bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0285 Long-term outcome of children with very early-onset non-monogenic colitis: a single center retrospective study
Authors: Pigneur B , Logrieco G , Cucinotta U , Ruemmele F , Charbit-Henrion F 
Published: January 2025

Abstract

Background
Very early-onset inflammatory bowel disease (VEOIBD), defined by IBD diagnosed before the age of 6 years, is a challenging condition with complex clinical features and limited long-term data. Our study describes the long-term outcome of patients diagnosed with VEOIBD without any identified genetic mutation.

Methods
Data on all consecutive patients aged 0–6 years diagnosed with colitis (CD, UC, or IBD-U) at Necker-Enfants Malades Hospital (Paris, France) between 2013 and 2023 were retrospectively reviewed. Patients with monogenic forms of VEOIBD and perianal disease were excluded. Clinical, biological, and endoscopic data were collected at diagnosis and during follow-up (1, 3 and 5 years). Comparisons were made between patients in remission and those with active disease at 3 years of follow up and between age groups (diagnosis before 2 and after2 years). A standardised questionnaire regarding environmental factors during pregnancy and infancy was sent to parents.

Results
Sixty-five patients (49% male, mean follow-up 4.8 ± 2.9 years, including 28 [41%]) with infantile IBD (diagnosed before the age of 2 years) were included. There were 8 (12%) patients with Crohn’s disease (CD), 21 (34%) with ulcerative colitis (UC) and 35 (54%) with IBD unclassified (IBDU). Most of the patients had pancolitis.
Only 3 patients underwent colectomy and diversion during follow-up. Corticosteroid-free remission rates were 48% at 1 year, 71% at 3 years, and 76% at 5 years.
64% of patients were treated with an immunosuppressant during follow-up, mainly azathioprine.
Earlier initiation of corticosteroids was associated with better 1-year remission rates.
Patients with infantile-onset IBD (IO-IBD) had more severe disease at diagnosis (higher disease activity and endoscopic scores, greater need for steroids; p=0.04). However, IO-IBD patients had better long-term outcomes, with lower anti-TNF-alpha use and fewer therapy escalations at 3 and 5 years (p&lt;0.05).
Finally, poorer outcomes were associated with maternal consumption of processed foods, paternal smoking and western lifestyle.

Conclusion
Patients with VEOIBD without genetic mutation exhibit low rate of complications and surgical interventions at the long term. Environmental factors seem to impact the disease burden even in VEOIBD.
P0319 The Fuction of Serological Biomarkers in Assessing Endoscopic Activity in Inflammatory Bowel Disease
Authors: Zhao Y , Liu X , Pu T , Wen H T 
Published: January 2025

Abstract

Background
Identifying IBD and evaluating disease activity depend critically on endoscopy. But it is expensive and intrusive, which emphasizes the need for more easily available and non-invasive biomarkers to help in IBD diagnosis and assessment. This work seeks to investigate their correlation with endoscopic activity and assess the diagnostic relevance in IBD.

Methods
Between January 2022 and September 2024, we registered 365 UC patients, 319 CD patients and 100 control patients at the First Affiliated Hospital of Zhengzhou University. The subsequent biomarkers were examined:WBC, Hb, PLT, N, L, HCT, EOS, ALB, GLB, CRP, ESR, ALB/GLB (AGR), CRP/ALB (CAR), CRP/L (CLR), PLT/ALB (PAR), PLT/L(PLR), N/L (NLR). MES, SES-CD were respectively utilized to evaluate endoscopic activity in UC and CD. Mild endoscopic activity was characterized by MES=1 or SES-CD=3-6, moderate activity by MES=2 or SES-CD=7-15, and severe activity by MES=3 or SES-CD≥16. Biomarker comparions were conducted among UC, CD, and control groups, and between biomarkers and endoscopic activity were examined.

Results
1. While Hb, HCT, L, ALB, and AGR were significantly lower (P&lt;0.05) in both UC and CD groups compared with controls, N, PLT, GLB, CRP, ESR, CAR, CLR, PLR, PAR, and NLR were significantly raised (P&lt;0.001). EOS levels in UC group averaged 0.19×109/L while in CD group they averaged 0.14×109/L, with this difference reaching statistical significance (P&lt;0.01).
2. Whereas WBC, PLT, N, CRP, ESR, GLB, CAR, CLR, PLR, PAR, and NLR were significantly increased (P&lt;0.01), Hb, HCT, ALB, and AGR were significantly lowered in those with moderate to severe disease compared to mild group. Significant variations in N, CRP, ESR, ALR, GLB, AGR, CAR, CLR, and PAR were noted among mild, moderate, and severe disease categories for CD patients (P&lt;0.05).
3. ESR (OR=1.09, P=0.0015), CAR (OR=381.71, P=0.0018) and PAR (OR=1.27, P=0.0072) were independent risk factors for UC endoscopic activity. The AUC of their combination (0.87; 95%CI 0.82-0.92) surpassed the individual values of ESR(0.81; 95%CI 0.75-0.87), CAR(0.84; 95%CI 0.79-0.89), and PAR(0.81; 95%CI 0.76-0.87). AGR (OR=0.05, P&lt;0.001) and CAR (OR=1.72, P=0.0117) were independent risk factors for endoscopic activity in CD. The AUC for the combination (0.81; 95%CI 0.75-0.86) was also higher than only AGR (0.80; 95%CI 0.74-0.85) or CAR (0.74; 95%CI 0.68-0.80).

Conclusion
IBD endoscopic activity was substantially correlated with biomarkers WBC, Hb, HCT, PLT, N, CRP, ESR, ALB, GLB, AGR, CAR, CLR, PLR, PAR, and NLR. While a lower AGR and a higher CAR may indicate more severe endoscopic activity in CD patients, elevated ESR, CAR, and PAR may point to more severe endoscopic activity in UC patients. Their amalgamation can enhance diagnostic efficacy.
P0321 Early improvement of mental health is associated with long-term disease remission in Ulcerative Colitis
Authors: Zheng J , Huang P , Feng R , Li L L , Chen M , Chen R , Zhang S 
Published: January 2025

Abstract

Background
Emerging evidence underscore the critical role of mental health in managing ulcerative colitis. However, the potential impact of early mental health improvement on long-term therapeutic outcomes remains poorly understood. This study aimed to explore the association between early mental health improvements and long-term disease remission.

Methods
This was a post hoc analysis using data from the SELECTION trial (NCT02914522) involving 381 patients treated with filgotinib. Mental health was assessed using the mental health subscale of the 36-item Short-Form Survey. Endoscopic, clinical, and histologic outcomes were assessed at week 58. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Receiver operating characteristic curves, combined with bootstrap resampling, were employed to determine the mental health response threshold.

Results
Early mental health improvements at week 10 were significantly associated with disease remission at week 58. After adjusting for potential confounders, the aOR of mental health improvements was 1.03 (95% CI: 1.00–1.06) for endoscopic remission, 1.03 (95% CI: 1.01–1.05) for clinical remission, 1.03 (95% CI: 1.01–1.05) for histologic remission, and 1.04 (95% CI: 1.01–1.07) for disease clearance at week 58. Patients who exhibited a mental health response at week 10 (defined as an increase in the mental health subscale score of ≥7.85) were more likely to achieve long-term endoscopic remission (aOR 2.67, 95% CI: 1.43–5.25), clinical remission (aOR 1.91, 95% CI: 1.22–2.99), histologic remission (aOR 1.98, 95% CI: 1.27–3.12), and disease clearance (aOR 3.48, 95% CI: 1.74–7.50). Additionally, incorporating mental health response assessment along with clinical remission significantly enhanced outcome predictions. Specifically, patients with only clinical remission at week 10 were approximately half as likely to achieve week-58 endoscopic remission (aOR 0.45, 95% CI: 0.21–0.91) compared to those who attained both mental health response and clinical remission.

Conclusion
Early mental health improvements independently predicted long-term disease remission in ulcerative colitis. Integrating mental health assessments into the management strategies may provide valuable insights beyond physical symptoms.
P0414 Serum Activin-A level as a new biomarker in active Ulcerative Colitis patients
Authors: Ayyildiz T , Ketenci Y B , Duygulu M E , Zorlu B Ş , Avcı B 
Published: January 2025

Abstract

Background
Ulcerative colitis is a lifelong inflammatory disease affecting the rectum and colon to varying degrees. Multiple scoring-classification methods, including endoscopic, clinical, and combined methods, have been used to assess disease severity. Various biomarkers are used for diagnosis and subtyping in ulcerative colitis, including fecal calprotectin, C-reactive protein, p-ANCA, ESR, anti-integrin αvβ6, and serum trefoil factor 3. In this study, we investigated whether there was a significant difference in serum activin-A levels, considered an indicator of intestinal inflammation, between symptomatic active ulcerative colitis patients and a control group.

Methods
The study included 34 patients and 18 controls, Patients were analyzed for serum Activin-A levels, symptomatic assessment, endoscopic evaluation, and laboratory parameters.

Results
Serum Activin-A levels in the patient group were significantly higher than those in the control group (p=0.034). Accordingly, with a sensitivity of 55.9% and a specificity of 72.2%, the cut-off value for Activin-A was found to be 486.925 pg/mL.

Conclusion
Serum activin A level has been associated with active ulcerative colitis

References
Namwanje M, Brown CW. Activins and inhibins: roles in development, physiology, and disease. Cold Spring Harb Perspect Biol. 2016;8(7):a021881. https://www.doi.org/10.1101/cshperspect.a021881
Sonoyama K, Rutatip S, Kasai T. Gene expression of activin, activin receptors, and follistatin in intestinal epithelial cells. Am J Physiol Gastrointest Liver Physiol. 2000;278(1):G89-97. https://www.doi.org/10.1152/ajpgi.2000.278.1.G89
Dignass AU, Jung S, Harder-d’Heureuse J, Wiedenmann B. Functional relevance of activin A in the intestinal epithelium. Scand J Gastroenterol. 2002;37(8):936-943. https://doi.org/10.1080/003655202760230900
Ogihara, R., Kurumi, H., Kanda, T., Yashima, K., Isomoto, H., & Yamaguchi, N. (2023). Serum Activin A Is a Novel Biomarker of Endoscopic Activity in Ulcerative Colitis. Gastroenterology research, 16(6), 334–341. https://doi.org/10.14740/gr1677
P0415 Bone turnover biomarkers alteration in patients with Inflammatory Bowel Disease
Authors: Omran S , Gamal Eldeen H , Abdel Latif Z , Abdou D , Hamdy R , Gaber A , Ali A , Shehab H , El Raziky M 
Published: January 2025

Abstract

Background
Because of glucocorticoids, chronic inflammation, malabsorption, and other factors, patients with inflammatory bowel disease (IBD) are at varying risk for osteoporosis (OP) and decreased bone mineral density. This puts individuals at risk for osteoporotic fractures, which have a negative impact on their quality of life. The purpose of this study is to measure bone turnover markers (BTMs) representing bone resorption and formation in an Egyptian cohort of IBD patients, compare them to healthy controls, and investigate their relationship to disease activity, extension, and treatment modalities.

Methods
The cross-sectional study included 92 participants: 45 IBD patients, 25 ulcerative colitis (UC), 20 Crohn’s disease (CD), and 47 controls. Overnight fasting blood samples were withdrawn for BTMs including bone formation markers (Procollagen I N-terminal propeptide {PINP} and bone specific alkaline phosphatase {BSAP}), bone resorptive marker (C-terminal telopeptide of type I collagen {CTX}).

Results
Serum CTX, PINP, and BALP levels increased significantly in IBD patients, indicating increased turnover and metabolic bone disease, but there were no significant differences between the UC and CD groups. In terms of disease activity and intestinal involvement, BTM levels in UC and CD patients were comparable. Anti-tumour necrosis-α (anti-TNF-α) users had considerably reduced CTX and PINP increases compared to non-users.

Conclusion
Biochemical testing with BTMs may be useful in the initial evaluation of bone health in IBD patients. Anti-TNF-α users were less likely to experience bone alterations compared to non-users.
P0422 CROHN-PREP study: Simplified bowel preparation adapted to small bowel capsule endoscopy in patients with Crohn’s disease; comparison with the reference method
Authors: Rouveyre R , Collins M , De Maissin A , Flamant M , Trang C , Bouguen G , Dib N , Bourreille A , Le Berre C 
Published: January 2025

Abstract

Background
Ileal involvement is common in Crohn’s disease (CD), affecting two-thirds of patients, of whom 10-15% also present with associated proximal small bowel (SB) lesions that are inaccessible to conventional endoscopy. This proximal location is associated with poorer outcomes, including higher risk of strictures and surgery. Therefore, regular monitoring of these patients is crucial, and SB capsule endoscopy (SBCE) has emerged as a valuable tool for assessing mucosal activity. Its acceptability greatly depends on prior bowel preparation. However, the latter remains debated, and data on this specific population of patients with CD are scarce. The CROHN-PREP study aimed to compare the efficacy of a simplified preparation to a polyethylene glycol (PEG)-based preparation in patients with an established diagnosis of CD.

Methods
This prospective, multicenter, single-blind, randomized controlled trial was conducted across six centers in France between June 2022 and April 2024. Patients were randomly assigned either to a simplified preparation (clear liquid diet + 500 mL + 1L of water) or a PEG-based preparation (24h-residue-free diet + 2L of PEG) in a 1:1 ratio with stratification on disease activity. Intestinal cleanliness (as quantified by the KODA score or qualitatively evaluated), patient’s acceptability of preparation and examination, diagnostic yield, capsule completion rate and SB transit time were compared between both groups.

Results
In total, 148 patients were included, in whom 142 SBCE were analyzable. Terminal ileal involvement was observed in 132 patients (93.0%), with proximal SB lesions associated in 10.6% of cases. No difference was observed in terms of intestinal cleanliness between the two groups. Patient acceptability of the preparation was twice as high—and nearly perfect—among those receiving the simplified preparation (P&lt;0.001). Similarly, acceptability of the examination itself was significantly higher in the simplified preparation group (P&lt;0.001) (Figure 1). The diagnostic yield, the rate of complete examinations, and intestinal transit time were comparable between the two groups.

Conclusion
CROHN-PREP is the first randomized controlled trial to evaluate SB cleanliness prior to SBCE exclusively in a CD patient population. A simplified preparation consisting of a clear liquid diet and water offers a viable alternative to a PEG-based preparation, offering comparable SB cleanliness and diagnostic outcomes while doubling patient’s acceptability. These findings are particularly relevant given the necessity of repeated examinations in patients with CD, in whom acceptability is critical to ensure continuity of care.
P0425 Factors Associated with Biopsy-Proven Cuffitis in Ulcerative Colitis Patients Following Colectomy with Ileal Anal-Pouch Anastomosis
Authors: Fishman M , Codish M , Rabinowitz K , Avni-Biron I , Godny L , Yanai H , Dotan I , Ollech J 
Published: January 2025

Abstract

Background
Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment in patients with refractory/complicated ulcerative colitis (UC). Inflammation of the small rectal remnant below IPAA lines (“cuff”) is designated cuffitis. Despite its clinical significance and characteristic endoscopic and histologic features, risk factors are vague. This study aimed to decipher demographic, disease, and surgery-related risk factors for histologically proven cuffitis.

Methods
In a comprehensive pouch clinic at a tertiary referral center (Rabin Medical Center), consenting patients were followed prospectively, with routine clinical, laboratory, and endoscopic evaluations. Patients after IPAA due to UC having≥1 cuff biopsy during follow-up were included. Histological cuff samples were scored based on the validated NANCY index. Cuffitis, the primary outcome, was defined as evidence of moderate-to-severe histologic inflammation (NANCY score 3-4). Univariate Cox models were used to assess hazard ratios (HRs) of various factors with the occurrence of cuffitis.

Results
Of 400 patients followed at the pouch clinic, 182 consented to prospective follow-up, and 116 underwent cuff biopsy, each having a median of 2 biopsies. Most patients had histological evidence of moderate-to-severe cuffitis (n=76, 65.5%). Significant associations with cuffitis included disease duration ≤10 years before surgery (HR 15.4, 95%CI; 4.0-59.1, p&lt;0.001); body mass index ≤ 18.5 (HR 3.83, 95%CI; 1.75-8.4, p&lt;0.001); Arab descent (HR 3.2, 95%CI; 1.1-9, p=0.03); immediate postoperative complications (HR 2.0, 95%CI; 1.24-3.2, p=0.004); strong association with pre-operative biologic treatment was observed, with a single biologic (anti-TNF 90%) used before colectomy having a HR of 5 (95%CI;2.6-9.7, p&lt;0.001) and multiple biologics having a HR of 14 (95%CI; 6.1-34, p&lt;0.001). Interestingly, refractory UC as the indication for IPAA (vs dysplasia) was not independently associated with an increased risk of cuffitis.

Conclusion
Several demographic, disease, and surgery-related factors associated with post-IPAA cuffitis were identified. These may be incorporated into decision-making processes. Furthermore, closer postoperative follow-up may be warranted in specific patient subgroups. ese patients may benefit from closer post-operative follow-up.
P0428 Validation of the Urgency-Numeric Rating Scale in Ulcerative Colitis and correlation with endoscopic, histological and manometric activity
Authors: Guimaraes A , Leal T , Caetano A C , Barbosa I , Costa D , Carvalho T , Mendes S , Soares J , Rodrigues Â , Gonçalves R 
Published: January 2025

Abstract

Background
The Urgency-Numeric Rating Scale (NRS) is a scale that assesses the severity of bowel urgency (BU), a common symptom in ulcerative colitis (UC) associated with significant morbidity. The aim of this study was to translate and validate this scale into Portuguese, as well as to assess the prevalence of BU in a cohort of UC patients and, in those in clinical remission, to evaluate its relation with endoscopic and histological activity and manometric changes.

Methods
After translation of the Urgency-NRS into Portuguese, patients with UC seen at the outpatient clinic were asked to complete the scale at T0, after 2 weeks (T1) and after 3 months (T2). PRO2, EQ-5D, EQ-VAS, IBD-Disk and the Global Perceived Effect (GPE) scale were also completed. Acceptability, reliability, construct validity, responsiveness and interpretability were assessed. A subgroup of patients in clinical remission with BU underwent rectosigmoidoscopy with rectal biopsies and anorectal manometry and were compared with a control group (in clinical remission without BU).

Results
126 patients were included (56,3% female), of whom 49,21% (n=62) had BU. Test- retest reliability was excellent (intraclass correlation coefficient 0,823). The Urgency-NRS scores correlated significantly with the PRO-2 (p&lt;0,001), IBD-Disk (p&lt;0,001), EQ-VAS (p&lt;0,001) and EQ-5D (p&lt;0,001), demonstrating construct validity. There were no differences in the Nancy histological index (p=1,000) between patients in clinical remission with urgency (n=14) and the control group (n=16). The Urgency-NRS values correlated with the volume of the first sensation on anorectal manometry (p=0,032).

Conclusion
The Urgency-NRS scale is an easy and quick tool for assessing BU and can be incorporated into clinical practice for the Portuguese population.
P0434 Clinical patterns and prognosis according to the time of diagnosis in Korean IBD Patients with over 10 years of disease duration
Authors: Park Y E , Park S B , Kang S B , Park Y , Kim D , Na S Y , Moon W ,   IBD Research Group of the Korean Association for the Study of Intestinal Diseases (KASID)
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic condition marked by intestinal inflammation. IBD diagnosed in children tends to more extensive involvement, but generally responds well to treatment than adult-onset cases. This study aims to compare the long-term clinical characteristics, treatment patterns, and prognosis of IBD in patients diagnosed before and after age 18.

Methods
A retrospective study was conducted using data from 352 IBD patients with a disease duration exceeding 10 years across four hospitals. Baseline characteristics, disease status, and treatment patterns were analyzed at diagnosis, 5 years, 10 years, and currently.

Results
Of the 352 patients, 80 (22.7%) were diagnosed before the age of 18, and 272 (77.3%) were diagnosed at age 18 or older. Patients diagnosed before 18 years of age presented more frequently with CD (82.5% vs. 40.1%), while UC was predominant in those diagnosed later (17.5% vs. 59.9%). Younger patients had a significantly higher prevalence of abdominal pain (66.3% vs. 49.3%), malnutrition/weight loss (22.8% vs. 9.6%), and anal fistula/abscess (25.0% vs. 4.8%) at diagnosis. Younger patients had more pancolitis type in UC (50% vs. 31.9%), and more perianal disease in CD (53% vs 20.7%). Younger patients exhibited higher rates of steroid usage initially, with a gradual shift towards biologics such as infliximab. Over time, disease behavior in CD patients often progressed, especially among those diagnosed at age 18 or older. Multivariate analysis identified fever, fistula/abscess at diagnosis, and biologic use or discontinuation as significant risk factors for recurrence.

Conclusion
In patients diagnosed with IBD before the age of 18, Crohn’s disease (CD) is more common, often presenting with abdominal pain, perianal disease, and extensive involvement. However, with appropriate treatment can maintain remission and achieve better long-term outcomes. In conclusion, these findings suggest that age at IBD onset significantly impacts disease progression and treatment outcomes, underscoring the need for age-tailored management strategies in long-term IBD care.

References
1.Thia KT, Loftus EV, Jr., Sandborn WJ, Yang SK (2008) An update on the epidemiology of inflammatory bowel disease in Asia. Am J Gastroenterol 103(12):3167-3182.
2.Duricova D, Burisch J, Jess T, et al. Age-related differences in presentation and course of pediatric inflammatory bowel disease; an update on the populationbased literature. J Crohns Colitis 2014;8(11):1351–61. 5.
3.Carroll MW, Kuenzig ME, Mack DR, et al. The impact of inflammatory bowel disease in Canada 2018: children and adolescents with IBD. J Can Assoc Gastroenterol 2019;2:S49–S67.