Predictive value of Milan ultrasound criteria in ulcerative colitis: A prospective observational cohort study
Abstract
Background: Endoscopic healing is an established treatment target for ulcerative colitis (UC). We have recently validated the Milan ultrasound criteria (MUC) to assess endoscopic activity in UC; a MUC score > 6.2 is a valid cut-off to discriminate endoscopic activity (Mayo endoscopic subscore > 1). Objective: The aim of this study was to assess the predictive value of MUC on disease course in a prospective cohort of UC patients. Methods: UC patients regardless of disease activity and current therapy, underwent colonoscopy and bowel ultrasound (US) at baseline in a blinded fashion. Correlations between baseline MUC and Mayo endoscopic subscore were assessed using Spearman's rank correlation. UC-related negative course (defined as the need for corticosteroids, or treatment escalation, or hospitalization, or need for colectomy: a composite outcome) over a median 20 months follow-up, was investigated using the Kaplan-Meier method and Cox regression analysis. Results: 98 UC patients were followed up for a median time of 1.6 years (IQR 0.9¬2.7). Milan ultrasound criteria and Mayo endoscopic subscore significantly correlated at baseline (ρ = 0.653; p < 0.001). 70 patients (71%) had negative disease course during the follow-up period. Milan ultrasound criteria > 6.2 at baseline was statistically significantly associated with negative disease course (HR: 3.87, 95% CI: 2.25-6.64, p < 0.001). Kaplan-Meier analyses drawed a statistically significantly lower cumulative probability of treatment escalation, need of corticosteroids, hospitalization and colectomy, among patients who had MUC ≤ 6.2 at baseline as compared to patients with MUC > 6.2 (p < 0.05 for all outcomes). Conclusion: we have demonstrated for the first time the value of bowel US and an US score in predicting disease course in UC. Milan ultrasound criteria, a validated US-based score, predicts disease course in UC. Milan ultrasound criteria ≤ 6.2 may be the new treatment target to achieve to reduce the risk of worse outcomes.
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BibTeX
@article{allocca2026predictive,
title = {{Predictive value of Milan ultrasound criteria in ulcerative colitis: A prospective observational cohort study}},
author = {Mariangela Allocca and Cecilia Dell'Avalle and Vincenzo Craviotto and Federica Furfaro and Alessandra Zilli and Ferdinando d'Amico and Stefanos Bonovas and Laurent Peyrin‐biroulet and Gionata Fiorino and Silvio Danese},
journal = {United European Gastroenterology Journal},
year = {2026},
month = sep,
doi = {10.1002/ueg2.12206},
url = {https://hal.univ-lorraine.fr/hal-04168249v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Predictive value of Milan ultrasound criteria in ulcerative colitis: A prospective observational cohort study
AU - Mariangela Allocca
AU - Cecilia Dell'Avalle
AU - Vincenzo Craviotto
AU - Federica Furfaro
AU - Alessandra Zilli
AU - Ferdinando d'Amico
AU - Stefanos Bonovas
AU - Laurent Peyrin‐biroulet
AU - Gionata Fiorino
AU - Silvio Danese
PY - 2026
DA - 2026/09/17
JO - United European Gastroenterology Journal
DO - 10.1002/ueg2.12206
UR - https://hal.univ-lorraine.fr/hal-04168249v1
AB - Background: Endoscopic healing is an established treatment target for ulcerative colitis (UC). We have recently validated the Milan ultrasound criteria (MUC) to assess endoscopic activity in UC; a MUC score > 6.2 is a valid cut-off to discriminate endoscopic activity (Mayo endoscopic subscore > 1). Objective: The aim of this study was to assess the predictive value of MUC on disease course in a prospective cohort of UC patients. Methods: UC patients regardless of disease activity and current therapy, underwent colonoscopy and bowel ultrasound (US) at baseline in a blinded fashion. Correlations between baseline MUC and Mayo endoscopic subscore were assessed using Spearman's rank correlation. UC-related negative course (defined as the need for corticosteroids, or treatment escalation, or hospitalization, or need for colectomy: a composite outcome) over a median 20 months follow-up, was investigated using the Kaplan-Meier method and Cox regression analysis. Results: 98 UC patients were followed up for a median time of 1.6 years (IQR 0.9¬2.7). Milan ultrasound criteria and Mayo endoscopic subscore significantly correlated at baseline (ρ = 0.653; p < 0.001). 70 patients (71%) had negative disease course during the follow-up period. Milan ultrasound criteria > 6.2 at baseline was statistically significantly associated with negative disease course (HR: 3.87, 95% CI: 2.25-6.64, p < 0.001). Kaplan-Meier analyses drawed a statistically significantly lower cumulative probability of treatment escalation, need of corticosteroids, hospitalization and colectomy, among patients who had MUC ≤ 6.2 at baseline as compared to patients with MUC > 6.2 (p < 0.05 for all outcomes). Conclusion: we have demonstrated for the first time the value of bowel US and an US score in predicting disease course in UC. Milan ultrasound criteria, a validated US-based score, predicts disease course in UC. Milan ultrasound criteria ≤ 6.2 may be the new treatment target to achieve to reduce the risk of worse outcomes.
SN - 2050-6406
SN - 2050-6414
ER -