Wearable technology, including wrist-worn smartwatches that monitor heart rate variability, may help identify and predict flares of inflammatory bowel disease, according to data presented at the Crohn’s and Colitis Congress.

“It is challenging to identify and predict IBD flares, and we lack easy and convenient means to monitor patients,” Robert P. Hirten, MD, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai,told Healio. “Currently we rely on the use of blood or stool tests, imaging tests such as CT scans or MRIs, colonoscopies [and] symptom reporting by patients. It is our hope to one day be able to use wearable devices, which are commonly used, convenient and passive, to be able to monitor for changes in the body that could alert us to a current or impending disease flare.”

To determine whether wearable technology assessing physiological metrics — including heart rate variability, a marker of autonomic nervous system function — may be able to predict IBD flares and other inflammatory events, Hirten and colleagues launched The IBD Forecast study.

Within this prospective study, the researchers enrolled patients with IBD (n = 125) aged 18 years or older in the United States, who were willing to use a commercially available wearable device, download a custom eHive app and answer daily questions.

Hirten and colleagues analyzed heart rate variability metrics using a mixed-effect cosigner model that integrated BMI, age and sex. They also used daily patient reported outcome (PRO)-2 surveys to assess clinical flares (flare; PRO-2 Crohn’s disease >7, PRO-2 ulcerative colitis >2), while inflammatory flare was evaluated through patient-reported C-reactive protein, defined as at least 5 mg/L.

According to preliminary analysis, the mesor of the circadian pattern of heart rate variability metrics was higher among patients undergoing clinical flare (mean = 44.43; 95% CI, 41.25-47.75) vs. those in clinical remission (mean = 43.03; 95% CI, 39.94-46.22). Additionally, the mesor of the circadian pattern was lower in patients with an inflammatory flare (mean = 38.16; 95% CI, 30.86-45.72) vs. patients with normal inflammatory markers (mean = 49.51; 95% CI, 43.12-56.26).

“We find that there are significant changes in autonomic nervous system function, reflected in heart rate variability measurements, when individuals with IBD develop symptoms or develop inflammation,” Hirten said. “This demonstrates the possibility of using wearable devices to identify, and possibly, predict flares.”

Although the IBD Forecast Study is still ongoing, Hirten noted that he hopes machine-learning algorithms can be developed with data from wearable devices to reliably track changes in autonomic function that precede an IBD flare.

“These early results demonstrate that wearable devices may hold promise in the ability to identify and predict IBD flares, though much more work is still needed,” Hirten told Healio. “I hope these results demonstrate that in the future we can use new technologies, like wearable devices, to monitor our patient’s health and improve their care.”