Intestinal Ultrasound’s Value for Assessing Disease Activity in IBD, with Noa Krugliak Cleveland, MD

Findings from research presented at Digestive Disease Week (DDW) 2024 are providing clinicians with an overview of the value of intestinal ultrasound for assessing disease activity in inflammatory bowel disease (IBD), calling attention to its benefit for treatment change and remission compared to conventional approaches to disease monitoring.

“[Intestinal ultrasound] can be utilized at every stage of disease management anywhere from diagnosis ruling on inflammatory bowel disease, characterizing disease extent, severity, even prognosis, and of course, for monitoring response,” Noa Krugliak Cleveland, MD, Assistant Professor of Medicine in the section of gastroenterology at the University of Chicago, explained to HCPLive.

She and a team of colleagues conducted a retrospective analysis including patients who completed induction therapy but had active disease as measured by simple clinical colitis activity index (SCCAI) >2 or Harvey-Bradshaw Index (HBI) >4 between October 2021 and October 2023 to assess time to treatment change, defined as time from a positive clinical index to the time of a medical decision made, and time to clinical remission, defined as time from a positive clinical index to the time of normalization (SCCAI ≤2, HBI ≤4 of the clinical index). Investigators compared results between patients monitored by intestinal ultrasound and those managed with a conventional approach, matched by provider and disease type.

Among a total of 54 patients (63 encounters), 33 were in the intestinal ultrasound cohort and 30 were in the conventional management cohort. In the intestinal ultrasound group, the average time to treatment change was 2.2 (±1.2) days compared to 25.6 (±14.5) days for conventional management (P = .050).

A total of 44 patients achieved clinical remission, including 22 patients from the intestinal ultrasound group and 22 from the conventional management group. However, the average time to remission was much shorter with intestinal ultrasound (128.1 ±22.3 days) compared to conventional management (230.6 ±38.2 days; P = .035). Investigators noted drug class did not affect time to treatment change or time to remission and the most significant reason for delay in the conventional group was awaiting endoscopy and fecal calprotectin results.

“The sky's the limit, we have so many questions,” Cleveland said. “It’s just how do you prioritize and where to start.”

References:

1. ^{Krugliak Cleveland N, Picker E, Choi N, et al. MONITORING IBD BY INTESTINAL ULTRASOUND DECREASES TIME TO TREATMENT CHANGE AND TIME TO REMISSION IN COMPARISON TO CONVENTIONAL MANAGEMENT: ANALYSIS OF PATIENTS WITH IBD ON MULTIPLE IBD THERAPIES. Abstract presented at Digestive Disease Week 2024, May 18 - 21, 2024.}