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Colonoscopies Reduced by 69% and Change in Clinical Management for One Out of Three Patients; Studies Presented at American College of Gastroenterology Meeting in San Diego.

Given Imaging Ltd. announced that new data presented at the American College of Gastroenterology ( ACG ) 2009 Conference show that by visualizing the small bowel with the PillCam SB video capsule, physicians can detect the cause of occult gastrointestinal bleeding (OGIB) and adapt how they manage and treat these patients. A separate study demonstrated that use of capsule endoscopy reduced the need for follow-up procedures, such as endoscopies as well as other procedures, thereby improving patient outcomes and reducing costs to the healthcare system. Given Imaging is exhibiting at booth #1803 at the conference, which is taking place in San Diego from October 23-28.

PillCam SB Improves Patient Outcomes and May Reduce Healthcare Costs

Results of the second study, a one-year follow-up study (#P1097), led by Dr. Robert Bulat, with Dr. Scott Pollack  and Dr. Geoffrey Kitzman, Department of Gastroenterology, Tulane University, demonstrated that use of capsule endoscopy reduced the need for follow-up procedures such as endoscopies as well as other procedures.

"While multiple studies have confirmed capsule endoscopy's value in definitively diagnosing patients with obscure GI bleeding, few clinical studies have assessed the impact of capsule endoscopy on patient outcomes," said Dr. Robert Bulat. "The results of our study show that in non-AVM/angioectasia patients, small bowel capsule endoscopy is associated with a reduction in blood transfusions, procedures and clinic visits, which is likely to have had a significant impact on reduction in healthcare costs and hopefully, improved quality of life."

Data were collected on all patients who underwent capsule endoscopy at Tulane University Hospital and Clinic from April 2003, through August 2005. Multiple diagnoses were discovered and many patients had more than one diagnosis. Forty-seven (47) patients suffering from obscure GI bleeding (OGIB) underwent capsule endoscopy and met the one-year follow-up criteria; 27 patients had other diagnoses. Researchers documented the number of office visits, units of Packed Red Blood Cell (PRBC) transfusions, as well as EGDs and colonoscopies for one year before and after the capsule endoscopy procedure.
Findings included:

For OGIB patients:

•   69% reduction in the number of colonoscopies
•   42% reduction in the number of EGDs performed
•   24% reduction in the number of office visits
•   20% reduction in the units of PRBC transfused

   
For patients with other diagnoses:

•   55% reduction in colonoscopies performed
•   50% reduction in units of PRBCs transfused
•   44% reduction in EGDs
•   35% reduction in office visits
  

Twenty patients were discovered to have arteriovenous malformations (AVMs). AVM patients had an 8% reduction in office visits, 40% reduction in EGDs and 82% reduction in colonoscopies, but reported a 48% increase in units of PRBCs transfused. Study authors indicate that PRBC increase is likely explained by the difficulty in treating AVMs and their association with recurrent bleeding. This group demonstrated strong reductions in number of endoscopies, which the authors noted may predict decreased health care costs.

Retrospective Study Looks at Treatment Changes (#P949)

The first, a single-center retrospective study (#P949) led by Laurel Fisher, M.D., Division of Gastroenterology, University of Michigan, Ann Arbor, showed that use of capsule endoscopy led to a change in clinical management in nearly one-third of all patients and 45 percent of obscure GI bleeding patients.

"GI bleeding is a severe condition, so it's crucial that we locate the source of the hemorrhage and treat the patient as quickly and effectively as possible," said Dr. Fisher. "This study demonstrates that capsule endoscopy allows us to make actionable diagnoses from the findings in a high percentage of patients."

This retrospective study reviewed the cases of 731 adult patients who underwent capsule endoscopy at the University of Michigan from January 2007 through December 2008 and excluded 59 patients due to poor preparation, gastric retention or lack of follow up. Researchers categorized capsule endoscopy findings as being significant, insignificant or questionably significant. Change in clinical management, either medical or procedural, was determined by a review of each medical record.

•   Overall 69% (464/672) of the patients had positive findings while 33%
•     (224/672) of the patients had significant capsule endoscopy findings.
•   A change in clinical management due to capsule endoscopy was reported
•     in 31% (209/672) of the patients.
•   Patients with obscure GI bleeding had a change in clinical management
•     in 45.1% (83/184) of the cases as a result of capsule endoscopy findings.
•   Of the patients included in the retrospective study, 30.2% (203) had
•     known or suspected Crohn's disease, 34.5% (231) had Iron Deficiency Anemia
•     (IDA), 29.9% (200) suffered from abdominal pain and 28.9% (148) of patients
•     had obscure GI bleeding.
• 
  
• Source: Given Imaging Ltd.

   
You can discuss more about Gastroenterology & Endoscopy and related topics in our Gastroenterology & Endoscopy group.