Ultrasonography Tight Control and Monitoring in Crohn's Disease During Different Biological Therapies: A Multicenter Study.

Adalimumab / therapeutic use Adult Biological Therapy Crohn Disease / diagnostic imaging Humans Infliximab / therapeutic use Male Ultrasonography
Biologicals Bowel Ultrasonography Crohn’s Disease Imaging Inflammation Monitoring

Journal

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775

Informations de publication

Date de publication:
04 2022
Historique:
received: 19 02 2021
accepted: 23 03 2021
pubmed: 30 3 2021
medline: 17 3 2022
entrez: 29 3 2021
Statut: ppublish

Résumé

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. 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. 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)]. Data indicate that BUS is useful to monitor biologics-induced bowel activity improvement/resolution in CD.

Sections du résumé

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.

Identifiants

DOI: 10.1016/j.cgh.2021.03.030 PMID: 33775896
pubmed: 33775896
pii: S1542-3565(21)00340-2
doi: 10.1016/j.cgh.2021.03.030
pii:
doi:

Substances chimiques

Infliximab B72HH48FLU
Adalimumab FYS6T7F842

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e711-e722

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Emma Calabrese (E)

Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome. Electronic address: emma.calabrese@uniroma2.it.

Antonio Rispo (A)

Gastroenterology, Department of Clinical Medicine and Surgery, Federico II, School of Medicine, Naples.

Francesca Zorzi (F)

Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome.

Elena De Cristofaro (E)

Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome.

Anna Testa (A)

Gastroenterology, Department of Clinical Medicine and Surgery, Federico II, School of Medicine, Naples.

Giuseppe Costantino (G)

Clinical Unit for Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina.

Anna Viola (A)

Clinical Unit for Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina.

Cristina Bezzio (C)

Gastroenterology Unit, ASST Rhodense, Rho Hospital, Rho.

Chiara Ricci (C)

Gastroenterology Unit, University and Spedali Civili of Brescia, Brescia.

Simonetta Prencipe (S)

Gastroenterology Unit, PO Barletta.

Chiara Racchini (C)

Santa Maria delle Croci Hospital, Ravenna.

Gianpiero Stefanelli (G)

Department of Life, Health and Environmental Sciences, Gastroenterology Unit, University of L'Aquila, L'Aquila.

Mariangela Allocca (M)

Humanitas Clinical and Research Center, Humanitas University, Department of Biomedical Sciences, Milan.

Salvatore Scotto di Santolo (S)

PSI Napoli Est ASL NA1 UO Gastroenterologia, Naples.

Mauro Valeriano D'Auria (MV)

Gastroenterology Unit "Umberto I" Hospital, Nocera Inferiore.

Paola Balestrieri (P)

Unit of Digestive Disease, Campus Bio Medico University of Rome, Rome.

Angelo Ricchiuti (A)

Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, Cisanello University Hospital of Pisa, Pisa.

Maria Cappello (M)

Gastroenterology and Hepatology Unit, AOU Policlinico "P. Giaccone", Palermo.

Flaminia Cavallaro (F)

Gastroenterology and Digestive Endoscopy, IRCCS Policlinico San Donato, San Donato Milanese, Milano.

Alessia Dalila Guarino (AD)

Gastroenterology, Department of Clinical Medicine and Surgery, Federico II, School of Medicine, Naples.

Giovanni Maconi (G)

Gastroenterology Unit, Department of Biomedical and Clinical Sciences, FBF-Sacco University Hospital, Milan.

Alessandra Spagnoli (A)

Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Rome.

Giovanni Monteleone (G)

Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome.

Fabiana Castiglione (F)

Gastroenterology, Department of Clinical Medicine and Surgery, Federico II, School of Medicine, Naples.

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Classifications MeSH

questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux humanisés › Adalimumab › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Thérapeutique › Biothérapie › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies inflammatoires intestinales › Maladie de Crohn › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Infliximab › Ultrasonography Tight Control and Monitoring...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Échographie › Ultrasonography Tight Control and Monitoring...