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Adult endoscopic scores accurately assess pediatric ulcerative colitis
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CHICAGO — Two endoscopic scoring indices originally designed for use in adults are reliable for endoscopic assessment in children with ulcerative colitis, according to research presented at NASPGHAN 2019.
Amanda Ricciuto, MD , PhD, of the Hospital for Sick Children in Toronto, said that in the shift to endoscopic remission as a treatment target in UC, the UC Endoscopic Index of Severity (UCEIS) and the Mayo Endoscopic Sub-score (MES) have become valuable tools in assessing adult patients.
“Neither has been formally validated or assessed in pediatrics,” she said during her presentation. “We aimed to assess the validity and reliability of UCEIS and the Mayo Score in pediatric UC, including pancolonic versions that take into consideration disease extent.”
Researchers performed a prospective study comprising 60 children with UC to assess the reliability of the UCEIS and MES in a pediatric population. Patients underwent colonoscopy, and four pediatric IBD experts scored the five segments of the colon using the two scoring indices.
Investigators compared inter-rater reliability and examined the ability of each endoscopic score to discriminate between disease activity.
Ricciuto and colleagues determined that inter-rater reliability was good for all endoscopic scores but numerically greater for the pancolonic versions of the indices compared with the rectosigmoid versions. These pancolonic variations also had a greater correlation with Pediatric UC Activity Index and C-reactive protein. In their assessment of sub-scores, researchers found that UCEIS bleeding scores had the worst inter-rater agreement, while vascularity had the best.
The UCEIS was better at discriminating patients with moderate disease from those with severe disease. Additionally, UCEIS and MES scores of 0 were highly specific in identifying histologic remission (93%-94%).
“The rectosigmoid and pancolonic versions of the UCEIS and the Mayo Score in this cohort showed excellent inter- and intra-reader reliability and very good construct validity as well, really providing support for their integration into routine clinical care and research,” Ricciuto concluded. – by Alex Young
Reference:
Ricciuto A, et al. Abstract 451. Presented at: NASPGHAN Annual Meeting; Oct. 18-19, 2019; Chicago.
Disclosures: Ricciuto reports no relevant financial disclosures.