Can Intestinal Ultrasound Predict Whether an IBD Biologic Will Keep Working?: Scandinavian Journal of Gastroenterology | September 2026

What Did the Study Find?

This prospective one-year study evaluated whether intestinal ultrasound (IUS) could predict sustained biologic effectiveness in 77 patients with IBD.

Transmural remission was defined as bowel-wall thickness ≤3 mm with absent Doppler activity.

78% of patients with transmural remission remained successfully on their biologic versus 38% without remission.

Treatment persistence meant avoiding dose escalation, corticosteroids, biologic switching and surgery.

IUS remission showed predictive performance broadly comparable with endoscopic remission.

When both transmural and endoscopic remission were achieved, 95% maintained treatment persistence over the following year.

The cohort was small and predominantly treated with infliximab.

Why Does It Matter?

IUS is increasingly moving beyond convenient disease assessment toward a non-invasive treat-to-target monitoring tool capable of informing longer-term therapeutic decisions.

GastroAGI Takeaway

A normal bowel wall with absent Doppler activity may provide meaningful reassurance that current biologic therapy can be continued. IUS could reduce unnecessary escalation and complement endoscopy, but this small observational study is practice-informing—not sufficient to replace endoscopic assessment universally.