bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1127 Diagnostic delay and economic burden in IBD: a multicenter italian experience in patients treated with biologics
Authors: Mocci G , Orrù G , Onidi F M , Bodini G , Picchio M , Ferronato A , Zampaletta C , Corpino M , Lorenzetti R , Usai Satta P , Elisei W , Tursi A 
Published: January 2024

Abstract

Background
Inflammatory bowel diseases (IBDs), Crohn's disease (CD) and ulcerative colitis (UC), are chronic and immune-mediated diseases with a relapsing-remitting trend. The overall incidence of these diseases is increasing. However, it is estimated that more than one third of patients experienced symptoms for more than one year before diagnosis. Delay in IBD diagnosis has several clinical, therapeutic and economic implications. Early diagnosis and proper treatment are the cornerstones for improving the standard of care for these patients.
This study aims to evaluate the diagnostic delay (DD) in patients with IBD and to analyze the clinical burden of the delay in IBD diagnosis in patients treated with biological drugs.

Methods
An observational and retrospective study was performed in IBD patients, regularly followed in four IBD Units. Data regarding delay in IBD diagnosis were assessed through a questionnaire evaluating the disease course. Moreover, data about biologics dispensation were obtained from the medical records in the period 2020-2022

Results
344 IBD patients were enrolled (UC 228, CD 116, M 198, F 146). Median age at diagnosis was 42 years (IQR 9-82); Median DD was 12 months (IQR: 6-24). No significant difference was found in median DD between UC [12 months (IQR: 4.5-12.0)] and CD patients [12 months (IQR: 12-48)]. However, the proportion of patients with a DD &gt;24 months was significantly (p=0.007) higher in CD (41/110 = 37,3%) than in UC patients (20/220=9%).
After a median disease duration of 10 years (IQR: 4-17), overall, 164 patients (49.7%) were exposed to one biologic agent, 105 patients (31.8%) were exposed to two biologic agents, 61 (18.5%) to three or more biologic agents. 18,5% of patients (61/330) underwent surgery.
The statistical analysis showed that DD &gt;24 months was not statistically significant associated with history of ≥ 2 biological drugs (p=0.51). Conversely, there was association with surgical treatment (p=0.004).

Conclusion
The diagnostic delay in IBD represents a challenge with clinical and, therapeutic impact. It’s crucial to cooperate with general practitioner and gastroenterologists not dedicated to IBD in order to reduce the diagnostic delay and guarantee an effective, appropriate and early treatment that will improve the patients’ quality of life and meanwhile reduce the health care system costs.
P1131 Epidemiological Characteristics of Inflammatory Bowel Diseases in The Last Decade: Multi-Center Türkiye Data
Authors: Akyuz F , Agargun B F , Atug O , Eskazan T , Yuksel I , Kochan K , Barutcu S , Asil M , Demirtas C , Bozkurt B , Cankurtaran E , Degirmenci A , Kefeli A , Ustaoglu M , Keskin M K , Sahin M , Ucer M , Erurker Ozturk T , Dervis Hakim G , Uyanikoglu A , Poturoglu S , Kalkan I H , Gulten M , Arhan M , Kav T , Toruner M , Akpinar H , Issever H , Celik A F 
Published: January 2024

Abstract

Background
This study aims to assess the past decade's epidemiology of inflammatory bowel disease (IBD) patients in Türkiye and identify year-to-year variations.

Methods
A total of 3463 patients diagnosed between 2010 and 2022 were included. The patients' demographic and phenotypic characteristics, smoking habits, and family histories were assessed. Differences between geographic regions and age groups were analyzed.

Results
Among patients, 1523 (44%) had Crohn's disease (CD), 1768 (51.1%) had ulcerative colitis (UC), and 23 (0.7%) had indeterminate colitis (Table). Male proportions were higher in both CD and UC patients, with the most common age range for diagnosis being 21-30 years (Figure). Over time, newly diagnosed cases and rates per population increased according to Turkish Statistical Institute data (Figure). Patients were divided into two groups based on diagnosis years (2010-2016 and 2016-2022), CD initially dominated, but UC prevalence grew in the last 6 years (p&lt;=0.001). Recently diagnosed CD patients showed higher inflammatory involvement (78.0% vs. 63.4%; p&lt;=0.001), and the inflammatory phenotype rose post-2016 (75.2% vs. 60.4%; p&lt;=0.001). CD patients had more smokers (24.2% vs. 10.9%; p&lt;=0.001) and family history of IBD (6.8% vs. 4.5%; p=0.004) than UC patients. Patients over 60 years old had a higher male gender ratio (64.4% vs. 55.9%; p&lt;=0.001) and UC frequency (62.2% vs. 52%; p&lt;=0.001) compared to those under 60 years old. The inflammatory phenotype in CD patients was lower in those under 60 years old compared to those over 60 years old (70.4% vs. 85.4%; p&lt;=0.001). The frequency of pancolitis in UC patients was lower in those over 60 years old (31.3% vs. 41.4%; p&lt;=0.001).

Conclusion
In Türkiye, IBD is more prevalent in males and is frequently diagnosed between ages 20 to 30. In CD, inflammatory and ileocolonic involvement is most common, while in UC, pancolitis is observed. The earlier diagnosis peak and increased pancolitis in UC patients might relate to tertiary centers' inclusion with transition clinics and focus on severe cases. Recently, newly diagnosed UC cases have notably surpassed CD cases.
P1137 Long-term trend of cumulative incidence of venous thromboembolism in Korean patients with inflammatory bowel disease: A nationwide population-based cohort study
Authors: Kim Y E , Kim S P , Park Y , Kim S H , Choi S , Choi H J , Jeong I S , Kim S H , Kim D Y , Oh S H , Yoon H J , Kim K M 
Published: January 2024

Abstract

Background
Venous thromboembolism (VTE) is a serious extraintestinal manifestation of inflammatory bowel disease (IBD). However, limited research has been conducted on the cumulative incidence of VTE in patients with IBD. Therefore, this study aimed to observe the trend of cumulative incidence of VTE after IBD diagnosis.

Methods
From 2005 to 2016, a population-based cohort study was conducted using health administration claims data from South Korea. IBD and VTE were defined by ICD-10 codes. Incidence density and cumulative incidence rate were analysed. The risk of variables including age, sex, and IBD subtype was comparatively analysed.

Results
A total of 35,508 newly diagnosed patients with IBD between 2005 and 2015 were followed up until 2016. Among them, 634 (1.8%) experienced VTE (619 adults and 15 children). The incidence densities of VTE per 10,000 person-year were 28.90 (range, 27.75–32.54) for overall IBD, 30.07 (range, 27.75–32.54) for adult IBD, and 11.08 (range, 6.20–18.27) for PIBD, respectively. The cumulative incidences of VTE at 0, 1-, 3-, 5-, and 10 years post-diagnosis were 0.01%, 0.30%, 0.80%, 1.30%, and 3.0%, respectively (Figure 1-A). Adulthood, female sex, and ulcerative colitis were associated with an increased risk of VTE (Figure 1-B, C, D).

Conclusion
The study showed a steady and gradual increase in the cumulative incidence of VTE in patients with IBD over a follow-up period of up to 11 years, with a slightly more rapid increase after 8 or 9 years. This trend was even more pronounced in children. This suggests that vigilant monitoring of VTE is necessary in the management of patients with IBD.
P1138 Long-term Epidemiological Trends in Emergency Hospital Admissions and Hospitalizations of Patients with Inflammatory Bowel Diseases in one of the biggest metropolises in western Poland in years 2010 to 2021
Authors: Mahadea D , Kotecki P , Miechowicz I , Dobrowolska A , Eder P 
Published: January 2024

Abstract

Background
A worldwide significant dynamic shift in the incidence and clinical course of Inflammatory Bowel Diseases (IBD) has been observed in the past years. One key indicator that embodies this variability is the necessity for urgent hospitalisation due to exacerbations of Crohn's Disease (CD) and Ulcerative Colitis (UC). The objective of this study was to assess this phenomenon in the Poznan Metropolis, one of the biggest metropolises in western Poland, over a 12-year timeframe.

Methods
Using the National Health Fund's database, urgent hospitalisations of patients with CD or UC from 2010-2021 were identified, and defined as unplanned admissions to emergency departments and inpatient units in Poznan Metropolis hospitals, which required hospitalisation. The ratio of emergency to planned hospitalisations were compared in two identical timeframes: 2010-2015 vs. 2016-2021 and, additionally, during the COVID-19 pandemic years 2020-2021 vs. 2018-2019. The data were analysed and compared according to diagnosis, age, gender and length of hospitalisation.

Results
The numbers of urgent and planned hospitalisations in regard to predefined time periods are shown in Table 1. The rate of acute to planned hospitalisations from 2010-2015 vs. 2016-2021 was 27% (809/3006) vs. 44.5% (1131/2540) (p &lt;0.0001). It increased significantly in all defined categories, except for patients over 60 years of age, where an insignificant decrease from 79% to 71% (p=0.4) was noted. Lower hospitalisation rates were observed among men compared to women (2010-2015: 28% vs. 46%; 2016-2021: 25% vs. 43%). The COVID-19 pandemic posed a paramount challenge to global healthcare systems. However, a statistically significant decrease in the rate of urgent to planned hospitalisations was only found in CD patients (47% vs. 34%; p=0.02; Figure 1). No impact on hospitalisation duration was observed during the COVID-19 pandemic as compared to 2018-2019.

Conclusion
Despite ongoing therapeutic advances, IBD remains a substantial challenge to healthcare systems, as evidenced by the increasing trend in urgent hospitalisations over time, regardless of the diagnosis, particularly among women. The COVID-19 pandemic significantly triggered global economic and healthcare crisis. However, the repercussions on the treatment of IBD patients in our Metropolis were inconsequential.
P1150 The sulfur microbial diet and prognosis of individuals with Inflammatory Bowel Disease in a prospective cohort study
Authors: Chen J , Dan L , Sun Y , Fu T , Wang X 
Published: January 2024

Abstract

Background
Intestinal sulfur-metabolizing microbes and its products like hydrogen sulfide can impact gut health and involves course of multiple gastro intestinal diseases. Recent studies demonstrated a specific diet pattern, sulfur microbial diet, can significantly influence these microbes. The sulfur microbial diet was delineated as a specific dietary pattern linked with the augmentation of sulfur-metabolizing microorganisms in humans, wherein an enhanced prevalence of these bacteria potentially escalates microbial hydrogen sulfide synthesis. This offered an opportunity to improve and modify disease course of chronic gastrointestinal diseases like inflammatory bowel disease (IBD) via the diet pattern that needed evidence. We aimed to prospectively examine the associations between sulfur microbial diet and the prognosis of individuals with IBD.

Methods
We included 1528 participants with IBD (477 Crohn’s disease [CD] and 1051 ulcerative colitis [UC]) from the UK Biobank. Sulfur microbial diet was a dietary index defined a priori based on increased abundance of 43 bacterial species involved with sulfur metabolism. We assessed adherence to this dietary pattern using validated 24-hour dietary recalls that were collected in 2009-2012 for five rounds. Two outcomes, bowel resection surgery and colorectal cancer (CRC), were obtained based on the national health databases. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results
After a mean (SD) follow-up of 9.9 (2.3) years, we documented 117 bowel resection surgeries events and 28 incident CRC. Compared to participants in the lowest tertile of sulfur microbial diet scores, those in the highest scores were associated with 76% higher risk of bowel resection surgeries (HR 1.76, 95% CI 1.12-2.77, P=0.014; P-trend=0.037) and 268% higher risk of CRC (HR 3,68, 95% CI 1.19-11.35, P=0.023; P-trend=0.019) in IBD (Table 1).

Conclusion
A higher sulfur microbial diet score was associated with an elevated risk of bowel resection surgery and CRC in individuals with IBD. More research is needed to explore whether this association differs across disease subtypes and locations.
P1154 Mediterranean dietary approaches to stop hypertension intervention for neurodegenerative delay (MIND) diet can reduce Inflammatory Bowel Disease risk: a prospective cohort study
Authors: Ye S , Sun Y , Chen X , Fu T , Ruan X , Dan L , Chen J , Du Z , Wang X 
Published: January 2024

Abstract

Background
The global increasing prevalence of Inflammatory Bowel Diseases (IBD) places a substantial burden on families and society at large. The lack of a definitive cure for this chronic condition underscores the critical need for effective preventive measures. Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, emphasizing natural plant-based foods while limiting animal products and high-saturated fats, emerges as a promising dietary approach. This study aims to bridge the gap in understanding the impact of the MIND diet on IBD risk.

Methods
We utilized data from 187,549 participants in the UK Biobank who provided dietary information and were free of IBD at baseline. Dietary information including the consumption of over 200 common foods and 30 beverages was collected for five rounds by a validated web-based 24-hour dietary recall questionnaire. A MIND diet score was evaluated based on the intake of ten beneficial and five unhealthy food groups and was further grouped by tertiles. The outcome of interest was Crohn’s disease (CD) and ulcerative colitis (UC), ascertained via inpatient data and primary care data. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results
After a mean follow-up of 10.7 years, we documented 335 and 655 incident CD and UC. The average age of the participants was 56.2 years, of which 55.0% were females. We found that greater adherence to the MIND diet, represented by higher diet score, was associated with a lower risk of CD (HR comparing extreme tertiles 0.66, 95% CI 0.50-0.89, P=0.006; P-trend=0.005) and UC (HR 0.80, 95% CI 0.65-0.98, P=0.030; P-trend=0.029) (Table 1). In the secondary analysis, we investigated the impact of fifteen individual food components in the MIND diet and found that consumption of olive oil was inversely associated with CD, and consumption of wine was inversely associated with UC.

Conclusion
We found higher adherence to the MIND diet was associated with lower risk of CD and UC. Our findings call for further research on the potential of the MIND diet to prevent IBD.
P1158 Comparison of comorbidities, and lifestyle habits between IBD patients, IBD patients with suspected SpA, and controls
Authors: Karling P , Pettersson N , Forsblad-d´Elia H 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a complex condition with systemic implications. Recent research emphasizes the connection between IBD and spondyloarthritis (SpA), sharing genetic and clinical traits. This cross-sectional case-control study investigates comorbidities and lifestyle habits in three groups: IBD patients, IBD patients with suspected SpA, and control group from the general population.

Methods
We obtained data from the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG) for 1,032 IBD patients (592 UC and 440 CD) and selected a control group of 16,756 individuals from the 2018 Swedish National Public Health Survey. Questionnaires covered comorbidities, self-perceived health, smoking, alcohol, and physical activity. Modified criteria for ASAS and AMOR was used to define SpA. Risk factors in patients with IBD for SpA were explored by logistic regression.

Results
IBD patients have higher rates of comorbidities such as hypertension (34.4%), asthma (15.6%), and diabetes (8.3%) compared to the control group.(Table 1). Notably, those with suspected concurrent SpA had even higher rates: hypertension (41.3% in axial SpA, 43.6% in peripheral SpA), asthma (22.4% in axial SpA, 21.5% in peripheral SpA), and diabetes (10.2% in axial SpA, 10.5% in peripheral SpA). Smoking habits differ, with a greater proportion of former smokers in the IBD group (38.3%) and a higher percentage of individuals who had never smoked in the control group (64.6%). Encouragingly, IBD patients demonstrated increased physical activity, with 70.3% engaging in 150 minutes of activity per week. Logistic regression analyses revealed associations between specific factors and the presence of SpA in IBD patients, including female gender (1.815, SD 1.325–2.488), BMI (1.073, SD 1.034–1.113), asthma (1.628, SD 1.038–2.553), gastritis (1.694, SD 1.070–2.683), and current/former smoking (1.359, SD1.004–1.840).

Conclusion
The prevalence of hypertension, asthma and diabetes were higher in patients with IBD compared to the general population. A higher proportion among the controls had never smoked but patients with IBD had lower alcohol consumption and were more physically active. This study sheds light on the IBD-SpA relationship and its impact on comorbidities and lifestyle. The findings aid clinicians in holistic patient management, emphasizing tailored care for specific comorbidities and lifestyle factors.
P1159 Gene and environment interactions in inflammatory bowel disease: a systematic review of human epidemiologic studies
Authors: Bai J , Bouwknegt D , Weersma R , Dijkstra G , van der Sloot K , Festen E 
Published: January 2024

Abstract

Background
Complex gene-environment interaction for Inflammatory Bowel Disease (IBD) remains elusive. This systematic review aims to summarize the current evidence of gene and environment interactions in IBD.

Methods
PubMed, EMBASE, Web of Science and Scopus were systematically searched from inception through July 20, 2022 to identify publications examining the interaction effect of genetic variants and environmental factors in IBD. Two investigators independently screened the title/abstract and full text according to the predefined criteria. All eligible studies were graded using STREGA guideline. The protocol was registered on PROSPERO (CRD42023443071).

Results
4,305 publications were identified and screened, resulting in 36 eligible studies. 17 studies reported statistically significant interactions.
The interaction effect of NOD2 and smoking was most frequently investigated and showed variant-specific interaction at rs2066847 regrading risk of Crohn’s disease (CD). Gene-smoking interactions were further identified in 1) other IBD risk genes (ATG16L1, IL23R, CALM3), as well as the IBD-genetic risk score (GRS), 2) detoxification genes (GSTP1 and ΗΜΟΧ1), 3) smoking-associated genes (CHRNA3, CHRNA5, PPP1R3C, BDNF), as well as the general smoking-GRS, and 4) the inflammation cytokine gene (IL-1β) using the candidate gene approach. Using the Illumina immune-focused Chip, another 64 smoking interacting variants were identified.
Gene-diet interactions were reported across different nutritional measures, including the intake of fatty acids with CYP4F3 and FADS2, serum level of selenium with SEPHS1and SEPSECS, dietary intake of potassium with IL21, alcohol consumption with IL12B, dietary heme iron intake with FcgRIIA and serum level of 25-hydroxyvitamin D with VDR. No genome wide environment interaction studies (GWEIS) of IBD have been conducted to date, while this strategy holds great potential to unravel the missing heritability influenced by environment factors for IBD.

Conclusion
While past studies have increased insights into potential gene-environmental interactions in the pathophysiology of IBD, current evidence is limited and inconclusive due to lack of replication of presented results, and limited study power. Further research, including GWEIS and clinical trials, is needed for future recommendations on lifestyle and dietary modification, based on individual genetic backgrounds.
P1165 Epidemiology and distinct features of inflammatory bowel disease in South Asia: a systematic review
Authors: Shenoy S , Jena A , Levinson C , Sharma V , Deepak P , Aswani-Omprakash T , Sebastian S , Colombel J F , Agrawal M 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD) is rising at an alarming rate in South Asia (SA, Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). However, studies detailing the epidemiology and clinical features of IBD in this region are limited. The purpose of this review is to comprehensively synthesise data on IBD in South Asia.

Methods
We developed and performed a systematic search in four biomedical electronic databases (Ovid Medline, Embase (Ovid), Global Health, Web of Science) and in relevant scientific meeting abstracts to identify all observational and interventional studies on the epidemiology, natural history, phenotype, therapeutics, and psychosocial features of IBD in SA from inception to November 15, 2021. The titles and abstracts of all the publications were screened and reviewed by two independent reviewers (SS, AJ). A descriptive review of the relevant data extracted from the selected publications was analysed.

Results
Of 11,673 eligible studies, 4416 were duplicates, 800 were reviewed in full text, and 413 were eligible for inclusion in one or more categories.
The following are the main findings of the systematic review: IBD incidence is higher in SA compared to other Asian countries. Similarly, IBD incidence and period prevalence are higher among SA immigrants compared to other immigrants. Ulcerative colitis (UC) is more prevalent than Crohn’s disease (CD) in SA across all age groups. Family history of IBD is important risk factor for IBD in SA. The mean delay in IBD diagnosis in SA is 2 years, and it is associated with increased risk of strictures and surgery. Male sex, small intestinal disease, perianal involvement, and penetrating and stricturing disease behaviour are predictors of surgery in CD. Disease duration and extent of colitis are risk factors for colorectal cancer. Colonic distribution and inflammatory behaviour is common in CD, whereas left sided colitis is common in UC. Steroids and azathioprine are mainstays of treatment, biologic use is less than 2%. Depression, anxiety, and post-traumatic stress are common among SA patients with IBD.

Conclusion
This comprehensive review highlights the current epidemiological trends and features of IBD in SA. Contrary to previous viewpoints, IBD in SA is similar in severity, complications, and burden as that in developed countries, and warrants urgent clinical interventions and allocation of resources.