Intestinal ultrasound helps monitor response in ulcerative colitis
Assessing bowel wall thickness with intestinal ultrasound can be a helpful tool to monitor therapeutic response in patients with ulcerative colitis, according to study results published in Gut.
Christian Maaser, MD, of the outpatient department of gastroenterology at Lüneburg Hospital in Germany, and colleagues wrote that reliable, but non-invasive methods to assess mucosal healing are in high demand in the world of IBD.
“Intestinal ultrasound represents a non-invasive modality to assess disease activity in IBD and to guide therapy decisions,” they wrote. “It is easy to use, inexpensive and can be used repeatedly without limitations and with immediate interaction opportunities with the patient.”
Researchers conducted a prospective study known as the Transabdominal Ultrasonography of the bowel in Subjects with IBD To monitor disease activity with UC (TRUST&UC) study at 42 IBD centers in Germany. They included patients with a diagnosis of proctosigmoiditis, left-sided colitis or pan colitis who were currently in clinical relapse (defined as Short Clinical Colitis Activity Index of at least 5; n = 224). They assessed disease activity and vascularization within the bowel wall areas using duplex/Color Doppler ultrasonography.
At baseline, 88.5% of patients had increased bowel wall thickness in the descending or sigmoid colon. Within 2 weeks of treatment, ultrasound revealed that the percentage of patients with increased bowel wall thickness decreased for both the descending (89.3% to 38.6%) and sigmoid colon (83% to 42.9%; P < .001). The percentage of patients with increased bowel wall thickness remained low at weeks 6 and 12.
Maaser and colleagues wrote that their findings showed a high correlation between normalization of bowel wall thickness and clinical response after 12 weeks of treatment. Among patients with normalized bowel wall thickness, 90.5% had symptomatic response and 9.5% did not (P < .001).
“Our findings give rise to the assumption that monitoring bowel wall thickness alone has the potential to predict therapeutic response,” they wrote. “The additional monitoring of fecal calprotectin could add further value in monitoring patients with UC. Future prospective studies are necessary to determine the value of intestinal ultrasound in predicting short- and long-term response and outcomes of therapies in UC.” – by Alex Young
Disclosure: Maaser reports receiving honorary fees from AbbVie, Biogen, Celgene, Ferring, Falk Foundation, Janssen, MSD Sharp & Dome, Takeda and Vifor. Please see the full study for all other authors’ relevant financial disclosures.