Early transmural response assessed by intestinal ultrasound predicts long-term clinical remission in patients with IBD: Results from the TRUST BEYOND study.

backgroundThe study sought to prospectively examine clinical, biochemical, and transmural outcomes. Transmural outcomes are assessed by ultrasound after 1 year in patients with inflammatory bowel disease (IBD) treated in line with standard of care.

methodsThe TRUST BEYOND study is a prospective, multicenter, noninterventional study at 49 sites in Germany, Austria, and Switzerland and includes 282 patients with IBD who have active disease at baseline. For this analysis, 163 patients with IBD (74 with Crohn's disease, 89 with ulcerative colitis) were followed up for 1 year. At baseline and at every 3 months, clinical, biochemical, and ultrasound parameters, such as bowel wall thickness and color Doppler sonography, were assessed.

resultsPatients with IBD demonstrated vast improvements in clinical, biochemical, and ultrasound assessments as early as week 12. Rates of transmural response and healing progressively increased over the study period to up to 77.5% and 39.3%, respectively, in patients with ulcerative colitis and to 66.2% and 27.0%, respectively, in patients with Crohn's disease. Patients with early transmural response achieved numerically higher rates of various outcomes at week 52 than patients without early transmural response. In a multivariate analysis, transmural response at week 12 predicted clinical remission at week 52 (odds ratio, 4.3; 95% confidence interval, 2.45-7.52; P < .001).

conclusionsThese results suggest that intestinal ultrasound is a suitable noninvasive modality to monitor patients with IBD in routine care. Transmural endpoints can be achieved in patients with IBD treated with standard of care and can predict outcomes after 1 year.