Inflammatory bowel diseases · 2026
Early Intestinal Ultrasound Assessment Predicts Therapy Response: An Easy Tool for Clinical Decision-Making.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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De Cristofaro Elena, Zorzi Francesca, Colella Alice, Basile Luca, Castiglione Fabiana, Rispo Antonio, Testa Anna, Guarino Alessia Dalila, Lolli Elisabetta, Cuccagna Elisa, Monteleone Giovanni, Calabrese Emma
Аннотация
BACKGROUND: Transmural healing (TH) has emerged as a therapeutic target in Crohn's disease (CD), providing a more comprehensive indicator of deep remission than mucosal healing alone. Intestinal ultrasound (IUS) is a noninvasive method for assessing TH, but its prognostic value remains insufficiently defined.
OBJECTIVE: The aim of this prospective study was to evaluate whether early improvement in IUS parameters during biological therapy could predict TH at 12 months.
DESIGN: This is a prospective multicenter study enrolling CD patients initiating biological therapies. IUS and Doppler parameters were assessed at baseline, 3 months, and 12 months. Delta (Δ) represented the variation in ultrasound measurements between baseline and 3 months. TH was defined as normalization of bowel wall features and absence of hypervascularization.
RESULTS: A total of 142 CD patients were included. At 12 months, the TH rate was 19%, the IUS response rate was 44%. Patients achieving TH showed a significantly greater ΔBWT than nonresponders (P = .0004). On ROC analysis, a ΔBWT reduction of 1.25 mm predicted TH with 73% sensitivity and 61% specificity. IUS responders had a significantly greater ΔBWT than nonresponders (P < .0001), with the same threshold predicting response with 83% sensitivity and 57% specificity. Notably, the combination of ΔBWT and Limberg score improvement was strongly associated with both TH (OR 13.26; P < .0001) and IUS response (OR 20.9; P < .0001) at 12 months.
CONCLUSION: Early reduction in BWT, especially when combined with Limberg score, is a strong predictor of TH and IUS response at 12 months, supporting the use of early IUS monitoring in clinical practice.
OBJECTIVE: The aim of this prospective study was to evaluate whether early improvement in IUS parameters during biological therapy could predict TH at 12 months.
DESIGN: This is a prospective multicenter study enrolling CD patients initiating biological therapies. IUS and Doppler parameters were assessed at baseline, 3 months, and 12 months. Delta (Δ) represented the variation in ultrasound measurements between baseline and 3 months. TH was defined as normalization of bowel wall features and absence of hypervascularization.
RESULTS: A total of 142 CD patients were included. At 12 months, the TH rate was 19%, the IUS response rate was 44%. Patients achieving TH showed a significantly greater ΔBWT than nonresponders (P = .0004). On ROC analysis, a ΔBWT reduction of 1.25 mm predicted TH with 73% sensitivity and 61% specificity. IUS responders had a significantly greater ΔBWT than nonresponders (P < .0001), with the same threshold predicting response with 83% sensitivity and 57% specificity. Notably, the combination of ΔBWT and Limberg score improvement was strongly associated with both TH (OR 13.26; P < .0001) and IUS response (OR 20.9; P < .0001) at 12 months.
CONCLUSION: Early reduction in BWT, especially when combined with Limberg score, is a strong predictor of TH and IUS response at 12 months, supporting the use of early IUS monitoring in clinical practice.