bluuebunny/crossref_metadata_2025_split huggingface dataset:
P462 Impact of teduglutide, a GLP-2 agonist, on inflammatory bowel disease-associated short bowel syndrome: a tertiary single-center study
Authors: de Seze M , Billiauws L , Bettolo J , Damas V , Hutinet C , Bonvalet F , Cazals-Hatem D , Villain C , Bouhnik Y , Joly F , Uzzan M 
Published: May 2021

Abstract

Background
Teduglutide (TED), a GLP2 agonist, have been shown to exert anti-inflammatory effects on the intestinal mucosa in murine preclinical models and evaluated with a positive trend in a phase 2a randomized controlled trial in non-short bowel syndrome (SBS) Crohn’s disease (CD) patients.
TED showed efficacy in reducing parenteral nutrition and or intravenous (PN/IV) dependence in SBS with intestinal failure (SBS-IF). However, limited data exists on its specific effect on the natural history of IBD in SBS patients treated with TED.
Therefore, we aimed to assess the efficacy and safety of TED in patients with IBD-associated SBS as well as the effect of TED on the course of IBD.

Methods
We conducted an observational retrospective study. Adult patients SBS-IF due to IBD and who were treated with TED were enrolled. Response was defined as a decrease of at least 20% in total volume of PN. Active IBD was defined based on morphologic and histologic data (CT-scan, colonoscopy and/or enteroMRI). Patients were followed until last news or TED discontinuation.

Results
We enrolled 14 IBD patients, including 2 patients with ulcerative colitis, with a median follow-up of 4.2 ± 4 years. Of the 12 CD patients, 11 had ileocolonic involvement and 1 had only small bowel involvement. 11 patients had type-1 SBS and 3 had type-2 SBS. 7 patients were only receiving intravenous fluid and 7 were on PN/IV. Patients were in average receiving PN/IV for 9.1 years at TED initiation.
Regarding IBD, 4 patients had active disease at inclusion, 3 with a structuring behavior and 1 with a fistulizing behavior. 5 patients were on biologic treatment (antiTNF or ustekinumab) at inclusion.
At month 3 (M3), 9 of 14 patients were responders. 3 were weaned from any iv supplementation. 3 of 7 patients initially on TPN were weaned from caloric input, including one still receiving iv fluids. Caloric input was in average at 7330 kcal/week at baseline versus 4615 at M3. Mean total parenteral volume went from 11849
ml/week at M0 to 8223 at M3.
2 of 4 patients with active disease at baseline showed improvement in disease activity while on TED. The latter 2 patients were totally weaned off PN/IV.Six patients withdrew TED during follow-up. 2 patients stopped after a diagnosis of cancer (1 melanoma and 1 chronic myeloid leukemia). Survival without TED discontinuation was estimated at 85.7 % IC95(69.2–100) at 1 year, 78.6% IC95(59.8–100) at 2 years and at 64.3% IC95(43.5–95) at 5 years

Conclusion
TED appears effective and safe in IBD-associated SBS-IF patients. In specific cases, it may impact positively the inflammatory course of the disease. Further prospective studies are warranted to specifically evaluate TED in IBD-associated SBS, including patients with active IBD.
P468 Analysis of international spontaneous reporting system databases for safety of corticosteroids in Inflammatory Bowel Disease: The Determinants, Incidence and consequences of Corticosteroid Excess (DICE)-impact study
Authors: Raine T , Bokemeyer B , Finney-Hayward T , Munsaka M , Liu M , Louis E 
Published: May 2021

Abstract

Background
Long-term use of corticosteroids (CS) may result in significant risk of adverse events (AEs), and the true incidence of AEs in patients with inflammatory bowel disease (IBD) receiving CS is unknown.1 Such AE data may be reported in spontaneous reporting systems (SRS). Using data-mining algorithms for disproportionality, we determined the frequency of AEs of special interest (AESIs) associated with CS in patients with IBD.

Methods
The FDA SRS database (FAERS) was examined for AE reports associated with prednisone/prednisolone (PRED) or budesonide (BUD) use for Crohn’s disease or ulcerative colitis from Q1 2008 to Q4 2019. The incidence of key predefined AESIs was determined and the association with CS therapy was assessed using the proportional reporting ratio (PRR) criteria.

Results
Totals of 420,913 and 33,215 all-cause AEs were reported for PRED and BUD, respectively. The number of AE reports for each CS increased over time (Figure 1) and this was reflected in an increase in the proportion of reports of all AEs over time relating to CS. Common AEs reported with CS therapy included diarrhoea, abdominal pain, pyrexia and weight loss (Figure 2). Compared with other drugs and based on the PRR criteria, AESIs including osteonecrosis, adrenal insufficiency and Cushingoid complications were more frequently reported in patients treated with PRED; adrenal insufficiency, pancreatitis and Cushingoid complications were more frequently reported in patients treated with BUD (Table 1). There was no confounding effect from gender or disease type identified between CS and any of the AESIs in patients with IBD.

Conclusion
Analysis of FAERS demonstrated that steroid-treated patients with IBD report AEs that are consistent with the known safety profile for CS. Cushingoid complications and adrenal insufficiency were common signals for PRED and BUD. The increased reporting of AEs over time may reflect growth in CS prescribing, or growing awareness and reporting of CS AEs by prescribers. This analysis will be repeated in multiple international SRS systems to provide a global image of AEs for CS use in IBD.

Reference
P474 Postoperative infectious complications in patients with Inflammatory Bowel Disease: experience of a tertiary center
Authors: Librero Jiménez M , Ortega Suazo E J , Sánchez Capilla A D 
Published: May 2021

Abstract

Background
Patients with Inflammatory Bowel Disease (IBD) are at increased risk of postoperative infectious complications (PIC). There are few studies and conflicting data regarding the risk factors involved in these patients. The aim of this study was to investigate the incidence of infectious complications and postoperative mortality in patients with IBD who underwent intestinal surgery, as well as describe the characteristics of our population and identify possible risk factors.

Methods
Retrospective study on patients with Inflammatory Bowel Disease (Crohn’s disease (CD) and Ulcerative Colitis (UC)) treated in “Virgen de las Nieves” University Hospital between January 2019 and December 2020. Patients who underwent small bowel or colorectal surgery were included. Information regarding demographic and clinical data, procedures, treatments and surgical outcomes were collected. Clinical outcomes documented were postoperative infectious complications and in-hospital mortality. Descriptive inferential were carried out.

Results
36 patients were included (47.2% male, median age 44.9 years). All the characteristics of our sample are detailed in Figures 1 and 2. Regarding surgical outcomes, 7 patients developed PIC (6 surgical site infection (SSI) and 1 multiple infections including pneumonia, candidemia and SSI). The features of these patients are detailed in Figures 3 and 4.

Conclusion
Postoperative infectious complications after intestinal surgery are an important cause of morbi-mortality in CD and UC patients. Identifying risk factors early, could help reduce the incidence of these complications.
Seven patients (19,4%) in our sample developed PIC, mostly SSI. All of them diagnosed of CD, which explains the greater need of surgery in them compared to patients with UC. These patients had more severe disease: penetrating pattern (B3 according to Montreal Classification) and ileocolonic location (L3). Most patients were receiving immunosuppressive treatments by the time of surgery, especially biological treatments. The median time of evolution of the disease was high, describing a profile of disease more advanced.
Our efforts should be determined to early prevention and treatment of modifiable risk factors during the perioperative period. In order to achieve this aim, further research is needed, with prospective, multicenter and wider population studies, trying to control any confusion factors. Finally, we would like to highlight the need of studies analyzing UC population, as most of them focus on patients with CD.
P490 The impact of the COVID-19 pandemic on gastroenterologists providing care to inflammatory bowel disease patients in Canada: preliminary data of a cross-sectional survey
Authors: Mikail M , Malhi G , Wilson A , Khanna R 
Published: May 2021

Abstract

Background
We aim to explore the impact of COVID-19 pandemic-related restrictions on gastroenterologists providing care to inflammatory bowel disease (IBD) patients in Canada.

Methods
We invited 28 Canadian gastroenterology societies, 14 academic centres and 101 community hospitals and private clinics to have their gastroenterologists engage in an online mixed methods survey from December 2020 - March 2021. The survey explored the impact of pandemic-related restrictions on gastroenterologists managing IBD patients and the impact on clinical decision-making, rates of consultation, investigations and endoscopies conducted before and during the pandemic.

Results
59 gastroenterologists (59.3% male) participated in our study with 40.7% having completed additional training in IBD. Respondents mean age was 43.7 years with 30.5% practising independently for a duration of less than or equal to 5 years. The majority of respondents were from Ontario (43.1%), Quebec (31%) and British Columbia (13.8%) with 62.7% practising primarily at an academic centre.
93.2% of respondents reported that their practice was affected by the pandemic. 44.6% note a reduction in the number of total consultations completed. Only 60% were able to arrange endoscopies for patients in an active IBD flare at an appropriate time interval compared to their pre-COVID practice. During the pandemic, 87.3% reported a reduction in the total endoscopies performed, with 43.8% of those individuals noting a minimum reduction of 25% of previous volumes. The following barriers attributed to the decrease in endoscopies performed during the pandemic: institutional-imposed restriction on daily allowed endoscopies (97.9%), indication for endoscopy was non-urgent (68.8%) and patient-requested cancellation due to a fear of contracting COVID-19 (87.5%).
63.6% of respondents were able to arrange outpatient laboratory investigations in less than 1-week prior to the pandemic vs. 41.8% arranging similar tests in 1–2 weeks during the pandemic. 50.9% were able to arrange diagnostic investigations in 1–2 months before the pandemic vs. 65% arranging similar tests in 3-months or more during the pandemic.
When advancing drug therapy in IBD patients before versus during the pandemic, respondents reported the following factors as playing a crucial role in clinical decision making: patient symptomatology (87% vs. 79.3%), laboratory investigations (94.8% vs. 96.6%), diagnostic imaging (89.7% vs. 81%) and endoscopy findings (89.7% vs 72.4%).

Conclusion
We illustrate that Canadian gastroenterologists have been affected by the pandemic, with decreases in endoscopy performance related to access and patient preference and less decision-making guided by endoscopy. Outpatient access to urgent investigations was reduced.
P501 Incidence and therapeutic management/treatment of very early onset inflammatory bowel disease during 2015–2020
Authors: Ninh G , Wewer V , Jakobsen C 
Published: May 2021

Abstract

Background
To investigate the incidence of very early onset inflammatory bowel disease (VEO-IBD) in a cohort representing two regions in Denmark during the period 2015–2019 and to assess the medical and surgical treatment.

Methods
All patients diagnosed with VEO-IBD within The Capital Region and The Zealand Region from January 1, 2015 to July 1, 2020 were included. Demographic and clinical data and medical and surgical treatment were extracted from the files.

Results
Forty patients with VEO-IBD were identified. The incidence rate was 2.0/100,000 (CI 95% 0.8–5.9) during the 2015–2019. Totally 35 patients (87.5%) received immunomodulatory therapy during follow-up. The cumulative risk of receiving immunomodulatory therapy after 1 year, 3 years and 5 years was 58% (95% CI 39–71), 88% (95% CI 70–95) and 91% (95% CI 73–97) respectively. Totally 23 patients (57.5%) received biological therapy. The cumulative risk of receiving biological therapy after 1 year, 3 years and 5 years was 37% (95% CI 19–50), 46% (95% CI 27–60) and 57% (95% CI 36–71) respectively. Six patients (15%) received vedolizumab. Four patients (10%) with VEO-IBD underwent a colectomy during the follow-up period of which two patients received vedolizumab.

Conclusion
The incidence of VEO-IBD was 2.0/100,000. Medical treatment with immunomodulators and biological therapy was used extensively, possibly reducing surgery. However, medical treatment remains a complicated balancing of the effect (anti-inflammatory), side effect (cancer risk) and surgery in VEO-IBD.
P520 ‘Eetscore’ in patients with Inflammatory Bowel Disease: an online tool to assess diet quality and provide personalised dietary advice
Authors: Lamers C R , van Erp L W , Slotegraaf A I , Groenen M J M , de Roos N M , Wahab P J , Witteman B J M 
Published: May 2021

Abstract

Background
Many patients with IBD believe diet affects the course of disease and is at least as important as medication in their IBD treatment. However, easy assessment of patients’ food intake and structured support of a healthy diet are lacking. The Eetscore is an online tool which assesses diet quality and subsequently gives personal dietary advice. We used the Eetscore to assess diet quality of IBD patients, evaluated if diet quality improved over time and studied correlations with quality of life (QoL) and clinical disease activity.

Methods
A prospective cohort study with adult IBD patients was performed. Participants completed the Eetscore, the short IBDQ and a clinical disease activity questionnaire (P-HBI or P-SCCAI) at baseline and after 1 month. The Eetscore is a validated web-based screening tool to assess diet quality based on 16 food components (e.g. meat, vegetables, fruit and fish). It consists of a short Food Frequency Questionnaire and is scored with the Dutch Healthy Diet 2015-index based on the Dutch dietary guidelines. The score of each component ranges from 0 to 10, resulting in a total score between 0 and 160. Higher scores indicate better adherence to Dutch dietary guidelines. The Eetscore subsequently provides personalised dietary advice based on the assessment. We assessed changes over time using paired samples t-tests or McNemar’s test and correlations using Pearson’s or Spearman’s correlation.

Results
We included 212 participants. At time of this preliminary analysis, 175 participants (60% female, 49% Crohn’s disease) completed baseline and 1-month assessments. Their median age was 49 years [IQR 32–58], BMI 25 kg/m2 [IQR 22–28] and disease duration 10 years [IQR 4–18]. At baseline, mean Eetscore was 98 ± 19, with highest median scores (≥8.5) on red meat, fat and oils, sweetened beverages, alcohol and salt intake, and lowest median scores (≤5) on nuts, legumes, processed meat and unhealthy choices (Figure 1). Diet quality increased with 5.6 points (95%CI 3.7–7.5) to a mean Eetscore of 103 ± 21 (p&lt;0.001) after 1 month. QoL improved from 53 ± 10 to 55 ± 9 (∆2.0 (95%CI 1.2–2.8); p&lt;0.001). The proportion of participants with clinically quiescent disease was comparable at both time points (71% vs 74%, p=0.29). Diet quality was not correlated with QoL or clinical disease activity.

Conclusion
This study suggests the Eetscore is a useful tool to monitor and support a healthy diet in IBD patients. Diet quality improved significantly following personalised dietary advice of the Eetscore. Short term results did not indicate a correlation between diet quality and QoL or clinical disease activity.
P526 Social functioning, work-productivity and psychological assessment in a cohort of patients with inflammatory bowel disease: an observational study
Authors: Todeschini A 
Published: May 2021

Abstract

Background
Patients with inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn’s disease, claims to suffer a significant hindrance in everyday life, because of the frequency of psychological complaints. The aim of this study was to identify and analyze social functioning, work productivity and psychological assessment in IBD patients and to correlate these parameters with history and activity of the disease.

Methods
An observational study was performed in 99 IBD patients. Psychosocial data were assessed through the administration of specific questionnaires: Social Functioning Questionnaire (QFS) for monitoring social functioning; Work Productivity and Activity Impairment questionnaire (WPAI) for work productivity; State-Trait Anxiety Inventory (STAI 1,2), for psychological assessment. IBD activity was measured by Partial Mayo score. Student’s t test or Wilcoxon rank sum test were used to compare continuous variables between subgroups and chi-square test to compare categorical variables. Univariate and multivariate linear regression were used, respectively, to assess the relationship between psychosocial and disease characteristics and to compare outcomes with determinant associated results in univariate regression.

Results
Univariate analysis showed a statistically significant correlation of the overall QFS score with both the level of education (0.6; 95% CI = 0.1–1.2; p = 0.028) and the unemployed status (- 4.5; 95% CI = -8.9- -0.1; p = 0.044). Moreover, the impairment of WPAI was greater in subjects with ulcerative colitis with severe endoscopic activity according with Partial Mayo score (15.5; 95% CI = 1.0–30.0; p = 0.038). Overall impairment in subjects with stable employment correlated with age (- 0.5; 95% CI = -0.9- -0.1; p = 0.010) and was greater in subjects who underwent at least one surgical operation (15.8; 95% CI = 3.0–28.6; p = 0.016). Psychological evaluation showed that state and trait anxiety correlated significantly with Partial Mayo score (respectively 1.8; 95% CI = 0.6–2.7; p = 0.004 and 1.3; 95% CI = 0.1–2.5; p = 0.042) and age (respectively - 0.2; 95% CI = -0.3- -0.1; p = 0.028 and - 0.3; 95% CI = -0.5 - -0.1; p = 0.037). State anxiety increased in case of long-standing illness (- 0.3; 95% CI = -0.5 - -0.1; p = 0.037), while the non-worker status correlated with trait anxiety when compared to paid employment (- 7.0; 95% CI = -0.9–13.1; p = 0.026).

Conclusion
Social functioning was correlated to the employment status and to the level of education. Work productivity was lower in UC patients with severe activity and who undergone at least one surgery related to IBD. The state of anxiety was related with age, duration and activity of illness, while the trait of anxiety was major in non-worker patients.
P556 Safety and efficacy of ustekinumab in the treatment of Crohn’s Disease: A systematic review and meta-analysis
Authors: Khorshid Fasge M , Cordie A , Abd-Elsalam S 
Published: May 2021

Abstract

Background
This systematic review and meta-analysis was designed to estimate the safety and effectiveness of ustekinumab in the treatment for Crohn’s disease (CD) in clinical trials and observational studies.

Methods
We retrieved all the related publications from PubMed, Cochrane, EBSCO, Google Scholar and EMBASE using a systematic search strategy. We only included the clinical trials and observational studies that were published in English.

Results
Only 31 studies that met the eligibility criteria out of the 733 identified studies were included. Twenty-one studies reported the clinical response rate; three of these were clinical trials, and the other 18 were cohort studies. The overall clinical response rate in the cohort studies was 0.539, 95% CI (0.419–0.659) with significant heterogeneity (I2 = 96.22%, P &lt; 0.001) and that in the clinical trials was 0.428, 95% CI (0.356–0.501). The pooled clinical remission rate was 0.399, 95% CI (0.295–0.503) in randomised control trials (RCTs) and 0.440, 95% CI (0.339–0.542) in cohort studies. Twenty-one studies reported the incidence of adverse effects. The rate of adverse effects was 0.158, 95% CI (0.109–0.207) in cohort studies and 0.690, 95% CI (0.633–0.748) in RCTs. Three RCTs had an infection rate of 0.275, 95% CI (0.245–0.295), while the 18 cohort studies had a rate of 0.076, 95% CI (0.047–0.105). Only ten studies reported the incidence of injection or infusion reaction; it was 0.035, 95% CI (0.027–0.043) for RCTs and 0.012, 95% CI (0.002–0.022) for cohort studies.

Conclusion
Ustekinumab is effective in the treatment of CD. However, more research is required on the safety profiles because there was considerable variation among the included studies.
P565 Illness perception as a clinical tool to detect mood disturbances (anxiety or depression) in inflammatory bowel disease patients
Authors: De Castro Parga M L , Pereyra D , Sanromán L , Figueira M , Hernández V , Pineda J , Martinez-Cadilla J , Pereira S , Rodriguez-Prada J I 
Published: May 2021

Abstract

Background
In patients suffering from inflammatory bowel disease (IBD), a prevalence of anxiety and/or depression of 30–35% has been reported in phases of clinical inactivity, reaching up to 60–80% in the flare-ups. Moreover, the presence of psychological comorbidity is now considered to complicate the course of IBD. Our aim was to evaluate the relationship between mood disturbances and individual illness perception.

Methods
Patients attending our tertiary hospital IBD outpatient clinic were enrolled. They filled the “Hospital anxiety and depression scale” (HADS) and the “Brief illness perception questionnaire” (BIPQ). Sociodemographic characteristics, phenotype and clinical course of IBD were reviewed as well. Ethical approval of the study was obtained.

Results
A total of 201 patients were analyzed: male 102 (50.7%) female 99 (47.3%), UC 113 (56.2%), CD 88 (43.8%). The HADS prevalence of psychological pathology was 24%, (22% anxiety, 6.9% depression), and 17% patients previously were on mood medications. There were no differences between CU and EC, although EC patients tended to show more anxiety. Women had a higher prevalence of anxiety (29% vs 15.6%) and depression (9.6% vs 4.7%) than men (p=0.03 and p=0.009). Anxiety was also associated with previous IBD hospitalization (p=0.005), and depression with living alone (p=0.007). The BIPQ dimensions: consequences, concern and emotional response were statistically associated with the presence of psychological pathology, anxiety and depression (p=0.0005 each).

Conclusion
Mood disturbances are frequently found in IBD patients, especially among females. A negative individual illness perception of the consequences and emotions related to IBD seems to correlated strongly with the presence of anxiety and/ or depression in these patients.