The Toronto IBD Global Endoscopic Reporting (TIGER) Score and its Ability to Predict Outcomes Regarding Steroid and Biologic Use in Ulcerative Colitis and Crohn’s Disease Patients – A Construct Validation Study

Aims The recently developed TIGER endoscopy score was established to reliably describe disease severity as it can be utilized for both Ulcerative Colitis (UC) and Crohn’s disease (CD) patients [1]. The aim of this prospective study was to assess the TIGER score’s ability to predict UC and CD patient outcomes including biologic and steroid use.

Methods A cohort of 78 patients with UC (n=40) and CD (n=38) was followed for 52 weeks in a multiple-visit prospective study. Each visit included patient interviews using the IBD disk questionnaire, blood draws for C-reactive protein (CRP) mg/DL, and fecal calprotectin (FC) μg/g. An endoscopy assessment was performed at baseline. Steroids, biologics, and dose escalations were recorded. Baseline total TIGER scores were dichotomized as <100 points (remission-mild endoscopic activity) or ≥100 points (moderate-severe endoscopic activity).

Results At baseline, UC and CD patients with TIGER scores ≥100 had significantly positively correlated with CRP mg/DL (p<0.001), FC μg/g (p<0.001), and IBD disk score (p<0.001).

At 52 weeks, UC and CD patients with baseline TIGER scores ≥100 had a significantly increased likelihood of requiring steroid use(p<0.0001). Moreover, UC and CD patients with baseline TIGER scores≥100 both had a significantly increased likelihood of being prescribed or having to subsequently escalate biologic therapy (p<0.0001).

Conclusions The TIGER endoscopy score demonstrates a significant association with CRP, FC, and IBD disk in both UC and CD patients. Moreover, the TIGER endoscopy score ≥100 points can be utilized as a measure to predict the likelihood of requiring certain therapeutic interventions.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 Zittan E, Steinhart AH, Aran H. et al. The Toronto IBD Global Endoscopic Reporting [TIGER] Score: A Single, Easy to Use Endoscopic Score for Both Crohn's Disease and Ulcerative Colitis Patients. J Crohns Colitis 2022; 16: 544-553

Publication History

Article published online:
14 April 2023