Non-Invasive Assessment of Inflammation and Treatment Response in Patients with Crohn’s Disease and Ulcerative Colitis using Contrast-Enhanced Ultrasonography Quantification

ackground & Aim: Novel biological therapies in Crohn’s disease (CD) or Ulcerative colitis (UC) require a proper follow-up for the assessment of bowel inflammation. While endoscopy is the standard method, the imaging techniques using contrast, particularly contrast enhanced ultrasonography (CEUS), are better tolerated by the patients and can be used more frequently. Our aim was to find the usefulness of dynamic CEUS quantification as compared to endoscopy in the assessment of disease activity and in the follow-up under therapy of the patients suffering from either CD or UC. Method: We have prospectively evaluated 67 patients with UC and 46 with CD, diagnosed by ileo-colonoscopy and biopsy, comparing the endoscopic scores with clinical scores, C reactive protein (CRP), intestinal wall thickness, layer scores after CEUS and TIC parameters (using SonoLiver® software – Imax, RT, TTP, mTT and AUC). For 25 patients with UC and 13 with CD we performed comparisons of the parameters before and after 3 months of treatment and correlated them with the changes in the endoscopic scores. Results: For UC, time-intensity curves (TIC) volume parameters (AUC) correlated better with endoscopy (ρ=0.64) than the clinical score (ρ =0.62). Other parameters such as CRP and thickness showed significant but less strong correlation, while TIC flow parameters (RT, TTP and mTT) did not show a significant correlation. Results were similar for CD (ρ=0.64 for Imax vs ρ=0.58 for CDAI). The best predictor for endoscopic improvement in both UC and CD was ln(AUC), with a Wilcoxon Z score of 3.76 and 2.61, respectively. There was also a good correlation between the difference of its values and the difference in endoscopic scores before and after the treatment (rho is 0.68 in UC and 0.73 in CD). Abbreviations: CD: Crohn’s disease; CDAI: Crohn‘s disease activity index; CDEIS: Crohn‘s disease endoscopic index of severity; CEUS: Contrast-enhanced ultrasonography; CICDA: Composite index of CD activity; CRP: C-reactive protein; IBD: Inflammatory bowel disease; Imax: Maximum intensity; ln(AUC): Natural logarithm of AUC; MPI: Maximum peak intensity; mTT: Mean transit time; ROI: Region of interest; RT: Rise time; SES-CD: Simple endoscopic score for Crohn‘s disease; TIC:

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P473 Long-term follow-up of switching from original adalimumab to adalimumab biosimilar: real-world data in IBD

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.602 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S416-S416 ◽

Cited By ~ 1

Author(s):

C Padilla Suarez ◽

K Webb ◽

N Persad ◽

J Sercombe ◽

E Tyler ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

C Reactive Protein ◽

Drug Levels ◽

Reactive Protein ◽

Loss Of Response ◽

Mayo Score

Abstract Background Studies have reported good efficacy outcomes for patients with inflammatory bowel disease (IBD) treated with biosimilars. There are limited long-term data. We assessed the long-term efficacy data and safety after switching from adalimumab to adalimumab biosimilars in patients with IBD. Methods A prospective single-centre observational study involving patients with Crohn’s disease or ulcerative colitis switched from adalimumab to adalimumab biosimilar and reviewed up to 12months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. Blood tests including C-reactive protein, adalimumab drug levels and anti-drug antibodies were monitored. We have recorded side effects and possible serious adverse effects. The plan is to continue the study for 24 months. Results 109 patients with IBD have completed at least 6 months of treatment with adalimumab biosimilar, 12 of which have ulcerative colitis and 97 Crohn’s disease. Most of them (88%) continued on biosimilar after 6 months. Patients discontinued the therapy due to loss of response or development of antibodies in one case. Two patients were switched to a different biosimilar due to the presence of side effects which were however not serious. Of those who remained on the treatment, 74.5% were in clinical remission at 6 months and 71.4% at 9 months. HB index, partial Mayo score, C-reactive protein and adalimumab drug levels did not show significant changes. We have not reported any serious adverse events. We hope than by February, at least 60% of these patients will have been on Adalimumab for 12 months and further amended date would be added. Conclusion Most of the patients switching from original adalimumab were maintained on biosimilar at 6 and 12months of follow-up with similar efficacy and safety as the original drug.

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Interactions among Interleukin-6, C-Reactive Protein and Interleukin-6 (-174) G/C Polymorphism in the Pathogenesis of Crohn’s Disease and Ulcerative Colitis

Acta Clinica Croatica ◽

10.20471/acc.2020.59.01.09 ◽

2020 ◽

Vol 59 ◽

Author(s):

Boris Takač

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Interleukin 6 ◽

C Reactive Protein ◽

Reactive Protein

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Adalimumab Treatment in Biologically Naïve Crohn’s Disease: Relationship with Ectopic MUC5AC Expression and Endoscopic Improvement

Gastroenterology Research and Practice ◽

10.1155/2014/687257 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Tsutomu Mizoshita ◽

Satoshi Tanida ◽

Hironobu Tsukamoto ◽

Keiji Ozeki ◽

Takahito Katano ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Activity Index ◽

Drug Efficacy ◽

Predictive Marker ◽

C Reactive Protein ◽

Reactive Protein ◽

Before And After ◽

Adalimumab Treatment ◽

Positive Groups

Background. Adalimumab (ADA) is effective for patients with Crohn’s disease (CD). However, there have been few reports on ADA therapy with respect to its relationship with pathologic findings and drug efficacy in biologically naïve CD cases.Methods. Fifteen patients with active biologically naïve CD were treated with ADA. We examined them clinically and pathologically with ectopic MUC5AC expression in the lesions before and after 12 and 52 weeks of ADA therapy, retrospectively.Results. Both mean CD activity index scores and serum C-reactive protein values were significantly lower after ADA therapy (P<0.001). In the MUC5AC negative group, all cases exhibited clinical remission (CR) and endoscopic improvement at 52 weeks. In MUC5AC positive groups, loss of MUC5AC expression was detected in cases having CR and endoscopic improvement at 52 weeks, while remnant ectopic MUC5AC expression was observed in those exhibiting no endoscopic improvement and flare up after 52 weeks.Conclusions. ADA leads to CR and endoscopic improvement in biologically naïve CD cases. In addition, ectopic MUC5AC expression may be a predictive marker of flare up and endoscopic improvement in the intestines of CD patients.

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Correlated Expression of High-Sensitivity C-Reactive Protein in Relation to Disease Activity in Inflammatory Bowel Disease: Lack of Differences between Crohn’s Disease and Ulcerative Colitis

Digestion ◽

10.1159/000094531 ◽

2006 ◽

Vol 73 (4) ◽

pp. 205-209 ◽

Cited By ~ 21

Author(s):

Liaz Zilberman ◽

Nitsan Maharshak ◽

Yaron Arbel ◽

Ori Rogowski ◽

Meirav Rozenblat ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Inflammatory Bowel

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Predictive value of time–intensity curves obtained with contrast-enhanced ultrasonography (CEUS) in the follow-up of 30 patients with Crohn's disease

Journal of Ultrasound ◽

10.1016/j.jus.2009.10.001 ◽

2009 ◽

Vol 12 (4) ◽

pp. 151-159 ◽

Cited By ~ 8

Author(s):

F. Giangregorio ◽

A. Bertone ◽

L. Fanigliulo ◽

G. Comparato ◽

G. Aragona ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Predictive Value ◽

Value Of Time ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

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Long-term follow up after switching from original infliximab to an infliximab biosimilar: real-world data

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819858052 ◽

2019 ◽

Vol 12 ◽

pp. 175628481985805 ◽

Cited By ~ 6

Author(s):

María Fernanda Guerra Veloz ◽

María Belvis Jiménez ◽

Teresa Valdes Delgado ◽

Luisa Castro Laria ◽

Belén Maldonado Pérez ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Adverse Events ◽

Reactive Protein ◽

Loss Of Response ◽

Mayo Score ◽

Inflammatory Bowel

Background: Several studies have reported positive efficacy outcomes for patients with inflammatory bowel disease treated with CT-P13, an infliximab biosimilar. Data from follow-up periods longer than 1 year are still scarce. Here, we assessed the long-term efficacy data, loss of response and safety after switching from infliximab to CT-P13 in patients with inflammatory bowel disease. Methods: This was a prospective single-center observational study involving patients with moderate-to-severe Crohn’s disease and ulcerative colitis switched from infliximab to CT-P13 treatment and reviewed up to 24 months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. C-reactive protein, infliximab drug levels, adverse events and antidrug antibodies were also monitored throughout the study. Results: A total of 64 patients with Crohn’s disease and 36 patients with ulcerative colitis were included. Most of them (72%) remained on CT-P13. Overall, 28% of patients discontinued the therapy due to loss of response, adverse events or long-lasting clinical remission. Remission at 18 and 24 months occurred in 69.9% and 68.5% of patients, respectively. Dose increase was performed in 22% of patients, with remission being reached in 60% of them. HB index, partial Mayo score, C-reactive protein and infliximab drug levels did not show significant changes. Serious adverse events were reported in 14% of patients. Overall, two patients developed low levels of antidrug antibodies. Conclusions: Most of the patients switching from original infliximab were maintained on CT-P13 at 2 years of follow up with a good profile of efficacy and safety.

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Serum levels of C-reactive protein in Crohn's disease and ulcerative colitis

European Journal of Clinical Investigation ◽

10.1111/j.1365-2362.1982.tb02244.x ◽

1982 ◽

Vol 12 (4) ◽

pp. 351-359 ◽

Cited By ~ 195

Author(s):

E. A. FAGAN ◽

R. F. DYCK ◽

P. N. MATON ◽

H. J. F. HODGSON ◽

V. S. CHADWICK ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Serum Levels ◽

C Reactive Protein ◽

Reactive Protein

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P457 Long-term follow-up of patients with IBD after switching from original adalimumab to adalimumab biosimilar during COVID 19 pandemic

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.581 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S451-S451

Author(s):

K Klimova ◽

C Padilla Suarez

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Side Effects ◽

Crohn's Disease ◽

Reactive Protein ◽

Loss Of Response ◽

Mayo Score ◽

Long Term Follow Up

Abstract Background Studies have reported good efficacy outcomes for patients with inflammatory bowel disease (IBD) treated with biosimilars. There are limited long term data. We assessed the long-term efficacy data and safety after switching from adalimumab to adalimumab biosimilar Imraldi in patients with IBD. Methods A prospective single-centre observational study involving patients with Crohn’s disease or ulcerative colitis switched from adalimumab originator to adalimumab biosimilar and reviewed up to 24months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. Blood tests including C-reactive protein, adalimumab drug levels and antidrug antibodies were monitored. We have recorded side effects and possible serious adverse effects including COVID 19 infection. Results 113 patients were switched to Adalimumab biosimilar Imraldi from Adalimumab originator between January 2019 to March 2019. After 12 months of treatment, 25 patients interrupted treatment and 89 (78.8%) continued. These were analysed after 24 months of treatment - 57 (52.3%) continued on Imraldi. Of those who discontinued, 9 were switched back to Adalimumab originator due to side effects, and 34 stopped treatment - 16 patients due to loss of response, 11 patients developed antibodies, 5 underwent a surgery, 4 were in remission and 4 did not tolerate side effects. There was no statistical difference in CRP or Adalimumab levels prior to switch, at 12 months and at 24 months between the patients who continued or discontinued treatment. Overall, 18 of the patients who completed 24 months of treatment reported side effects, most frequently pain after injection (9 patients), followed by skin rash and recurrent infections (in 3 patients each). No patient was diagnosed with COVID 19 during until now. Conclusion After 24 months of follow up, 52.3% patients continued on adalimumab biosimilar and no serious side effects were reported. In particular, none of our patients acquired COVID 19 infection.

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Intestinal ultrasound and management of small bowel Crohn’s disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284818771367 ◽

2018 ◽

Vol 11 ◽

pp. 175628481877136 ◽

Cited By ~ 7

Author(s):

Torsten Kucharzik ◽

Christian Maaser

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Disease Recurrence ◽

Primary Diagnosis ◽

New Developments ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography ◽

Bowel Imaging

As Crohn’s disease (CD) is predominantly located within the small bowel, imaging of the small bowel plays an intriguing role in the primary diagnosis as well as in the monitoring of patients with CD. Intestinal ultrasound (IUS) offers several advantages over endoscopy and other imaging modalities. Obvious advantages of IUS include noninvasiveness, rapid availability and cost effectiveness. IUS has been shown to have high accuracy in detecting small bowel CD and determining intra- and extramural complications such as stenoses, fistulae and abscesses. IUS has also been shown to be highly effective in determining postoperative disease recurrence and in follow up of patients under treatment. The following review summarizes current developments in the use of IUS for the detection of small bowel lesions and complications. The aim of this review is to suggest algorithms on how to use IUS in managing patients with small bowel CD in clinical practice. Suggested applications on the use of high frequency IUS in CD are extended by discussing new developments such as contrast-enhanced ultrasonography and elastography.

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