S1541 Management by Intestinal Ultrasound Compared to Conventional Management Is Associated With Increased Objective Monitoring Frequency in Patients With Active Inflammatory Bowel Disease

Introduction: Intestinal ultrasound (IUS) is a non-invasive and accurate tool to monitor disease activity in patients (pts) with inflammatory bowel disease (IBD). We previously demonstrated that management by IUS compared to conventional management is associated with shorter time to achieving clinical remission (128 vs 230 days, P = 0.04). In order to understand the variables influencing our prior findings, in this study we assessed whether IUS management is associated with more enhanced monitoring, treatment adjustments, or surgical interventions compared to conventional management (CM). Methods: We previously performed a retrospective analysis of pts with IBD seen between October 2021-October 2023 who were managed by IUS or CM, matched by provider and disease type and phenotype. At index inclusion pts were required to have active clinical disease (Simple Clinical Colitis Activity Index >2 or Harvey-Bradshaw Index >4), and a subsequent treatment change. In this analysis of the cohort, we assessed for the number of monitoring events (clinic visit, bowel imaging by CT, MR or IUS, endoscopy, or fecal calprotectin (FCP)), number of treatment changes, and surgical intervention over 12 months. Pts could be included twice if they relapsed after 12 months of follow up. Standard t-test, Fisher’s exact test, and Mann-Whitney U tests were used. Results: Fifty-four pts were included with a total of 62 index encounters (32 = IUS, 30 = CM), managed by 3 different providers. For the IUS and CM cohorts respectively: median number of monitoring events per pt was 7 (IQR 4-7) vs 5 (IQR 4-7.75), (P = 0.1515); the median number of clinic visits was 3 (IQR 2-4) vs 2 (2-3), (P = 0.3406); the median number of objective monitoring was 4 (IQR 2-6) vs 2 (IQR 2-5), (P = 0.02934); the number of pts who had an additional treatment change within 12 months was 15/28 (53.6%) vs 14/29 (48.3%), (P = 0.793); the number of pts who underwent surgery within 12 months was 5/28 (11.1%) vs 5/29 (21.7%), (P = 1.0). Conclusion: Management by IUS compared to CM is associated with increased number of objective monitoring events, but not more clinic visits, treatment changes, or surgeries; this suggests improved remission rates may be due to tighter objective disease monitoring.