bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1175 Handheld ultrasound devices are an accurate alternative to cart-based ultrasound for IBD disease activity assessment
Authors: Fernandes R , Swe E , Khaing M M , Gilmore R , Khoo E , An Y K , Begun J 
Published: January 2025

Abstract

Background
Intestinal ultrasound has revolutionised inflammatory bowel disease (IBD) care, as a quick, cost-effective, accurate and reliable tool for assessing IBD activity. Recently high-quality handheld ultrasound devices (HHUS) have emerged, representing a more accessible, cheaper alternative to expensive and cumbersome cart-based ultrasounds (CBUS), however their accuracy for IUS has not been studied. We aimed to assess the accuracy of HHUS compared to CBUS in a real-world IBD population.

Methods
We prospectively recruited patients attending outpatient IBD clinics in a tertiary centre from 18 July to 1 October 2024. Patients were first scanned by IUS trainees or clinicians certified by the Gastroenterological Network of Intestinal Ultrasound using 1-2 HHUS (Clarius™ L15 HD3 (CL) and/or GE™ Vscan Air CL (GE) using linear and convex probes as needed) and then CBUS. We collected baseline demographics, standard ultrasound parameters, disease activity classification, concordance with CBUS, and the predicted impact on clinical management. Qualitative statistical analyses and diagnostic accuracy calculations were performed.

Results
We performed IUS on 101 patients (49% ulcerative colitis, 52% Crohn’s disease, 46% male, median age 39 years, median BMI 23.4 kg/m2), using CL in 69 (total segments 260) and GE in 57 (total segments 220). The demographics and scan results are detailed in Table 1. Overall concordance for disease activity status (classified as "active" or "inactive") with CBUS was 93% for CL and 91% for GE, and 100% and 95% respectively for patients with a BMI &gt;25 kg/m2. There were 5 discordant scans each for CL (7%) and GE (9%) mostly related to discrepancies in bowel wall thickness in either the sigmoid colon or terminal ileum (there was a discrepant Doppler result in 1 case), in which 4 cases for both GE and CL reported high clinician confidence with the results. It was anticipated that the discordant result would negatively impact management in 4 (5.8%) cases for CL and 3 (5.2%) cases for GE. Overall sensitivity and specificity were high in both CL (85% and 100%) and GE (76% and 100%) and remained reasonably high for all segments (see Figure 1).

Conclusion
Both CL and GE HHUS represent viable alternatives to CBUS, with high diagnostic accuracy for IUS in IBD patients with normal and high BMIs. Given significantly lower costs, use of HHUS could improve access to IUS in IBD care internationally. There is a small risk that rare discordant results could negatively impact management, however this risk could be mitigated by interpreting IUS findings in the context of other disease activity markers and considering a repeat IUS using CBUS where there is uncertainty regarding findings.
P1179 Real-world Effectiveness of Tofacitinib on Ulcerative Colitis Associated Spondyloarthropathy (RETUCAS): a Multicentre Prospective Study from the Italian Group for the Study of Inflammatory Bowel Diseases (IG-IBD)
Authors: Macaluso F S , Grova M , Bossa F , Carparelli S , Pugliese D , Cuccia G , Cappello M , Muscarella S , Saibeni S , Bezzio C , Armuzzi A , Gravina G A , Pellegrino R , Caprioli F A , Sorge A , Soriano A , Ribaldone D G , Festa S , Variola A , Ferracane C , Onali S , Fantini M C , Orlando A ,   Italian Group for the study of Inflammatory Bowel Diseases (IG-IBD)
Published: January 2025

Abstract

Background
The efficacy of Tofacitinib (TOFA) in several rheumatic diseases led to expectations on a possible benefit of this drug for the treatment of ulcerative colitis (UC)-associated spondyloarthropathy (SpA).

Methods
Real-world Effectiveness of Tofacitinib on Ulcerative Colitis Associated Spondyloarthropathy (RETUCAS) is a prospective, multicentre, observational study designed to assess the effectiveness of TOFA on UC-associated SpA and promoted by the Italian Group for the study of Inflammatory Bowel Disease (IG-IBD). Patients with UC and an established diagnosis of active axial or peripheral SpA at baseline were included. The primary endpoint was the steroid-free joint response (SFJR - defined by a decrease of ≥ 1.1 units of ASDAS-CRP for axial SpA, and a decrease of &gt; 0.6 units of DAS28-CRP for peripheral SpA compared with baseline with no steroids use) at week 8 and 52.

Results
Forty-four patients were included [axial Spa: 9.1%; peripheral SpA: 70.4%; combined axial and peripheral (mixed) SpA: 20.5%]. At 8 weeks, SFJR was reported in 52.3.% of patients, with a significant difference between patients with peripheral SpA compared with the subgroup of patients with axial and mixed SpA (67.7% vs. 15.4%; p=0.001). At 52 weeks, SFJR was reported in 59.1% of patients (peripheral SpA: 71.0% vs. axial and mixed SpA: 30.8%; p=0.01).

Conclusion
This is the first prospective study designed specifically for the assessment of IBD-associated SpA and based on rheumatological scores. In patients with UC and multiple previous therapeutic failures, TOFA was effective on peripheral SpA, while more data are needed on axial SpA.
P1180 Long-Term Outcomes of Enteroscopic Balloon Dilatation and Risk Factors for Surgery in Small Bowel Stricturing Crohn's Disease: A Prospective Observational Study
Authors: Hong S N , Kim J E , Kim E R , Chang D K , Kim Y H 
Published: January 2025

Abstract

Background
The long-term outcomes of enteroscopic balloon dilatation (EBD) for small bowel strictures in patients with Crohn's disease (CD) are not well understood. Although Crohn's strictures can be classified into web-like, ulcerated, and spindle-shaped strictures based on endoscopic findings, the outcomes of EBD according to the shape of Crohn’s strictures have not been analyzed. The primary outcome was to evaluate the cumulative surgery-free rate, and the secondary outcome is to evaluate the risk factor for subsequent surgery after EBD.

Methods
This prospective, longitudinal, observational study enrolled patients with CD who underwent EBD for small bowel strictures using single-balloon enteroscopy between 2015 and 2023 at Samsung Medical Center, Seoul, Korea.

Results
A total of 150 consecutive patients who underwent 238 EBDs were included in this study with mean follow-up of 42.4±19.1 months. Thirty-one patients (20.7%) underwent surgery after EBD, and the cumulative 1-, 3-, and 5-year surgery-free rates were 86.7%, 80.4%, and 76.6%, respectively. The cumulative surgery-free rates of EBD for web-like, ulcerated, and spindle-shaped strictures were 96.3%, 91.0%, and 73.3% at 1 year, 96.3%, 84.9%, and 63.0% at 3 years, and 96.3%, 78.3%, and 63.0% at 5 years, respectively (p=0.001). Multivariate Cox regression analysis identified spindle-shaped stricture (vs. web-like stricture: hazard ratio [HR], 10.97; 95% confidence interval [CI], 1.23-97.74, p=0.032) and starting/switching biologics (vs. no biologics: HR, 0.33; 95% CI, 0.12-0.89; p=0.029) as risk factors for surgery after EBD. The major complication rate of EBDs was 2.7% (4/150) on per-patient analysis and 1.7% (4/238) on per-procedure analysis.

Conclusion
EBD for small bowel strictures in patients with CD may be an effective and safe alternative to surgery. EBD for web-like strictures showed favorable outcomes, while EBD for spindle-shaped strictures showed poor outcomes.
P1187 Healthcare professionals’ experiences of assessing and managing IBD-related fatigue in clinical practice – a mixed methods study
Authors: Watson N , Chalmers D , Czuber-Dochan W 
Published: January 2025

Abstract

Background
Fatigue is one of the most debilitating symptoms of inflammatory bowel disease (IBD), significantly impacting quality of life. Healthcare professionals (HCPs) recognise this but are often unsure of how to address fatigue [1]. We explored HCPs experiences of assessing and managing fatigue in patients with IBD to identify potential avenues for improvement.

Methods
We conducted a mixed method study with (1) an online survey amongst 17 gastroenterologists, 81 IBD nurses, one pharmacist, and 36 other/unspecified HCPs working in IBD (n=135) and (2) semi-structured interviews with two gastroenterologists, three IBD nurses, and a psychologist (n=6). Descriptive statistics summarised the quantitative data, while thematic analysis was applied to the qualitative data.

Results
Fatigue assessment was seen as an important and prevalent issue by the HCPs; 93.5% reported fatigue as a common symptom with 83% stating that they encounter it “often” to “always”. Most HCPs reported that the assessment (85.1%) and re-assessment (61.5%) of fatigue was a standard part of their clinical practice . Assessment itself was mostly unstructured; 85% of HCPs predominantly relied on patient descriptions with 77.2% reporting systemic barriers to using quantitative measures. 62.9% of HCPs reported offering additional support for fatigue, mostly through additional medical testing (Table 1). 24.4% would refer individuals to other services.
Qualitative data highlighted discrepancies in assessment preferences. Two HCPs found the IBD-F scale [2] helpful as it provided a framework for them to consider the impact of fatigue, and offered patients direction. Meanwhile, Four reported systemic challenges with additional measures, like insufficient time to review the data and discuss issues around fatigue, as well as limited knowledge of management strategies to suggest.

Conclusion
While IBD-related fatigue is important to HCP’s, assessment is largely unstructured. Findings indicate a need for education on management strategies and resources to improve communication around fatigue.

References
[1]Czuber-Dochan, W., Norton, C., Bredin, F., Darvell, M., Nathan, I., & Terry, H. (2014). Healthcare professionals' perceptions of fatigue experienced by people with IBD. Journal of Crohn's and Colitis, 8(8), 835-844.
[2]Czuber-Dochan, W., Norton, C., Bassett, P., Berliner, S., Bredin, F., Darvell, M., ... & Terry, H. (2014). Development and psychometric testing of inflammatory bowel disease fatigue (IBD-F) patient self-assessment scale. Journal of Crohn's and Colitis, 8(11), 1398-1406.
P1190 Generation of blood-derived reference samples with endogenous cytokines
Authors: Bain-Wendlinger C , Lavocat F , Poyau A , Silva J , Cousin E , Serraz C 
Published: January 2025

Abstract

Background
Biomarkers have become an integral part of drug development and decision-making. The quantification of cytokines, commonly used to gain insights into pathological processes in indications such as Inflammatory Bowel Diseases (IBD), and for monitoring therapeutic intervention, should rely on robust and performant methods.
Relevant reference samples are crucial for evaluating the performance of biomarker assays implemented in the context of clinical studies, but
oHow to evaluate the parallelism of a method for biomarkers that are non-detectable in healthy donors (HD)?
oDoes the selectivity of the recombinant protein in the biological matrix reflect the endogenous biomarker?
oHow does the stability of the recombinant protein compare with endogenous biomarker?
oCan you use incurred samples (informed consent, sufficient volume) for evaluating parallelism and stability?

Methods
To address these questions, we generated samples with endogenous biomarkers, named MAQC, by spiking supernatants of stimulated PBMC in the serum or plasma from HD. Three to four levels of MAQC per cytokine were prepared and used to assess parallelism, selectivity and long-term stability (LTS) at -80°C of pro- and anti-inflammatory cytokines and chemokines by use of V-plex, S-plex kits from MSD and ELLA kits. For all these parameters, accuracy was determined, with a target acceptance of 70-130% of the nominal value for selectivity and LTS or upstream dilution for parallelism.

Results
We were able to generate serum and plasma reference samples with low- to high-range levels of Th1 (IFN-g, IL-12p70, IL-2, TNF-α, CCL-2), Th2 (IL-4, IL-13, IL-10), Th17 (IL-17A) and Proinflammatory (IL-6, IL-8, IL-1β) cytokines. Selectivity was acceptable for most cytokines, except for IL-13, IL-4, IL-17A and IL-6. For IL-6, a major interference was observed in some samples, likely due to the presence of soluble IL-6 receptor in the original serum sample. For the other 3 cytokines, interference, leading to a bias close to -30%, was observed that could not be lifted by diluting samples. For all cytokines but IL-13, endogenous diluted similarly as recombinant protein from calibrator. Twelve months LTS was demonstrated for all cytokines in MAQC and comparable to recombinant proteins spiked in human serum.

Conclusion
To conclude, reference samples with endogenous cytokines/chemokines can be produced from primary immune cells. These can be used to assess parallelism and long-term stability when sufficient volume of matrices with high enough concentrations are not available. These would be even more valuable if they could be commercially available for use as quality controls in validation and clinical studies.
P1200 Increasing rate of hospitalization for inflammatory bowel disease is an age-related effect: A Canadian population-based study
Authors: Goodwin S , Wilk P , Yuan Y , Haan M , Jairath V 
Published: January 2025

Abstract

Background
Inflammatory bowel diseases (IBDs), including Crohn’s Disease (CD) and Ulcerative Colitis (UC), are chronic diseases that pose significant challenges to patients and healthcare systems. To understand trends in the risk of all-cause hospitalization for individuals with CD and UC we explored age, period, and cohort effects in Canada.

Methods
We utilized repeated cross-sectional survey data from the 2005-2014 Canadian Community Health Survey (CCHS) to identify individuals with self-reported CD or UC. These individuals were linked to their hospitalization records from the Discharge Abstract Database (DAD) and were followed for three years. Cross-classified random-effects two-level models were used to estimate fixed effects for age and its quadratic term (level 1) and random effects for time periods and birth cohorts (level 2), adjusted for sex, on the risk of hospitalization within three years.

Results
An estimated 84,000 CD and 113,000 UC individuals were eligible for study inclusion. From this, an estimated 30,250 and 39,890 all-cause hospitalizations occurred within three years post-entry into the study for CD and UC individuals, respectively. Broadly, the risk of hospitalization within three-years increased with age and across birth-cohorts, with older cohorts experiencing greater risks of hospitalization. A small, but statistically significant temporal effect was identified for both CD and UC groups. Within birth cohorts, the risk of hospitalization increased across ages for CD, but in individuals with UC, the risk of hospitalization decreased across ages, except for the two oldest birth cohorts.

Conclusion
Overall, results support the hypothesis that age effects are primarily responsible for fluctuations in the risk of hospitalizations1. Risk of all-cause hospitalization has remained relatively stable from 2005 to 2014 in Canada and differences across time periods may be a consequence of the age-distribution at each time period. As the prevalence of CD and UC continues to rise and the Canadian population continues to be comprised of growing number of older-aged individuals, increasing the allocation of healthcare resources to prevent age-related risks of hospitalizations would be beneficial to reduce hospital burdens.

References
1.Buie et al. 2023. Doi: 10.1093/ibd/izad020
P1202 Metabolic-dysfunction associated liver disease in patient with Inflammatory Bowel Disease: Is obesity the major driver of disease progression?
Authors: Bracciamà E , Di Giorgio F M , Melatti P , Amato L M , Salerno I A , Ajovalasit R , Di Prima L , Scalia S , Gambadauro D , Pennisi G , Petta S , Cappello M 
Published: January 2025

Abstract

Background
Prevalence of MASLD in patients with Inflammatory Bowel Disease (IBD) has been reported 24.4% in a recent metaanalysis and 21.6% in a previous cross-sectional study from our center. However, data on the progression of MASLD in IBD patients are scanty. We aimed to investigate the prevalence and the progression of MASLD, diagnosed by non-invasive tools, in a homogeneous cohort of patients with IBD followed in our referral center.

Methods
Consecutive IBD patients without known chronic liver disease were retrospectively enrolled and prospectively followed between 2020 and 2024. MASLD was defined as Controlled Attenuation Parameter (CAP) ≥275 dB/m according to EASL criteria. Significant fibrosis was defined as Liver Stiffness (LSM) ≥8 kPa by FibroScanÒ. Demographic, metabolic and biochemical data were collected at baseline and at the last follow-up visit. All patients were genotyped for PNPLA3 rs738409 C&gt;G by Taqman assay. Univariate logistic regression analysis was performed to identify risk factors associated with the prevalence of MASLD and its progression.

Results
230 patients (mean age was 46.1±13.4 years, 49.2% were males, 50.8% had Crohn’s disease, mean disease duration was 9.4±7.5 years) were recruited. 14.8% of them were obese (BMI &gt; 30 kg/m2), 9.8% diabetic. 49.2% were PNPLA3 rs738409 CG/GG. 62 out of 230 patients had complete metabolic and biochemical assessment at follow-up. Mean follow-up time was 4 years. At baseline, according to EASL criteria, 31.1% (19/62) had MASLD. 19.1% (8/42) of patients without steatosis at baseline, developed steatosis at follow-up; while 42.1% of those having steatosis at baseline, did not show steatosis at follow-up. Two patients without fibrosis assessed by LSM at baseline developed significant fibrosis, while two patients with fibrosis at baseline experienced fibrosis regression. 13.5% developed obesity. Obesity was significantly associated with the prevalence of MASLD both at baseline (p=0.01) and on follow-up (p=0.01) and was a predictor of steatosis progression (p=0.01); no association was found in relation to sex, PNPLA3 polymorphism, disease characteristics and the use of biologics. Diabetes was not significantly associated with MASLD in our cohort, but the number of patients was low.

Conclusion
One third of IBD patients had MASLD and obesity was the main predictor of its prevalence and progression, highlighting the relevance of active surveillance of MASLD and appropriate nutritional and lifestyle counselling especially in obese IBD patients. The use of biologics to control inflammation seems to have no influence on MASLD progression but data need further confirm in larger cohorts.
P1203 Spatial mapping and geographic variation of inflammatory bowel disease in Canada: A population-based study using Statistics Canada data
Authors: Goodwin S , Haan M , Yuan Y , Wilk P , Jairath V 
Published: January 2025

Abstract

Background
Crohn’s Disease (CD) and Ulcerative Colitis (UC) pose significant challenges to patients and healthcare systems, with a rising incidence and prevalence globally1,2. To address the challenges of health resource allocation and understand the geographic distribution of these conditions in Canada, we conducted the spatial mapping of IBD across Canada using national population survey data available from Statistics Canada.

Methods
We utilized data from the 2009-2018 Canadian Community Health Survey (CCHS) to identify individuals with CD or UC. Prevalence rates, both crude and adjusted for age and sex, were calculated for each health region in Canada. Spatial dependencies between health regions were estimated using global Moran’s I and local indicators of spatial association (LISA) were used to identify clusters of health region (hot-spots) where the prevalence was significantly higher than in other areas. We further applied spatial simultaneous autoregressive lag models to explore the influence of region-level sociodemographic factors on identified spatial dependencies.

Results
A total of 492,560 individuals from 2010-2018 CCHS were included, representing 29,846,350 Canadians across 109 health regions. Survey data revealed that 0.38% of Canadians self-reported having CD and 0.47% reported having UC. The majority of respondents reported being urban-residing, middle-aged, and white. Across Canadian provinces, the age and sex-standardized prevalence of IBD ranged from 742 per 100,000 in Quebec to 1267 per 100,000 in Nova Scotia (Figure 1). Spatial analysis identified significant dependencies among health regions, but these spatial associations were explained by the differing distributions of sociodemographic characteristics in each health region (Table 1). Increased health region-level prevalence of CD and UC was associated with a larger proportion of individuals 30+ years, identifying as a female, immigrants, or as white (p&lt;0.05 for each).

Conclusion
Data from this large, population-based Canadian national survey demonstrated significant geographic variation in the prevalence of CD and UC. However, after adjusting for patient demographic characteristics, the spatial dependency became non-significant. Key characteristics related to urbanization including the age distribution and proportion of immigrants in a health region were associated with increased prevalence rates. These results suggest that differences in CD and UC prevalence between geographic areas are primarily driven by individual demographics rather than differences in characteristics of local healthcare delivery systems and further support the notion that characteristics of urbanization increase the prevalence of IBD in an area1.

References
1.Ng et al., 2017. Doi: 10.1016/s0140-6736(17)32448-0
2.Coward et al., 2023. Doi: 10.1093/jcag/gwad004
P1204 Childhood EBV infection is protective against IBD, while adulthood EBV infection is not: a population-based cohort study
Authors: Agrawal M , Allin K H , Hansen A V , Colombel J F , Jess T 
Published: January 2025

Abstract

Background
Emerging data indicate a role of Epstein Barr Virus (EBV) infection in immune-mediated diseases risk. However, its role in inflammatory bowel disease (IBD) risk remains to be elucidated.

Methods
We conducted a nationwide population-based cohort study leveraging cross-linked Danish registers consisting of individuals with a record of being tested for EBV between January 1, 2008 and August 31, 2020. We determined the impact of previous EBV infection, active IBV infection, and no EBV infection on IBD risk, based on EBV serological tests, using adjusted Cox proportional hazards regression analyses after adjusting for sex, type of test, year of test, and age at test. We also determined the impact of age at infection, categorized as early or late childhood or adulthood (0-12, 13-20, and ≥21 years, respectively).

Results
Of 20,386 individuals included in the study who were followed from the first EBV test for a median (IQR) of 3.93 (2.18-5.95) years, 250 developed IBD. In the overall analysis, there were null associations between prior or current EBV infection and IBD risk. In analyses stratified by age, EBV infection in early and late childhood were associated with a protective effect against IBD, although not statistically significant in the former group (aHR 0.81, 95% CI 0.40, 1.66 and 0.50, 95% CI 0.26, 0.95, respectively). This association was driven by an increase in the risk of Crohn’s disease (CD), but not ulcerative colitis (aHR 0.36, 95% CI 0.15, 0.87 and aHR 0.82, 95% CI 0.32, 2.11, respectively). Among adults, while EBV infection was not associated with IBD risk (aHR 2.17, 95% CI 0.71, 6.62), the effect estimate was in the opposite direction relative to that in childhood, suggesting a potentially increased risk.

Conclusion
In a nationwide cohort, childhood EBV infection was protective against CD. Adulthood EBV infection was not protective, and possibly associated with increased IBD risk, although this was not statistically significant. Validation studies will help elucidate further.