scholarly journals Bowel Ultrasound: a Non-invasive, Easy to Use Method to Predict the Need to Intensify Therapy in Inflammatory Bowel Disease Patients

2021 ◽  
Author(s):  
Anda Les ◽  
Razvan Iacob ◽  
Roxana Saizu ◽  
Bogdan Cotruta ◽  
Adrian Ionut Saizu ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Wall ◽  
Doppler Signal ◽  
Treatment Intensification ◽  
Non Invasive ◽  
Subgroup Analyses ◽  
Inflammatory Bowel ◽  
Bowel Ultrasound ◽  
Active Disease

Background and Aims: Bowel ultrasound (BU) is a non-invasive, inexpensive, widely available tool, valuable for inflammatory bowel disease (IBD) assessment. The aim of the present study was to investigate the clinical utility of BU to predict the need to intensify therapy in IBD patients. Methods: One hundred seventeen IBD patients (89 Crohn’s disease, and 28 ulcerative colitis) diagnosis established at least 6 months before enrolment, undergoing maintenance therapy were prospectively included in the study. Bowel ultrasound investigated the following parameters: the bowel wall thickness (BWT), loss of wall stratification, the presence of the bowel wall Doppler signal, the visible lymph nodes, the mucosal hyperechoic spots, and the irregular external bowel wall. The patients were followed-up for 6 months, registering the need to escalate the treatment regimen. Subgroup analyses were conducted for patients requiring immediate treatment intensification (37 subjects), due to active disease at baseline and patients with subsequent treatment intensification, in the 6 months follow-up period (21 cases) in comparison to patients that required no therapeutic optimization (59). Results: During the follow-up, 49.6% of patients needed treatment escalation. All the investigated BU variables were significantly associated with the main outcome. In the multivariate analysis, the mean BWT (p<0.0001), and the presence of the bowel wall Doppler signal (p=0.007) were independent predictors of the main outcome. For the subgroup analyses: mean BWT (p=0.0001) and the presence of the bowel wall Doppler signal (p=0.01) were independent predictors for immediate treatment intensification (active disease at baseline) and mean BWT (p=0.0003) and the lack of bowel wall stratification (p=0.05) were independent predictors for the need of subsequent therapeutic optimization. Logistic regression prediction models and prediction scores (BU score) had the best AUROC values (>0.91) when compared to traditional biomarkers of active inflammation, such as C reactive protein or fecal calprotectin. Conclusion: Bowel ultrasound could be used as a non-invasive, easy to use diagnostic tool to predict the need to intensify therapy in patients with IBD.

scholarly journals P400 Bowel ultrasonography, a non invasive easy-to-use method to predict the need to step-up therapy in inflammatory bowel disease patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S409-S409
Author(s):  
A Les ◽  
R Iacob ◽  
B Cotruta ◽  
R Saizu ◽  
L Gheorghe ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Bowel Wall ◽  
Univariate Analysis ◽  
Doppler Signal ◽  
Treat To Target ◽  
Treatment Intensification ◽  
Bowel Wall Thickness ◽  
Inflammatory Bowel ◽  
Bowel Ultrasound ◽  
Ultrasound Features

Abstract Background Inflammatory bowel diseases (IBD) are chronic conditions that require multiple endoscopic and imaging assessments. Recent guidelines recommend bowel ultrasonography (BUS) as a complimentary imaging technique to assess transmural and extraintestinal lesions. The aim of the present study was to evaluate the accuracy of BUS in predicting the need to step-up therapy in IBD patients. Methods 117 IBD patients were included in the study (28 diagnosed with ulcerative colitis, 89 with Crohn’s disease). Following bowel ultrasound features bowel ultrasound features have been investigated: bowel wall thickness, loss of wall stratification, presence of bowel wall Doppler signal, the presence of hyperechoic spots inside the bowel wall, the irregularity of the external layer of the wall, the presence of creeping fat (mesenteric hypertrophy), the presence of visible lymph nodes. Patients were followed up for the next 6 months and data regarding their therapy was noted. Results During follow-up, therapeutic step-up, or biological treatment intensification (study outcome) were considered in 49.5% of cases in our study group. In a univariate analysis all the studied bowel ultrasound features but not the disease phenotype were significantly associated with the outcome. In the multivariate analysis only mean bowel wall thickness (&lt;0.0001) and the presence of bowel wall Doppler signal (0.007) were independent predictors. Using the logistic regression prediction model, a score to evaluate the need of IBD treatment intensification could be calculated - Bowel Ultrasound Score (BU Score). The AUROC of the new BU score as a predictor for treatment intensification at 6 months in patients with IBD is 0.92, with a sensitivity of 84% and a specificity of 89%, indicating a good clinical utility. For the same outcome, AUROC for CRP was 0.81 whereas for fecal calprotectin was 0.85. Conclusion As the “treat to target concept” is the currently accepted novel treatment paradigm, incorporating BUS in IBD patients monitoring (BU score) provides an easy-to-use and readily available tool to stratify patients in need for therapeutic intensification.

scholarly journals P317 Key features of bowel ultrasonography in managing inflammatory bowel disease patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S312-S313
Author(s):  
A Les ◽  
R Iacob ◽  
R Costache ◽  
L Gheorghe ◽  
C Gheorghe
Keyword(s):  
Inflammatory Bowel Disease ◽  
Wall Thickness ◽  
Biological Markers ◽  
Bowel Disease ◽  
Bowel Wall ◽  
Independent Predictor ◽  
Doppler Signal ◽  
Bowel Wall Thickness ◽  
Inflammatory Bowel ◽  
Treatment Escalation

Abstract Background Bowel ultrasonography (BUS) is an accurate imaging method for detecting and monitoring inflammatory bowel disease (IBD) patients. This technique is recommended by current guidelines besides gold standard endoscopic assessment in managing IBD patients. Several BUS characteristics strongly correlate with biological markers of inflammation suggesting that these tests could be used in monitoring IBD patients but is yet unknown how these features predict the patient’s evolution. Methods Our study included 95 consecutive IBD patients (24 diagnosed with ulcerative colitis, 71 with Crohn’s disease) with both active and inactive disease at presentation. IBD diagnosis was established endoscopically and histologically. Patients with superimposed infection (viral or bacterial) and patients that had solely rectal involvement of the disease were excluded. BUS was conducted at baseline by one skilled examiner blinded to biological data. Biological markers were evaluated at baseline and all cases were prospectively followed-up for the need of therapy escalation during the next 6 months. The following BUS characteristics were registered in every patient: bowel wall thickness, alteration of wall structure, thickened mucosa or submucosa, presence of hyperechoic spots in the mucosal wall, irregularity of the external wall, Doppler signal, presence of mesenteric hypertrophy, presence of lymph nodes, and an overall assessment of the examination. No special preparation was needed before BUS. Results Of all the monitored sonographic features, the following characteristics correlated with the need of increasing treatment in the following 6 months: bowel wall thickness, altered structure of the wall, hypertrophic mucosa, Doppler signal, and the overall assessment of the examination (p &lt; 0.001). The presence of the lymph nodes, hyperechoic spots in the mucosa, thickened submucosa and the irregularity of the external wall were not statistically significant correlated with the need for treatment escalation. The strongest correlation with the need for increasing treatment was documented for a mean bowel wall thickness &gt; 5 mm and for Doppler signal presence in the bowel wall (p &lt; 0.00001). In the multivariate analysis, Doppler signal presence was the only independent predictor for the need treatment escalation during a 6-month follow-up. Conclusion The most important sonographic features with an impact on therapeutic decision making in IBD patients are: bowel wall thickness, Doppler signal, altered stratification of the wall and mesenteric hypertrophy. In our analysis, the Doppler signal was the only independent predictor for the need for step-up therapy.

scholarly journals P570 The burden of anaemia remains significant over time in patients with inflammatory bowel disease at a tertiary referral centre

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S480-S480
Author(s):  
K Singh Singh ◽  
A Al-Khoury ◽  
Z Kurti ◽  
L Gonczi ◽  
P Golovics ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Intravenous Iron ◽  
Severe Anaemia ◽  
Iron Therapy ◽  
Tertiary Referral ◽  
Inflammatory Bowel ◽  
Intravenous Iron Therapy ◽  
Active Disease ◽  
Over Time

Abstract Background Anaemia is an important complication and/or extra-intestinal manifestation of inflammatory bowel disease (IBD), as well as a predictor of poor outcomes. The aim of this study was to determine the occurrence of anaemia and the frequency of anaemia screening over time, at a tertiary referral IBD centre. Methods We retrospectively reviewed the occurrence of anaemia at the time of referral or diagnosis and during follow-up at the McGill University Health Centre (MUHC) IBD centre. Consecutive patients presenting with an outpatient visit (‘index visit’) between July and December 2016 and between December 2018 and March 2019 were included. Disease characteristics, biochemistry and medical management, including the need for intravenous iron therapy were captured. Results 1356 and 1293 CD and UC patients [disease duration: 12 (IQR:6–22) and 10 (IQR: 5–19) years] were included in the 2 periods. The prevalence of moderate or severe anaemia at referral/diagnosis (15.4% and 8.5%) and during the follow-up (11.1% and 8.1%) was higher in CD than in UC patients, with a decrease of anaemia in CD patients between the 2 periods. The prevalence of any anaemia at follow-up was 22.4% and 18.7% in CD and in UC, while 82.7% of patients were tested at least once for anaemia during a 6-month period. UC patients with more extensive disease, treated with steroids or biologics at the time of referral but not during follow-up, active disease, or an elevated calprotectin at the time of assessment, and CD patients with active disease, elevated CRP or calprotectin at the time of assessment, with complicated disease, perianal involvement, previous respective surgery or colonic disease location, had a higher risk of anaemia. Intravenous iron therapy was prescribed in 46 patients (46.8% patients (37/79) with moderate or severe anaemia) with 72.3% having active disease (CD: 65.2%, steroid 83.3%, biological therapy: 78.6%, CRP: 97.8%, FCAL: 73.9%) in the second cohort. 91.3% of patients receiving intravenous iron had an extensive evaluation of anaemia pre- and post-therapy (CBC, ferritin, transferrin, TSAT, B12, folate). Anaemia improved by &gt;2g/l in 56.5% after 4–6 weeks (intravenous iron dose &gt;1000mg in 87% of patients). Four patients required a blood transfusion. Conclusion Anaemia occurred frequently in this IBD cohort, at referral to the centre and during follow-up, and contributes to the burden of IBD in referral populations. Most patients were assessed for anaemia regularly and with accurate anaemia workup in patients prescribed intravenous iron therapy, yet the targeted management of moderate to severe anaemia was suboptimal.

scholarly journals P277 Frequency and effectiveness of empirical anti-TNF dose intensification in Inflammatory Bowel Disease: systematic review with meta-analysis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S309-S309
Author(s):  
L Guberna Blanco ◽  
O P Nyssen ◽  
M Chaparro ◽  
J P Gisbert
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Medical Condition ◽  
Cochrane Library ◽  
Therapeutic Drug ◽  
Dose Intensification ◽  
Loss Of Response ◽  
Subgroup Analyses ◽  
Inflammatory Bowel

Abstract Background Loss of response to anti-TNF (tumor necrosis factor) therapies in inflammatory bowel disease occurs in a high proportion of patients. However, the precise incidence of dose intensification (DI) and its effectiveness remains unclear. Our aims were: 1) To evaluate the need of DI of anti-TNF therapy either by increasing the dose or decreasing doses’ interval; 2) To evaluate possible variables influencing its requirement; 3) To assess the effectiveness of empirical DI. Methods Bibliographical searches were performed in Pubmed, Embase, the Cochrane Library and CINAHL. Selection: prospective and retrospective studies assessing loss of response to anti-TNF therapy, considered as the need of DI, in Crohn’s disease (CD) and ulcerative colitis (UC) patients treated for at least 12 weeks with an anti-TNF drug [infliximab (IFX), adalimumab (ADA), certolizumab or golimumab]. Exclusion criteria: studies using anti-TNF as prophylaxis for postoperative recurrence in CD or those where DI was based on therapeutic drug monitoring. Data synthesis: Effectiveness by intention-to-treat (random effects model). Data were stratified by medical condition (UC vs. CD), anti-TNF drug and follow-up. Subgroup analyses were performed to explore heterogeneity. Results In total, 174 studies (32,031 patients) were included. The overall rate of DI requirement after 12 months follow-up was 27% (95%CI 23-31, I2=96%, 51 studies) in naïve patients and 38% (95%CI 31-46, I2=87%, 18 studies) in non-naïve patients. The rate of DI requirement was higher in patients with prior anti-TNF exposure (c²=6.5, P=0.01) and in UC patients (c²=4.7, P=0.03). The rate of DI requirement in naïve patients after 36 months follow-up was 35% (95%CI 27-43%; I2=98%; 22 studies). The overall short-term response and remission rates to empirical DI in naïve patients were 66% (95%CI 61-71%; I2=81%; 35 studies) and 48% (95%CI 35-62%; I2=97%; 27 studies), respectively. Subgroup analyses are presented in the tables. Conclusion Loss of response to anti-TNF agents ―and consequent DI― occur frequently in IBD (approximately in 1/4 at one year and in 1/3 at 3 years). DI requirement is higher in UC patients and in those with prior anti-TNF exposure. Empirical DI is a relatively effective therapeutic option.

scholarly journals P533 Adalimumab 80mg every other week in inflammatory bowel disease: Treatment intensification outcomes in real life clinical practice

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S507-S509
Author(s):  
M I Calvo Moya ◽  
I Omella Usieto ◽  
I El Hajra Martinez ◽  
E Santos Perez ◽  
Y Gonzalez Lama ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Bowel Disease ◽  
Smoking Habit ◽  
Real Life ◽  
Fecal Calprotectin ◽  
Treatment Intensification ◽  
Loss Of Response ◽  
Inflammatory Bowel

Abstract Background Adalimumab (ADA) intensification is recommended for inadequate or loss of response in inflammatory bowel disease (IBD) patients. A new presentation of ADA 80mg administered every other week (eow) has been approved as an alternative to ADA 40mg every week (ew). Data regarding impact of ADA 80mg eow in clinical practice is still scarce. The aim of this study was to assess long-term durability, safety and cost-effectiveness of treatment with ADA 80mg eow in patients with IBD. Methods A retrospective cohort study in a tertiary hospital that included all IBD patients under intensified maintenance therapy with ADA 80mg eow was performed. Durability was calculated considering the time from the first dose to treatment withdrawn or to the end of follow-up. Biological remission (BR) was defined as CR together with fecal calprotectin (FC) &lt;250µg/g and C-reactive protein (CRP) &lt;5mg/dl. Economic impact of ADA 80mg eow was estimated considering current price of both ADA 40mg and ADA 80mg pens at our centre. Results Sixty-three patients (52 CD and 11 CU) were included; median age 47 (IQR 39–59), 54% male; median duration of the disease before ADA of 11 years (IQR 6–20); 30% were active smokers. Among CD patients, 56% had ileal disease, 17% colonic and 27% ileocolonic. The inflammatory behavior was the most frequent (52%) and 31% had perianal disease. In UC, 55% had extensive colitis. 44 patients (70%) were bio-naïve and 36 (57%) received immunosuppressants at baseline. At the time of escalation, 48 patients (76%) were symptomatic. After intensification, 52 (83%) patients (CD 42 and UC 10) achieved CR and 46 (73%) BR. The changes in the levels of FC, CRP and ADA were significant (p &lt;0.001) (Graphs 1–3). 22 patients (35%) discontinued treatment after a median of 6.5 (IQR 5–10) months due to: 11 no clinical response (50%), 4 loss of response (18%), 3 adverse events (14%) (psoriasis) and 4 endoscopic progression (18%). 44 patients (70%) remained under treatment and in CR (median follow-up 17 months, IQR 13–24) (Graph 4) and with a median ADA levels of 10.46 mg/l (IQR 7.34–15.25). Use of ADA 80 eow regimen saved 223500€ in patients who maintained treatment. In the multivariate analysis, being in CR when intensifying reduced the risk of treatment discontinuation by 87% (HR 0.13, 95%CI 0.02–0.99; p&lt;0.001), having reached BR by 99.5% (HR 0.05, 95%CI 0.02–0.14; p &lt;0.001) and having ADA levels ≥5 mg/l after intensification by 68% (HR 0.32, 95%CI 0.13–0.75; p = 0.02). Smoking habit was associated with treatment withdrawn (HR 1.74, 95%CI 1.02–2.96; p=0.04). Conclusion ADA intensification to 80mg eow in IBD patients is safe, effective and may reduce costs in real life clinical practice. Early intensification, even in CR, may enhance ADA treatment durability.

scholarly journals P184 Disease activity in Inflammatory Bowel Disease patients is associated with increased liver fat content during follow-up

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S254-S255
Author(s):  
E Van Lingen ◽  
M Tushuizen ◽  
M Steenhuis ◽  
T van Deynen ◽  
J Martens ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Liver Fibrosis ◽  
Disease Activity ◽  
Bowel Disease ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Active Disease

Abstract Background Increased liver steatosis is a frequently reported condition in patients with Inflammatory Bowel Disease (IBD). Different factors, both metabolic and IBD-associated, are believed to be contribute to the pathogenesis. The aim of our study was to calculate the prevalence of liver steatosis (LS) and fibrosis (LF) in IBD patients and evaluate which factors influence changes in steatosis and fibrosis during follow-up. Methods From June 2017 to February 2018, consecutive adult IBD patients were enrolled. Demographic and bio-chemical data were collected at baseline and after 6 to 12 months. The degree of LS and LF was assessed by transient elastography (Fibroscan). LS was defined as a Controlled Attenuation Parameter (CAP) ≥248, LF as a liver stiffness value (Emed) ≥7.3 kPa and IBD disease activity as C-reactive protein (CRP) ≥10 mg/l and/or fecal calprotectin (FCP) ≥150 μg/g. Changes in LS and LF were studied using ∆CAP and ∆Emed (follow-up minus baseline). An independent sample T-test was used to analyze the mean change in ∆CAP and ∆Emed. Univariate and multivariate linear regression analyses were performed, a P-value of ≤0.05 was considered significant. Results A total of 117 IBD patients were enrolled, of which 86 patients were also seen for follow-up. Of these 86 patients, 57% were male with a mean age of 43 (16.1) years. 48% of the patients suffered from Crohn’s disease. The mean Body Mass Index (BMI) was 25.0 (4.7) kg/m2 and 28 patients (33%) had an active episode of IBD at enrollment. The prevalence of LS at baseline was 39%, the prevalence of LF at baseline 13%. The mean change in ∆CAP was 22.44 (75.7) in patients with active disease at baseline and -34.1 (67.5) in patients in remission at baseline (p=0.001). The mean change in ∆Emed was 0.40 (1.9) in patients with active disease at baseline and -0.53 (2.7) in patients in remission at baseline (p=0.075).). Using a multivariate analysis, disease activity at baseline (B=37, 95%CI 6.38–67.61,P=0.018) and LS at baseline (B=-0.4, 95%CI -0.64 – -0.23,P=0.000) were associated with an increase in LS during follow-up. In univariate analyses, no factors associated with LF during follow-up were found. Conclusion Our study reveals a high prevalence of liver steatosis and liver fibrosis in IBD patients. Active IBD at baseline was associated with an increase in liver steatosis during follow up, but not with an increase in liver fibrosis.

scholarly journals P56 Two year follow up of children with inflammatory bowel disease (IBD) treated with Vedolizumab and Ustekinumab

2021 ◽  
Author(s):  
Roxana Mardare ◽  
Natasha Burgess ◽  
Dominic Studart ◽  
Protima Deb ◽  
Marco Gasparetto ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel

scholarly journals Utility of routinely collected electronic health records data to support effectiveness evaluations in inflammatory bowel disease: a pilot study of tofacitinib

2021 ◽  
Vol 28 (1) ◽  
pp. e100337
Author(s):  
Vivek Ashok Rudrapatna ◽  
Benjamin Scott Glicksberg ◽  
Atul Janardhan Butte
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pilot Study ◽  
Disease Activity ◽  
Real World ◽  
Bowel Disease ◽  
P Value ◽  
Health Records ◽  
Real World Evidence ◽  
Inflammatory Bowel

ObjectivesElectronic health records (EHR) are receiving growing attention from regulators, biopharmaceuticals and payors as a potential source of real-world evidence. However, their suitability for the study of diseases with complex activity measures is unclear. We sought to evaluate the use of EHR data for estimating treatment effectiveness in inflammatory bowel disease (IBD), using tofacitinib as a use case.MethodsRecords from the University of California, San Francisco (6/2012 to 4/2019) were queried to identify tofacitinib-treated IBD patients. Disease activity variables at baseline and follow-up were manually abstracted according to a preregistered protocol. The proportion of patients meeting the endpoints of recent randomised trials in ulcerative colitis (UC) and Crohn’s disease (CD) was assessed.Results86 patients initiated tofacitinib. Baseline characteristics of the real-world and trial cohorts were similar, except for universal failure of tumour necrosis factor inhibitors in the former. 54% (UC) and 62% (CD) of patients had complete capture of disease activity at baseline (month −6 to 0), while only 32% (UC) and 69% (CD) of patients had complete follow-up data (month 2 to 8). Using data imputation, we estimated the proportion achieving the trial primary endpoints as being similar to the published estimates for both UC (16%, p value=0.5) and CD (38%, p-value=0.8).Discussion/ConclusionThis pilot study reproduced trial-based estimates of tofacitinib efficacy despite its use in a different cohort but revealed substantial missingness in routinely collected data. Future work is needed to strengthen EHR data and enable real-world evidence in complex diseases like IBD.

scholarly journals Crohn’s disease and ulcerative colitis patient-reported outcomes signs and symptoms for the remote management of inflammatory bowel disease during the COVID-19 pandemic

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sergio Pinto ◽  
Erica Loddo ◽  
Salvatore Paba ◽  
Agnese Favale ◽  
Fabio Chicco ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Bowel Disease ◽  
Patient Reported Outcomes ◽  
Signs And Symptoms ◽  
Patient Reported ◽  
Inflammatory Bowel ◽  
Active Patients ◽  
Active Disease

Abstract Background and aims The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn’s Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. Methods CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. Results Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. Conclusions PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.

Sign in / Sign up

Export Citation Format

Share Document