imaging Crohn Disease - drug therapy Crohn's disease Endoscopy Humans Immunosuppressive agents Inflammation Inflammatory bowel diseases Intestine Intestines Intestines - pathology Lesions Life Sciences Patients Prospective Studies Remission Remission (Medicine) Severity of Illness Index Ultrasonic imaging Ultrasonography Ultrasound |
| Title | Bowel ultrasound score is accurate in assessing response to therapy in patients with Crohn’s disease |
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