TY - JOUR

T1 - Defining transabdominal Intestinal Ultrasound treatment response and remission in Inflammatory Bowel Disease

T2 - Systematic review and expert consensus statement

AU - Ilvemark, Johan F K F

AU - Hansen, Tawnya

AU - Goodsall, Thomas M

AU - Seidelin, Jakob B

AU - Al-Farhan, Heba

AU - Allocca, Mariangela

AU - Begun, Jakob

AU - Bryant, Robert V

AU - Carter, Dan

AU - Christensen, Britt

AU - Dubinsky, Marla C

AU - Gecse, Krisztina B

AU - Kucharzik, Torsten

AU - Lu, Cathy

AU - Maaser, Christian

AU - Maconi, Giovanni

AU - Nylund, Kim

AU - Palmela, Carolina

AU - Wilson, Stephanie R

AU - Novak, Kerri

AU - Wilkens, Rune

N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.

PY - 2022

Y1 - 2022

N2 - BACKGROUND AND AIMS: No consensus exists on defining intestinal ultrasound response, transmural healing, or transmural remission in inflammatory bowel disease, nor clear guidance for optimal timing of assessment during treatment. This systematic review and expert consensus study aimed to define such recommendations, along with key parameters included in response reporting.METHODS: Electronic databases were searched from inception to July 26, 2021, using pre-defined terms. Studies were eligible if at least two intestinal ultrasound assessments at different time points during treatment were reported, along with an appropriate reference standard. The QUADAS-2 tool was used to examine study-level risk of bias. An international panel of experts (n=18) rated an initial 196 statements (RAND/UCLA process, scale 1-9). Two videoconferences were conducted, resulting in additional ratings of 149 and 13 statements, respectively.RESULTS: Out of 5826 records, 31 full-text articles, 16 abstracts, and one research letter were included. 83% (40/48) of included studies showed a low concern of applicability, while 96% (46/48) had a high risk of bias. A consensus was reached on 41 statements, with clear definitions of IUS treatment response, transmural healing, transmural remission, timing of assessment, and general considerations when using intestinal ultrasound in inflammatory bowel disease.CONCLUSIONS: Response criteria and time-points of response assessment varied between studies complicating direct comparison of parameter changes and their relation to treatment outcomes. To ensure a unified approach in routine care and clinical trials, we provide recommendations and definitions for key parameters for intestinal ultrasound response to incorporate into future prospective studies.

AB - BACKGROUND AND AIMS: No consensus exists on defining intestinal ultrasound response, transmural healing, or transmural remission in inflammatory bowel disease, nor clear guidance for optimal timing of assessment during treatment. This systematic review and expert consensus study aimed to define such recommendations, along with key parameters included in response reporting.METHODS: Electronic databases were searched from inception to July 26, 2021, using pre-defined terms. Studies were eligible if at least two intestinal ultrasound assessments at different time points during treatment were reported, along with an appropriate reference standard. The QUADAS-2 tool was used to examine study-level risk of bias. An international panel of experts (n=18) rated an initial 196 statements (RAND/UCLA process, scale 1-9). Two videoconferences were conducted, resulting in additional ratings of 149 and 13 statements, respectively.RESULTS: Out of 5826 records, 31 full-text articles, 16 abstracts, and one research letter were included. 83% (40/48) of included studies showed a low concern of applicability, while 96% (46/48) had a high risk of bias. A consensus was reached on 41 statements, with clear definitions of IUS treatment response, transmural healing, transmural remission, timing of assessment, and general considerations when using intestinal ultrasound in inflammatory bowel disease.CONCLUSIONS: Response criteria and time-points of response assessment varied between studies complicating direct comparison of parameter changes and their relation to treatment outcomes. To ensure a unified approach in routine care and clinical trials, we provide recommendations and definitions for key parameters for intestinal ultrasound response to incorporate into future prospective studies.

U2 - 10.1093/ecco-jcc/jjab173

DO - 10.1093/ecco-jcc/jjab173

M3 - Review

C2 - 34614172

VL - 16

SP - 554

EP - 580

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 4

ER -