Abstract Introduction Intestinal ultrasound (IUS) is a valuable tool for assessing short-term responses to treatment of ulcerative colitis (UC). Nevertheless, no prior reports on IUS use, earlier than week 6-14, are known for predicting long-term endoscopic responses. This study evaluated whether IUS (transabdominal and transperineal) at week 1 can predict long-term clinical–endoscopic remission (CER) and histo-endoscopic mucosal improvement (HEMI) following advanced therapies. Methods This was a post hoc analysis of a prospective study examining the predictive value of IUS at baseline and weeks 1 and 8 after the initiation of advanced therapy in patients with active UC. CER and HEMI were defined based on the Mayo endoscopic subscore and Geboes score assessed from colonoscopy after 14 weeks. The predictive values of the IUS for CER and HEMI were assessed using a receiver operating characteristic (ROC) analysis. Results Of the 69 patients, 15 (21%) achieved CER and 11 (16%) achieved HEMI. At week 1, reduction in rectal bowel wall thickness (Δrectal BWT) was significantly greater in the CER and HEMI groups than those without these improvements (CER: 1. 1 ± 0. 7 vs. -0. 1 ± 1. 4, P 0. 01; HEMI: 1. 2 ± 0. 7 vs. 0. 0 ± 1. 4, P 0. 01). However, Δrectal BWT at week 8 did not differ between the groups. ΔRectal BWT at week 1 accurately predicted both CER (AUC 0. 75; 95% CI 0. 60-0. 86; P = 0. 02) and HEMI (AUC 0. 79; 95% CI 0. 65-0. 88; P = 0. 02) with high accuracy. Conclusion Assessing the rectal wall thickness at week 1 is valuable for predicting advanced therapy-induced CER and HEMI in patients with UC. Clinical Trials Registry Number UMIN000032422 (https: //upload. umin. ac. jp/cgi-open-bin/ctrₑ/ctrᵥiew. cgi? recptno=R000036970).
Sagami et al. (Tue,) studied this question.