bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0437 Positive anti-Saccharomyces cerevisiae antibodies do not affect clinical outcomes in pediatric patients with Crohn’s disease treated with anti-TNF therapy
Authors: LIng D , Grabovski R , Matar M , Shamir R , Shouval D S , Weintraub Y 
Published: January 2025

Abstract

Background
Anti-Saccharomyces cerevisiae antibodies (ASCA) have been associated with a more aggressive Crohn’s disease (CD) phenotype. However, the effect of ASCA serology on the response to biologic therapy, specifically in children on anti-TNF therapy, is unknown. Our goal was to assess whether ASCA levels are associated with clinical outcomes in pediatric CD patients treated with anti-TNF antibodies.

Methods
A single center retrospective study. Demographic, clinical and laboratory data were collected from pediatric CD patients (aged 2.2-17.9 years) treated with anti-TNF therapy, who were tested for IgG ASCA levels upon diagnosis, between 2010-2023. The cut-off value for a positive ASCA result was defined as 30 EU/mL. Clinical outcomes included durability of anti-TNF therapy, corticosteroid-free survival (CSFS) at week 52 of therapy, IBD-associated hospitalizations and IBD related surgery.

Results
One hundred seventy-two patients with CD (69 ,39% females) with a median age at diagnosis of 13.5 (11.1-15.4) years were included. Ninety-two (52%) patients had positive ASCA (&gt; 30 EU/mL). ASCA positivity was associated with female sex (p=0.02) and ileocolonic disease location at diagnosis (p=0.02). Sixty-six (37%) patients were treated with infliximab and 111 (63%) with adalimumab. The median time of follow-up in our cohort was 115 (65-174) weeks. Time to discontinuation of anti-TNF was comparable between patients with ASCA positive and negative levels (97.8% vs. 97.4% and 89.3% vs. 87.4% at 1 and 3 years, respectively). In addition, time to IBD-associated hospitalization and surgery were also similar. Interestingly, patients with positive ASCA achieved CSFR more often, compared to patients with ASCA negative (P=0.04). Sub-analysis of patients with high ASCA values, the top 20%, (&gt;80 EU/mL) demonstrated significantly longer durability of anti-TNF, compared to the patients with lower ASCA levels (&lt;80 EU/mL,p= 0.02).

Conclusion
ASCA positivity is not associated with worse outcomes in pediatric patients with CD treated with TNF antagonists.
P0438 Altered Visceral Sensitivity in patients with Ulcerative Colitis in remission
Authors: Trikola A , Mylonas I , Gerasimos S , Viazis N 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) in remission is commonly associated with residual symptoms, despite adequate inflammatory control. Distinguishing between inflammatory and non-inflammatory causes is essential, in order to target therapy and avoid any unnecessary treatment escalation. Once mucosal inflammation has been excluded through endoscopic evaluation, high resolution anorectal manometry (HRAM) along with sensory testing could help symptom assessment. The aim on this study is to explore whether established physiologic diagnostic modalities such as HRAM could add value in investigation of patients with UC in remission.

Methods
Patients with confirmed UC in remission (after proper endoscopic assessment) were evaluated with Visceral Sensitivity Index (VSI, 15 items, ranging 0-75). They subsequently underwent HRAM with a solid-state catheter followed by the rectal sensory test by a gradual rectal distention according to the IAPWG Protocol, aiming to access rectal physiology and sensory perception.

Results
A total of 32 eligible adult patients (43% females, mean age 40,8 y.o.) were enrolled. Internal consistency for VSI was excellent (Cronbach’s alpha=0.933). Total mean VSI scores were 43.15 (26.11-60.19). An increased VSI score was reported in 12/37 (37.5%) of patients, whereas 20/32 (62.5%) of patients ranged low. Patients with increased total VSI scored significantly worse in bloating and abdominal distention, anxiety when going to new restaurants and worry, avoiding new foods, belief in a serious illness indication, a frightening abdominal discomfort and vigilance while no significant differences were found in mean rectal pressures and outcomes of balloon inflation (table 1).

Conclusion
Although a 37% of patients with UC in endoscopic remission score high in VSI, rectal pressures and perception as observed by the HRAM and ballon distention test are non-significant. VSI displays excellent consistency when evaluating patients with UC.
P0442 Prevalence and Impact of E-cigarettes on Disease Outcomes in Patients with Inflammatory Bowel Disease
Authors: Almuhaya H , Alashkar R , Alsebaai D , Albadawi N , Almutairdi A , Attamimi M , Desai S , Al-Bawardy B 
Published: January 2025

Abstract

Background
Electronic cigarettes (EC) have gained popularity as an alternative to traditional cigarette smoking. The harms of traditional cigarette smoking in Crohn’s disease (CD) are well established, but it is unclear if EC have similar harmful effects. Our aim was to determine the prevalence, predictors and impact of EC on clinical outcomes in patients with IBD.

Methods
This a cross-sectional study of a prospectively maintained single-center IBD registry from September 1st 2023-September 30th, 2024. The study included all patients aged 14-years and older who had a confirmed diagnosis of IBD including CD, ulcerative colitis (UC), IBD-unclassified (IBD-U), excluding those with pouchitis. The Primary outcomes were to determine the prevalence and predictors of EC use among patients diagnosed with IBD. The secondary outcomes assessed the impact of EC on clinical outcomes in IBD patients including the need for surgical intervention, CD progression (perianal disease, stricturing or penetrating complications), need for &gt; 2 advanced therapies and composite outcome (intestinal surgery, disease progression, &gt; 2 advanced therapies).

Results
A total of 412 patients were enrolled in the study (mean age 33 ± 13 years; 68% with CD) and 55% were male. Overall, 25% (n=102) of the cohort had traditional cigarette smoking history. EC use prevalence among IBD patients was 10.2% (n=42) (6.6% current, 3.6% previous users). Compared to non-users, EC-previous/current users were more likely to be male and have and have history of traditional cigarette smoking (Table 1). The prevalence of EC use was similar between patients with and without a history of intestinal surgery (10% for both, p &gt; 0.9), with no significant differences noted in CD (p = 0.4) or UC (p = 0.5) subgroups. In CD, the prevalence of EC use was similar in patients with and without stricturing disease (8.9% vs. 13%; p=0.3), and perianal disease (13% vs. 11%; p=0.7). For penetrating disease, EC use was 7.8%, compared to 16% in those without penetrating disease (p=0.06). No difference in EC use was found in those patients who required &gt; 2 advanced therapies (10%; n=4) vs. those who required ≤ 2 advanced therapies (10%; n=38) (p &gt; 0.9). EC use was noted in 11% (n=29) in patients who developed the composite outcome vs. 8.2% (n=13) in those who did not (p=0.3).

Conclusion
Up to 10% of IBD patients reported EC use, which was associated with male sex and history of traditional cigarette smoking. In our cohort, no association between EC use and unfavourable clinical outcomes was noted but larger studies with longer follow up duration are needed to further elucidate the impact of EC use on clinical outcomes in IBD.
P0446 Increased risk of venous thromboembolism post hospital discharge in patients with Inflammatory Bowel Disease: a systematic review and meta-analysis
Authors: Subhaharan D , Zaka A , Mridha N , Haig A , Mohsen W , Kakkadasam Ramaswamy P 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) increases the risk of venous thromboembolism (VTE). During acute hospitalisation, the risk increases up to six-fold, but is mitigated with pharmacological VTE prophylaxis. The European Crohn’s Colitis Organisation (ECCO) recommends extended prophylaxis for atleast 3 weeks for IBD patients undergoing major surgery. However, it is currently unknown whether this also applies for non-surgical hospitalisations for IBD patients. We performed an updated systematic review and meta-analysis to evaluate this risk. The primary outcome was evaluating the risk of post-hospitalisation VTE within 30 days after an IBD-related surgical or non-surgical hospitalisation.

Methods
PubMed, MEDLINE, EMBASE, CENTRAL and Web of Science was searched up until 1st June 2024 for observational cohort studies evaluating rates of VTE in IBD hospitalisations. Odds ratios were calculated using a random-effects model. Subgroup and sensitivity analysis were conducted in order to explore sources of heterogeneity.

Results
Seven eligible studies were included (973,267 IBD patients). 52.9% were female and mean age was 45.3 +/- 3.2 years. Average follow up was 43.2 +/- 5.6 months. Patients with IBD were associated with an increased risk of VTE within 30 days post-discharge in the adjusted analysis (OR 1.58; 95% CI 1.41-1.78) with moderate heterogeneity observed (I² = 67%, p = 0.005). Subgroup analysis based on hospitalisation type (surgical vs. non-surgical) revealed an increased risk amongst surgical hospitalisation for post discharge VTE (OR 1.34; 95% CI 1.09–1.64) with moderate heterogeneity (I² = 35%, p = 0.21). In contrast, non-surgical hospitalisation demonstrated a higher risk of post-discharge VTE (OR 1.70; 95% CI 1.52–1.90) with no significant heterogeneity (I² = 0%, p = 0.37). The overall effect size across both subgroups suggested a significant association between IBD and post-discharge VTE, with an odds ratio of 1.61 (95% CI 1.46–1.78), and moderate heterogeneity (I² = 45%, p = 0.10).

Conclusion
There is an independently increased risk of VTE within 30 days of a flare of IBD in both surgical and non-surgical hospitalisations. Extended VTE prophylaxis for all hospitalisations should be considered. Further prospective studies are required to identify specific patient risks.
P0545 Risk of rapidly progressive disease course in patients with pediatric-onset ulcerative colitis
Authors: D’Arcangelo G , Raso T , Ammattatelli F , Distante M , Zucconi F , Rotulo S , Aloi M 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) disease course is unpredictable at diagnosis and its management is still based on a “onesize-fits-all” approach. We aimed to investigate predictive factors of a rapidly progressive course in pediatric UC.

Methods
Retrospective case-control study conducted at Pediatric Gastroenterology Unit of Umberto I Hospital in Rome. We included newly diagnosed UC patients aged &lt; 18 years, with a minimum follow-up of 24 months. Demographic and clinical data, laboratory, endoscopic and histologic findings at diagnosis were collected and compared between patients with indolent UC and those with a rapidly progressive (RP) course, defined if they experienced one of the following within the first 24 months after diagnosis: acute severe colitis under antiTNFα unresponsive to IV steroids, need for colectomy and need for second-line biologics or advanced small molecules with at least two different mechanisms of action1.

Results
One hundred and forty-two children were included, 61 (43 %) with a RP course and 81 (57 %) with an indolent course of disease. RP children had higher age (11.3 ± 4.2 vs 9 ± 4, p=0.0002) and a higher PUCAI (50 ± 13 vs 40.4 ± 12, p&lt;0.0001) at diagnosis then those with indolent course. Hemoglobin was lower in RP group (11.6 ± 1.8 vs 12.4 ± 1.2 g/dL, p=0.001). RP children had higher rate of cecal patch at endoscopy (19% vs 2% p=0.001) and lower rate of sclerosing cholangitis (0 vs 8%, p=0.01). Endoscopic activity was more severe in RP compared to indolent patients as shown by the higher rate of Mayo 3 score (18% vs 2%, p=0.002) and median UCEIS (3.9 ± 1 vs 3.3 ± 0.9, p=0.001). The rate of severe histologic activity as graded by the local pathologist was higher in RP children (18% vs 1 %, p=0.004). The presence of a cecal patch at endoscopy was the only independent predictor for a rapidly progressive disease at the multivariate logistic regression analysis [OR 9.2 (95% CI 1.9-67.1), p=0.0009].

Conclusion
Children with a RP course seem to present with older age and a more clinically and endoscopically severe disease. However, only the endoscopic finding of a cecal patch emerged as an independent predictor of this course. These findings warrant confirmation in larger prospective cohorts to support a future personalized approach to UC.

References
1.Parigi TL, D’Amico F, Abreu MT, Dignass A, Dotan I, Magro F, Griffiths AM, Jairath V, Iacucci M, Mantzaris GJ, O’Morain C, Reinisch W, Sachar DB, Turner D, Yamamoto T, Rubin DT, Peyrin-Biroulet L, Ghosh S, Danese S. Difficult-to-treat inflammatory bowel disease: results from an international consensus meeting. Lancet Gastroenterol Hepatol. 2023 Sep;8(9):853-859.
P0549 Colombian Observer Inter-agreement in intestinal Ultrasound for ulcerative Colitis (COI-UC)
Authors: Parra Izquierdo L V , Ernest Suárez K , Argollo M , Frías-Ordoñez J , Orduz G , Ibañez E , Vargas M , Cubillos S , Verstockt B 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) is a non-invasive and effective tool for assessing intestinal inflammation in ulcerative colitis (UC) patients. Inter-observer agreement (IOA) in IUS for UC is crucial for accurate disease monitoring, particularly in countries and centers just implementing and educating on IUS, such as Colombia. Therefore, we conducted a study to assess the reliability of IUS in UC by comparing two Colombian gastroenterologists who performed prior at least 40 intestinal ultrasounds.

Methods
Thirty-seven patients with both clinically (in)active UC were included. Two gastroenterologists scanned all patients, assessing key IUS parameters, including bowel wall thickness (BWT), colour Doppler signal (CDS), loss of bowel wall stratification (BWS), presence or absence of mesenteric fat proliferation (i-fat) and lymph nodes. Statistical methods such as Cohen’s kappa or intraclass correlation coefficients (ICCs) were used to quantify agreement levels between both observers.

Results
Inter-observer agreement in BWT was analyzed per colonic segment and a moderate ICC average was found (0.746). However, for the most affected segment, the ICC was excellent (k=0.967), as was the agreement in calculating the Milan ultrasound score (MUC) score (k=0.981), the modified Limberg score (k=0.94) and CDS (k=0.94). Loss of BWS had a good agreement (k=0.83), while the agreement on the presence of lymph nodes and i-fat was moderate (k=0.53) and low (k=0.31), respectively.

Conclusion
Establishing a solid IOA with IUS for UC patients is vital for enhancing diagnostic accuracy and disease monitoring. Standardized acquisition and assessment of UC utilizing IUS with established reliability is important to expand the use of IUS in developing countries where this tool may be more cost-effective. Our results show a good to excellent IOA in this first Colombian initiative to implement IUS in UC. Further educational initiatives and improved standardization could further improve agreement among practitioners.
P0557 Multiomics analysis identifies key pathways associated with severe disease course in children with IBD: a prospective study
Authors: Azulay A , Talmor Y , Borenstein E , Focht G , Maslov T , Yogev D , Ledder O , Lev-Tzion R , Orlanski Meyer E , Assa A , Turner D 
Published: January 2025

Abstract

Background
Identifying biological pathways that are associated with poor disease course in IBD may improve early risk stratification and guide targeted therapeutic approaches. We therefore aimed to integrate multiomics data determined at disease onset to explore pathways associated with disease course in pediatric IBD, focusing on both microbial and host-derived signals.

Methods
Children with IBD were enrolled at disease onset and followed prospectively for18 months. Samples for whole exome sequencing (WES), serum metabolomics, stool metabolomics, and microbiome were analyzed using MaAsLin2 for differential expression and Random Forest for outcome prediction for single-omic. A late integration approach with Support Vector Machine was applied for multi-omics prediction. Severe outcome was defined as steroid-dependency, early or multiple biologics, or IBD-related hospitalizations/surgeries. Pathway enrichment analyses for each omic were assessed using Fisher’s exact test and odd ratio (OR) was calculated to asses the enrichment magnitude.

Results
Altogether, 182 children were enrolled (123 with CD (28% severe course) and 59 UC (39% severe course). Several pathways were differentially enriched in the severe group (Figure 1). Shared pathways across CD and UC included AGE-RAGE signaling, implicated in oxidative stress and inflammation (OR=36 [95%CI 3-459] in CD and OR=92 [7-1121] in UC), and choline metabolism in cancer, associated with lipid signaling, inflammation, and fibrosis (OR=37 [95%CI 4-382] and OR=66 [3-475]). CD-specific pathways included sphingolipid metabolism (OR=30 [95%CI 2-393]), linked to barrier dysfunction and chronic inflammation, glycerolipid metabolism (OR=11 [95%CI 1-160]), and fat digestion and absorption (OR=16 [95%CI 3-167]), highlighting disruptions in nutrient absorption and inflammation. UC-specific pathways included pathways in cancer (OR=23 [95%CI 3-263]), reflecting tissue remodeling and neoplasia risk, inflammatory regulation of TRP channels (OR=14 [95%CI 1-143]), contributing to colonic inflammation, sensory perception and purine metabolism (OR=5 [95%CI 0.4-58]). Random Forest machine learning models showed modest to no predictive performance of the different omics (area under ROC curve ranged between 0.41-0.67 in CD, and 0.38-0.72 in UC; Table 1).

Conclusion
Key biological pathways were identified in association with severity of disease course in pediatric IBD, utilizing large datasets of genetics, metabolomics and microbiome. The findings offer insights into mechanisms underlying pediatric IBD and highlight potential therapeutic targets as well as biomarkers for early intervention.
P0629 A scoping review of evidence-based dietary guidance and guidelines published by national and international organisations on Inflammatory Bowel Disease
Authors: Dimakis I K , Kapsoritakis A , Argyriou K , Manolakis A , Grammatikopoulou M , Gkikas K , Gerasimidis K , Androutsos O , Svolos V 
Published: January 2025

Abstract

Background
Despite emerging evidence indicating the critical importance of diet interventions for induction and maintenance of remission of inflammatory bowel disease (IBD), we still lack consistent guidelines for diet recommendations and nutrition therapy. The aim of this in-depth scoping review was to identify evidence-based dietary guidance and clinical guidelines produced by national and international organisations on IBD and summarize their content for diet interventions to induce and maintain remission.

Methods
An extensive literature search was undertaken on PubMed (January ‘14 to November ‘24), including MeSH terms (“Inflammatory Bowel Disease” OR IBD OR Crohn’s OR Colitis) AND (diet OR diet* OR food OR nutrition OR nutr*) AND (guideline OR consensus OR “expert review” OR “topical review”). Eligible articles included evidence-based dietary guidance and clinical guidelines for adults living with IBD, produced by national and international organisations. Paediatric guidelines and articles not in English were excluded.

Results
417 records were identified. After full-text review 10 papers fulfilled eligibility criteria. The eligible evidence-based dietary guidance and clinical guidelines were manuscripts produced by the European Crohn’s Colitis Organisation, International Organization For the Study of Inflammatory Bowel Disease, American Gastroenterological Association, European Society for Clinical Nutrition and Metabolism. Australasian society for parenteral and enteral nutrition, British Society of Gastroenterology, British Dietetic Association and the Dietitian Crohn’s Colitis Australian Network. Thirty different interventions were identified within different guidelines, proposed to induce and/or maintain remission for Crohn’s disease (CD) and/or ulcerative colitis. Exclusive enteral nutrition was recommended for induction of remission in CD by 9 out of 10 guideline articles. Similarly, CDED coupled with Partial Enteral Nutrition (PEN) was recommended for induction of remission in CD by 3 out of 10 guideline articles. Partial enteral nutrition was recommended for maintenance of remission in CD by 3 out of 10 guideline articles. Lastly, probiotic supplementation was recommended for induction of remission in UC by 2 out of 10 guideline articles. The remaining interventions were either recommended within a single guideline or there were inconsistent recommendations for their use between organisations.

Conclusion
The findings of this scoping review provide an overview of dietary guidelines by national and international professional organizations and can support collaboration between organizations worldwide thus reducing duplication of effort, facilitating reproducibility, and identifying guidance discrepancies.
P0631 Short-term effectiveness of risankizumab in patients with Crohn´s Disease: Experience in our centre
Authors: Valdés Delgado T , Rodríguez Gallardo M , Maldonado Pérez B , Belvis Jiménez M , Castro Laria L , Argüelles Arias F 
Published: January 2025

Abstract

Background
The recent introduction of Risankizumab to the therapeutic arsenal for Crohn’s disease (CD) has represented a revolution, owing to the positive efficacy outcomes observed in pivotal studies. Our aim was to assess the short-term effectiveness and safety of Risankizumab in CD patients in routine clinical practice.

Methods
A retrospective, observational, single-centre study was conducted, including CD patients undergoing treatment with Risankizumab who had completed at least the induction phase (week 12). The primary endpoint was clinical remission, defined as a Harvey-Bradshaw Index (HBI) ≤ 4. We analysed baseline and end-of-follow-up (weeks 12-24) results for clinical remission, faecal calprotectin (FC), and C-reactive protein (CRP). Additionally, drug persistence at the end of follow-up was also analysed and adverse events were recorded.

Results
A total of 36 patients were included, with a median age of 45 years [IQR 34-54] and a median disease duration of 9 years [3-18]. The predominant location and pattern were ileocolonic and inflammatory, respectively. The 77.8% (28/36) had failed two or more biologics, and 3 patients were biologic-naïve (Table 1).
The median baseline HBI was 8 [IQR 6-8], decreasing to 4 [IQR 2-5] at the end of follow-up between weeks 12-24 (p &lt;0.001) (Figure 1A).
The median baseline FC was 880 μg/g [IQR 640-2200], decreasing to 400 μg/g [220-575] at the last evaluation, between weeks 12-24 (p &lt;0.001) (Figure 1B).
Regarding CRP, the median baseline was 5 mg/L [IQR 2-7], decreasing to 2 mg/L [IQR 2-5] at the end of follow-up (p= 0.003) (Figure 1C).
Up to 94.4% of patients maintained Risankizumab at the end of follow-up (Figure 1D). Adverse events (AEs) were observed in 4 patients, of whom 2 had to discontinue treatment without being able to attribute the experienced AEs to the drug.

Conclusion
In our cohort of CD patients treated with Risankizumab, 64% achieved clinical remission in the short term, maintaining treatment at the end of follow-up in 94%. Our results are comparable to those obtained in the drug’s clinical trials.