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    Home > Active Ingredient News > Digestive System Information > IBD: Intestinal ultrasound assessment of intestinal behavior predicts early response to anti-TNF therapy in patients with Crohn's disease

    IBD: Intestinal ultrasound assessment of intestinal behavior predicts early response to anti-TNF therapy in patients with Crohn's disease

    • Last Update: 2022-01-22
    • Source: Internet
    • Author: User
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    Anti-tumor necrosis factor (TNF)-α drugs, such as infliximab, are widely used to treat CD patients, especially those with frequent relapses, severe disease activity, and poor prognosis
    .
    However, up to 40% of patients do not respond to anti-TNF-α drugs, and about 10% have adverse drug reactions that interfere with treatment
    .
    Therefore, predicting and monitoring response to anti-TNF-α therapy is crucial in the era of "tight control" and "prescribed medicine" strategies

    .
    There are several findings that suggest that C-reactive protein, fecal calprotectin, mucosal changes, and transmural lesions assessed by cross-sectional imaging are associated with treatment outcomes in CD patients receiving antineoplastic drugs

    .
    Endoscopy is the gold standard for evaluating the efficacy of CD patients within 3-6 months of treatment with antineoplastic drugs

    .
    Given that frequent endoscopic assessments during short-term follow-up are not feasible due to their invasiveness, there is a clinical need for an alternative objective, easily reproducible, but noninvasive assessment method

    .

    Anti-tumor necrosis factor (TNF)-α drugs, such as infliximab, are widely used to treat CD patients, especially those with frequent relapses, severe disease activity, and poor prognosis
    .

    As a cross-sectional imaging modality for CD, bowel ultrasonography has been recommended and has been widely used to assess changes in the bowel in CD
    .
    Previous studies have demonstrated that shear wave elastography (SWE) is a feasible and accurate ultrasound elastography modality for noninvasive quantitative analysis of intestinal fibrosis in CD patients

    .
    The degree of fibrosis has been reported to affect the therapeutic effect of antitumor drugs

    .
    Therefore, SWE may help predict early response to anti-TNF therapy and may be an indicator of improvement in intestinal fibrosis

    .
    Therefore, this study aimed to investigate (a) changes in intestinal behavior in CD patients receiving anti-TNF therapy by ultrasound; (b) the feasibility of shear wave elastography (SWE) in predicting early response to anti-TNF therapy

    .

     

    We included patients with ileal or ileocolonic CD who received anti-TNF therapy
    .
    All patients underwent bowel ultrasonography at baseline and at weeks 2, 6, and 14

    .
    Changes in bowel wall thickness, bowel wall Doppler signal (Limberg score), and SWE values ​​were compared using linear mixed models

    .
    The primary outcome measure was early response to anti-TNF therapy and was based on clinical and colonoscopy findings at Week 14

    .

     

    Twenty of the 30 patients included in this study responded to anti-TNF therapy at week 14
    .
    Compared with the non-responder group, the intestinal wall thickness and SWE value of the responder group showed a significant downward trend (P = 0.
    003)

    .
    Compared with baseline, bowel wall thickness, Limberg score, and SWE values ​​were significantly lower in the responder group as early as week 2 (P < 0.
    001)

    .
    Baseline SWE values ​​(21.
    3±8.
    7 vs.
    15.
    3±4.
    7 kPa, P=0.
    022) and bowel wall thickness (8.
    5±2.
    3 vs.
    6.
    9±1.
    5 mm, P=0.
    027) were significantly higher in the non-responder group than in the responder group

    .

    Figure: B-ultrasound showing intestinal lesions

     

    This study conclusively demonstrated that changes in intestinal ultrasound behavior can be assessed as early as 2 weeks after initiation of anti-TNF therapy, and that early response to anti-TNF therapy can be predicted by intestinal ultrasound and elastography
    .

    This study conclusively demonstrated that changes in intestinal ultrasound behavior can be assessed as early as 2 weeks after initiation of anti-TNF therapy, and that early response to anti-TNF therapy can be predicted by intestinal ultrasound and elastography
    .

    Original source:

    Yu-Jun Chen.
    Et al.
    Longitudinal Bowel Behavior Assessed by Bowel Ultrasound to Predict Early Response to Anti-TNF Therapy in Patients with Crohn's Disease: A Pilot Study.
    Inflammatory Bowel Diseases.
    2021.

    Longitudinal Bowel Behavior Assessed by Bowel Ultrasound to Predict Early Response to Anti-TNF Therapy in Patients with Crohn's Disease: A Pilot Study.


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