Crohn's & Colitis 360Pub Date : 2023-09-21eCollection Date: 2023-10-01DOI: 10.1093/crocol/otad050
Joëlle St-Pierre, Maxime Delisle, Hengameh Kheirkhahrahimabadi, Thomas M Goodsall, Robert V Bryant, Britt Christensen, Rose Vaughan, Aysha Al-Ani, Richard J M Ingram, Joan Heatherington, Dan Carter, Cathy Lu, Christopher Ma, Kerri L Novak
{"title":"Bedside Intestinal Ultrasound Performed in an Inflammatory Bowel Disease Urgent Assessment Clinic Improves Clinical Decision-Making and Resource Utilization.","authors":"Joëlle St-Pierre, Maxime Delisle, Hengameh Kheirkhahrahimabadi, Thomas M Goodsall, Robert V Bryant, Britt Christensen, Rose Vaughan, Aysha Al-Ani, Richard J M Ingram, Joan Heatherington, Dan Carter, Cathy Lu, Christopher Ma, Kerri L Novak","doi":"10.1093/crocol/otad050","DOIUrl":"10.1093/crocol/otad050","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) require accessible, timely, and noninvasive strategies to monitor disease. The aim was to assess the integration of intestinal ultrasound (IUS) on decision-making and endoscopy utilization in a standardized care pathway.</p><p><strong>Methods: </strong>This prospective, multicenter, international, observational cohort study included patients seen within a centralized model for IBD care was conducted during the COVID pandemic. Patients were evaluated with IUS alone or in combination with an in-clinic, unsedated sigmoidoscopy. Demographic, clinical, laboratory, and imaging data, clinical decisions, and need for urgent endoscopy, hospitalization, and surgeries were recorded.</p><p><strong>Results: </strong>Of the 158 patients included, the majority had an established diagnosis of Crohn's disease (<i>n</i> = 123, 78%), and 47% (<i>n</i> = 75) of patients were on biologic therapy. IUS identified active inflammation in 65% (<i>n</i> = 102) of patients, and strictures in 14% (<i>n</i> = 22). Fecal calprotectin levels correlated with inflammation detected on IUS (median of 50 μg/g [Q1-Q3: 26-107 μg/g] without inflammation and 270 μg/g [Q1-Q3: 61-556 μg/g] with inflammation; <i>p</i> = 0.0271). In the majority of patients, clinical assessment with IUS led to an acute change in IBD-specific medications (57%, <i>n</i> = 90) and avoided or delayed the need for urgent endoscopy (85%, <i>n</i> = 134). Four patients were referred for urgent surgical consultation.</p><p><strong>Conclusions: </strong>Point-of-care IUS used in a flare clinic pathway is a useful strategy to improve effective IBD care delivery and to assist in therapeutic management decisions, in many cases avoiding the acute need for endoscopy.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10558199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-09-18eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad049
{"title":"Correction to: Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn's Disease Might Be Associated With Increased Rates of Stoma Construction.","authors":"","doi":"10.1093/crocol/otad049","DOIUrl":"https://doi.org/10.1093/crocol/otad049","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/crocol/otad038.].</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/1f/otad049.PMC10506167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-09-18eCollection Date: 2023-10-01DOI: 10.1093/crocol/otad051
Tia Goss Sawhney, Angela Dobes, Sirimon O'Charoen
{"title":"Real-World Persistency for Inflammatory Bowel Disease Biologics Using Patient Registry Data.","authors":"Tia Goss Sawhney, Angela Dobes, Sirimon O'Charoen","doi":"10.1093/crocol/otad051","DOIUrl":"10.1093/crocol/otad051","url":null,"abstract":"<p><strong>Background: </strong>Although it is a truism that drugs benefit patients only when taken, surprisingly little is known about real-world drug-use persistence and discontinuation, even for expensive biologic drugs.</p><p><strong>Methods: </strong>We used longitudinal self-reported drug-use data from the inflammatory bowel disease (IBD) Partners registry of people with IBD to construct Kaplan-Meier drug-use persistency graphs for biologic drug-use spans that started between 2017 and 2022.</p><p><strong>Results: </strong>We examined 2034 drug-use spans for 1594 survey participants. Most of the biologic drugs had a 75%+ persistency rate around the one-year mark and 60%+ persistency at the 3-year mark. The overall persistency and the differences in persistency between drugs were aligned with published literature.</p><p><strong>Conclusions: </strong>This analysis demonstrates the feasibility of collecting IBD-specific patient-reported drug persistency data via a voluntary patient registry. Patient-reported persistency provides real-world drug persistency data and the patient's perspectives as to why they discontinued use of the drug-a combination of data and perspective that is not available from any other real-world medical record, claim, and pharmacy data source that are valuable to physician, patients, payers, healthcare policymakers, and health technology assessment organizations.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-08-26eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad046
Sang Hyoung Park
{"title":"Golimumab for Ulcerative Colitis: One More Option to SAVE the Colon.","authors":"Sang Hyoung Park","doi":"10.1093/crocol/otad046","DOIUrl":"10.1093/crocol/otad046","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492443/pdf/otad046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-08-17eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad034
William J Sandborn, Jingjing Chen, Krisztina Kisfalvi, Edward V Loftus, Geert D'Haens, Ninfa Candela, Karen Lasch, Douglas C Wolf, Sharif M Uddin, Silvio Danese
{"title":"Practical Primer Addressing Real-World Use Scenarios of Subcutaneous Vedolizumab in Ulcerative Colitis and Crohn's Disease: Post Hoc Analyses of VISIBLE Studies.","authors":"William J Sandborn, Jingjing Chen, Krisztina Kisfalvi, Edward V Loftus, Geert D'Haens, Ninfa Candela, Karen Lasch, Douglas C Wolf, Sharif M Uddin, Silvio Danese","doi":"10.1093/crocol/otad034","DOIUrl":"10.1093/crocol/otad034","url":null,"abstract":"<p><strong>Background: </strong>Vedolizumab, an anti-α<sub>4</sub>β<sub>7</sub> integrin approved for intravenous (IV) treatment of moderately to severely active ulcerative colitis (UC) and Crohn's disease (CD), was evaluated as a subcutaneous (SC) formulation in maintenance therapy for UC and CD in phase 3 VISIBLE 1, 2, and open-label extension studies, and recently approved in Europe, Australia, and Canada. Our aim was to evaluate efficacy and safety of IV and SC vedolizumab in clinically relevant UC and CD scenarios.</p><p><strong>Methods: </strong>Post hoc data analyses from VISIBLE trials examined: (1) whether baseline characteristics predict clinical response to 2 vs 3 IV vedolizumab induction doses; (2) efficacy and safety of switching during maintenance vedolizumab IV to SC in patients with UC; (3) vedolizumab SC after treatment interruption of 1-46 weeks; (4) increasing dose frequency of vedolizumab SC from every 2 weeks (Q2W) to every week (QW) after disease worsening.</p><p><strong>Results: </strong>No baseline characteristics were identified as strong predictors of response to 2 vs 3 vedolizumab infusions. Most patients achieved clinical response after 2 or 3 doses of IV vedolizumab maintained with SC treatment. Clinical remission and response rates were maintained in patients transitioned from maintenance vedolizumab IV to SC treatment. Of patients with UC, ≥75% achieved response following resumption after dose interruption. Escalation to QW dosing resulted in ≥45% of patients regaining response after loss while receiving vedolizumab Q2W.</p><p><strong>Conclusions: </strong>Clinical real-world scenarios with vedolizumab SC were reviewed using VISIBLE studies data. Vedolizumab SC provides an additional dosing option for patients with UC and CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-08-07eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad043
Bincy P Abraham, Dheeraj Reddy, Adam Saleh
{"title":"Integrating Intestinal Ultrasound into an Inflammatory Bowel Disease Practice: How to Get Started.","authors":"Bincy P Abraham, Dheeraj Reddy, Adam Saleh","doi":"10.1093/crocol/otad043","DOIUrl":"10.1093/crocol/otad043","url":null,"abstract":"<p><p>Intestinal ultrasound (IUS) offers a safe, noninvasive, point-of-care tool for diagnosing and monitoring disease activity in patients with inflammatory bowel disease (IBD). IUS is used widely in Europe and Canada for IBD, but it remains underutilized in the United States. Growing interest in IUS in the United States has prompted many IBD centers to train their faculty in IUS. This, however, raises questions about how to effectively use this new tool in the United States, which does not use a social medicine model like those implemented in Europe and Canada. Here, we provide a practical framework for incorporating IUS in an IBD practice in the United States, including training requirements, equipment, and protocols for implementing IUS in daily practice.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/fd/otad043.PMC10500970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10635107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-07-27eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad039
Edward L Barnes, Poonam Beniwal-Patel, Parakkal Deepak, Laura Raffals, Maia Kayal, Marla Dubinsky, Shannon Chang, Peter D R Higgins, Jennifer I Barr, Chelsea Anderson, Raymond K Cross, Millie D Long, Hans H Herfarth
{"title":"Dietary Patterns Are Not Associated With Disease Activity Among Patients With Inflammatory Conditions of the Pouch in a Prospective Cohort.","authors":"Edward L Barnes, Poonam Beniwal-Patel, Parakkal Deepak, Laura Raffals, Maia Kayal, Marla Dubinsky, Shannon Chang, Peter D R Higgins, Jennifer I Barr, Chelsea Anderson, Raymond K Cross, Millie D Long, Hans H Herfarth","doi":"10.1093/crocol/otad039","DOIUrl":"10.1093/crocol/otad039","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based recommendations regarding the influence of diet on inflammatory conditions of the pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are limited.</p><p><strong>Methods: </strong>We analyzed dietary patterns at enrollment in a prospective registry of patients with 1 of 4 inflammatory conditions of the pouch (acute pouchitis, chronic antibiotic-dependent pouchitis, chronic antibiotic refractory pouchitis, and Crohn's disease of the pouch). We analyzed dietary intake by disease activity at enrollment and then compared dietary patterns among patients who remained in remission throughout the 12-month follow-up to those patients who experienced a disease relapse. We also compared dietary patterns among patients with inflammatory conditions of the pouch to the United States Department of Agriculture (USDA) recommended daily goals.</p><p><strong>Results: </strong>Among 308 patients, there were no differences in dietary patterns among patients with 1 of the 4 disease states at enrollment. Additionally, among the 102 patients in remission at baseline, there were no significant differences noted among patients who went on to experience a disease flare in the 12 months after enrollment compared to those patients who remained in remission. However, patients with inflammatory conditions of the pouch demonstrated decreased intake of several food groups and macronutrients including dairy, fruits, vegetables, whole grains, and fiber when compared to USDA recommendations.</p><p><strong>Conclusions: </strong>In a prospective cohort, we demonstrated no impact of dietary patterns on disease activity. The relative deficiencies in several food groups and macronutrients among patients after IPAA indicate the potential role of targeted nutritional counseling in this population.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/3f/otad039.PMC10374273.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-07-25eCollection Date: 2023-10-01DOI: 10.1093/crocol/otad040
Karin Cerna, Dana Duricova, Martin Lukas, Martin Kolar, Nadezda Machkova, Veronika Hruba, Katarina Mitrova, Kristyna Kubickova, Marta Kostrejova, Jakub Jirsa, Kristyna Kastylova, Stepan Peterka, Gabriela Vojtechova, Milan Lukas
{"title":"Subcutaneous Infliximab in Refractory Crohn's Disease Patients: A Possible Biobetter?","authors":"Karin Cerna, Dana Duricova, Martin Lukas, Martin Kolar, Nadezda Machkova, Veronika Hruba, Katarina Mitrova, Kristyna Kubickova, Marta Kostrejova, Jakub Jirsa, Kristyna Kastylova, Stepan Peterka, Gabriela Vojtechova, Milan Lukas","doi":"10.1093/crocol/otad040","DOIUrl":"10.1093/crocol/otad040","url":null,"abstract":"<p><strong>Background: </strong>A subcutaneous formulation of infliximab (IFX-SC) approved to treat patients with inflammatory bowel disease may offer improved efficacy versus intravenous infliximab.</p><p><strong>Methods: </strong>Patients with refractory Crohn's disease (CD, <i>n</i> = 32) previously treated unsuccessfully with at least 2 biologics were treated with IFX-SC and followed from baseline at Week 0 (W0) to Week 30 (W30). The study's primary endpoint was the treatment's persistence at W30, while secondary goals included the analysis of serum infliximab trough levels (TL IFX), dynamics of anti-IFX antibodies (ATIs), and clinical, serum and fecal markers of CD activity during IFX-SC treatment.</p><p><strong>Results: </strong>Midterm treatment persistence with the continuation of treatment after W30 was 53%. TL IFX median values showed rapid, significant upward dynamics and exceeded 15.5 μg/mL at W30, whereas median ATI levels significantly declined. Among ATI-negative patients at W0 (<i>n</i> = 15), only one showed IFX immunogenicity with newly developed ATIs at W30. Among ATI-positive patients at W0, ATI seroconversion from ATI-positive to ATI-negative status was observed in 10 of 17 patients (58.8%). Patients who had continued IFX-SC treatment at W30 showed significant decreases in C-reactive protein (<i>P</i> = .0341), fecal calprotectin (<i>P</i> = .0002), and Harvey-Bradshaw index (<i>P =</i> .0029) since W0.</p><p><strong>Conclusions: </strong>Patients with refractory CD previously treated with at least 2 biologics exhibited clinically relevant improvement with IFX-SC, which showed less immunogenic potential than IFX-IV and highly stable TL IFX.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85085579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-07-19eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad038
Alaa El-Hussuna, Casper Steenholdt, Mette Louise Merrild Karer, Natasja Nyggard Uldall Nielsen, Angela Mujukian, Phillip R Fleshner, Igors Iesalnieks, Nir Horesh, Uri Kopylov, Harel Jacoby, Haider Mahmoud Al-Qaisi, Francesco Colombo, Gianluca M Sampietro, Marco V Marino, Mark Ellebæk, Nina Sørensen, Valerio Celentano, Nikhil Ladwa, Janindra Warusavitarne, Gianluca Pellino, Aurang Zeb, Francesca Di Candido, Luis Hurtado-Pardo, Matteo Frasson, Lumir Kunovsky, Ali Yalcinkaya, Sandra Alonso, Miguel Pera, Cristina Antón Rodríguez, Ana-Minaya Bravo, Alvaro Garcia Granero, Ozan Can Tatar, Antonino Spinelli, Niels Qvist
{"title":"Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn's Disease Might Be Associated With Increased Rates of Stoma Construction.","authors":"Alaa El-Hussuna, Casper Steenholdt, Mette Louise Merrild Karer, Natasja Nyggard Uldall Nielsen, Angela Mujukian, Phillip R Fleshner, Igors Iesalnieks, Nir Horesh, Uri Kopylov, Harel Jacoby, Haider Mahmoud Al-Qaisi, Francesco Colombo, Gianluca M Sampietro, Marco V Marino, Mark Ellebæk, Nina Sørensen, Valerio Celentano, Nikhil Ladwa, Janindra Warusavitarne, Gianluca Pellino, Aurang Zeb, Francesca Di Candido, Luis Hurtado-Pardo, Matteo Frasson, Lumir Kunovsky, Ali Yalcinkaya, Sandra Alonso, Miguel Pera, Cristina Antón Rodríguez, Ana-Minaya Bravo, Alvaro Garcia Granero, Ozan Can Tatar, Antonino Spinelli, Niels Qvist","doi":"10.1093/crocol/otad038","DOIUrl":"10.1093/crocol/otad038","url":null,"abstract":"<p><strong>Background: </strong>Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated.</p><p><strong>Methods: </strong>This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers.</p><p><strong>Results: </strong>Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (<i>P</i> < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (<i>P</i> = .07).</p><p><strong>Conclusions: </strong>Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/98/otad038.PMC10460196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2023-07-14eCollection Date: 2023-07-01DOI: 10.1093/crocol/otad037
Jill K J Gaidos, Badr Al Bawardy, Francis A Farraye, Miguel Regueiro
{"title":"Use of Standardized Inflammatory Bowel Disease Endoscopy Scores in Clinical Practice.","authors":"Jill K J Gaidos, Badr Al Bawardy, Francis A Farraye, Miguel Regueiro","doi":"10.1093/crocol/otad037","DOIUrl":"10.1093/crocol/otad037","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) treatment targets include mucosal healing based on standardized endoscopic scoring systems. The rates and ease of use of these scoring systems in practice have not been well described. We aimed to assess the rates and factors associated with the use of IBD endoscopic scoring systems in practice from IBD LIVE attendees.</p><p><strong>Methods: </strong>IBD Live is an international case-based conference focusing on the management of patients with IBD. We created a web-based survey consisting of 38 questions on the frequency and ease of use of various IBD endoscopic scores. This survey was emailed to the IBD Live listserv in March 2022 with a second email sent 14 days later. We included only respondents who are currently performing endoscopy. Continuous variables were analyzed using an unpaired student's <i>t</i>-test. Categorical variables were analyzed using Pearson's chi-square test.</p><p><strong>Results: </strong>There were 65 responses out of 170 (38.2% response rate) regular attendees. Eleven responses were excluded (4 with no response on the use of endoscopy scores, and 7 were not performing endoscopy). Of the respondents, 72.2% are from the United States, 70.4% are adult gastroenterologists, 53.9% in academic practice, and 40.7% in practice for ≥15 years. Of the endoscopy scores used ≥50% of the time, 74.1% were using the Mayo Endoscopic Subscore (MES), 72.3% using the Rutgeerts Score, 61.2% using the Simple Endoscopic Score for Crohn's Disease, and 28.6% using the Pouchitis Disease Activity Index. Attending IBD LIVE ≥ monthly (<i>P</i> = .028), attending an IBD conference at least every 2 years (<i>P</i> = .020), and having the scoring system incorporated into the endoscopy documentation software (<i>P</i> = .002) were associated with more consistent use of the MES. Attending IBD Live at least monthly (<i>P</i> = .026), having an IBD volume of ≥50% (<i>P</i> = .011), and attending an IBD conference at least every 2 years (<i>P</i> = .004) was associated with more frequent use of the Rutgeerts score. There were no factors that increased the use of other endoscopic scores.</p><p><strong>Conclusions: </strong>The MES and the Rutgeerts score are more commonly used with much lower rates of use of endoscopic scores for Crohn's disease and pouchitis. The use of these endoscopy scores is more common among those who regularly attend IBD conferences, have higher volume IBD practices, and have these scoring systems incorporated into endoscopy software. Further evaluation of barriers to use and ways to improve utilization of endoscopic scoring for Crohn's disease and pouchitis is needed.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/73/otad037.PMC10407976.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}