P706 Monitoring asymptomatic patients with Crohn's disease: the role of intestinal ultrasound Article Swipe
Nikolas Dussias
,
Laura Melotti
,
Elena Mazzotta
,
A Decorato
,
Nicholas Vanigli
,
Fernando Rizzello
,
Paolo Gionchetti
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjac190.0836
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjac190.0836
Background Intestinal Ultrasound (IUS) is a non-invasive, widely available technique that can rapidly evaluate bowel wall thickness and provide direct visualization of bowel vascularisation and motility. Studies have shown high concordance between ultrasound and MR enterography and endoscopy for disease location and activity, and fewer technical difficulties associated with IUS. While more is known about the role of IUS in evaluating response to pharmacologic treatment in CD patients, data regarding the monitoring of asymptomatic patients are scarce. Our objective was to study the impact of IUS in the management of patients with CD in stable clinical remission in a real-world setting. Methods We conducted a retrospective, monocentric observational study in patients with CD in clinical remission (Harvey Bradshaw Index ≤ 4), not in treatment with immunomodulators/immunosuppressants, in whom annual monitoring via IUS was performed. Biochemical data including C-reactive protein (CRP) and relevant ultrasound parameters (bowel wall thickness, extension and vascularization via Limberg score) were recorded. Changes in treatment or the need for second-level diagnostic tests based on ultrasound findings were registered along with outcomes at 1 year follow-up. Results A total of 201 patients with CD underwent IUS at our center between March and May 2021. Of these, 86 were in clinical remission with mesalazine treatment/no treatment. In 49/86 (57%) of cases, significant ultrasound findings were reported. In 27/49 cases, ultrasound findings led to a treatment modification or a second-level diagnostic test. Specifically, 12 patients were started on a course of oral budesonide or metronidazole; of these, 6 were in remission at 1 year follow-up, 3 patients required surgery within 1 year, and 2 experienced a disease flare treated with a second course of budesonide. Of the 15 patients in which a second-level diagnostic test was performed, in 12 cases disease activity was confirmed: 6 were started on a course of budesonide or metronidazole with persistent clinical remission at 1 year, 2 were started on biologics, and 4 developed complications during the follow-up period and were referred for surgery. In the remaining 3 cases, the second level diagnostic test excluded active disease and the patients maintained clinical remission at 1 year follow-up. Conclusion The results of this study demonstrate how IUS can be a useful tool that can modify treatment strategies and stratify patients requiring more invasive second-level diagnostic exams, with the objective of reducing clinical relapses. Prospective, randomized studies with large cohorts are needed to confirm these findings.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ecco-jcc/jjac190.0836
- https://academic.oup.com/ecco-jcc/article-pdf/17/Supplement_1/i837/48954152/jjac190.0836.pdf
- OA Status
- bronze
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4318578781
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4318578781Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ecco-jcc/jjac190.0836Digital Object Identifier
- Title
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P706 Monitoring asymptomatic patients with Crohn's disease: the role of intestinal ultrasoundWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
-
2023-01-30Full publication date if available
- Authors
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Nikolas Dussias, Laura Melotti, Elena Mazzotta, A Decorato, Nicholas Vanigli, Fernando Rizzello, Paolo GionchettiList of authors in order
- Landing page
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https://doi.org/10.1093/ecco-jcc/jjac190.0836Publisher landing page
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https://academic.oup.com/ecco-jcc/article-pdf/17/Supplement_1/i837/48954152/jjac190.0836.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/ecco-jcc/article-pdf/17/Supplement_1/i837/48954152/jjac190.0836.pdfDirect OA link when available
- Concepts
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Medicine, Asymptomatic, Ultrasound, Mesalazine, Internal medicine, Gastroenterology, Concordance, Observational study, Budesonide, Inflammatory bowel disease, Radiology, Disease, Surgery, CorticosteroidTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1Per-year citation counts (last 5 years)
- Related works (count)
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10Other works algorithmically related by OpenAlex
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