An international multicenter real-life prospective study of electronic chromoendoscopy score PICaSSO in Ulcerative Colitis.

Abstract:

BACKGROUND & AIMS:Endoscopic and Histologic remission are important goals in the treatment of ulcerative colitis (UC). We investigated the correlation of the recently developed Paddington International Virtual ChromoendoScopy ScOre( PICaSSO) and other established endoscopic scores against multiple histological indices and prospectively assessed outcomes. METHODS:In this prospective multicenter international study Inflammatory activity was assessed with high definition and virtual chromoendoscopy in the rectum and sigmoid using Mayo Endoscopic Score (MES), UC Endoscopic Index of Severity (UCEIS) and PICaSSO. Targeted biopsies were taken for assessment using Robarts Histological Index (RHI), Nancy Histological index (NHI), ECAP, Geboes and Villanacci. Follow up data was obtained at 6 and 12 months after colonoscopy. RESULTS:307 patients were recruited. There was strong correlation between PICaSSO and histology scores, significantly superior to correlation coefficients of MES and UCEIS with histology scores. A PICaSSO score of ≤3 detected histologic remission by RHI (≤3 + absence of neutrophils) with AUROC 0.90 (95% CI 0.86-0.94) and NHI (≤1) AUROC 0.82 (95% CI 0.77-0.87). The inter-observer agreement for PICaSSO was 0.88 (95% CI 0.83-0.92). At 6- and 12-months follow-up PICaSSO score ≤3 predicted better outcomes than PICaSSO >3 {hazard ratio HR 0.19 (0.11-0.33) and 0.22 (0.13-0.34) respectively} as well as PICaSSO 4-8 {HR 0.25 (0.12,0.53) and 0.22 (0.12,0.39) respectively} and similar to histologic remission. CONCLUSION:In this first real-life multicenter study, the PICaSSO score correlated strongly with multiple histological indices. Furthemore, PICaSSO score predicted specified clinical outcomes at 6 and 12 months similar to histology. Thus, PICaSSO can be a useful endoscopic tool in the therapeutic management of UC.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Iacucci M,Smith SC,Bazarova A,Shivaji UN,Bhandari P,Cannatelli R,Daperno M,Ferraz J,Goetz M,Gui X,Hayee B,De Hertogh G,Lazarev M,Li J,Nardone OM,Parra-Blanco A,Pastorelli L,Panaccione R,Occhipinti V,Rath T,Tontini

doi

10.1053/j.gastro.2020.12.024

subject

Has Abstract

pub_date

2020-12-18 00:00:00

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(20)35563-3

pub_type

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