TY - JOUR
T1 - Defining Transabdominal Intestinal Ultrasound Treatment Response and Remission in Inflammatory Bowel Disease
T2 - Systematic Review and Expert Consensus Statement
AU - International Bowel Ultrasound [IBUS] Group
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 - Publisher Copyright:
© 2021 The Author(s).
PY - 2022/4/1
Y1 - 2022/4/1
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 [IUS] 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, and 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 [IUS] 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, and 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.
KW - Intestinal ultrasound
KW - inflammatory bowel disease
KW - transmural healing
KW - transmural remission
KW - treatment response
UR - http://www.scopus.com/inward/record.url?scp=85130002217&partnerID=8YFLogxK
U2 - 10.1093/ecco-jcc/jjab173
DO - 10.1093/ecco-jcc/jjab173
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C2 - 34614172
AN - SCOPUS:85130002217
SN - 1873-9946
VL - 16
SP - 554
EP - 580
JO - Journal of Crohn's and Colitis
JF - Journal of Crohn's and Colitis
IS - 4
ER -