Predictive Validity of the TIGER Score for Daily-Life Disease Burden, Complications, and Medication Use in Inflammatory Bowel Disease After 12 Months

INTRODUCTION: – The Toronto Inflammatory Bowel Disease (IBD) Global Endoscopic Reporting (TIGER) score was developed to provide 1 endoscopic scoring index for patients with both Crohn's disease (CD) and ulcerative colitis (UC). The goal of this study was to assess the predictive validity the TIGER score for daily-life disease burden (IBD Disk) and disease complications.METHODS: – A prospective 12-month study was conducted in 1 tertiary IBD center. Baseline colonoscopy was performed. Moderate-to-severe mucosal involvement was defined as a TIGER score ≥100, Simple Endoscopic Score for CD >6, Mayo Endoscopic Score >1, and was used as a predictor for clinical outcomes. At each visit, IBD Disk questionnaires, disease complications, hospitalizations, surgeries, and medications were documented.RESULTS: – A total of 107 adults, 52 with CD and 55 with UC, were included. Patients with a baseline TIGER score ≥100 had a significantly higher prevalence of an IBD Disk score ≥40 after the 12-month follow-up period despite receiving advanced therapy (33.9% vs 7.8%, P < 0.001). There were significantly more patients with a baseline TIGER score ≥100 who experienced at least 1 hospitalization (39.3% vs 2.0%, P < 0.001), underwent surgery (14.3% vs 0.0%, P < 0.005), had IBD-related complications (41.1% vs 9.8%, P < 0.001), and required steroids (67.9% vs 5.9%, P < 0.001) or advanced therapy (85.7% vs 7.8%, P < 0.001). Similar significant results were obtained with Simple Endoscopic Score for CD and Mayo Endoscopic Score as predictors of outcomes over the 12 months.DISCUSSION: – The TIGER score is a simple endoscopic score for patients with CD and UC with an adequate predictive validity for worse clinical outcomes while having noninferiority to the current best-referenced endoscopic scores.