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Monday Poster Session

Category: Colon

P1580 - Endoscopic Scoring Indices for Assessing Disease Severity in Familial Adenomatous

Monday, October 23, 2023
10:30 AM – 4:15 PM PT
Location: Exhibit Hall
Has Audio
Anna L.. Silverman, MD1, Hicham Bouchiba, MD2, Arthur Aelvoet, MD, PhD2, John MacDonald, MS3, Brian G. Feagan, MD4, Vipul Jairath, MBChB, DPhil, FRCPC5, Christopher Ma, MD, MPH6, Evelien Dekker, MD, PhD2, Niloy Samadder, MD7
1Mayo Clinic, Scottsdale, AZ; 2UMC Amsterdam, Amsterdam, Noord-Holland, Netherlands; 3Alimentiv Inc., London, ON, Canada; 4Western University, London, ON, Canada; 5Alimentiv Inc., Western University, London, ON, Canada; 6Alimentiv Inc., University of Calgary, Calgary, AB, Canada; 7Mayo Clinic, Phoenix, AZ

Introduction: Several therapeutics are in development for familial adenomatous polyposis (FAP) to reduce polyp burden, the incidence of cancer and prevent or postpone surgery. However, there is limited consensus on the optimal method for measuring disease severity in FAP. We aimed to systematically review existing endoscopic severity indices for FAP.

Methods: We searched MEDLINE, EMBASE and the Cochrane Library from inception to May 22, 2023 to identify studies that evaluated endoscopic disease severity and severity in children and adults with FAP.

Results: A total of 94 studies were included. We evaluated component items of scoring indices, such as polyp count, polyp size and histology, and the scoring indices themselves (Table 1). Partial validation was observed for polyp count and size. The most common reported scoring index was the Spigelman classification system, which was used for assessing the severity of duodenal involvement. A single study reported almost perfect inter- and intra-observer agreement for this system. The InSIGHT polyposis staging system, which was used for assessing colorectal polyp burden has been partially validated. It showed substantial inter-observer reliability, however it lacked intra-observer reliability. Novel criteria for high-risk gastric polyps was developed and assessed for inter-observer reliability; however it showed a poor level of agreement. Another scoring index assessing the anal transition zone has not undergone validation.

Discussion: There are no fully validated endoscopic disease severity indices for FAP. Development and validation of reliable and responsive endoscopic disease severity instrument will be informative for clinical care, research and to assess the impact of pharmacological therapies on polyp burden in FAP.


Disclosures:
Anna Silverman indicated no relevant financial relationships.
Hicham Bouchiba indicated no relevant financial relationships.
Arthur Aelvoet indicated no relevant financial relationships.
John MacDonald: Alimentiv – Employee.
Brian Feagan: AbbVie – Advisory Committee/Board Member, Consultant, Speakers Bureau. AbolerIS – Consultant. AgomAB Therapeutics – Consultant. Allianthera – Consultant. Amgen – Advisory Committee/Board Member, Consultant. AnaptysBio – Consultant. Applied Molecular Transport Inc. – Consultant. Arena Pharma – Consultant. Avir – Consultant. Azora Therapeutics – Consultant. Baxter – Consultant. BioJamp – Consultant. Biora Therapeutics – Consultant. Boehringer Ingelheim – Advisory Committee/Board Member, Consultant. Boston Pharma – Consultant. Bristol Myers Squibb – Consultant. Celgene/BMS – Advisory Committee/Board Member, Consultant. Connect BioPharma – Consultant. Cytoki – Consultant. Disc Medicine – Consultant. Duality – Consultant. EcoR1 – Advisory Committee/Board Member, Consultant. Eli Lilly – Consultant. Equillium – Consultant. Ermium – Consultant. Everest Clinical Research Corp. – Consultant. Ferring Pharmaceuticals – Consultant. First Wave – Consultant. Galapagos – Consultant. Galen Atlantica – Consultant. Genentech/Roche – Advisory Committee/Board Member, Consultant. Gilead – Consultant. GlaxoSmithKline – Advisory Committee/Board Member, Consultant. Glenmark – Consultant. Gossamer Pharma – Consultant, stock shareholder. Hoffmann-LaRoche – Consultant. Hot Spot Therapeutics – Consultant. Imhotex – Consultant. ImmunExt – Consultant. Immunic Therapeutics – Consultant. Index Pharma – Advisory Committee/Board Member, Consultant. Intact Therapeutics – Consultant. JAKAcademy – Consultant. Janssen – Advisory Committee/Board Member, Consultant, Speakers Bureau. Japan Tobacco Inc. – Consultant. Kaleido Biosciences – Consultant. L.E.K. Consulting – Consultant. Landos Biopharma – Consultant. Leadiant – Consultant. LifeSci Capital – Consultant. Lument AB – Consultant. Millennium – Consultant. MiroBio – Consultant. Morphic Therapeutics – Advisory Committee/Board Member, Consultant. Mylan – Consultant. Novartis – Advisory Committee/Board Member. OM Pharma – Consultant. Origo BioPharma – Advisory Committee/Board Member, Consultant. Orphagen – Consultant. Otsuka – Consultant. Pandion Therapeutics – Consultant. Pfizer – Advisory Committee/Board Member, Consultant. Play to Know AG – Consultant. Progenity – Advisory Committee/Board Member, Consultant. Prometheus Therapeutics and Diagnostics – Advisory Committee/Board Member, Consultant. Protagonist – Consultant. PTM Therapeutics – Consultant. Q32 Bio – Consultant. Rebiotix – Consultant. RedHill Biopharma – Consultant. Redx – Consultant. Roche – Consultant. Sandoz – Consultant. Sanofi – Consultant. Seres Therapeutics – Consultant. Silverback Therapeutics – Consultant. Surrozen Inc. – Consultant. Takeda – Advisory Committee/Board Member, Consultant, Speakers Bureau. Teva – Advisory Committee/Board Member, Consultant. Thelium – Consultant. Theravance – Consultant. Tigenix – Consultant. Tillotts Pharma – Advisory Committee/Board Member, Consultant. UCB Pharma – Consultant. VHSquared Ltd. – Consultant. Viatris – Consultant. Western University, Alimentiv Inc – Employee. Ysios – Consultant. Ysopia – Consultant. Zealand Pharma – Consultant.
Vipul Jairath: AbbVie – Advisory Committee/Board Member, Consultant, Speakers Bureau. Alimentiv Inc – Advisory Committee/Board Member, Consultant. Arena pharmaceuticals – Advisory Committee/Board Member, Consultant. Asahi Kasei Pharma – Advisory Committee/Board Member, Consultant. Asieris – Advisory Committee/Board Member, Consultant. Astra Zeneca – Advisory Committee/Board Member, Consultant. Avoro Capital – Advisory Committee/Board Member, Consultant. Bristol Myers Squibb – Advisory Committee/Board Member, Consultant, Speakers Bureau. Celltrion – Advisory Committee/Board Member, Consultant. Eli Lilly – Advisory Committee/Board Member, Consultant. Endpoint Health – Advisory Committee/Board Member, Consultant. Ferring – Advisory Committee/Board Member, Consultant, Speakers Bureau. Flagship Pioneering – Advisory Committee/Board Member, Consultant. Fresenius Kabi – Advisory Committee/Board Member, Consultant, Speakers Bureau. Galapagos – Advisory Committee/Board Member, Consultant, Speakers Bureau. Genentech – Advisory Committee/Board Member, Consultant. Gilde Healthcare – Advisory Committee/Board Member, Consultant. Gilead – Advisory Committee/Board Member, Consultant. GlaxoSmithKline – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member, Consultant, Speakers Bureau. Merck – Advisory Committee/Board Member, Consultant. Metacrine – Advisory Committee/Board Member, Consultant. Mylan – Advisory Committee/Board Member, Consultant. Pandion – Advisory Committee/Board Member, Consultant. Pendopharm – Advisory Committee/Board Member, Consultant. Pfizer – Advisory Committee/Board Member, Consultant, Speakers Bureau. Prometheus Biosciences – Advisory Committee/Board Member, Consultant. Protagonist – Advisory Committee/Board Member, Consultant. Reistone Biopharma – Advisory Committee/Board Member, Consultant. Roche – Advisory Committee/Board Member, Consultant. Sandoz – Advisory Committee/Board Member, Consultant. Second Genome – Advisory Committee/Board Member, Consultant. Sorriso pharmaceuticals – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant, Speakers Bureau. Teva – Advisory Committee/Board Member, Consultant. Topivert – Advisory Committee/Board Member, Consultant. Ventyx – Advisory Committee/Board Member, Consultant. Vividion – Advisory Committee/Board Member, Consultant.
Christopher Ma: AbbVie – Consultant, Speakers Bureau. Alimentiv – Consultant, Speakers Bureau. Amgen – Consultant, Speakers Bureau. AVIR Pharma Inc – Consultant, Speakers Bureau. BioJAMP – Consultant. Bristol Myers Squibb – Consultant, Speakers Bureau. Celltrion – Consultant. Ferring – Consultant, Grant/Research Support, Speakers Bureau. Fresenius Kabi – Consultant, Speakers Bureau. Janssen – Consultant, Speakers Bureau. McKesson – Consultant. Mylan – Consultant. Organon – Speakers Bureau. Pendopharm – Consultant, Speakers Bureau. Pfizer – Consultant, Grant/Research Support, Speakers Bureau. Prometheus Biosciences Inc. – Consultant. Roche – Consultant. Sanofi – Consultant. Springer Publishing – Royalties. Takeda – Consultant, Speakers Bureau. Tillotts Pharma – Consultant.
Evelien Dekker: Ambu and InterVenn – Consultant, Stock Options. FujiFilm – Consultant, Grant/Research Support, Endoscopy equipment, Speakers Bureau. GI Supply – Speakers Bureau. IPSEN – Speakers Bureau. Norgine – Speakers Bureau. Olympus – Consultant, Speakers Bureau. PAION – Speakers Bureau.
Niloy Samadder: Alimentiv Inc – Consultant. Jansen – Consultant. Recursion Pharmaceuticals – Consultant. Tempest Pharmaceuticals – Consultant.


Anna L.. Silverman, MD1, Hicham Bouchiba, MD2, Arthur Aelvoet, MD, PhD2, John MacDonald, MS3, Brian G. Feagan, MD4, Vipul Jairath, MBChB, DPhil, FRCPC5, Christopher Ma, MD, MPH6, Evelien Dekker, MD, PhD2, Niloy Samadder, MD7. P1580 - Endoscopic Scoring Indices for Assessing Disease Severity in Familial Adenomatous, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.