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Bridging the Gap: From Clinic to Home in IBD Monitoring. 弥合差距:从临床到家庭的IBD监测。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1093/ibd/izaf251
Luisa Bertin, Edoardo Vincenzo Savarino

Home-based capillary blood sampling represents a paradigm shift toward patient-centered IBD monitoring, offering particular advantages for pediatric populations while requiring external validation before widespread clinical implementation.

以家庭为基础的毛细血管采血代表了向以患者为中心的IBD监测的范式转变,为儿科人群提供了特别的优势,但在广泛的临床实施之前需要外部验证。
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引用次数: 0
Combination Therapy With Fecal Microbiota Transplantation and Vedolizumab for Induction of Remission in Ulcerative Colitis: An Open-Label Pilot Study. 粪便菌群移植和Vedolizumab联合治疗溃疡性结肠炎缓解:一项开放标签的试点研究。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1093/ibd/izaf284
Saad Syed, Paul Moayyedi, Dina Kao, Jaiminkumar Patel, John K Marshall, Michael Surette, Neeraj Narula
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引用次数: 0
Altered Gut Microbiota in Pediatric Quiescent Crohn's Disease Patients with Iron Deficiency Anemia. 儿童静止性克罗恩病伴缺铁性贫血患者肠道菌群的改变
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1093/ibd/izaf295
Elliott S Gordon, Jeremy Goc, Alexander Grier, Charlene Thomas, Jennifer Lentine, Robbyn E Sockolow, Gregory F Sonnenberg

Background: Iron deficiency anemia (IDA) is the most common extra-intestinal complication in inflammatory bowel disease (IBD). The persistence of iron deficiency in patients living with quiescent IBD remains poorly understood. Given the extensive body of research linking IBD pathogenesis to microbiome disruptions, it is hypothesized that alterations in the microbiota or immune responses may drive the persistence of IDA in quiescent Crohn's disease. This study aimed to determine whether changes in the gut microbiota or immune phenotypes contribute to IDA, while uncovering potential mechanisms driving IDA in quiescent disease.

Methods: This cross-sectional, descriptive, and analytical study utilized 141 samples from pediatric Crohn's disease patients with and without iron deficiency as well as healthy controls for initial 16S microbiome analysis and a smaller subset for Shotgun Metagenomics and immunologic analyses. Fecal and peripheral blood samples were obtained from the Jill Roberts Institute Live Cell Bank.

Results: While no major differences were observed in the overall gut microbiome composition between pediatric patients with quiescent Crohn's disease, with or without IDA, notable shifts in specific microbial strains were identified. Specifically, levels of Anaerobutyricum soehngenii and Alistipes shahii were significantly altered. Metagenomic analysis revealed an enrichment of pathways related to short-chain fatty acid metabolism and ascorbate degradation, indicative of functional change in these microbes.

Conclusions: This is the first comprehensive microbiome analysis of quiescent pediatric Crohn's disease with concomitant IDA. The findings indicate modest but significant microbial strain-level differences and associated functional pathways, potentially implicating microbiota-mediated mechanisms in the persistence of IDA.

背景:缺铁性贫血(IDA)是炎症性肠病(IBD)中最常见的肠外并发症。静止性IBD患者持续缺铁的原因尚不清楚。鉴于将IBD发病机制与微生物群破坏联系起来的广泛研究,假设微生物群或免疫反应的改变可能驱动静止性克罗恩病中IDA的持续存在。本研究旨在确定肠道微生物群或免疫表型的变化是否有助于IDA,同时揭示在静止疾病中驱动IDA的潜在机制。方法:这项横断面、描述性和分析性研究使用了141份来自患有和不患有铁缺乏症的儿童克罗恩病患者以及健康对照者的样本进行初始16S微生物组分析,并对一小部分样本进行Shotgun宏基因组学和免疫学分析。粪便和外周血样本来自吉尔罗伯茨研究所活细胞库。结果:虽然在患有或不患有IDA的静止性克罗恩病的儿科患者之间,总体肠道微生物组组成没有观察到重大差异,但确定了特定微生物菌株的显着变化。具体来说,soehngeni厌氧丁酸菌和Alistipes shahii的水平显著改变。宏基因组分析显示,与短链脂肪酸代谢和抗坏血酸降解相关的途径丰富,表明这些微生物的功能发生了变化。结论:这是首次对伴有IDA的静止期儿童克罗恩病进行全面的微生物组分析。研究结果表明,微生物菌株水平存在适度但显著的差异和相关的功能途径,可能暗示微生物介导的IDA持续机制。
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引用次数: 0
Cross-Sectional Imaging Features Associated With Disease Progression in Crohn's Disease. 与克罗恩病进展相关的横断影像特征。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1093/ibd/izaf219
Salam P Bachour, Shravya Srinivas-Rao, Nikitha Uma Baskaran, Manasi Agrawal, Henrik Albaek Jacobsen, Lone Larsen, Tine Jess, Jean-Frederic Colombel, Ryan C Ungaro, Avinash Kambadakone, Ashwin N Ananthakrishnan

Background and aims: Progressive Crohn's disease (CD) often requires early initiation of biologic or immunomodulator therapy for disease management. However, some patients may have a milder disease course that may be managed with a less aggressive strategy. Our study aims to determine cross-sectional radiographic features that predict progression of CD.

Methods: This was a multi-institution, retrospective cohort of adult CD patients without prior immunomodulator or biologic use, prior surgery, or CD-related hospitalization, who underwent abdominal cross-sectional imaging prior to 2018. Index cross-sectional imaging was reviewed by 2 radiologists who extracted 37 features pertaining to the intestine, mesentery, or extra-luminal complications. The primary outcome was composite progression of disease defined as initiation of an immunomodulator or biologic agent, surgical intestinal resection, or CD-related hospitalization.

Results: Our study included 177 CD patients who underwent cross-sectional imaging (81% CT). 81 patients (45.8%) experienced composite progression of disease. On multivariable regression, small bowel wall thickening >5 mm (aOR 8.59; P < .001), distal colonic inflammation (aOR 3.95; P = .03), and segmental mural hyperenhancement (aOR 2.44; P = .04) were independently associated with progression of disease. Absence of radiologic features identified a subgroup with a low rate (13.7%) of disease progression.

Conclusions: Cross-sectional imaging can be used to identify patients with mild CD who are at higher risk for progression. Absence of these features may identify mild CD requiring less aggressive treatment strategies and define a population eligible for trials of management strategies for mild CD.

背景和目的:进行性克罗恩病(CD)往往需要早期开始生物或免疫调节治疗的疾病管理。然而,一些患者可能病情较轻,可以采用不那么激进的策略进行管理。我们的研究旨在确定预测CD进展的横切面影像学特征。方法:这是一项多机构、回顾性队列研究,研究对象是在2018年之前接受腹部横切面成像的成年CD患者,他们之前没有使用过免疫调节剂或生物制剂,没有手术史,也没有CD相关的住院史。2名放射科医师回顾了指数横断成像,他们提取了37个与肠、肠系膜或腔外并发症有关的特征。主要终点是疾病的复合进展,定义为开始使用免疫调节剂或生物制剂、肠手术切除或cd相关住院治疗。结果:我们的研究包括177例CD患者,他们接受了横断面成像(81%的CT)。81例(45.8%)出现了疾病的复合进展。在多变量回归中,小肠壁增厚bbb50 mm (aOR 8.59; P)。结论:横断成像可用于识别轻度CD患者进展风险较高的患者。缺乏这些特征可以确定轻度乳糜泻需要较少积极的治疗策略,并确定有资格进行轻度乳糜泻管理策略试验的人群。
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引用次数: 0
Statin Use is Associated With Lower Odds of IBD-Related Surgery Among Patients With Moderate-to-Severe Inflammatory Bowel Disease. 他汀类药物的使用与中度至重度炎症性肠病患者ibd相关手术的低几率相关。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1093/ibd/izaf227
Jennifer D Claytor, Palak Rajauria, Jellyana Peraza, Jean-Frederic Colombel, Ryan C Ungaro

Background: Statins may have anti-inflammatory activity in inflammatory bowel disease (IBD). We aimed to investigate any impact of statins on disease progression in moderate-to-severe IBD.

Methods: We conducted a retrospective cohort study of patients with moderate-to-severe IBD and at least 2 outpatient visits between 2000 and 2023 at a large, urban hospital system. Using the Mount Sinai Data Warehouse, we collected data on biologic, small molecule, or immunomodulator use for IBD, cardiovascular (CV) medications, and International Classification of Diseases codes designating IBD hospitalizations and surgeries. Our primary outcome was IBD-related surgery in statin users and nonusers, adjusting for IBD and CV risk. Our secondary outcomes were IBD-related hospitalization, advanced therapy persistence, and time to IBD surgery. Multivariable regression analyses and propensity score matching were used to adjust for relevant clinical variables. Cox regression analysis assessed time to surgery in statin users versus nonusers.

Results: We identified 2421 patients with moderate-to-severe IBD who had longitudinal outpatient follow-up: 375 statin users and 2046 nonusers. Statin users had fewer IBD-related surgeries (5% vs 9%; P = .007). Statin users had a trend, but no significant difference, toward fewer hospitalizations per person (0.73 hospitalizations/person among statin users and 0.93 in nonusers; P = .09), although no difference in therapy persistence was noted. Statin users had lower hazards of surgery at 16 149 patient-years of follow-up (adjusted hazard ratio, 0.47; 95% confidence interval [CI], 0.26-0.85; P = .012). Propensity-adjusted odds ratios (ORs) showed a lower risk of IBD surgery (adjusted OR, 0.51; 95% CI, 0.27-0.95; P = .034) but not of IBD hospitalization (adjusted OR, 0.91; 95% CI, 0.73-1.14; P = .424) among statin users.

Conclusions: Patients with moderate-severe IBD using statins were less likely to experience IBD-related surgery in a real-world, electronic health record-based cohort.

背景:他汀类药物可能对炎症性肠病(IBD)有抗炎作用。我们的目的是调查他汀类药物对中度至重度IBD疾病进展的影响。方法:我们对2000年至2023年间在大型城市医院系统中至少有2次门诊就诊的中重度IBD患者进行了回顾性队列研究。利用西奈山数据仓库,我们收集了生物、小分子或免疫调节剂用于IBD、心血管(CV)药物的数据,以及IBD住院和手术的国际疾病分类代码。我们的主要结局是他汀类药物使用者和非使用者的IBD相关手术,调整IBD和CV风险。我们的次要结局是IBD相关住院、晚期治疗持续性和IBD手术时间。采用多变量回归分析和倾向评分匹配对相关临床变量进行调整。Cox回归分析评估了他汀类药物使用者与非他汀类药物使用者的手术时间。结果:我们确定了2421例中重度IBD患者进行了纵向门诊随访:375例他汀类药物使用者和2046例非他汀类药物使用者。他汀类药物使用者的ibd相关手术较少(5% vs 9%; P = 0.007)。他汀类药物服用者有减少人均住院次数的趋势,但没有显著差异(他汀类药物服用者0.73次/人,非他汀类药物服用者0.93次/人,P = 0.09),尽管在治疗持久性方面没有注意到差异。他汀类药物使用者在随访16 149患者年时手术风险较低(校正风险比0.47;95%可信区间[CI], 0.26-0.85; P = 0.012)。经倾向校正的比值比(OR)显示,他汀类药物使用者的IBD手术风险较低(校正OR为0.51;95% CI为0.27-0.95;P = 0.034),但IBD住院风险较低(校正OR为0.91;95% CI为0.73-1.14;P = 0.424)。结论:在现实世界中,基于电子健康记录的队列中,使用他汀类药物的中重度IBD患者不太可能经历IBD相关手术。
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引用次数: 0
Systematic review and meta-analysis of childhood exposure to antibiotics and the subsequent risk of IBD. 儿童抗生素暴露与随后IBD风险的系统回顾和荟萃分析。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1093/ibd/izaf324
Ketil Størdal, Svend Andersen, Karl Mårild, Vilhelm Larsson, Henrik Imberg

Background: Antibiotic use in early childhood may alter the developing microbiome and has been proposed as a risk factor for inflammatory bowel disease (IBD). We conducted a systematic review to examine the association between childhood antibiotic use and subsequent risk of IBD.

Methods: In a systematic literature search, we identified cohort and case-control studies reporting the association between antibiotic use (exposure age <1 to 17 years) and development of IBD. MEDLINE and EMBASE databases were searched from inception through December 31, 2024. Studies reporting a hazard ratio, odds ratio, or risk ratio (RR) were included. To account for heterogeneity, pooled estimates were calculated using the DerSimonian-Laird random-effects model. Estimates were adjusted for potential confounding as reported in the original studies.

Results: We identified 10 studies, of which 8 (n = 2783 cases) reported associations between childhood antibiotics and IBD risk. Additionally, 2 studies on Crohn's disease (CD) and 1 on ulcerative colitis were included in disease-specific analyses. In pooled analyses, antibiotic exposure compared with no exposure was associated with increased risk of IBD (RR, 1.42; 95% confidence interval [CI], 1.23-1.66), CD (RR, 1.59; 95% CI, 1.39-1.81), and ulcerative colitis (RR, 1.23; 95% CI, 1.08-1.40). Heterogeneity was low to moderate (I2 = 0%-35%), and funnel plots did not indicate publication bias (Egger's test, P = .12-.43). Adjustment for infections did not attenuate the association between childhood antibiotic exposure and IBD development.

Conclusions: While causal interpretation should be cautious, childhood exposure to antibiotics was associated with an increased risk of later IBD, particularly for CD.

背景:儿童早期使用抗生素可能会改变发育中的微生物群,并被认为是炎症性肠病(IBD)的危险因素。我们进行了一项系统综述,以检查儿童抗生素使用与随后IBD风险之间的关系。方法:在系统的文献检索中,我们确定了报告抗生素使用(暴露年龄)之间关联的队列研究和病例对照研究。结果:我们确定了10项研究,其中8项(n = 2783例)报告了儿童抗生素与IBD风险之间的关联。此外,2项关于克罗恩病(CD)的研究和1项关于溃疡性结肠炎的研究被纳入疾病特异性分析。在汇总分析中,与未暴露抗生素相比,暴露抗生素与IBD (RR, 1.42; 95%可信区间[CI], 1.23-1.66)、CD (RR, 1.59; 95% CI, 1.39-1.81)和溃疡性结肠炎(RR, 1.23; 95% CI, 1.08-1.40)的风险增加相关。异质性为低至中度(I2 = 0%-35%),漏斗图未显示发表偏倚(Egger检验,P = 0.12 - 0.43)。对感染进行调整并没有减弱儿童抗生素暴露与IBD发展之间的关联。结论:虽然因果关系的解释应该谨慎,但儿童暴露于抗生素与后来IBD的风险增加有关,特别是CD。
{"title":"Systematic review and meta-analysis of childhood exposure to antibiotics and the subsequent risk of IBD.","authors":"Ketil Størdal, Svend Andersen, Karl Mårild, Vilhelm Larsson, Henrik Imberg","doi":"10.1093/ibd/izaf324","DOIUrl":"https://doi.org/10.1093/ibd/izaf324","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic use in early childhood may alter the developing microbiome and has been proposed as a risk factor for inflammatory bowel disease (IBD). We conducted a systematic review to examine the association between childhood antibiotic use and subsequent risk of IBD.</p><p><strong>Methods: </strong>In a systematic literature search, we identified cohort and case-control studies reporting the association between antibiotic use (exposure age <1 to 17 years) and development of IBD. MEDLINE and EMBASE databases were searched from inception through December 31, 2024. Studies reporting a hazard ratio, odds ratio, or risk ratio (RR) were included. To account for heterogeneity, pooled estimates were calculated using the DerSimonian-Laird random-effects model. Estimates were adjusted for potential confounding as reported in the original studies.</p><p><strong>Results: </strong>We identified 10 studies, of which 8 (n = 2783 cases) reported associations between childhood antibiotics and IBD risk. Additionally, 2 studies on Crohn's disease (CD) and 1 on ulcerative colitis were included in disease-specific analyses. In pooled analyses, antibiotic exposure compared with no exposure was associated with increased risk of IBD (RR, 1.42; 95% confidence interval [CI], 1.23-1.66), CD (RR, 1.59; 95% CI, 1.39-1.81), and ulcerative colitis (RR, 1.23; 95% CI, 1.08-1.40). Heterogeneity was low to moderate (I2 = 0%-35%), and funnel plots did not indicate publication bias (Egger's test, P = .12-.43). Adjustment for infections did not attenuate the association between childhood antibiotic exposure and IBD development.</p><p><strong>Conclusions: </strong>While causal interpretation should be cautious, childhood exposure to antibiotics was associated with an increased risk of later IBD, particularly for CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical response for 12 months or more to the first advanced therapy in IBD decreases long-term risk of hospitalization: a spirited stride…. IBD首个高级治疗12个月或更长时间的临床反应降低了长期住院风险:一个充满活力的进步....
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1093/ibd/izag003
Jimmy K Limdi
{"title":"Clinical response for 12 months or more to the first advanced therapy in IBD decreases long-term risk of hospitalization: a spirited stride….","authors":"Jimmy K Limdi","doi":"10.1093/ibd/izag003","DOIUrl":"https://doi.org/10.1093/ibd/izag003","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frequency of computed tomography scans in Crohn's disease patients in the emergency department. 急诊科克罗恩病患者的计算机断层扫描频率
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1093/ibd/izag008
Hannah W F Goodrich, Firrah Saeed, Neal D Dharmadhikari, Marylouise Moran, David Grand, Jonathan Movson, Samir A Shah

Background: Crohn's Disease patients are often subject to repeat computed tomography (CT) upon presentation to the emergency departments (ED). Due to early age of diagnosis and increase in ED visits, they can be exposed to substantial radiation posing long term increased risk of malignancy. In this retrospective study, we assess frequency of CT scans in the ED, urgent findings on CT, and patient characteristics correlating with multiple scans. We hope to identify predictive factors for urgent findings and for negative CT scans.

Methods: Six-hundred-and-sixty previously diagnosed Crohn's patients from four gastroenterology practices presented to three hospitals between April 15, 2015 and December 31, 2018 for 2473 total encounters. Patients were identified and cross-referenced with a radiology database search generating 1778 CT scans performed. Data was analyzed for presence of findings and demographics.

Results: CT scans were performed in 72% of encounters. There was a skewed distribution of CT scans (skew = 3.30), with 41% receiving only 1 scan, 43% receiving 2-4, and 16% receiving >5; the maximum was 24 scans for 1 patient. Positive findings including obstruction, perforation, or abscess were found in 28.5% of scans. Patients with barriers to healthcare had an increased rate of ED visits and imaging findings.

Conclusions: Radiation exposure in Crohn's patients is higher than that of the general population, owing to multiple CT scans often performed acutely in the ED. Factors we assessed could not reliably predict urgent findings on CT and a significant percentage of patients had urgent findings. However, we identified a group with multiple CTs associated with barriers to healthcare.

背景:克罗恩病患者在急诊科(ED)就诊时经常需要重复进行CT扫描。由于早期诊断和急诊就诊的增加,他们可能暴露在大量辐射中,长期增加恶性肿瘤的风险。在这项回顾性研究中,我们评估了急诊科CT扫描的频率、CT上的紧急发现以及与多次扫描相关的患者特征。我们希望确定紧急发现和阴性CT扫描的预测因素。方法:2015年4月15日至2018年12月31日期间,来自四个胃肠病学诊所的660名先前诊断为克罗恩病的患者在三家医院就诊,共2473次就诊。对患者进行识别,并与放射学数据库进行交叉参考,检索产生了1778次CT扫描。分析数据是否存在调查结果和人口统计学特征。结果:72%的患者接受了CT扫描。CT扫描呈偏态分布(偏态= 3.30),41%的患者仅接受1次扫描,43%的患者接受2-4次扫描,16%的患者接受5次扫描;最多为1名患者进行24次扫描。28.5%的扫描发现阳性结果包括梗阻、穿孔或脓肿。有保健障碍的患者急诊科就诊率和影像学检查结果增加。结论:由于在急诊科经常进行多次CT扫描,克罗恩病患者的辐射暴露高于一般人群。我们评估的因素不能可靠地预测CT上的紧急发现,而且有相当比例的患者出现了紧急发现。然而,我们确定了一组与医疗保健障碍相关的多重ct。
{"title":"Frequency of computed tomography scans in Crohn's disease patients in the emergency department.","authors":"Hannah W F Goodrich, Firrah Saeed, Neal D Dharmadhikari, Marylouise Moran, David Grand, Jonathan Movson, Samir A Shah","doi":"10.1093/ibd/izag008","DOIUrl":"https://doi.org/10.1093/ibd/izag008","url":null,"abstract":"<p><strong>Background: </strong>Crohn's Disease patients are often subject to repeat computed tomography (CT) upon presentation to the emergency departments (ED). Due to early age of diagnosis and increase in ED visits, they can be exposed to substantial radiation posing long term increased risk of malignancy. In this retrospective study, we assess frequency of CT scans in the ED, urgent findings on CT, and patient characteristics correlating with multiple scans. We hope to identify predictive factors for urgent findings and for negative CT scans.</p><p><strong>Methods: </strong>Six-hundred-and-sixty previously diagnosed Crohn's patients from four gastroenterology practices presented to three hospitals between April 15, 2015 and December 31, 2018 for 2473 total encounters. Patients were identified and cross-referenced with a radiology database search generating 1778 CT scans performed. Data was analyzed for presence of findings and demographics.</p><p><strong>Results: </strong>CT scans were performed in 72% of encounters. There was a skewed distribution of CT scans (skew = 3.30), with 41% receiving only 1 scan, 43% receiving 2-4, and 16% receiving >5; the maximum was 24 scans for 1 patient. Positive findings including obstruction, perforation, or abscess were found in 28.5% of scans. Patients with barriers to healthcare had an increased rate of ED visits and imaging findings.</p><p><strong>Conclusions: </strong>Radiation exposure in Crohn's patients is higher than that of the general population, owing to multiple CT scans often performed acutely in the ED. Factors we assessed could not reliably predict urgent findings on CT and a significant percentage of patients had urgent findings. However, we identified a group with multiple CTs associated with barriers to healthcare.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Persistence and safety of subcutaneous infliximab up to 1 year after switching from intravenous infliximab in pediatric inflammatory bowel disease: a multicenter real-world cohort study. 从静脉注射英夫利昔单抗转为皮下注射英夫利昔单抗治疗儿童炎症性肠病长达1年的持久性和安全性:一项多中心真实世界队列研究
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1093/ibd/izaf335
Esmée Helen Boute, Laura Gianolio, Shaden Mahmmod, Saverio Pochesci, Katherine Armstrong, Paul Henderson, David Charles Wilson, Lissy de Ridder, Richard Kay Russell, Johanna Caroline Escher

Introduction: Real-world data regarding subcutaneous infliximab (SC-IFX) in patients with pediatric inflammatory bowel disease IBD (PIBD) is scarce. We evaluated SC-IFX as maintenance therapy in PIBD patients who switched to SC-IFX from intravenous infliximab (IV-IFX) treatment.

Methods: In this retrospective multicenter study we identified PIBD patients who switched to SC-IFX. The primary outcome was treatment persistence at up to 12 months post-switch. Secondary outcomes included relapse rate (defined as Pediatric Ulcerative Colitis Activity Index [PUCAI]  ≥10/ weighted PCDAI  ≥ 12.5 with biochemical/endoscopic evidence of disease activity), IFX trough levels, immunogenicity, safety, and acceptance.

Results: Sixty-six patients switched to SC-IFX (48% males; median switch-age, 16.5 years; IQR, 14.9-17.3 years; median switch-weight, 60 kg; range, 13-102 kg), 41/66 (62%) with Crohn Disease. Pre-switch, the median IV-IFX maintenance dose was 10 mg/kg every 6 weeks; 58/66 patients (88%) were in clinical remission. The initial SC-IFX regimen was 120 mg every other week in 62/66 patients (94%). SC-IFX persistence was 78% (95% CI, 66-91) at 12 months post-switch, with 89% of patients persisting on IFX, either intravenous (IV) or subcutaneous (SC), at the end of follow-up. Relapses were observed in 11/66 patients (17%) over a median follow-up of 11.0 months (IQR, 5.1-12.0); 6 patients underwent SC-IFX dose intensification, with 3 successfully regaining clinical response. Regarding anti-drug antibodies (ADA), 3 out of 4 patients who were ADA positive on IV-IFX resolved post-switch. Overall, 19/66 patients (29%) reported 21 adverse events (AEs), including 3/21 severe AEs. The majority (53/66 patients; 80%) expressed a positive attitude toward SC-IFX.

Conclusions: The largest documented PIBD cohort switching to SC-IFX to date showed high treatment persistence at 1 year, confirming SC-IFX as an effective and safe maintenance alternative to IV-IFX.

关于儿童炎症性肠病IBD (PIBD)患者的皮下英夫利昔单抗(SC-IFX)的实际数据很少。我们评估了SC-IFX作为PIBD患者从静脉注射英夫利昔单抗(IV-IFX)治疗转为SC-IFX的维持治疗。方法:在这项回顾性多中心研究中,我们确定了改用SC-IFX的PIBD患者。主要结局是转换后治疗持续12个月。次要结局包括复发率(定义为小儿溃疡性结肠炎活动指数[PUCAI]≥10/加权PCDAI≥12.5,生化/内镜证据表明疾病活动)、IFX谷底水平、免疫原性、安全性和接受度。结果:66例患者转为SC-IFX(男性48%,中位转换年龄16.5岁,IQR 14.9-17.3岁,中位转换体重60 kg,范围13-102 kg), 41/66例(62%)为克罗恩病。切换前,IV-IFX的中位维持剂量为每6周10 mg/kg;58/66例(88%)患者临床缓解。62/66例患者(94%)的初始SC-IFX方案为每隔一周120 mg。转换后12个月,SC-IFX的持久性为78% (95% CI, 66-91),在随访结束时,89%的患者持续静脉注射(IV)或皮下注射(SC) IFX。在中位随访11.0个月(IQR, 5.1-12.0)期间,11/66例患者(17%)出现复发;6例患者接受SC-IFX剂量强化,其中3例成功恢复临床反应。在抗药物抗体(ADA)方面,4例IV-IFX ADA阳性患者中有3例在转换后消退。总体而言,66例患者中有19例(29%)报告了21例不良事件(ae),其中3/21例为严重ae。大多数患者(53/66例,80%)对SC-IFX表示积极态度。结论:迄今为止,最大的PIBD队列改用SC-IFX显示了1年的高治疗持久性,证实SC-IFX是IV-IFX的有效和安全的维持替代方案。
{"title":"Persistence and safety of subcutaneous infliximab up to 1 year after switching from intravenous infliximab in pediatric inflammatory bowel disease: a multicenter real-world cohort study.","authors":"Esmée Helen Boute, Laura Gianolio, Shaden Mahmmod, Saverio Pochesci, Katherine Armstrong, Paul Henderson, David Charles Wilson, Lissy de Ridder, Richard Kay Russell, Johanna Caroline Escher","doi":"10.1093/ibd/izaf335","DOIUrl":"https://doi.org/10.1093/ibd/izaf335","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world data regarding subcutaneous infliximab (SC-IFX) in patients with pediatric inflammatory bowel disease IBD (PIBD) is scarce. We evaluated SC-IFX as maintenance therapy in PIBD patients who switched to SC-IFX from intravenous infliximab (IV-IFX) treatment.</p><p><strong>Methods: </strong>In this retrospective multicenter study we identified PIBD patients who switched to SC-IFX. The primary outcome was treatment persistence at up to 12 months post-switch. Secondary outcomes included relapse rate (defined as Pediatric Ulcerative Colitis Activity Index [PUCAI]  ≥10/ weighted PCDAI  ≥ 12.5 with biochemical/endoscopic evidence of disease activity), IFX trough levels, immunogenicity, safety, and acceptance.</p><p><strong>Results: </strong>Sixty-six patients switched to SC-IFX (48% males; median switch-age, 16.5 years; IQR, 14.9-17.3 years; median switch-weight, 60 kg; range, 13-102 kg), 41/66 (62%) with Crohn Disease. Pre-switch, the median IV-IFX maintenance dose was 10 mg/kg every 6 weeks; 58/66 patients (88%) were in clinical remission. The initial SC-IFX regimen was 120 mg every other week in 62/66 patients (94%). SC-IFX persistence was 78% (95% CI, 66-91) at 12 months post-switch, with 89% of patients persisting on IFX, either intravenous (IV) or subcutaneous (SC), at the end of follow-up. Relapses were observed in 11/66 patients (17%) over a median follow-up of 11.0 months (IQR, 5.1-12.0); 6 patients underwent SC-IFX dose intensification, with 3 successfully regaining clinical response. Regarding anti-drug antibodies (ADA), 3 out of 4 patients who were ADA positive on IV-IFX resolved post-switch. Overall, 19/66 patients (29%) reported 21 adverse events (AEs), including 3/21 severe AEs. The majority (53/66 patients; 80%) expressed a positive attitude toward SC-IFX.</p><p><strong>Conclusions: </strong>The largest documented PIBD cohort switching to SC-IFX to date showed high treatment persistence at 1 year, confirming SC-IFX as an effective and safe maintenance alternative to IV-IFX.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term clinical and endoscopic outcomes of ulcerative colitis after liver transplantation: a multicenter cohort study on the use and safety of advanced therapies. 肝移植后溃疡性结肠炎的长期临床和内镜预后:一项关于先进疗法的使用和安全性的多中心队列研究
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-30 DOI: 10.1093/ibd/izaf330
Ebru Ar, Irini Solomonidou, Henrike Lenzen, Miriam Wiestler, Claudia Veltkamp, Katharina Willuweit, Jassin Rashidi-Alavijeh, Hartmut H Schmidt, Richard Vollenberg, Phil-Robin Tepasse, Jonel Trebicka, Stefanie Tischendorf, Carsten Elfers, Karim Hamesch, Arne Bokemeyer

Background: Some patients with ulcerative colitis (UC) develop advanced liver disease due to conditions such as primary sclerosing cholangitis (PSC) and may require liver transplantation (LT). However, data on the long-term course of UC and the use of advanced therapies in LT recipients are limited. We aimed to evaluate UC activity before and after LT, as well as the role of advanced therapies over extended follow-up in this population.

Methods: This was a retrospective, multicenter cohort study including 213 patients with UC who underwent LT between 2000 and 2022. Clinical disease activity (partial Mayo score), endoscopic disease activity (Mayo endoscopic subscore), and the use of advanced therapies were evaluated before and after transplantation.

Results: Among the 213 patients, the clinical remission rate was 84.7% before and 81.2% after LT, showing no significant change (P = .416). Despite stable clinical remission, 27.9% of patients exhibited moderate-to-severe endoscopic inflammation during long-term follow-up (mean: 110 months). The use of advanced therapies increased significantly after LT (from 3.7% to 12.7%, P = .005) and was not associated with an increase in infectious complications (P = .591).

Conclusions: In most patients, clinical disease activity remains stable after LT. However, persistent moderate-to-severe mucosal inflammation is observed in a substantial subset during long-term follow-up. Advanced therapies, particularly vedolizumab, are being used more frequently in this setting and may offer disease control without a corresponding increase in infection risk. These findings underscore the need for individualized, interdisciplinary management and further prospective evaluation of treatment strategies in this population.

背景:一些溃疡性结肠炎(UC)患者由于原发性硬化性胆管炎(PSC)等疾病发展为晚期肝脏疾病,可能需要肝移植(LT)。然而,关于UC的长期病程和LT受体使用先进疗法的数据是有限的。我们的目的是评估肝移植前后UC的活性,以及先进疗法在该人群中延长随访期间的作用。方法:这是一项回顾性、多中心队列研究,包括213例UC患者,他们在2000年至2022年间接受了肝移植。评估移植前后的临床疾病活动性(部分Mayo评分)、内镜下疾病活动性(Mayo内镜亚评分)和先进疗法的使用情况。结果:213例患者中,术后临床缓解率分别为84.7%和81.2%,差异无统计学意义(P = 0.416)。尽管临床缓解稳定,但27.9%的患者在长期随访期间(平均:110个月)表现出中度至重度内窥镜炎症。LT后先进疗法的使用显著增加(从3.7%增加到12.7%,P =。005),与感染并发症的增加无关(P = .591)。结论:在大多数患者中,临床疾病活动在lt后保持稳定。然而,在长期随访期间,在相当一部分患者中观察到持续的中度至重度粘膜炎症。先进的治疗方法,特别是vedolizumab,在这种情况下被更频繁地使用,可能在不增加感染风险的情况下提供疾病控制。这些发现强调了在这一人群中进行个性化、跨学科管理和进一步前瞻性评估治疗策略的必要性。
{"title":"Long-term clinical and endoscopic outcomes of ulcerative colitis after liver transplantation: a multicenter cohort study on the use and safety of advanced therapies.","authors":"Ebru Ar, Irini Solomonidou, Henrike Lenzen, Miriam Wiestler, Claudia Veltkamp, Katharina Willuweit, Jassin Rashidi-Alavijeh, Hartmut H Schmidt, Richard Vollenberg, Phil-Robin Tepasse, Jonel Trebicka, Stefanie Tischendorf, Carsten Elfers, Karim Hamesch, Arne Bokemeyer","doi":"10.1093/ibd/izaf330","DOIUrl":"https://doi.org/10.1093/ibd/izaf330","url":null,"abstract":"<p><strong>Background: </strong>Some patients with ulcerative colitis (UC) develop advanced liver disease due to conditions such as primary sclerosing cholangitis (PSC) and may require liver transplantation (LT). However, data on the long-term course of UC and the use of advanced therapies in LT recipients are limited. We aimed to evaluate UC activity before and after LT, as well as the role of advanced therapies over extended follow-up in this population.</p><p><strong>Methods: </strong>This was a retrospective, multicenter cohort study including 213 patients with UC who underwent LT between 2000 and 2022. Clinical disease activity (partial Mayo score), endoscopic disease activity (Mayo endoscopic subscore), and the use of advanced therapies were evaluated before and after transplantation.</p><p><strong>Results: </strong>Among the 213 patients, the clinical remission rate was 84.7% before and 81.2% after LT, showing no significant change (P = .416). Despite stable clinical remission, 27.9% of patients exhibited moderate-to-severe endoscopic inflammation during long-term follow-up (mean: 110 months). The use of advanced therapies increased significantly after LT (from 3.7% to 12.7%, P = .005) and was not associated with an increase in infectious complications (P = .591).</p><p><strong>Conclusions: </strong>In most patients, clinical disease activity remains stable after LT. However, persistent moderate-to-severe mucosal inflammation is observed in a substantial subset during long-term follow-up. Advanced therapies, particularly vedolizumab, are being used more frequently in this setting and may offer disease control without a corresponding increase in infection risk. These findings underscore the need for individualized, interdisciplinary management and further prospective evaluation of treatment strategies in this population.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Inflammatory Bowel Diseases
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