Novel endoscopic scoring system for immune mediated colitis: A multicenter retrospective study of 674 patients Journal Article
| Authors: | Wang, Y.; Abu-Sbeih, H.; Tang, T.; Shatila, M.; Faleck, D.; Harris, J.; Dougan, M.; Olsson-Brown, A.; Johnson, D. B.; Shi, C.; Grivas, P.; Diamantopoulos, L.; Owen, D. H.; Cassol, C.; Arnold, C. A.; Warner, D. E.; Alva, A.; Powell, N.; Ibraheim, H.; De Toni, E. N.; Philipp, A. B.; Philpott, J.; Sleiman, J.; Lythgoe, M.; Daniels, E.; Sandhu, S.; Weppler, A. M.; Buckle, A.; Pinato, D. J.; Thomas, A.; Qiao, W. |
| Article Title: | Novel endoscopic scoring system for immune mediated colitis: A multicenter retrospective study of 674 patients |
| Abstract: | Background and Aims: No endoscopic scoring system has been established for immune-mediated colitis (IMC). This study aimed to establish such a system for IMC and explore its utility in guiding future selective immunosuppressive therapy (SIT) use compared to clinical symptoms. Methods: This retrospective, international, 14-center study included 674 patients who developed IMC after immunotherapy and underwent endoscopic evaluation. Ten endoscopic features were selected by group consensus and assigned 1 point each to calculate an IMC endoscopic score (IMCES). IMCES cutoffs were chosen to maximize specificity for SIT use. This specificity was compared between IMCESs, and clinical symptoms were graded according to a standardized instrument. Results: A total of 309 (45.8%) patients received SIT. IMCES specificity for SIT use was 82.8% with a cutoff of 4. The inclusion of ulceration as a mandatory criterion resulted in higher specificity (85.0% for a cutoff of 4). In comparison, the specificity of a Mayo endoscopic subscore of 3 was 74.6%, and the specificity of clinical symptom grading was much lower at 27.4% and 12.3%, respectively. Early endoscopy was associated with timely SIT use (P <.001; r = 0.4084). Conclusions: This is the largest multicenter study to devise an endoscopic scoring system to guide IMC management. An IMCES cutoff of 4 has a higher specificity for SIT use than clinical symptoms, supporting early endoscopic evaluation for IMC. © 2024 American Society for Gastrointestinal Endoscopy |
| Keywords: | adult; aged; middle aged; retrospective studies; major clinical study; clinical feature; clinical trial; disease course; monotherapy; sensitivity and specificity; consensus; melanoma; lung cancer; pathology; retrospective study; urogenital tract cancer; severity of illness index; immunotherapy; colonoscopy; multicenter study; clinical evaluation; scoring system; colitis; colon perforation; corticosteroid; immunosuppressive treatment; sigmoidoscopy; immunosuppressive agents; ulcer; immunosuppressive agent; receiver operating characteristic; reference value; diagnostic test accuracy study; infliximab; procedures; colon ulcer; immune checkpoint inhibitor; immune mediated injury; transverse colon; humans; human; male; female; article; vedolizumab; checkpoint inhibitor therapy |
| Journal Title: | Gastrointestinal Endoscopy |
| Volume: | 100 |
| Issue: | 2 |
| ISSN: | 0016-5107 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2024-08-01 |
| Start Page: | 273 |
| End Page: | 282.e4 |
| Language: | English |
| DOI: | 10.1016/j.gie.2024.01.024 |
| PUBMED: | 38272276 |
| PROVIDER: | scopus |
| PMCID: | PMC11832009 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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