bluuebunny/crossref_metadata_2025_split huggingface dataset:
A189 IMPACT OF PHYSICAL ACTIVITY AND MEDICATIONS ON BODY COMPOSITION DYNAMICS IN PEDIATRIC IBD PATIENTS: A PROSPECTIVE STUDY
Authors: Djani L , Orius K , Neale N , Dehbidi Assadzadeh L , Tongue G , Huang F , Yang X , Bouthot J , Deslandres C , Jantchou P 
Published: February 2025

Abstract

Background
Although inflammatory bowel disease (IBD) severity is associated with decreased body mass index (BMI) in pediatric patients, many of them gain weight during follow-up. Physical activity levels (PAL) are associated with lower BMI dynamics while overweight/obesity worsen health outcomes in children. Few studies have explored BMI evolution and its related factors in this population.

Aims
To investigate BMI dynamics in children with IBD from diagnosis to last follow-up and assess the impact of PAL, disease phenotype/activity, and medication on BMI changes.

Methods
Pediatric IBD patients prospectively completed the Canadian Health Measure Survey quarterly for one year to assess PAL and were classified into three groups based on PAL (sedentary, moderately active or extremely/vigorously active). Clinical disease activity was classified using physician global assessment, PUCAI and sPCDAI. BMI was assessed at each visit.

Results
A total of 256 patients (56% male, median age 14y [IQR (interquartile range): 13-16]) were included. At diagnosis, 56% were normal weight, 38% underweight, 5% overweight, and 2% obese. By the first visit, 74% were normal weight, 4% underweight, 17% overweight, and 5% obese. The median time from diagnosis to the first study visit was 29 months [IQR: 7-44] during which patients gained a mean of 2.97 (95% CI: 2.64;3.31) BMI points.
The following factors were associated with BMI gain: disease duration (Pearson Coefficient Correlation [95% CI]:0.42 [0.31;0.51]), age at diagnosis (-0.13 [-0.25; -0.01]), BMI at diagnosis (-0.23 [-0.34; -0.11]), BMI z-scores at diagnosis (-0.32 [-0.42; -0.20]) and higher age at inclusion (0.20 [0.08;0.31]).
In a multivariate logistic regression, we found that being underweight compared to normal weight (adjusted odds ratio (aOR) =0.15 [0.06; 0.39]) and exposition to anti-TNFα (aOR = (3.89 [1.17; 12.97]) were independently associated to the risk for overweight/obesity during follow-up.

Conclusions
We observed a 15% increase in overweight/obesity prevalence and a 34% decrease in underweight prevalence in patients over the studied interval. BMI gain was significantly linked to exposure to anti-TNFa, warranting further investigations.
Table 1. Mean BMI Differences Between Diagnosis and First Study Visit

Funding Agencies
None
A192 CHANGING TRENDS IN ARTHRITIS PREVALENCE AMONG INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE: INSIGHTS FROM A POPULATION-BASED STUDY
Authors: Crowley E , Kuenzig E , Widdifiled J , Benchimol E I , Lam M , Jairath V , Rohekar S , Targownik L , Watson M , Berard R 
Published: February 2025

Abstract

Aims
The burden of arthritis among individuals with inflammatory bowel disease (IBD) is poorly understood. We describe changes over time in the annual prevalence of inflammatory arthritis (IA) and musculoskeletal (MSK)-related physician encounters among individuals with IBD.

Methods
We conducted a retrospective repeated cross-sectional study using Ontario population-based health administrative data. We used the Ontario Crohn’s and Colitis Cohort which comprises all IBD patients derived from health administrative data using validated age-specific case-identification algorithms. Individuals diagnosed with IBD between April 01, 2003, and March 31, 2020 (population denominator) were followed from their first IBD code (index date) until they died or were lost to follow-up (out-migrated/lost health care coverage), or until the end of available follow-up data (March 31, 2020). We identified the cumulative prevalence of inflammatory arthritis (≥1 hospitalization/ED encounter or ≥2 physician billing claims with IA-related diagnosis codes with ≥1 by a rheumatologist within 365 days). Separately we identified the annual number of individuals with ≥1 hospitalization/ED encounter/physician billing claim with any non-trauma related MSK-specific diagnosis codes. The annual age- and sex-standardized cumulative prevalence of both IA and MSK among individuals living with IBD each year were determined.

Results
Over the study period, the number of individuals living with IBD increased from 54,283 in 2003 to 108,857 in 2020; the number of children &lt;18yrs increased from 1,547 to 2,667. Among all ages, the age/sex standardized cumulative IA prevalence within the IBD cohort increased from 6.8% (95% CI 6.5-7.2%) in 2003 to 15.2% (95%CI 15.0-15.8%) by 2020 (Figure 1). IA was slightly more common among those with Crohn’s than ulcerative colitis (17.4% vs 13.2%, respectively). By 2020, IA prevalence was 6.8% among children/youth &lt;18yrs, 17.4% among those 18-64yrs, and 23.1% among those ≥65yrs. Overall, crude annual prevalence of an MSK-related encounter remained relatively stable from 30.6% in 2003 to 27.7% in 2020.

Conclusions
This study is the first to provide population-level estimates of IA and MSK-related conditions in people with IBD. The cumulative prevalence of IA among individuals with IBD has steadily increased over time, particularly among those ≥65years, while MSK-related encounters have not. This may be related to increased physician recognition of IA or increased access to care and diagnosis. These findings have implications for healthcare costs and utilization, given the specialized care and expertise required to manage IA in the context of complex, comorbid conditions like IBD.

Funding Agencies
CCC
A194 PATTERNS OF INFLAMMATORY BOWEL DISEASES IN NORTHWESTERN ONTARIO
Authors: Lee C , Farahvash A , Smith S , Clark M , Zezos A , Siddiqui R , Dubois S , Rumbolt C , Green J , Zezos P 
Published: February 2025

Abstract

Background
Geographic disparity adds to the challenges of caring for patients with inflammatory bowel disease (IBD) in Canada. Northwestern Ontario is one of the least densely populated regions among Canadian provinces, with limited existing research examining patients affected by IBD.

Aims
We sought to 1) describe the clinical trends and characteristics of patients with IBD in Northwestern Ontario and 2) compare the course of disease among patients residing in urban versus rural areas.

Methods
Thunder Bay is the major site for specialized care in Northwestern Ontario, allowing for the inclusion of approximately all IBD patients in the region. This retrospective study involved data collected over a 25-year period from January 1, 1999 to October 1, 2024. Northwestern Ontarians with diagnostic confirmation of IBD were included. Deceased patients were excluded. Participants were identified using billing codes and keywords from electronic records of three gastroenterologists practicing at the Thunder Bay Regional Health Sciences Centre, the only tertiary care centre in Northwestern Ontario. Data were collected from clinic and hospital records. Student’s t-test and chi-squared test were used in statistical analysis.

Results
Among 2115 patients who were screened, this preliminary analysis identified 1061 IBD patients, including 546 (51.5%) with ulcerative colitis, 481 (45.3%) with Crohn’s disease, and 34 (3.2%) with unclassified colitis. Mean age was 52.6±17.3 years and 49.9% were female. Mean age at diagnosis was 36.2±17.0 years and median time to diagnosis was 5 months. There were significantly more smokers among patients with Crohn’s. Based on the last clinical encounter, 692 (65.2%) patients were in clinical remission, 174 (16.4%) were in active disease, and 186 (17.5%) were lost to follow up. Current medications included biologics (369, 34.8%), 5-ASA (366, 34.5%), immunomodulators (119, 11.2%), and glucocorticoids (71, 6.7%). Throughout the course of disease, mean number of Emergency Department visits and hospital admissions were 2.6±4.7 and 1.2±2.4 respectively, and 325 (30.6%) patients underwent IBD-related surgery.
The cohort included 752 (70.9%) urban residents and 309 (29.1%) rural residents. No significant difference was observed between urban and rural residents, including age, sex, disease type, prevalence of biologic use, disease severity based on the Montreal classification, or current disease status.

Conclusions
This study characterizes the patient population and clinical trends of IBD in a low population density region in Ontario. There appears to be homogeneity between rural and urban residents, with comparable patient and disease features, and access to medications including biologics.

Funding Agencies
None
A200 A POPULATION-BASED ASSESSMENT OF PHYSICAL ACTIVITY AND EXERCISE IN PERSONS WITH IBD
Authors: Dolovich C L , Chochinov S , Ly G , Oketola A , Narvey S , Larance S , Raman M , Webber S , Bernstein C N 
Published: February 2025

Abstract

Background
It is known that physical activity (PA)/exercise is associated with a reduced risk in chronic disease. However, less is known about its impact on inflammatory bowel disease (IBD) specifically. Research generally uses the terms ‘PA’ and ‘exercise’ interchangeably, which although similar, are overlapping classifications of activity. As a result, interpreting and comparing existing findings can be challenging.

Aims
We aimed to assess the physical activity and exercise profiles of persons with IBD, their limitations in undertaking PA/exercise, and how PA correlates with active disease and fatigue in a population-based sample in Manitoba, Canada.

Methods
A cross-sectional survey study was undertaken by participants in the University of Manitoba IBD Research Registry. The survey included sociodemographic factors, PA/exercise, the International Physical Activity Questionnaire (IPAQ), Inflammatory Bowel Disease Symptom Inventory (IBDSI), and Modified Fatigue Impact Scale (MFIS). Bivariate and logistic regression analyses were used to assess the association between PA and disease activity and fatigue.

Results
The survey was completed by 1257 of 2740 invitees (45.8%). The mean age of participants was 60.8 +/- 13.0 years. The most common type of PA and exercise that respondents participated in were walking for leisure/exercise (84%) and the most common type of PA and exercise avoided was running/jogging (16%). Physically active status per IPAQ was categorized as inactive-low in 42.5%, moderately active in 32.0%, and highly active in 25.5%. Average fatigue levels were mean 24.9 SD 18.9 per MFIS. PA and fatigue levels were similar for those &gt;55 vs those &lt;55 years. For ulcerative colitis (UC) persons, after adjusting for demographic and clinical factors, the odds of lower levels of PA were greater among females [aOR 95% CI, 1.76 (1.12-2.78)], ever smoked [aOR 95% CI, 2.55 (1.11-5.73)], active disease (per IBDS) [aOR 95% CI, 1.68 (1.07-2.62)], and with an increase in MFIS total score [aOR 95% CI, 1.02 (1.01-1.04)].

Conclusions
There was a high rate of inactive to low PA among persons with IBD. Females with UC especially need to be encouraged to increase their PA. While it is not surprising that persons with active disease may have reduced or even avoided PA, this requires further study. Since as a result, PA may reduce deconditioning that may accompany periods of active disease and increased fatigue. These findings underscore the need for tailored PA/exercise guidelines for individuals with IBD. Future research should explore objective measures of PA to better understand PA/exercise in both younger and older adult populations.

Funding Agencies
CAG, None
A201 USTEKINUMAB VERSUS VEDOLIZUMAB PREDICTORS OF RESPONSE IN IBD PATIENTS WITH ANTI-TNF EXPOSURE: A PRELIMINARY REPORT
Authors: Homsi H , Khan U , Lawendy B , Abbas U , Khanna R , Wilson A 
Published: February 2025

Abstract

Background
Ustekinumab and vedolizumab are biologics that are effective in treating inflammatory bowel disease (IBD). Previous studies using propensity score matching have found no significant difference in their efficacy overall. Interestingly, these studies did not highlight clinical variables associated with optimal drug response and other treatment outcomes which could help inform treatment selection for patients after anti-tumor necrosis factor (anti-TNF) agent exposure.

Aims
To evaluate clinical variables associated with response to ustekinumab versus vedolizumab in IBD patients with anti-TNF exposure.

Methods
A single-center retrospective cohort study was conducted in IBD patients with prior anti-TNF exposure, treated with one of ustekinumab or vedolizumab. Participants were assessed for clinical remission at 12 months using the Harvey Bradshaw Index for Crohn’s Disease (CD) (HBI≤4) and the Partial Mayo Score for Ulcerative Colitis (UC) (≤2). Secondary outcomes included 6-month remission, surgery, hospitalization, use of rescue glucocorticoids, adverse events, and treatment discontinuation in patients followed for at least 1 year. Potential clinical variables associated with the primary and secondary outcomes were assessed using multivariable logistic regression analyses for each drug group.

Results
A total of 118 patients (CD, n=61; UC, n=57) treated at a tertiary care center in London, Ontario, Canada, were included in the analysis. Patients received at least one dose of ustekinumab (n=58) or vedolizumab (n=60). For both the vedolizumab-exposed and ustekinumab-exposed cohorts, 6- and 12-month disease remission were associated with high dose therapy (vedolizumab, 12-month, adjusted OR=6.62, 95%CI 1.95-26, p=0.004; 6-month, adjusted OR=4.77, 95%CI 1.43-17.58, p=0.014 versus ustekinumab, 12-month, adjusted OR=4.08, 95%CI 1.19-15.26, p=0.029; 6-month, adjusted OR=4.57, 95%CI 1.30-18.34, p=0.022). For the vedolizumab-exposed cohort, treatment discontinuation was associated with age (p=0.039), weight (p=0.031) and high dose therapy (p=0.008). Similarly, the need for rescue glucocorticoids was associated with age (p=0.021). No other clinical variables were associated with the primary or secondary outcomes for either cohort.

Conclusions
Ustekinumab and vedolizumab demonstrated similar efficacy in achieving clinical remission in our study population. The odds of achieving remission from either at 6 and 12 months was higher amongst individuals receiving high-dose therapy. Vedolizumab treatment discontinuation was associated with a younger age and lower weight. No other clinical variables were associated with drug response in either cohort. Larger studies are warranted to confirm these findings and identify other predictors of response that can guide biologic selection in IBD management.

Funding Agencies
None
A208 MENTAL HEALTH, WORK IMPAIRMENT, AND MEDICATION SATISFACTION AMONGST INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE RECEIVING LONG-TERM BIOLOGIC AND ADVANCED TREATMENT
Authors: Hazan E , Stefanova E , Afshar A , Patel A , Targownik L 
Published: February 2025

Abstract

Background
Biologic and advanced immunotherapies have been shown to be effective in controlling biochemical, endoscopic, and histologic disease activity in individuals with Inflammatory Bowel Disease (IBD). However, there is limited data assessing the prevalence of somatic symptoms, mental health, and quality of life (QoL) in this population. To provide holistic care and appropriately manage both gut and somatic symptoms, it is critical to assess the prevalence of these symptoms and impairments.

Aims
This study assessed the prevalence of mental health deficits, quality of life, and work impairment in IBD patients who are being treated with biologic and advanced therapies for at least six months. The objective was to assess whether significant gaps in these domains persist as well as whether individuals are satisfied with their current advanced treatment.

Methods
Cross-sectional data was prospectively collected using a survey completed by individuals &gt;18 years old, with a known diagnosis of Ulcerative Colitis, Crohn’s Disease, or Indeterminate Colitis, who have been receiving a biologic or advanced immunotherapy at a stable dose for &gt;= 6 months. In addition to demographic data, the survey contained validated questionnaires assessing mental health, work impairment, and QoL. The presence of deficits in these domains was then evaluated using absolute scores and validated cutoffs.

Results
This study included 37 individuals who completed the survey as well as an additional 3 who completed part of it. 85% of respondents agreed that their current therapy has improved their symptoms and 62.5% of respondents are satisfied with their current treatment. 5.4-29.7% and 13.5-29.7% endorsed symptoms consistent with depression and anxiety respectively on different questionnaires. 51.4% of respondents endorsed active symptoms, and 56.8% endorsed symptom severity consistent with non-remission. A mean of 2.74 hours of weekly work productivity were lost due to IBD activity.

Conclusions
The majority of individuals with IBD on long-term advanced therapy report symptom improvement and satisfaction with their treatment. However, more than half endorsed ongoing symptoms of IBD, including work impairment, and nearly one-third endorsed mental health impairment consistent with depression or anxiety. This suggests that despite perceived treatment efficacy, significant gaps in these domains persist.

Funding Agencies
None
A209 EVALUATION OF THE ROLE OF DUSP1 AND DUSP16 GENES IN THE REGULATION OF INTESTINAL EPITHELIAL FONCTIONS
Authors: Huard R , Ntunzwenimana J C , Lévesque C , Rivard M , Goyette P , Rioux J D 
Published: February 2025

Abstract

Background
Inflammatory bowel disease (IBD) is associated with inflammation of the gastrointestinal tract, resulting from a dysregulation of the immune response to microbes in the intestinal lumen. Dr. Rioux’s laboratory has identified over 200 genomic regions associated with IBD. However, the challenge lies in identifying the causal gene in many of these. To address this problem, our laboratory completed a transcriptomic screen following overexpression of IBD-associated genes in intestinal epithelial cells. This study demonstrates that DUSP1 and DUSP16, two phosphatases targeting MAP Kinases (MAPKs), regulate the expression of several shared genes involved in intestinal differentiation and homeostasis.

Aims
Our research hypothesis is that the DUSP1 and DUSP16 genes participate in the regulation of biological processes involved in IBD and critical for the integrity of the intestinal barrier. More specifically, we want to determine how a reduction in DUSP1 and DUSP16 affects the biological pathways leading to the regulation of epithelial junction integrity, as well as inflammasome activation and IL-18 secretion.

Methods
In this project, we studied Caco-2 cells expressing DUSP1 or DUSP16 knockdown and their effect on intestinal epithelial cell functions. Among other things, we observed the cells’ ability to form a tight monolayer in 2D and spheroids in 3D. We also analyzed by Western blotting the impact of knockdowns on inflammasome formation and normal activity.

Results
Our results show that Dusp1 and DUSP16 knockdowns disrupt the ability of Caco-2 cells to form a tight monolayer and to form spheroids. In addition, our inflammasome analysis shows that KDs deregulate inflammasome activity.

Conclusions
These results demonstrate that decreased expression of the DUSP1 and DUSP16 genes impacts several functions essential to the maintenance of intestinal epithelial cell homeostasis, such as intestinal barrier integrity and inflammasome activation.

Funding Agencies
CIHRNIH
A210 BARRIERS TO ACCESSING INTERVENTIONS FOR PSYCHOLOGICAL DISTRESS IN PERSONS LIVING WITH IBD
Authors: Willett N , Heisler C , Rohatinsky N , Farina S , Stewart M , Vallis M , Shepherd T , Huard T , Neil E , Jones J 
Published: February 2025

Abstract

Background
Inflammatory Bowel Disease-related psychological distress (IBD-PD) refers to the emotional impact of IBD and is associated with mental health disorders, increased IBD activity, and premature mortality. Up to 90% of IBD patients experience some form of IBD-PD. The inability to provide person-centered care for IBD-PD that is proportional to clinical need is a critical issue.

Aims
The aim of this research initiative was to identify barriers to accessing evidence-based interventions for mental health support for IBD-PD.

Methods
This was a qualitative research study in which virtual semi-structured interviews took place between Oct 2021 and Mar 2022. The semi-structured interview script was developed with researchers, IBD care providers, and patient research partners and was guided by the COM-B Behaviour Change Wheel framework and the Theoretical Domains Framework (TDF). Adults (&gt; 18 years of age) with a confirmed diagnosis of IBD were recruited from IBD clinics. Using thematic analysis as per Braun and Clarke (2006), codes were generated to identify themes.

Results
The total number of participants recruited was 14. The mean participant age was 37.6 years (range 23-57) with 57.1% as female (8/14). In terms of geographical locale, 28.6% lived rurally (4/14) and 71.4% (10/14) lived in an urban area. Thematic analyses identified the following themes: 1) Mental health is an important part of integrated IBD care. 2) Barriers to accessing psychological supports persist and include stigma, ignorance of IBD and mental health, costs and insurance coverage, and limited access and availability; 3) Health care providers should do more to address and refer patients to mental health supports.

Conclusions
From the perspective of the patient, accessing care for IBD-PD is challenging due to financial, physical, administrative, sociocultural, and informational barriers. Patients’ previous interactions with the healthcare system and mental health care providers color their view on mental health care and influence their preferences for context, setting and delivery mode for interventions. It is important to engage patients in the design and implementation of health service interventions. The information they share highlights barriers patients frequently encounter, and which aspects of care can be improved to meet patient-specific needs and match patient preferences.

Funding Agencies
None