Su1517: IBD PATIENTS WITH EARLY CLINICAL AND SONOGRAPHIC IMPROVEMENTS ACHIEVE BETTER LONG-TERM OUTCOMES THAN PATIENTS WITH CLINICAL IMPROVEMENTS ALONE - ONE YEAR INTERIM RESULTS OF THE TRUST BEYOND STUDY

Kucharzik, Torsten; Helwig, Ulf; Seibold, Frank; Biedermann, Luc; Högenauer, Christoph; Fischer, Imma; Hammer, L; Kolterer, S; Rath, Stefan

doi:10.1016/s0016-5085(22)61439-2

Cited by 2 publications

(2 citation statements)

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“…63 In the TRUST BEYOND follow-up IUS study focused on biologics and JAK inhibitors (CD and UC), segmental improvement from pathological to normal BWT (TR) occurred in 30% within 12 weeks. 99 These findings are in line with another prospective international IUS trial on ustekinumab treatment in CD, where TR was more likely to occur in large bowel 25% (16 weeks) and 50% (48 weeks) versus small bowel 5% (16 weeks) and 13% (48 weeks), respectively. 77 In a very recent MRE study assessing both MaRIA and Clermont score without specifically examining TR, improvement was found to be most prominent within the first 12 weeks of treatment for ulcer healing, oedema, reduction of BWT, Comb sign, and even complications, although Clermont and MaRIA score continued to improve slightly till 52 weeks.…”

Section: Changes In Transmural Disease Activity With Medical Therapysupporting

confidence: 88%

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

Wilkens

Novak

Panaccione

et al. 2021

Therap Adv Gastroenterol

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Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.

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Section: Changes In Transmural Disease Activity With Medical Therapysupporting

confidence: 88%

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

Wilkens

Novak

Panaccione

et al. 2021

Therap Adv Gastroenterol

View full text Add to dashboard Cite

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“…Disease manifestations in the rectum are usually difficult to detect and to monitor by using transabdominal IUS. Transperineal ultrasonography has recently been shown to accurately determine disease activity of UC in the rectum and to follow up proctitis after treatment initiation (95).…”

Section: Intestinal Ultrasoundmentioning

confidence: 99%

Monitoring of patients with active inflammatory bowel disease

Kucharzik

Verstockt

2023

Front. Gastroenterol.

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In the current treat-to-target era, close and tight monitoring of patients with inflammatory bowel disease has become increasingly important. Although the importance of patient reported outcomes (PROMs) cannot be underestimated, its moderate association with biochemical and histo-endoscopic outcomes highlights the need for additional monitoring strategies. Endoscopic and histological remission are linked with improved long-term outcomes, but require more invasive assessments. Hence, non-invasive monitoring modalities are becoming increasingly relevant, with emerging evidence demonstrating the added clinical value of transmural assessment, both in Crohn’s disease and ulcerative colitis. The current review covers the multiple treatment targets present in IBD care, and focusses in particular on the increasing importance of intestinal ultrasound. Finally, we propose a potential algorithm to monitor patients with IBD in daily clinical practice and highlight gaps for future research in monitoring IBD strategies.

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Su1517: IBD PATIENTS WITH EARLY CLINICAL AND SONOGRAPHIC IMPROVEMENTS ACHIEVE BETTER LONG-TERM OUTCOMES THAN PATIENTS WITH CLINICAL IMPROVEMENTS ALONE - ONE YEAR INTERIM RESULTS OF THE TRUST BEYOND STUDY

Cited by 2 publications

References 0 publications

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

Monitoring of patients with active inflammatory bowel disease

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