bluuebunny/crossref_metadata_2025_split huggingface dataset:
P861 Frequency and Influence of a Positive Family History on the Clinical Course of Inflammatory Bowel Diseases
Authors: Liava C , Sinakos E , Dimitroulas T , Navrozidou C , Akriviadis E 
Published: January 2023

Abstract

Background
Previous studies on the difference in phenotypes and disease course between familial and sporadic inflammatory bowel diseases (IBD) have resulted in heterogenous conclusions. However, a positive family history is considered the strongest recognizable risk factor for developing IBD and is present in 8-12% of cases. We aimed to compare the frequency of a positive family history between patients with Crohn’s disease (CD) and ulcerative colitis (UC) and additionally to evaluate possible clinical parameters that may influence the clinical course of familial IBD cases, based on retrospectively-prospectively collected data of a cohort of IBD patients followed in daily clinical practice.

Methods
Patients with biopsy-confirmed IBD aged 10–90 years old were included in the study. A comprehensive questionnaire was used to collect data on each site visit from July 2018 to March 2022. Logistic regression analysis was used to examine clinical parameters that may influence the clinical course of familial IBD cases and the chi-squared test to compare the frequency of a positive family history between patients with UC and CD.

Results
We collected 300 patients diagnosed with IBD (180 with CD, 113 with UC, and 7 with indeterminate colitis). About 10% of IBD patients had a first degree relative with IBD (13% in CD and 4% in UC group, P&lt; .05), as summarized in table 1. Female IBD patients had a 4-fold increased risk to have a first degree relative with IBD (OR 3.79; 95% CI: 1.44-9.98; P&lt; .01). Similarly, CD patients had a 3-fold increased risk (OR 3.31; 95% CI: 1.08-10.18); P&lt; .05). IBD patients who had a first degree relative with IBD were at greater risk for hospitalization for IBD flare or other complications (OR 3.07; 95% CI: 1.12-8.38; P&lt; .05), to undergo a surgical procedure, mainly colectomy (OR 5.20; 95% CI: 1.98-13.68; P&lt; .01), to develop perianal disease (OR 3.42; 95% CI: 1.25-9.35; P&lt; .05), to develop sacroiliitis (OR 3.72; 95% CI: 1.40-9.91; P&lt; .01), and to being treated with anti-TNF agents (OR 3.21; 95% CI: 1.14-9.08; P&lt; .05). Furthermore, in patients with a family history of IBD there was a trend for extraintestinal manifestations (OR 2.47; 95% CI: 0.91-6.74; P= .078), especially from the musculoskeletal system (OR 2.45; 95% CI: 0.94-6.34; P= .066), skin (OR 2.83; 95% CI: 0.94-8.45; P= .065) and ocular system (OR 4.92; 95% CI: 0.89-27.26; P= .068), as shown in table 2.

Conclusion
In this retrospective-prospective cohort study, family history of IBD in first degree relatives was present in 13% of patients with CD and 4% of patients with UC, and was associated with increased risk for hospitalization, surgical procedures, occurrence of perianal disease, treatment with anti-TNF agents, and a trend for developing EIMs.
P863 Exploring patients’ perceptions of clinical research in inflammatory bowel disease and barriers to participating in clinical trials
Authors: Chatten K , Kalra P , Bower P , Mclaughlin J , Ghosh S , Limdi J 
Published: January 2023

Abstract

Background
The rising incidence and prevalence of inflammatory bowel disease (IBD), its uncertain aetiology and multidimensional and negative effects on people’s lives have underscored the importance and need for research across disciplines. Despite this, participation in research in IBD remains relatively low, with virtually no data exploring patients’ perceptions and barriers to participation in research among people living with IBD. This is a preliminary report from an on-going study in the UK.

Methods
Consecutive outpatients attending IBD clinics at our centre were invited to complete a questionnaire survey. Information on patient demographics, disease duration and activity were recorded and patient perceptions and barriers to participating in research were explored.

Results
Of 401 patients approached to date, 332 (82.8%) consented to complete the questionnaire. Of 60 patients who declined, 70% were male. Among 332 participants, 176 (53.2%) were female, age between 18- 80. 164 participants had Crohn’s disease (CD,49.4%), 147 ulcerative colitis (UC) (44.3%), 8 (2.4%) had IBD-unspecified and 13 (3.9%) were unsure of their diagnosis. 209 (63%) patients were on biologics. The mean Harvey Bradshaw Index (HBI) was 4.4 (CD) and partial Mayo score 2.1 (UC).
303 (91.3%) participants said they would participate in research, but only 65.3% stated they would be interested in drug trials. Reasons cited for participation were to advance medical knowledge (277/303, 91.4%) followed by the possibility of “effective” treatment (231/303, 76.2%).
Of those that stated they were not interested in research at all, 17/29 (58.6%) were male. Their most important reasons for not wanting to participate were time constraints followed by concern for health. Although optional to answer if interested in research, a further 100/303 (33%) cited concern for own health (54/100, 54.0%) followed by time constraints (34/100, 34%) as barriers. Only 15 felt deterred by the possibility of receiving a placebo (15/100, 15%) or having more tests (12/100 12%).
Direct conversation with their doctor (201/332, 60.5%) was felt most motivational to participation in research.

Conclusion
Most patients express interest in participating in IBD research, with majority interested in participating drug trials. The placebo element did not deter sentiment about participation in trials and direct communication with clinicians is valued. More data will be available for analysis and reporting in the coming months.
P883 Parental and perinatal risk factors associated with onset of Inflammatory Bowel Disease: A systematic literature review and meta-analysis
Authors: Mallon K , Mcbride C , Doherty G , Burns R 
Published: January 2023

Abstract

Background
Several risk factors have been associated with the onset of Inflammatory Bowel Disease (IBD), including pre and early life exposures occurring during gestation and up to the end of an infant’s first year of life.
Perinatal factors linked to the subsequent development of IBD include parental and environmental exposures. It is postulated that exposure to such factors impacts immune system development leading to alterations in immune responses and increased susceptibility to disease.
Limited evidence evaluates this association systematically whilst focusing specifically on the perinatal period. The purpose of this review was to systematically determine whether parental and perinatal factors are associated with IBD onset.

Methods
We searched the following electronic databases: Ovid MEDLINE, Web of Science, and the Cochrane Library. Searches were conducted from 01/01/2002 until 26/01/2022. Keywords and search terms related to ‘perinatal’ and ‘inflammatory bowel disease’ were applied.
Case control studies, RCTs and cohort studies evaluating the association between parental and perinatal factors and IBD were included.
Study protocol details have been published on the International Prospective Register of Systematic Reviews (PROSPERO). Available from: http://https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022290798Databases

Results
Our initial search identified 14,989 potentially relevant articles to include (see Figure 1). After title and abstract screening there were 119 articles that met the eligibility criteria. After full-text review and further assessment of these 119 articles, 18 articles were deemed suitable for study synthesis based on the eligibility criteria.
Across the 18 articles, a range of parental and perinatal factors were included: family history IBD (n=8), breastfeeding (n=7), disease during pregnancy (n=4), maternal age (n=4), birth delivery method (n=4), antibiotic exposure (n=3), pre-term birth (n=3), birth weight (n=2), environmental exposures in infancy (e.g. pet exposure, rural dwelling) (n=2), diet (n=1), vaccination (n=1) and maternal smoking (n=1).

Conclusion
This review provides a detailed summary of parental and perinatal factors associated with the onset of IBD. The evidence generated will influence the development of diagnostic risk assessment tools and detailed patient pathway paradigms to address current shortcomings within the delivery of IBD care, providing opportunities to improve efficiency and reduce healthcare costs. The findings will inform on key targets for primary prevention strategies at this early life stage and provide valuable insight on IBD onset to academics, clinicians, patients and policy makers.
P884 Association between psychosocial factors experienced in childhood or adolescence and occurrence of Inflammatory Bowel Disease (IBD) in adulthood: a case-control study in Quebec, Canada
Authors: Esmingeaud L , Jantchou P , Nicolau B , Madathil S , Rousseau M C 
Published: January 2023

Abstract

Background
The incidence of inflammatory bowel disease (IBD) has been steadily increasing worldwide and its etiology remains poorly understood. This study aims to estimate the associations between exposure to psychosocial factors in childhood or adolescence and the development of IBD in adulthood, separately for Crohn's disease and ulcerative colitis.

Methods
A case-control study nested in a population-based birth cohort was carried out. A total of 993 cases of Crohn's disease, 489 cases of ulcerative colitis and 914 controls born between 1970 and 1974 in Quebec, Canada, were analyzed. Sociodemographic and medical information were extracted from administrative databases. Participants filled out a questionnaire including a section on selected psychosocial factors experienced over their life course. Odds ratios (OR) and confidence intervals (95% CI) for the associations between psychosocial factors in childhood (0-9 years), adolescence (10-17 years) or over the full pediatric period (0-17 years), and IBD in adulthood were estimated by unconditional logistic regression models adjusted for potential confounding factors. For each association, a model including tailored covariates selected with a directed acyclic graph was estimated. The number of psychosocial factors experienced over the pediatric period was also analyzed in relation to the risk of IBD in adulthood.

Results
Some factors were associated with the risk of Crohn’s disease, such as sexual abuse in childhood (OR=1.58; 95% CI: 1.08-2.30) or over the full pediatric period (OR=1.39; 95% CI: 1.04-1.84). Likewise, the following factors occurring during adolescence were associated with increased odds of Crohn’s disease: parental neglect (OR=1.64; 95% CI: 1.01-2.66), the death of a loved one (OR=1.37; 95% CI: 1.02-1.85), and anxiety disorders (OR=1.66; 95% CI: 1.02-2.70). An association was identified between the experience of anxiety disorders from 0 to 17 years and ulcerative colitis in adulthood (OR=1.67; 95% CI: 1.05-2.67). Finally, exposure to three or more (vs. none) psychosocial factors from 0 to 17 years old was associated with the occurrence of Crohn's disease (OR=1.63; 95% CI: 1.13-2.36), but not ulcerative colitis (OR=0.98; 95% CI: 0.60-1.60) in adulthood.

Conclusion
In this study, the occurrence of sexual violence, parental neglect, the death of a loved one or anxiety disorders during childhood and/or adolescence was associated with the development of IBD in adulthood. Our results bring new light to the etiological puzzle of IBD by focusing on psychosocial factors and their accumulation during periods of vulnerability. Further studies taking into account resilience and assessing microbiota changes will be needed to confirm these results.
P885 Does long term corticosteroid use increase the risk of femur fracture in Inflammatory Bowel Disease patients? : A nationwide population-based cohort study
Authors: Kim B , Sung Hoon J , Jiyoung L 
Published: January 2023

Abstract

Background
Inflammatory Bowel Disease (IBD) patients have been reported to have a higher frequency of femur fracture than healthy controls. Based on the data femur fractures in IBD patients, not many studies analyzing this correlation have been reported various risk factors, including corticosteroid therapy. Aim of this study was to demonstrate the prevalence of femur fracture in IBD patients with long-term corticosteroids.

Methods
The National Healthcare Insurance Service (NHIS) database of IBD patients between 2008-2018 was used for this cohort study. We collected the data of ICD-10 code, sex, age, comorbidities, corticosteroid use and IBD-related medications. The sex- and 10-year age matched non-IBD reference population was extracted during the same study period at a matching ratio of 1:3.

Results
From 2008 to 2018, 33,778 patients with IBD and 101,265 patients in the reference population were followed up for a median 5.0 years. The result showed that the use of corticosteroid more than 1year increased the risk of femur fracture of both Ulcerative Colitis and Crohn's Disease patient ((HR 2.83; 95% CI 1.37-5.84; P&lt;0.01 and HR 2.62; 95% CI 1.00-6.86; p&lt;0.05), respectively. Also, long term use of corticosteroid increased the severity of femur fracture (HR 0.62; 95% CI 0.43-0.90; p&lt;0.05).

Conclusion
Femur fractures in patients with IBD patients are generally associated with results in hospitalization and related with significant morbidity and mortality. As use of corticosteroid and its duration contributed to femur fracture risk include its severity, prevention of fracture and careful corticosteroid therapy strategy should be considered.
P889 Serologic response with antimicrobial antibodies during the preclinical phase of inflammatory bowel disease
Authors: Rodríguez-Lago I , Cabriada J L , Barreiro-de Acosta M 
Published: January 2023

Abstract

Background
Previous data have shown that the inflammatory process underlying ulcerative colitis (UC) and Crohn’s disease (CD) can start years before the diagnosis. Serum proteomic and serologic markers have been identified during this period, providing the opportunity for early detection of the initial immune disturbances. Our aim was to determine if patients with an incidental diagnosis of UC or CD demonstrate a serologic response based on antimicrobial antibodies, therefore preceding the symptomatic onset of the disease.

Methods
We performed a prospective single-center study including all asymptomatic subjects with a diagnosis of UC or CD during the colorectal cancer screening program and available data on antimicrobial antibodies between 01/10/2013 – 29/02/2022. The diagnosis of IBD was established by a combination of clinical data, endoscopic findings suggestive of UC or CD, and after histologic confirmation. ASCA IgA, ASCA IgG (EliA ASCA IgA/IgG, ThermoFisher) and ANCA (EUROPattern, PerkinElmer; EliA IgG, ThermoFisher) antibodies were determined. Positive results were considered above 10 U/mL for ASCA, 3.5 for ANCA-MPO and 2.00 for ANCA-PR3. Descriptive statistics were used.

Results
A total of 26 incidentally-diagnosed patients were included, 19 with UC (21% left-sided, 32% extensive; 53% former smokers), and 7 with CD (57% ileal, 29% colonic; 14% active smokers), with a median age of 51 years (IQR, 51-57). Three patients showed at least one positive test (12%). One patient (5%) with extensive UC showed positive ANCA results, and he developed symptoms 2 months after diagnosis. Two patients (28%) with CD (L2B2 and L1B1, according to Montreal classification) showed positivity to ASCA IgA/IgG at diagnosis, and both have remained asymptomatic after a median of 23 months. After a median follow-up of the whole cohort of 54 months (IQR, 26-67), 12 patients (46%) developed symptomatic disease.

Conclusion
A low proportion of patients with an incidental diagnosis of IBD demonstrate a serological response based on antimicrobial antibodies, suggesting that this situation corresponds to the initial phases of IBD when systemic immune disturbances might not be detectable yet.
P893 Budget impact analysis of introducing infliximab subcutaneous for the treatment of Inflammatory Bowel Disease in Latvia
Authors: Yoo H K , Jang M Y , Kwon T S 
Published: January 2023

Abstract

Background
Since the marketing authorisation of infliximab (IFX) subcutaneous (SC) in 2021, most of the western European countries had adopted CT-P13 SC. However, a few central and eastern European (CEE) countries including Latvia failed to adopt the new version of IFX. Infliximab SC injection at home significantly reduces number of outpatient visits and intravenous (IV) administrations. This is a tremendous benefit for countries with modest healthcare budget like Latvia because it will contribute to the effective use of hospital resources, especially in a pandemic era. This study describes the economic impact of introducing CT-P13 SC to the Latvian market from the perspective of society.

Methods
A prevalence-based budget impact model was developed incorporating epidemiological data, administration cost data, and patient share data from Nacionālais Veselības Dienests (NVD). The analysis compared a “world with” CT-P13 SC scenario to a “world without” CT-P13 SC. The cost of IFX SC was assumed to be at parity to IFX IV which allows to capture the savings from the administration cost. This model compares annual cost of treatment including drug acquisition costs, administration cost and indirect cost of same molecule and further line of treatments (vedolizumab, ustekinumab, and tofacitinib).

Results
This model estimates the financial impact on 2,000 patients with Crohn’s disease (CD) and ulcerative colitis (UC). Savings yield from IV administration cost is approximately €135,000 over the five-year period. Compared to the “world without” scenario, the introduction of CT-P13 SC resulted in cost savings of €1.03 million for treating CD and UC in Latvia over a 5-year period. The savings will be able to treat additional 220 patients, which equates to 11% of current patients, in a 5-year period.

Conclusion
Despite poor access to biologics in Latvia compared to other European countries, utilisation of IFX is high in Latvia compared to other biologics. Adding a SC treatment option to the existing care will not only improve patient outcome but also may lead to cost savings for the Latvian society. Parity pricing of IFX SC to IV IFX will enable budget reduction and result in improved patient experience with infliximab.
P894 Diagnostic yield of routine stool pathogen tests during the relapse of Inflammatory Bowel Disease
Authors: Huang V , Albadrani A , Alshowair M 
Published: January 2023

Abstract

Background
To make the diagnosis of Inflammatory bowel disease (IBD) flare, it is traditionally necessary to exclude infectious colitis, including bacteria and parasites. Furthermore, Infectious colitis prevalence varies between geographic areas of the world.
It has been a routine clinical practice of sending broad stool testing and cultures to the laboratory before starting targeted therapy for IBD flare. The purpose of this study is to examine the yield of stool testing in adult patients with inflammatory bowel disease flare.

Methods
It is a retrospective study. We reviewed the medical records of the admitted patients with IBD flare at Mount Sinai Hospital, Toronto, Canada between October 2018, and August 2019. We used a computer-generated list of patients admitted with a diagnosis of IBD. We excluded patients with no confirmed diagnosis of IBD or admitted for reasons other than IBD flare. A number of variables were recorded, such as the patient's demographics, concurrent and previous IBD therapy, steroid use, presenting symptoms, vital signs, and the results of the initial laboratory investigation

Results
This study included 96 adult patients admitted with IBD flare. A total of ninety-four of our samples were tested for C. difficile at the time of admission. Only 9.4% were positive for C. difficile. Six of them had ulcerative colitis and three had Crohn’s disease.
The percentage of patients evaluated with stool cultures was 86%, while the percentage of patients evaluated for ova and parasites was 51% at the time of patient admission. Only 34% of the population had colonic biopsies stained for Cytomegalovirus (CMV) of which 74% had ulcerative colitis. None of the stool cultures nor CMV tests were positive in our population.
The risk of acquiring C difficile infection was not significantly correlated with the patient's disease phenotype, the biological therapy they were receiving, or their smoking history. In our sample, clinical tests and routine laboratory tests did not predict infectious colitis. The CRP level, as well as the neutrophil and eosinophil counts, were not associated with positive C. difficile infection.

Conclusion
In IBD flare, we did not routinely identify pathogens besides C difficile. Aside from areas where bacterial or parasitic infections are prevalent, routine stool testing with cultures and parasites has a low yield.
P906 Prevalence and CARD9 IBD risk variant rs4077515 in a Chilean IBD Cohort
Authors: Pérez T , Bustamante M L , Magne F , Alvares D , Álvarez-Lobos M , Hernandez-Rocha C , Aguliar N , Azocar L , Baez P , Zazueta A , Estela R , Escobar S , Silva V , De la Vega A , Arriagada E , Espino A , Miquel J F , Travisany D 
Published: January 2023

Abstract

Background
Genome-wide association studies (GWAS) have identified hundreds of polymorphisms associated with an increased risk of developing IBD. Among risk genes identified by GWAS, CARD9, a gene encoding an adapter molecule involved in the innate immune response to fungi and bacteria, has been related to IBD risk. CARD9 alleles in IBD patients may have either a protective function or a high genetic risk factor such as rs4077515. Interestingly, the CARD9S12N (rs4077515) variant has a higher frequency in the Latin South American population than the Caucasian population. The relevance of rs4077515 in the risk of IBD in the Latino population is unknown.

Aims
(1) To estimate allele and genotype frequencies for rs4077515 in IBD patients and Chilean controls and compare with Ensembl genome database (public data available). (2) To compare the allele and genotype distributions in IBD patients and controls, including association tests and estimation of ORs according to additive, dominant and recessive penetrance models.

Methods
260 IBD patients were genotyped using the TaqMan SNP genotyping technology based on qPCR. Aggregated genotype information for 3147 population-based Chilean controls was retrieved from a published study on gallstones in Chileans (Lorenzo et al., Hepatology 2021). We calculated the allele and genotype frequencies for rs4077515 and then compared these frequencies with controls. A Chi-square test of association was used under the null hypothesis of no association between genotypes and disease. Univariate and multiple logistic regression were performed (additive, dominant, and recessive penetrance models).

Results
Table 1 compares rs4077515 allele and genotype frequencies in Chileans and other populations (Ensembl data set). Table 2. exhibits the estimated odds ratio for IBD, CD, and UC in Chilean population. Table 3. reveals the association results for rs4077151 models in the Chilean population.

Conclusion
In this study, the A risk allele for rs4077515 is significantly more frequent in the Chilean population than reported in other populations such as European, but similar to Amerindian. In this Chilean cohort, the variant rs4077515 is not associated with higher IBD risk. However, this could be an effect of sample size, or patients carrying rs4077515 requires an additional factor to IBD development.