S902 Intestinal Ultrasound Response and Transmural Remission After 48 Weeks of Treatment With Ustekinumab in Crohn’s Disease: STARDUST Trial Substudy Results by Line of Treatment and by Location

Kucharzik, Torsten; Wilkens, Rune; D’Agostino, Maria; Maconi, Giovanni; Bars, Manuela Le; Lahaye, Marjolein; Bravatá, Ivana; Nazar, Maciej; Ni, Lioudmila; Ercole, E.; Allocca, Mariangela; Machková, Naděžda; Voogd, Floris E. de; Palmela, Carolina; Vaughan, Rose

doi:10.14309/01.ajg.0000777140.83650.94

Cited by 9 publications

(13 citation statements)

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“… 3 While both trials did not assess earlier timepoints, in the Stardust IUS substudy significant response rates defined as a reduction in BWT of >25% compared to baseline were detected as early as 4 weeks following initiation of ustekinumab treatment. 4 The data from these three multicentre trials suggest that an IUS examination at an even earlier timepoint than the 6‐month as recommended in the ECCO‐ESGAR guideline might be more feasible to differentiate responders from non‐responders leading to an earlier optimization of therapy and potentially better long‐term outcome.…”

Section: Clinical Case Amentioning

confidence: 99%

Ultrasonography in inflammatory bowel disease – So far we are?

2022

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Intestinal ultrasound (IUS) is a non‐invasive and accurate tool to assess inflammatory bowel disease. The ECCO‐ESGAR guideline recommends the use of IUS for the assessment of disease activity and complications in Crohn's disease (CD). In addition, an increasing body of evidence suggests the use of IUS as alternative to colonoscopy in monitoring CD and in assessing disease activity of ulcerative colitis. Early responsiveness of IUS findings by the first weeks of treatment and the advantage to perform the procedure in real time may dramatically change frequency of the assessment of treatment response in the future and speed up the clinical decision‐making process. Development of validated and reproducible sonographic scores to measure disease activity and therapeutic response and spread of knowledge of IUS remain relevant issues for the future in which current researchers and the International Bowel Ultrasound (IBUS) Group are actively engaged.

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Section: Clinical Case Amentioning

confidence: 99%

Ultrasonography in inflammatory bowel disease – So far we are?

2022

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“… 20 These findings were similar to the STARDUST sub-study [ n = 76, ustekinumab], with IUS response for colon and terminal ileum at 40% and 30%, respectively, at Week 16, 57 with a continued difference at Week 48, 63% vs. 40%. 58 A significant reduction of BWT was already observed at Week 4. 57 Early initial response was also documented in a paediatric population with a significant reduction of BWT, CDS, and length of disease 2 weeks after initiation with infliximab [IFX].…”

Section: Resultsmentioning

confidence: 91%

Defining Transabdominal Intestinal Ultrasound Treatment Response and Remission in Inflammatory Bowel Disease: Systematic Review and Expert Consensus Statement

Ilvemark

Hansen

Goodsall

et al. 2021

Journal of Crohn's and Colitis

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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.

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“…Frühere Untersuchungszeitpunkte wurden in dieser Studie nicht gewählt. In der kürzlich publizierten STARDUST-Studie konnte eine relevante Reduktion der Darmwanddicke bereits nach 4 Wochen beobachtet werden, im Kolon war der Effekt ausgeprägter als im terminalen Ileum [102]. Die Geschwindigkeit des Ansprechens objektiver Entzündungsparameter hängt neben der Krankheitsaktivität und dem Befallsmuster der Erkrankung naturgemäß auch vom verwendeten Therapeutikum ab.…”

Section: Kommentarunclassified

Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004

Sturm

Atreya

Bettenworth³

et al. 2022

Z Gastroenterol

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Kinder und Jugendliche Fertilität Medikamente in der Schwangerschaft und Stillzeit Entbindung Impfungen des Neugeborenen Der*die ältere CED-Patient*in M. Crohn -Leitlinie AG 07 Ernährung Ernährung Ernährung als Krankheitsauslöser beim M. Crohn Ernährung als ein den Krankheitsverlauf modulierender Faktor Ernährung als therapeutischer Ansatz bei Patient*innen mit M. Crohn Ernährung zur Behandlung von Defiziten bzw. Mangelzuständen

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S902 Intestinal Ultrasound Response and Transmural Remission After 48 Weeks of Treatment With Ustekinumab in Crohn’s Disease: STARDUST Trial Substudy Results by Line of Treatment and by Location

Cited by 9 publications

References 0 publications

Ultrasonography in inflammatory bowel disease – So far we are?

Ultrasonography in inflammatory bowel disease – So far we are?

Defining Transabdominal Intestinal Ultrasound Treatment Response and Remission in Inflammatory Bowel Disease: Systematic Review and Expert Consensus Statement

Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004

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