TY - JOUR
T1 - An international multicenter real-life prospective study of electronic chromoendoscopy score PICaSSO in ulcerative colitis
AU - Iacucci, Marietta
AU - Smith, Samuel CL
AU - Bazarova, Alina
AU - Shivaji, Uday
AU - Bhandari, Pradeep
AU - Cannatelli, Rosanna
AU - Daperno, Marco
AU - Ferraz, Jose
AU - Goetz, Martin
AU - Gui, Xianyong
AU - Hayee, Bu
AU - De Hertogh, Gert
AU - Lazarev, Mark
AU - Li, Jim
AU - Nardone, Olga
AU - Parra-Blanco, Adolfo
AU - Pastorelli, Luca
AU - Panaccione, Remo
AU - Occhipinti, Vincenzo
AU - Rath, Timo
AU - Tontini, Gian Eugenio
AU - Vieth, Michael
AU - Villanacci, Vincenzo
AU - Zardo , Davide
AU - Bisschops, Raf
AU - Kiesslich, Ralf
AU - Ghosh, Subrata
N1 - Funding: Marietta Iacucci and Subrata Ghosh are part-funded by the NIHR Birmingham Biomedical Research Centre The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
PY - 2020/12/18
Y1 - 2020/12/18
N2 - 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 the 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 (Extent, Chronicity, Activity, Plus score),
Geboes, and Villanacci. Follow-up data were obtained at 6 and 12 months after
colonoscopy.
Results
A total of 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 area under the receiver operating characteristic curve
(AUROC) 0.90 (95% confidence interval [CI] 0.86–0.94) and NHI (≤1) AUROC 0.82
(95% CI 0.77–0.87). The interobserver 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. Furthermore, 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.
AB - 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 the 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 (Extent, Chronicity, Activity, Plus score),
Geboes, and Villanacci. Follow-up data were obtained at 6 and 12 months after
colonoscopy.
Results
A total of 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 area under the receiver operating characteristic curve
(AUROC) 0.90 (95% confidence interval [CI] 0.86–0.94) and NHI (≤1) AUROC 0.82
(95% CI 0.77–0.87). The interobserver 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. Furthermore, 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.
U2 - 10.1053/j.gastro.2020.12.024
DO - 10.1053/j.gastro.2020.12.024
M3 - Article
SN - 0016-5085
JO - Gastroenterology
JF - Gastroenterology
ER -