P189 Prospective Validation Study Regarding Disease Complications of the Toronto IBD Global Endoscopic Reporting (TIGER) Score in Ulcerative Colitis and Crohn’s Disease Patients
Zittan, E.(1,2,3)*;Levy, M.(1,3); Saban , L.(1); Vered, S.(4); Steinhart, A.H.(5); Milgrom, R.(5); Gralnek, I.M.(1,3); Silverberg, M.S.(5); Zelber-Sagi, S.(2);
(1)Emek Medical Center, The Abraham and Sonia Rochlin IBD Unit- Department of Gastroenterology and Liver Diseases, Afula, Israel;(2)Haifa University, School of Public Health- Faculty of Social Welfare and Health Sciences, Haifa, Israel;(3)Technion-Israel Institute of Technology, The Rappaport Faculty of Medicine, Haifa, Israel;(4)Haifa University, Department of Statistics, Haifa, Israel;(5)Mount Sinai Hospital- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology & Hepatology- Department of Medicine- University of Toronto, Toronto, Canada;
Background
The recently developed TIGER endoscopy score was established to reliably describe disease severity as it can be utilized for both Ulcerative Colitis (UC) and Crohn’s disease (CD) patients.1 The aim of this study was to assess the TIGER score’s ability to predict outcomes regarding complications such as surgeries, hospitalizations, and drug or disease-related side effects in a sample of both UC and CD patients.
Methods
A cohort of 78 patients with UC (n=40) and CD (n=38) were included in a 52-week multiple visit prospective study. Each visit included patient interviews, IBD disk questionnaire, blood draws for C-reactive protein (CRP), and fecal calprotectin (FC). Endoscopy was performed at baseline. Baseline total TIGER scores were dichotomized as <100 (remission-mild activity) or ≥100 (moderate-severe activity) as a predictor of complications such as surgeries, hospitalizations, and side effects.
Results
At baseline, compared to patients with TIGER scores <100, UC patients with TIGER scores ≥100 had significantly higher CRP, FC, and IBD disk. In CD patients, at baseline, compared to patients with TIGER scores <100, patients with TIGER scores ≥100 had significantly higher CRP, FC, and IBD disk. In terms of hospitalizations, at 52-weeks, compared to patients with baseline TIGER scores <100, UC and CD patients with baseline TIGER scores ≥100 had a significantly increased likelihood of being hospitalized (p<0.02). More specifically, at 52-weeks, 38.5% and 34.5% of UC and CD patients with baseline TIGER scores ≥100 experienced at least one disease-related hospitalization, respectively. Comparatively, there were zero hospitalizations in UC or CD patients with baseline TIGER scores <100. In terms of surgeries, at 52-weeks, 0% and 11.1% of UC and CD patients with baseline TIGER scores <100 had surgery compared to 3.9% and 24.1% of UC and CD patients with baseline TIGER scores ≥100, respectively. In terms of side effects, at 52-weeks, compared to patients with baseline TIGER scores <100, UC and CD patients with baseline TIGER scores ≥100 had a significantly increased likelihood of reporting a side effect from both medications and the disease (p<0.006). More specifically, 0% and 11.1% of UC and CD patients with baseline TIGER scores <100 reported medication and disease side effects compared to 11.5% and 19.2% of UC and CD patients with baseline TIGER scores ≥100, respectively.
Conclusion
The TIGER endoscopic score demonstrates significant association with CRP, FC and IBD disk in both UC and CD patients. Moreover, the TIGER score can be utilized as a measure to predict the likelihood of UC and CD patients with moderate-to-severe disease burden experiencing a disease complications.
1. Zittan E, et al. J Crohns Colitis 2022;16:544-553.