bluuebunny/crossref_metadata_2025_split huggingface dataset:
P435 Plasma inflammation-related proteins as markers of anxiety and depression disorders in inflammatory bowel disease patients
Authors: Zhou M S , Dang Y , Xu F , Xu C Y , Wang Z , Wang C S E , Zhu S Y , Li P , Wu J , Shi H Y 
Published: January 2024

Abstract

Background
Up to 25%-35% of patients with inflammatory bowel disease (IBD) suffer from anxiety or depression. Inflammatory and immune response processes may play an important role in the co-occurrence of IBD and mood disorders. We aimed to investigate the plasma inflammation-related proteins that can characterize the anxiety and depression disorders in IBD patients.

Methods
Plasma was collected from 61 IBD patients, and the OLINK panel (Target 96 Inflammation) was used to quantify the expression levels of 92 inflammation-related proteins. The Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression symptoms.

Results
Among the involved IBD patients (median age 37, 40.98% female), 26.23% had anxiety and 29.51% had depression. Compared with IBD patients without mental disorders, the plasma level of FGF-23 was significantly increased in IBD patients with anxiety or depression disorders (P=0.035). Besides, the levels of CCL20 (P=0.039) and CXCL1 (P=0.021) were up regulated in IBD patients with anxiety and depression, respectively (Figure 1). Correlation analysis showed that the plasma level of CXCL1 (r=0.254, P=0.047) and FGF-23 (r=0.318, P=0.012) were positively correlated with the total degree of anxiety and depression disorders, while DNER (r=-0.300, P=0.018) appeared a reverse correlation trend. On the other hand, the plasma level of FGF-23 (r=0.351, P&lt;0.01) was positively correlated with anxiety degree in IBD patients. As for the depression disorder, we found a positive correlation in plasma CXCL1 (r=0.296, P=0.020) level, and negative correlations were found in levels of IL-8(r=-0.256, P=0.045), uPA (r=-0.264, P=0.038), IL-20 (r=-0.290, P=0.022) and DNER (r=-0.353, P&lt;0.01) (Figure 2).

Conclusion
We found specific plasma inflammation-related proteins for anxiety and depression disorders in IBD patients. The high incidence of anxiety and depression in IBD patients may be attributed to the stimulation of high levels of inflammatory factors.
P496 Interdisciplinary student-led screening clinics can identify undernutrition, sarcopenia and mental health risk in ambulatory patients with Inflammatory Bowel Disease
Authors: Plush S , Burfield K , Kumar S , Bryant R , Day A 
Published: January 2024

Abstract

Background
The changing landscape of allied health practice has led to the emergence of student-led clinics as a resource to enable workforce capacity. Undernutrition, sarcopenia, and poor mental health are common in inflammatory bowel disease (IBD) and affect quality of life. Despite high prevalence, these co-morbidities are under-recognised due to lack of service capacity. This study aimed to determine the frequency of undernutrition, reduced physical performance and mental health risk identified by a novel student-led interdisciplinary screening clinic in ambulatory patients with IBD.

Methods
Sixteen final year dietetic, physiotherapy or exercise physiology students conducted 5-10 weekly half day interdisciplinary outpatient clinics within a tertiary IBD service between July and October 2023. Following training, students completed all aspects of the interdisciplinary consult under direct dietetic supervision. Risk screening assessments comprised of anthropometrics, depression anxiety and stress scale-21 (DASS21), subjective global assessment (SGA), short physical performance battery (SPPB), handgrip strength (HGS) and inflammatory bowel disease-nutrition screening tool (IBD-NST). Consecutive patients attending a tertiary IBD outpatient service were contacted to participate in the clinic following their gastroenterology appointment. Descriptive statistics were completed, and prevalence is presented as number (n) and percentage.

Results
Screening assessments were completed for 88 patients in the 15-week period (Table1). Patient acceptance was high with 86% of patients approached consenting to participate. High hip to waist ratio was present in 68% (n=60/88) of patients suggestive of visceral adiposity (Figure 1a). The IBD-NST identified mild nutrition risk in 5% (n=4/88) of patients and generated a referral to dietetics with a moderate nutrition risk in 21% (n=19/88) of patients (Figure 1b). Malnutrition was detected in 10% (n=8/88) of the patient population (Figure 1c). Mental health risk was elevated in 63% (n=50/79) of patients screened (Figure 1e, f, g). Physical impairment was present in 52% (n=46/88) of patients (Figure 1h &1i). The screening clinic generated 48 referrals through to varied allied health disciplines for individualised therapy.

Conclusion
A student-led interdisciplinary screening clinic ensures timely identification of patient risk for undernutrition, sarcopenia and poor mental health, improving access to early intervention opportunities. Students can act as a valuable enabler for workforce capacity at a time when the health service providers are stretched.
P524 Etrasimod shows low risk of adverse events following concomitant use with opioids or antidepressants in patients with ulcerative colitis
Authors: Afzali A , Regueiro M , Yarur A J , Zabana Y , Ng S C , Menon S S , McDonnell A , Lazin K , Keating M , Bhattacharjee A , Branquinho D , Bananis E , Peyrin-Biroulet L 
Published: January 2024

Abstract

Background
Etrasimod is an oral, once-daily (QD), selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). Unlike the other S1P receptor modulator approved for UC, etrasimod and its metabolites do not have a molecular structure to inhibit monoamine oxidase (MAO).1 Coadministration of drugs that inhibit MAO with opioids and antidepressants may increase the risk of adverse events (AEs), including hypertension.2 This post hoc analysis evaluated the incidence of AEs potentially related to serotonin syndrome in patients taking etrasimod and concomitant opioids or antidepressants in the phase 3 ELEVATE UC 52 (NCT03945188) and ELEVATE UC 12 (NCT03996369) trials.

Methods
Safety data pooled from both trials were analysed in patients receiving etrasimod 2 mg QD (up to 52 weeks of exposure) with/without concomitant opioids or antidepressants. We report the proportions of patients who had ≥1 concurrent AE potentially related to serotonin syndrome, consisting of one standardised MedDRA Query, one query based on the Hunter Criteria and supplemental preferred terms (pyrexia, tachycardia and hypertension-related AEs).3

Results
Among 527 patients receiving etrasimod, 77 (14.6%) and 35 (6.6%) patients were taking concomitant opioids or antidepressants, respectively. Most patients on concomitant opioids or antidepressants were White (80.0–88.3%); male (50.6–51.4%); their median age was 35.0 (18.0–70.0) and 41.0 (19.0–74.0) years, respectively. More patients with vs without concomitant opioids or antidepressants, respectively, consumed alcohol (40.3% vs 24.7% and 48.6% vs 25.4%) and used tobacco (40.3% vs 20.9% and 34.3% vs 23.0%). The incidence of other AEs potentially related to serotonin syndrome was low and generally comparable in all subgroups; reported rates of pyrexia and tachycardia were similar in patients with/without concomitant opioids or antidepressants (Table). Hypertension-related AEs were infrequent and generally balanced. No AEs per the Hunter Criteria were reported in patients on concomitant opioids or antidepressants (Table). No reported AEs were serious or led to treatment discontinuation among patients taking these concomitant medications.

Conclusion
The incidence of AEs was low and comparable in patients receiving etrasimod with or without concomitant opioids or antidepressants. This analysis supports the low likelihood of clinically relevant drug–drug interactions between etrasimod and medications commonly prescribed to patients with UC, such as opioids or antidepressants.
References
1. Lee CA et al. Clin Pharmacol Drug Dev 2023; 12: 553–571.
2. Sands BE et al. J Crohns Colitis 2023; online ahead of print.
3. Dunkley EJC et al. QJM 2003; 96: 635–642.
P525 Utilisation of endoscopic ultrasonography for submucosal cushion measurement to determine eligibility for endoscopic submucosal dissection in ulcerative colitis-associated dysplasia: A case series
Authors: Kim K , Hong S W , Hwang S W , Park S H , Ye B D , Byeon J S , Myung S J , Yang S K , Yang D H 
Published: January 2024

Abstract

Background
Endoscopic submucosal dissection (ESD) has gained traction as an effective therapy for ulcerative colitis (UC)-associated dysplasia, yet identifying fitting ESD candidates is challenging by substantial submucosal (SM) fibrosis from chronic inflammation. We report our experience utilising endoscopic ultrasonography (EUS) to assess ESD eligibility by measuring SM cushion thickness.

Methods
Retrospective case-series includes nine patients who were diagnosed or referred to as UC-associated dysplasia in surveillance colonoscopies between August 2017 and October 2023. After scanning dysplastic lesions (Fig A-B), hyaluronic acid solution was injected into the SM layer (Fig C). EUS with a mini-probe quantified SM cushion beneath the dysplastic lesion (Fig D), and ESD was performed in cases with at least 2.0 mm of SM cushion thickness (Fig E-F).

Results
Among ten cases from nine patients, eight cases met the criteria and underwent ESD, while two cases (Patient 3, Patient 7) were regarded as unsuitable for ESD with SM cushion thickness less than 2.0 mm. Median disease duration was 19 years, and median age at diagnosis of UC-associated dysplasia was 50 years. Median SM cushion thickness ranged from 4.2 to 6.9 mm. Median procedure time was 50 minutes, and median size of resected specimens and lesions were 31.5 x 24.5 mm and 16.0 x 12.5 mm, respectively. en bloc resection was achieved in all cases, with an 87.5% R0 resection rate. No perforation occurred; only one required post-discharge endoscopic bleeding control after four days post-discharge.

Conclusion
EUS-measured SM cushion thickness may be a valid approach that provides an objective criterion for determining ESD eligibility in UC-associated dysplasia. This would help guide individualised treatment in UC-associated dysplasia, reducing unnecessary procedures or surgery.
P581 Age-related patterns in biological therapy use and surgery among patients with IBD: Insights from the Belgian PANTHER cohort
Authors: Celis J , Truyens M , Verstockt S , Glorieus E , De Wolf M , Lenfant M , Barbaraci M , Sabino J , Ferrante M , Geldof J , Verstockt B , Laukens D , Cleynen I , Vandermeulen L , Vermeire S , Lobaton T ,   IBD Research Unit
Published: January 2024

Abstract

Background
Inflammatory bowel diseases (IBD) are predominantly diagnosed during the second to third life decade. However, the disease may manifest itself at any age and current understanding of differences in clinical presentation and therapy use among age groups is still limited. We aimed to analyse age-related patterns in biological and surgical treatment among patients with IBD.

Methods
This study utilized data from the PANTHER cohort, a prospective Belgian inception cohort including 473 adult patients with IBD from 3 Belgian referral centres. Patient inclusion took place from 2015 to 2023. Patients were categorized into groups based on the age at diagnosis: 'young adult-onset' (18-39 years), 'adult-onset' (40-59 years), and ‘elderly-onset’ (³60 years). Baseline characteristics and treatments were analysed using Chi square, Mann-Whitney U tests, log-rank tests and/or Cox regression in SPSS.

Results
Baseline characteristics are shown in Table 1. No significant differences were found between age groups in terms of IBD diagnosis, gender, median follow-up duration, and smoking status.
Use of biologics differed significantly across age groups with highest uptake in young-adult onset patients (65.8%, P&lt;0.001). Significant differences were found in selection of first biologic with vedolizumab as most frequently selected option in the elderly compared to anti-TNF in the youngest age group (P=0.002). Time to initiation of a biological was earlier in the youngest cohort (P=0.002, Figure 1). Cox regression analysis revealed that older age at diagnosis (HR 0.987, 95%CI [0.98;0.996], P=0.006), UC (HR 0.495, 95%CI [0.50;0.39], P&lt;0.001) and centre of follow-up (Brussels vs Leuven: HR 0.663, 95%CI [0.4;1], P=0.048) were associated with a lower risk of biological initiation. When analysing CD separately, independent risk factors associated with biological use were perianal disease (HR 2.26, 95%CI [1.6;3.2], P&lt;0.001), L3 (HR 1.85, 95%CI [1.3;2.6], P&lt;0.001,) and L4 (HR 12.7, 95%CI [1.6;98.7], P=0.015,) location (compared to L1 location). In UC patients, E2 (HR 7.9, 95%CI [2.8;22.4], P&lt;0.001) and E3 (HR 6.9, 95%CI [2.4;19.3], P&lt;0.001) were related to earlier use of biologics.
During follow-up, 19% of CD and 5.1% of UC patients required IBD-related surgery. Univariate analysis showed a higher need for surgery in younger patients (P=0.042), however, this difference was no longer significant when analysing CD (P=0.272) and UC (P=0.09) patients as separate groups.

Conclusion
Analysis of the PANTHER Biobank reveals significant age-related variation in the administration of biological therapies among IBD patients.
P591 Treatment of microscopic colitis: retrospective analysis of consecutive single centre patients
Authors: Kiudelis V , Kiudeliene E , Kupcisnkas J , Kupcinskas L 
Published: January 2024

Abstract

Background
Microscopic colitis (MC) is a chronic autoimmune inflammatory condition of the colon that causes watery diarrhoea along with other symptoms like bowel incontinence. MC is a benign condition with no increase in cancer risk or impact on survival but it usually requires treatment due to significantly impaired quality of life. Even though MC therapy is symptom oriented, recent studies have shown that almost half the patients require long-term medical treatment.

Methods
A retrospective analysis of consecutive MC patients treated in Lithuanian University of Health Sciences Hospital Kauno Klinikos over the last 6 years was performed. Patient characteristics and clinical information was obtained from electronic records.

Results
94 MC patients were treated in our centre since 2017, 46 (49 %) with collagenous colitis (CC), 39 (41.5 %) with lymphocytic colitis (LC), 2 (2.1 %) with incomplete CC and 7 (7.4 %) with incomplete LC. 77 patients were female (82 %). Median age was 59 years [44.8-70.3]. There was a tendency for men to be younger (median 42 [37-68]) than women (median 60 [50-70.5]) but not significantly (p&gt;0.05).
During the 6-year period 67 patients (71.3 %) were treated with budesonide, 33 (35.1 %) received only one course and went into clinical remission while 34 (36.2 %) needed either multiple courses or continuous treatment for relapsing or chronic active disease respectively. Primary non-response to budesonide wasn’t documented in any patient. 8 patients (8.5 %) were treated with azathioprine due to budesonide dependency or intolerance but it was discontinued in all but 1 patient due to lack of response or adverse events. 3 patients (3.2 %) were treated with biological therapy. 1 patient was treated with adalimumab which was discontinued due to adverse events, 1 was treated with infliximab which was switched to vedolizumab due to loss of response, and 1 was treated with vedolizumab which was switched to adalimumab due to primary non-response. At the time of analysis 61 patients (64.9 %) were receiving no active treatment, 21 (22.3 %) were receiving intermittent courses of budesonide, 6 (6.4 %) had been prescribed budesonide on demand, 3 (3.2 %) were taking budesonide continuously, 1 (1.1 %) was taking azathioprine and 2 (2.1 %) were on biological therapy. There was no difference between CC and LC patients.Conclusion
A little less than half of the patients needed long-term medical treatment. While budesonide was widely used and usually effective, we observed a need for advanced therapies as well.
P655 The ileorectal anastomosis after a total colectomy is a feasible and valid surgical alternative in the treatment of inflammatory bowel disease
Authors: Tapiolas I , Mañosa M , Troya J , Vela S , Pares D , Mesonero F , Valera P , Riestra S , Iglesias E , Rodríguez-González E , Guardiola J , García López S , Carpio D , Vega P , Martín Arranz M D , Ramos L , Busquets D , Sierra M , Martínez Montiel P , Sicilia B , Ricart E , Garcia Planella E , Huguet J M , Vera I , Gomollon F , Rivero M , De Castro L , Barreiro de Acosta M , Rodríguez Lago I , Gisbert J P , Garcia Sepulcre M F , Calvet X , Bermejo F , Pérez Calle J L , Gutierrez A , Lucendo A J , Muñoz Vilafranca M D C , Navarro Llavat M , Calafat M , Doménech E ,   ENEIDA
Published: January 2024

Abstract

Background
Colectomy is still necessary in some patients with inflammatory bowel disease (IBD). The decision of the technique for the restoration of the bowel continuity depends on the characteristics of the patient and whether it is Crohn’s disease (CD) or ulcerative colitis (UC). The options for the reconstruction are proctectomy with an ileoanal reservoir or an ileorectal anastomosis (IRa).
The aim of this study is to evaluate the need of a proctectomy with a definitive ileostomy after an ileorectal anastomosis, the associated risk factors and the need for advanced therapies.

Methods
This retrospective study includes patients with colectomy and IRa from the ENEIDA national registry. Medical treatment offered during the postoperative follow up and the need for a proctectomy and a definitive ileostomy were evaluated according to the type of IBD.

Results
Of the 394 patients who underwent an IR, 37% had UC and 63% CD with a medium age of 58 years (RIQ 48-68) and a median follow-up after the IR of 174 months (RIQ 70- 266). 17% of UC’s patients and 42% of CD’s patients had associated perianal disease (p&lt;0.001). The cumulative probability for a definitive ileostomy in UC’s patients was 1%, 2%, and 6% at 5, 10 and 20 years respectively and 1%, 3%, and 11% at 5, 10 and 20 years respectively for the CD (p=0.035). Postoperative maintenance treatment with biologicals was left in 45% (44% UC and 47% CD; p=0.28). During follow-up, the probability of starting biological treatment was 8%, 17%, 35% at 2, 5 and 10 years in CD and 3%, 12%, 28% at 2, 5 and 10 years in UC (p=0.59).

Conclusion
The probability of requiring a definitive ileostomy/proctectomy after an IR is low, although is more frequent in patients with CD than with UC. Because of this low probability an IR is a valid alternative to the reservoir or even to the proctectomy with a definitive ileostomy in selected patients, keeping in mind one third of the patients would need advanced therapies.
P661 Ustekinumab in Crohn’s disease: A three-year multicentre prospective study from Hungary - Assessing efficacy, drug sustainability, and safety
Authors: Barkai L J , Gonczi L , Farkas K , Farkas B , Molnar T , Szamosi T , Schafer E , Golovics P , Juhasz M , Patai A , Vincze A , Sarlos P , Farkas A , Dubravcsik Z , Toth T G , Miheller P , Lakatos P L , Ilias A 
Published: January 2024

Abstract

Background
While randomized controlled trials have shown ustekinumab (UST) as an effective therapeutic option for Crohn’s disease (CD), there is a lack of long-term observational data in real-world CD patient settings. This prospective study seeks to evaluate the clinical effectiveness, sustainability, and safety of UST in a nationwide multicentre cohort of CD patients over three years. The aim is to bridge the gap in our understanding of UST's real-world implications for long-term CD management.

Methods
CD patients undergoing ustekinumab (UST) treatment were consecutively enrolled at nine Hungarian Inflammatory Bowel Disease centers from January 2019 to May 2020. Over a three-year period, comprehensive data on patient demographics, disease characteristics, treatment history, clinical disease activity (measured by the Harvey Bradshaw Index (HBI)), biomarkers, and endoscopic activity (evaluated using the Simple Endoscopic Score for Crohn’s Disease (SES-CD)) were systematically collected.

Results
Involving 148 patients, the cohort comprised 48.9% with complex behavior of CD and 97.2% with previous anti-TNF exposure. Pre-induction remission rates were observed at 12.2% (HBI) and 5.1% (SES-CD). Clinical remission rates (HBI) at the end of the first, second, and third years were 52.2%, 55.6%, and 50.9%, respectively. Criteria for endoscopic remission were met in 14.3%, 27.5%, and 35.3% of subjects at the end of the first, second, and third years. Dose intensification was notable, with 84.0% of patients on an 8-weekly and 29.9% on a 4-weekly regimen by the end of year 3. Throughout the follow-up period, drug sustainability stood at 76.9%, and no serious adverse events were observed.

Conclusion
Our study confirms that ustekinumab is a sustainable, effective, and safe long-term treatment for Crohn's disease patients with a severe disease phenotype and a history of high anti-TNF failure, with the need for frequent dose adjustments.