1
|
Spadaccini M, Hassan C, Rondonotti E, Antonelli G, Andrisani G, Lollo G, Auriemma F, Iacopini F, Facciorusso A, Maselli R, Fugazza A, Bambina Bergna IM, Cereatti F, Mangiavillano B, Radaelli F, Di Matteo F, Gross SA, Sharma P, Mori Y, Bretthauer M, Rex DK, Repici A. Combination of mucosa-exposure device and computer-aided detection for Adenoma Detection during Colonoscopy: a randomized trial. Gastroenterology 2023:S0016-5085(23)00595-4. [PMID: 37061169 DOI: 10.1053/j.gastro.2023.03.237] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND & AIMS Both Computer-aided detection (CADe)- assisted and Endocuff-assisted colonoscopy have shown to increase adenoma detection. We investigated the performance of the combination of the two tools compared to CADe-assisted colonoscopy alone to detect colorectal neoplasias during colonoscopy in a multicenter randomized trial. METHODS Men and women undergoing colonoscopy for CRC screening, polyp surveillance, or clincial indications at 6 centers in Italy and Switzerland were enrolled. Patients were assigned (1:1) to colonoscopy with the combinations of CADe (GI-Genius, Medtronic) and a mucosal exposure device (Endocuff Vision -ECV-, Olympus) or to CADe-assisted colonoscopy alone (control group). All detected lesions were removed and sent to histopathology for diagnosis. The primary outcome was adenoma detection rate (ADR, the percentage of patients with at least 1 histologically proven adenoma or carcinoma). Secondary outcomes were adenomas detected per colonoscopy, advanced adenomas and serrated lesions detection rate, the rate of unnecessary polypectomies (polyp resection without histologically proven adenomas), and withdrawal time. RESULTS From July 1, 2021 to May 31, 2022, 1316 subjects were randomized and eligible for analysis; 660 to the ECV group, 656 to control group). The ADR was significantly higher in the ECV group (49.6%) than in the control group (44.0%) (relative risk [RR], 1.12; 95% confidence interval [CI], 1.00-1.26; p = 0.04). Adenomas detected per colonoscopy were significantly higher in the ECV group (mean, 0.94+0.54) than in the control group (0.74+0.21) (incidence rate ratio, 1.26; 95% CI: 1.04-1.54; p: 0.02). The two groups did not differ in term of detection of advanced adenomas and serrated lesions. There was no significant difference between groups in withdrawal time (9.01±2.48 seconds for the ECV group vs 8.96 ±2.24 for controls; P = 0.69) or proportion of subjects undergoing unnecessary polypectomies (RR: 0.89; 95% CI: 0.69-1.14. p: 0.38). CONCLUSIONS The combination of CADe and EndocuffVision during colonoscopy increases ADR and adenomas detected per colonoscopy without increasing withdrawal time compared to CADe alone. CLINICALTRIALS gov no: NCT04676308.
Collapse
Affiliation(s)
- Marco Spadaccini
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy.
| | - Cesare Hassan
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy
| | | | - Giulio Antonelli
- "Sapienza" University of Rome, Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Rome, Italy; Ospedale dei Castelli Hospital, Gastroenterology and Digestive Endoscopy Unit, Ariccia, Italy
| | - Gianluca Andrisani
- Campus Bio-Medico, University of Rome, Digestive Endoscopy Unit, Rome, Italy
| | - Gianluca Lollo
- Università della Svizzera Italiana, Department of Gastroenterology and Hepatology, Lugano, Switzerland
| | - Francesco Auriemma
- Humanitas Mater Domini, Gastrointestinal Endoscopy Unit, Castellanza, Italy
| | - Federico Iacopini
- Ospedale dei Castelli Hospital, Gastroenterology and Digestive Endoscopy Unit, Ariccia, Italy
| | - Antonio Facciorusso
- University of Foggia, Gastroenterology Unit, Department of Surgical and Medical Sciences, Foggia, Italy
| | - Roberta Maselli
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy
| | - Alessandro Fugazza
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy
| | | | - Fabrizio Cereatti
- Ospedale dei Castelli Hospital, Gastroenterology and Digestive Endoscopy Unit, Ariccia, Italy
| | - Benedetto Mangiavillano
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Mater Domini, Gastrointestinal Endoscopy Unit, Castellanza, Italy
| | | | - Francesco Di Matteo
- Campus Bio-Medico, University of Rome, Digestive Endoscopy Unit, Rome, Italy
| | - Seth A Gross
- NYU Langone Health, Division of Gastroenterology and Hepatology, New York, New York
| | - Prateek Sharma
- Kansas City VA Medical Center, Gastroenterology and Hepatology, Kansas City, United States
| | - Yuichi Mori
- University of Oslo, Clinical Effectiveness Research Group, Oslo, Norway; Showa University Northern Yokohama Hospital, Digestive Disease Center, Yokohama, Japan
| | | | - Douglas K Rex
- Indiana University School of Medicine, Division of Gastroenterology/Hepatology, Indianapolis, Indiana, USA
| | - Alessandro Repici
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy
| |
Collapse
|
2
|
Cannatelli R, Ferretti F, Carmagnola S, Bergna IMB, Monico MC, Maconi G, Ardizzone S. Risk of adverse events and reported clinical relapse after COVID-19 vaccination in patients with IBD. Gut 2022; 71:1926-1928. [PMID: 34819330 DOI: 10.1136/gutjnl-2021-326237] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Rosanna Cannatelli
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Francesca Ferretti
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Stefania Carmagnola
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Irene Maria Bambina Bergna
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Maria Camilla Monico
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Giovanni Maconi
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Sandro Ardizzone
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| |
Collapse
|
3
|
Tursi A, Mocci G, Elisei W, Allegretta L, Colucci R, Della Valle N, De Medici A, Faggiani R, Ferronato A, Forti G, Larussa T, Lorenzetti R, Luzza F, Penna A, Pranzo G, Rodinò S, Sacco R, Sebkova L, Zampaletta C, Graziosi C, Picchio M, Bergna IMB, Maconi G. Long-term, Real-life, Observational Study in Treating Outpatient Ulcerative Colitis with Golimumab. J Gastrointestin Liver Dis 2021; 30:456-461. [PMID: 34812437 DOI: 10.15403/jgld-3992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Several studies have found Golimumab (GOL) effective and safe in the short-term treatment of ulcerative colitis (UC), but few long-term data are currently available from real world. Our aim was to assess the long-term real-life efficacy and safety of GOL in managing UC outpatients in Italy. METHODS A retrospective multicenter study assessing consecutive UC outpatients treated with GOL for at least 3-month of follow-up was made. Primary endpoints were the induction and maintenance of remission in UC, defined as Mayo score ≤2. Several secondary endpoints, including clinical response, colectomy rate, steroid free remission and mucosal healing, were also assessed during the follow-up. RESULTS One hundred and seventy-eight patients were enrolled and followed up for a median (IQR) time of 9 (3-18) months (mean time follow-up: 33.1±13 months). Clinical remission was achieved in 57 (32.1%) patients: these patients continued with GOL, but only 6 patients (3.4%) were still under clinical remission with GOL at the 42nd month of follow-up. Clinical response occurred in 64 (36.4%) patients; colectomy was performed in 8 (7.8%) patients, all of them having primary failure. Steroid-free remission occurred in 23 (12.9%) patients, and mucosal healing was achieved in 29/89 (32.6%) patients. Adverse events occurred in 14 (7.9%) patients. CONCLUSIONS Golimumab does not seem able to maintain long-term remission in UC in real life. The safety profile was good.
Collapse
Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria; Department of Medical and Surgical Sciences, Post- graduate School of Digestive Diseases, Catholic University, Rome, Italy.
| | - Giammarco Mocci
- Division of Gastroenterology, Brotzu Hospital, Cagliari, Italy.
| | - Walter Elisei
- Division of Gastroenterology, S. Camillo Hospital, Rome, Italy.
| | - Leonardo Allegretta
- Division of Gastroenterology, Santa Caterina Novella Hospital, Galatina (LE), Italy.
| | - Raffaele Colucci
- Digestive Endoscopy Unit, San Matteo degli Infermi Hospital, Spoleto (PG), Italy.
| | | | - Antonio De Medici
- Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy.
| | | | | | - Giacomo Forti
- Division of Digestive Endoscopy, S. Maria Goretti Hospital, Latina, Italy.
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | | | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy.
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, Valle D'Itria Hospital, Martina Franca (TA), Italy.
| | - Stefano Rodinò
- Division of Gastroenterology, Ciaccio-Pugliese Hospital, Catanzaro, Italy.
| | - Rodolfo Sacco
- Division of Gastroenterology, A.O. Ospedali Riuniti, Foggia, Italy.
| | - Ladislava Sebkova
- Division of Gastroenterology, Ciaccio-Pugliese Hospital, Catanzaro, Italy.
| | | | - Camilla Graziosi
- Division of Gastroenterology, Belcolle Hospital, Viterbo, Italy.
| | - Marcello Picchio
- Division of General Surgery, P. Colombo Hospital, ASL Roma 6, Velletri (Roma), Italy.
| | - Irene Maria Bambina Bergna
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy.
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy.
| |
Collapse
|