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Surveillance in inflammatory bowel disease: white light endoscopy with segmental re-inspection versus dye-based chromoendoscopy - a multi-arm randomised controlled trial (HELIOS)
Surveillance in inflammatory bowel disease: white light endoscopy with segmental re-inspection versus dye-based chromoendoscopy - a multi-arm randomised controlled trial (HELIOS)
Te Groen M, Wijnands AM, den Broeder N, de Jong DJ, van Dop WA, Duijvestein M, Fidder HH, van Schaik F, Hirdes MMC, van der Meulen-de Jong AE, Maljaars PWJ, Voorneveld PW, de Boer KHN, Peters CP, Oldenburg B, Hoentjen F; Dutch Initiative on Crohn and Colitis
Gut. 2025 Mar 6;74(4):547-556. doi: 10.1136/gutjnl-2024-333446. PMID: 39819862.
Highlights

• The HELIOS study was multicentre, randomised controlled trial, seeking to compare different surveillance strategies to detect coloretal neoplasia in IBD patients espaço.png

• IBD patients without active disease and scheduled for endoscopic surveillance were randomised 2:2:1 to HD white-light endoscopy with segmental re-inspection of each colonic segment (double pass), HD chromoendoscopy or single-pass HD white-light endoscopy. Primary outcome was colorectal neoplasia detection rate and a non-inferiority margin of 10% was defined. espaço.png

• A total of 563 patients were included. Colorectal neoplasia detection rates were 10.3% (n=24/234) for HD white-light endoscopy with segmental re-inspection, 13.1% (n=28/214) for HD chromoendoscopy and 6.1% (n=7/115) for single-pass HD white-light endoscopy. espaço.png

• HD white-light endoscopy with segmental re-inspection was non-inferior to HD chromoendoscopy for colorectal neoplasia detection in IBD patients. This suggests that the benefit of HD chromoendoscopy may be due to longer withdrawal and inspection time. However, the neoplasia detetion rate of WL-HD with double pass was not statistically superior to single pass WL-HD. espaço.png

• In clinical practice, HD white-light endoscopy with segmental re-inspection might be a reasonable alternative to HD chromoendoscopy