Determining the usefulness of Capsule Scoring of Ulcerative Colitis in predicting relapse of inactive ulcerative colitis

Abstract

Background and Aim: The usefulness of second-generation colon capsule endoscopy (CCE2) in ulcerative colitis (UC), especially in clinically inactive patients, has been reported. Capsule Scoring of Ulcerative Colitis (CSUC) was developed as a severity index for UC. We aimed to determine whether CSUC is useful for predicting relapse during clinical remission. Methods: Forty-one UC patients in clinical remission who underwent CCE2 were prospectively registered from April 2016 to August 2019. Patients' CSUC score was obtained; those with subsequent relapse were followed up retrospectively. The correlation of CSUC with white blood cell count, platelet count, albumin, C-reactive protein, fecal calprotectin and fecal lactoferrin levels, and fecal immunochemical test results was evaluated; their predictive values for future relapse were compared. Results: The correlations of CSUC with white blood cell, platelet, albumin, C-reactive protein, fecal calprotectin, fecal immunochemical test, and fecal lactoferrin values were r s = 0.13, 0.27, À0.25, 0.15, 0.50, 0.43, and 0.50, respectively. CSUC was higher in 12 patients who relapsed within 1 year than in 29 patients who remained in clinical remission (2.83 ± 1.95 vs 0.72 ± 1.00, P < 0.01). Receiver operator characteristic curve analysis showed that CSUC ≥ 1 was a predictor of relapse (area under the curve of 0.82, sensitivity of 83.3%, specificity of 58.6%) and maybe superior to fecal biomarkers. In the univariate analysis, patients with CSUC of 0 had a lower relapse rate than those with CSUC of ≧ 1 (P = 0.03, log-rank test). After analyzing patients who underwent CCE2 within 6 months after the successful induction treatment, results showed that those with CSUC of ≤ 1 remained in clinical remission for a year. Conclusion: CSUC predicts relapse within 1 year in UC patients in clinical remission, especially when used 6 months after induction treatment.

The Entire Intestinal Tract Surveillance Using Capsule Endoscopy after Immune Checkpoint Inhibitor Administration: A Prospective Observational Study

“…The present study also suggested that CSUC, which had been developed for evaluating the severity of ulcerative colitis, could be useful for assessing the development of ICI-induced enterocolitis. Matsubayashi et al reported that a CSUC of ≥1 was significantly associated with the relapse of ulcerative colitis [ 44 ]. Despite the limited number of patients included herein, our result showed that those who developed ICI-induced colitis had significantly higher CSUC than those who did not.…”

Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

“…The correlation coefficients of CSUC with biomarkers and clinical score were similar to those of the UCEIS. A prospective study in 41 UC patients in clinical remission who underwent CCE-2 showed that the CSUC was significantly higher in the 12 patients who relapsed within 1 year than in the 29 patients who remained in clinical remission (2.83 ± 1.95 vs. 0.72 ± 1.00; p < 0.01) [ 103 ]. Moreover, CSUC ≥ 1 was found to be prognostic of relapse, with a sensitivity of 83.3%, a specificity of 58.6%, and an accuracy of 0.82, and to be superior to the prognostic ability of fecal biomarkers [ 103 ].…”

“…A prospective study in 41 UC patients in clinical remission who underwent CCE-2 showed that the CSUC was significantly higher in the 12 patients who relapsed within 1 year than in the 29 patients who remained in clinical remission (2.83 ± 1.95 vs. 0.72 ± 1.00; p < 0.01) [ 103 ]. Moreover, CSUC ≥ 1 was found to be prognostic of relapse, with a sensitivity of 83.3%, a specificity of 58.6%, and an accuracy of 0.82, and to be superior to the prognostic ability of fecal biomarkers [ 103 ]. However, the CSUC requires further validation prior to its widespread use to accurately determine the disease activity and extent of UC.…”

Scoring Systems for Clinical Colon Capsule Endoscopy—All You Need to Know

“…The calculated correlation coefficient for CSUC with FC was 0.50 (2-tailed p -value < 0.01) in this study. In addition, a CSUC ≥1 was shown to be a predictor of relapse through receiver operator characteristic curve analysis (area under the curve of 0.82, sensitivity of 83.3%, and specificity of 58.6%) [ 20 ].…”