bluuebunny/crossref_metadata_2025_split huggingface dataset:
P842 SARS-CoV-2 antibody titers analysis in immune mediated inflammatory disease patients after COVID-19 vaccination: a monocentric retrospective study
Authors: Delaleeuwe I , Aoun J , Hoyois A , Brasseur C , Di Romana S , Muls V 
Published: January 2023

Abstract

Background
Immune-mediated inflammatory diseases (IMID) including inflammatory bowel diseases (IBD) and inflammatory arthritides are commonly treated with biological therapies, in particular anti-TNF. Patients on anti-TNF have impaired protective immunity following pneumococcal, influenza and viral hepatitis. However, the serological response to COVID-19 vaccination is still under-studied. Recent studies demonstrated that serologic response is attenuated in IMID patients on immunosuppressive therapy. In this study, the primary outcome is to describe the antibody response in IMID patients according to baseline patient characteristics, type of inflammatory disease, treatment and disease activity. Secondary outcome is to compare antibody response in patients treated with anti-TNF, versus other biologic therapies.

Methods
This study is a monocentric retrospective study, including 265 IMID patients followed at CHU Saint Pierre, Belgium, between 2021 and 2022. Respective baseline patient characteristics, vaccination status, treatment type, disease activity and SARS-CoV-2 antibody titers (IgG) after first, second and third vaccination were collected and analyzed.

Results
A total of 265 patients were enrolled (mean age 47 years old, 35% males, 67% IBD patients). Of these, 217 patients (82%) completed the 2 doses of vaccination and 130 patients (49%) the 3 doses, while 40 patients (15%) remained unvaccinated. Antibody titers after 2 doses of vaccination were available for 50 patients. In this group, the median antibody titer was 93 AU/mL [26-421] after first vaccination, raised up to 640 AU/mL [271-800] after the second vaccination (Δ85%, p&lt;0.0001). Similarly, a statistically significant increase was noted in the subgroup of patients with available serologic data after 3 vaccination doses (N=18). The median antibody titer after the first vaccination in anti-TNF subgroup (N=15) was lower than that in other biotherapies subgroup (N=23); 34 AU/mL [6-145] versus 131 AU/mL [34-704] respectively. However, after the second vaccination, higher antibody titers were found in the anti-TNF subgroup, 686 AU/mL [321-800] versus 400 AU/mL [250-800] (p&lt;0.388).

Conclusion
In our cohort of IMID patients, followed at CHU Saint Pierre, Belgium, there was a statistically significant raise in antibody titers after the second and third dose of COVID-19 vaccination, regardless of the type of inflammatory disease, disease activity, type of treatment and vaccine type. The antibody titers in this particular immunocompromised population were comparable to that found in the literature for the general population. More prospective observational studies are needed with a larger sample size to determine the characteristics of patients with sub-optimal serological response.
P843 Mucinous and signet-ring colonic adenocarcinoma in Inflammatory Bowel Disease
Authors: Neri B , Pizzi F , Savino L , Salvatori S , Mossa M , Lolli E , Calabrese E , Sica G , Petruzziello C , Monteleone G , Biancone L 
Published: January 2023

Abstract

Background
Colorectal cancer (CRC) risk is increased in patients (pts) with long-standing colitis related to Inflammatory Bowel Disease (IBD). A higher frequency mucinous and signet-ring colonic adenocarcinoma has been suggested in IBD, but data regarding risk factors for these aggressive CRC are currently lacking. Primary aim was to assess the frequency of mucinous and signet-ring adenocarcinoma in IBD pts with CRC. Secondary aim was to assess risk factors for these histotypes of CRC.

Methods
From January 2002 to July 2022, all IBD pts with concomitant CRC were retrospectively enrolled. Inclusion criteria: 1) age ≥18; 2) well-defined diagnosis of IBD and CRC; 3) available histological and surgical report. Exclusion criteria: Missing data. Characteristics of IBD were reported according to standard criteria. Data were expressed as median [range]. Student-t Test and χ2 test were used for comparisons. Univariate logistic regression model was applied for assessing risk factors for mucinous and signet-ring adenocarcinoma (OR [95%CI]).

Results
The study population included 40 IBD pts with concomitant CRC: 24 (60%) with Ulcerative Colitis (UC) and 16 (40%) with Crohn’s Disease (CD). CRC included standard adenocarcinoma in 23 (57.5%) and mucinous or signet-ring in 17 (42.5%) pts. CD was more frequently stricturing in pts with standard adenocarcinoma (7 [77.8%] vs 1 [14.4%], p=0.04). CRC most frequently involved the rectum in pts with mucinous or signet-ring adenocarcinoma vs standard adenocarcinoma (4 [17.4%] vs 8 [47.1%]; p=0.04). Other IBD characteristics did not differ between standard and mucinous or signet-ring adenocarcinoma, including: age at CRC diagnosis (61 [30-80] vs 53 [29.80]; p=0.61), gender (F): 8 [34.8%] vs 5 [29.4%]; p=0.98), IBD duration at CRC diagnosis (14 [1-45] vs 17 [1-36]; p=0.74), smoking status (p=0.78), IBD type (UC: 14 [60.9%] vs 9 [56.3%]; p=0.84), UC extent and CD localization, frequency of perianal disease (p=0.37), thiopurine (p=0.55) or biologic (p=0.55) use. The proportion of pts surgically treated for CRC (20 [86.9%] vs 17 [100%], p=0.34) and the frequency of CRC-related death (3 [13.1%] vs 5 [29.4%]; p=0.37) were also comparable between groups. At diagnosis, CRC stage was comparable between pts with standard vs mucinous or signet-ring adenocarcinoma (stage I: 6 [26.1%] vs 1 [5.9%]; p=0.21; II: 9 [39.1%] vs 4 [23.5%]; p=0.48; III: 5 [21.7%] vs 7 [41.2%]; p=0.34); IV: 3 [13.1%] vs 2 [11.8%]; p=0.71). At univariate analysis, no specific risk factors for mucinous and signet-ring colonic adenocarcinoma were detected.

Conclusion
In the tested cohort of IBD patients with CRC, mucinous and signet-ring adenocarcinomas were observed in almost half of cases, although no specific risk factors were identified.
P847 Insomnia is common in IBD and associated with increased disability and abdominal pain
Authors: Barnes A , Andrews J , Bryant R V , Mountifield R 
Published: January 2023

Abstract

Background
Insomnia is common in those with chronic medical conditions. Insomnia is associated with decreased quality of life and is readily treatable through cognitive behavioural therapy for insomnia (CBTi). This study aimed to describe the associations with insomnia in an IBD population and its relationship with IBD related disability.

Methods
An online questionnaire was administered through three tertiary IBD centres, social media and through a patient advocacy group (Crohn’s Colitis Australia). The questionnaire included the insomnia index severity (ISI), a validated assessment of insomnia and its severity, with a score over 14 considered clinically significant insomnia. Validated measures of anxiety (GAD-7), depression (PHQ-9), physical activity (sIPAQ), and disability (IBD-DI-SR) were also utilised. IBD activity was assessed clinical IBD activity scores (HBI or SCCAI).

Results
There were 670 responses included in the analysis. Median age was 41 years (32-70), with the majority being female (78%), and 57% having Crohn’s disease. The mean disease duration was 11.9 years (10.4), 30% had undergone surgery for IBD and around half were on biologics (50.5%).
The mean ISI score was 12.7 (6.09). Over a third of the cohort had at least moderate insomnia (ISI&gt;15). A one-way ANOVA revealed differences in disability scores (IBD-DI-SR) (see table 1) between insomnia severity groups (F(3,619) = 20.99, p &lt; 0.001), with disability scores worsening with increasing severity of insomnia.
Multivariable logistic regression analysis (see table 2) revealed that clinically significant insomnia was significantly associated with clinically active IBD, abdominal pain, clinically significant anxiety, and clinically significant depression.

Conclusion
Insomnia is common in people with IBD with at least one third reporting moderate insomnia. Given that insomnia was associated with increased disability, consideration should be given for routine screening for insomnia in IBD patients. Mental health conditions and ongoing pain should be addressed with consideration given to referral for CBTi.
P850 Co-medication before and after onset of inflammatory bowel disease in adults or elderly
Authors: Lund K , Zegers F D , Nielsen J , Brodersen J B , Knudsen T , Kjeldsen J , Larsen M D , Nørgård B M 
Published: January 2023

Abstract

Background
The incidence of Inflammatory Bowel Disease (IBD) is increasing. Co-medication is clinically important in addition to the treatment of IBD. However, real-world data on co-medication is sparse. Thus, we aimed to describe whether a diagnosis of IBD affects the prescription pattern of co-medication used to treat other diseases in adult-onset and elderly-onset IBD.

Methods
This nationwide cohort study utilized data from Danish Health Registers. We included patients with adult-onset of IBD (18-59 years of age) and elderly-onset of IBD (+60 years of age) from 1998-2018 with three years of follow-up after the diagnosis for all patients. We identified patients who had at least two diagnoses of IBD in The National Patient Register. We described redeemed prescriptions of 11 common groups for medication used to treat conditions other than IBD using data from The Danish National Prescription Registry.

Results
We identified 36,165 incident patients. We created two cohorts; 27,386 (75%) had adult-onset IBD, and 8,779 (25%) patients had elderly-onset IBD, Table 1. The proportion of patients with redeemed prescriptions in both cohorts was statistically significantly increased one and three years after onset of IBD for antidepressants, antipsychotics, sedatives/hypnotics, opioids, non-opioid analgesics, antidiabetics, and proton pump inhibitors, compared to one and three years before diagnosis, Figure 1 & Figure 2.

Conclusion
The proportion of patients with redeemed prescriptions for antidepressants, antipsychotics, sedatives/hypnotics, opioids, non-opioid analgesics, antidiabetics, and proton pump inhibitors was significantly increased one and three years after a diagnosis of IBD compared to one and three years before diagnosis.
P852 predictors of complicated disease course in UC in an administrative database: a nationwide study from the epi-IIRN
Authors: Lujan R , Atia O , Focht G , Greenfeld S , Kariv R , Loewenberg Weisband Y , Lederman N , Matz E , Dotan I , Turner D 
Published: January 2023

Abstract

Background
There is uncertainty about the ability to predict disease course in UC, often since prediction studies are small and include selected population. We aimed to use a large nationwide cohort to explore predictors of disease course in UC.

Methods
Data of patients diagnosed with UC in the epi-IIRN cohort 2005-2020 were retrieved from the four Israeli Health-Maintenance-Organizations covering 98% of the population. The following potential predictors were explored: demographic data, laboratory results, induction medications, and extra-intestinal manifestations. The primary outcome was complicated disease course defined as colectomy, steroid-dependency, or need for more than one biologic class. Hierarchical clustering categorized disease severity at diagnosis based on available laboratory results into four groups of disease severity (mild, moderate, severe, and extreme).

Results
A total of 15,111 UC patients with 114,208 person-years of follow-up were included, of whom 2,213 (14%) had complicated disease course. The latter was predicted in a Cox multivariable regression model by induction therapy with biologics (HR 3.84 [2.4-6.12]) and severity of laboratory tests prior to diagnosis (HR 1.41 [1.03-1.92]). The use of topical treatment (5-ASA or steroids enema/suppository) as monotherapy was protective with a decreased risk of complicated disease course (compared with untreated, HR 0.5 [0.38-0.63). Younger age of diagnosis (HR of pediatric-onset compared to adult-onset 1.79 [1.48-2.15]) and recent year of diagnosis (HR 1.03 [1-1.04]) were also associated with complicated outcome. Jews had 23% reduced risk of complicated disease course compared with Arabs (HR 0.77 [0.60-0.97]) (Figure 1). Specifically in the laboratory tests, there was a gradual increase in complicated disease amongst the disease severity clusters (p&lt;0.001; Figure 2).

Conclusion
In this nationwide cohort, complicated disease course was apparent in 14% of patients and predicted by serum laboratory tests and induction therapy with biologics. Jewish ethnicity and topic therapy (reflecting proctitis) were associated with better outcomes.
P854 Race and ethnicity in ulcerative colitis clinical trial enrolment: a post hoc analysis of patient demographics and clinical characteristics from GEMINI 1, VARSITY, and VISIBLE 1
Authors: Khan R M Q , Ananthakrishnan A N , Loftus Jr E V , Iroku U , Mukherjee R , Uddin S , Odufalu F D , Liu J 
Published: January 2023

Abstract

Background
The incidence of inflammatory bowel disease (IBD) has risen among Black individuals and Hispanic or Latino individuals in the USA in recent decades; however, these patients are underrepresented in clinical trials of IBD therapies. We aimed to perform a post hoc analysis of the baseline demographics and clinical characteristics in three phase 3 clinical trials of vedolizumab for ulcerative colitis (UC) to identify differences between racial and ethnic groups.

Methods
The baseline demographics and clinical characteristics of patients with UC who were enrolled in GEMINI 1, VARSITY, and VISIBLE 1 were pooled and stratified by race and ethnicity, which were self-reported. The inclusion criteria for these trials included adult patients with moderately to severely active UC who had a prior inadequate treatment response, loss of response, or intolerance to conventional therapies or anti-tumour necrosis factor α treatment. Data were analysed using descriptive statistics, with mean or median values calculated for continuous variables, and the number and proportion of patients reported for categorical variables. T-tests and exact tests were used to compare continuous and categorical variables, respectively, between Black and White patients and between Hispanic or Latino patients and those who were not Hispanic or Latino.

Results
We included 1,358 patients, of whom 1,171 (86.2%) were White, 148 (10.9%) were Asian, 14 (1.0%) were Black, and 25 (1.8%) were of multiple or unspecified racial groups (Table 1). Black patients had significantly higher mean weight (87.9 kg vs 74.8 kg, p &lt; 0.01) and body mass index (30.5 kg/m2 vs 25.2 kg/m2, p &lt; 0.01), but lower albumin (38.5 g/L vs 41.2 g/L, p &lt; 0.05) and haemoglobin levels (115.5 g/L vs 126.1 g/L, p &lt; 0.05) than White patients (Table 1). Ethnicity data were recorded for 465 patients (34.2%). Hispanic or Latino patients were shorter in height (166.6 cm vs 171.0 cm, p &lt; 0.01) and had shorter mean disease duration (4.6 years vs 7.6 years, p &lt; 0.01) than those who were not Hispanic or Latino (Table 2). A non-significant, but numerically greater proportion of Hispanic or Latino patients had pancolitis than those who were not Hispanic or Latino (50.0% vs 35.8%).

Conclusion
In this post hoc analysis of vedolizumab clinical trials, Black patients and Hispanic or Latino patients with UC had differences in certain demographic and disease characteristics versus White patients and patients who were not Hispanic or Latino, respectively. These differences may have implications for therapy. Thus, inclusion of a more diverse patient population that reflects the demographics of the general population is warranted to adequately ascertain drug efficacy across racial and ethnic groups.
P871 Consideration of smoking and familial aggregation of appendectomy together may change our previous belief about the influence of appendectomy in Inflammatory Bowel Disease (Ulcerative Colitis vs Crohn's Disease)
Authors: Bakkaloglu O K , Eskazan T , Onal U , Candan S , Balamir M , Kurt E A , Hatemi I , Erzin Y , Celik A F 
Published: January 2023

Abstract

Background
While appendectomy is known to be associated with Crohn's Disease (CD), it is claimed to be protective against Ulcerative Colitis (UC). However, it is not clear whether this is a cause-effect relationship or is due to different inflammatory and genetic characteristics of the two different diseases. The discrete effects of smoking on the course of CD and UC are well known. Yet, the familial aspect of appendectomy in IBD patients and its relationship with smoking have not been discussed before.

Methods
The frequency of appendectomy, smoking status of the patients (never / ever smoker) and their relations with each other were evaluated in 227 CD, 180 UC patients and their families (including biological parents and children).

Results
58% of the patients were male and the median age in the whole group was 42 years (Table-1). Age was found to be higher in UC patients compared to CD (44-40 p:0.002). The frequency of appendectomy in the whole group was 16.5%; It was 6.7% in UC and 24.8% in CD (p:0.001) (Reference prevalence of appendectomy in normal population is reported as %7). Age was higher in patients with appendectomy compared to IBD patients without appendectomy (45-41 p:0.08). Smoking was detected more frequently in both CD patients, and IBD patients with appendectomy (both p&lt;0.001). The risk of appendectomy in IBD patients was associated with a family history of appendectomy (31%-15% p:0.005). Similar to the increased incidence of appendectomy in CD patients, family history of appendectomy in IBD patients was associated with a family history of CD, but this relationship could not be demonstrated for UC. The frequency of appendectomy in families of CD patients was higher than in families of UC patients (22%-15% p:0.07). In the regression analysis, CD, smoking and increasing age were found to be independently associated with appendectomy in IBD patients (Table 2).

Conclusion
The co-occurrence of CD and appendectomy, compared to UC, and the relationship between appendectomy and family history suggest that similar genetic factors and ultimately inflammatory pathways may be effective in both diseases. The association of smoking with increased CD and appendectomy frequencies, together with its paradoxical effect on UC, suggests that smoking may be a triggering factor on inflammatory pathways in some individuals with this genetic background. These results may also jeopardize the recently claimed protective role of appendectomy on UC.
P872 Underrepresentation of Palestinian Citizens of Israel in Israeli Inflammatory Bowel Disease Trials
Authors: Hassan M , Ghersin I 
Published: January 2023

Abstract

Background
Recent studies have described a significant racial disparity, with a very low proportion of racial minorities, in clinical trials of therapies for inflammatory bowel diseases (IBD), along with limited reporting of ethnicity data.
Palestinian citizens of Israel (commonly referred to as Israeli Arabs) are Israel’s largest ethnic minority, comprising 21% of the Israeli population. This minority group suffers from substantial health inequalities, as evidenced by increased rates of obesity, smoking and diabetes and a lower life expectancy compared to Israeli Jews. It is worth noting that the incidence of IBD among Palestinian citizens of Israel is on the rise.
We sought to describe ethnic representation in Israeli IBD clinical trials.

Methods
We systematically reviewed Israeli IBD trials from the past 20 years.
Each publication was examined for ethnicity data.
The proportion of trials reporting ethnicity were calculated among all reported.

Results
The search yielded 99 publications.
The year of publication ranged from 2002 to 2022.
Only 7 of 99 trials (7.1%) included ethnicity demographics, with 92/99 (92.9%) not reporting ethnicity at all.
There was no mention of ethnicity or limitations surrounding ethnicity inclusion in the discussion section of any of the other included publications.
Of the 7 trials reporting ethnicity, 6 studies included Palestinian patients (6/99 trials, 6.1%). The other study reported data regarding IBD among Ethiopian Jews migrating to Israel.
Data regarding the religious affiliation of Palestinian patients was available in 3 out of 6 studies (50%).

Conclusion
The reporting of ethnicity and the inclusion of Palestinian citizens of Israel in Israeli IBD trials have been poor.
Greater effort should be made at multiple levels for the appropriate participation of all ethnic groups in Israeli IBD trials.
We believe this will enhance our understanding of disease processes and response to treatment in different patient populations, and ultimately improve the quality of life of our patients.
P874 Comparison and Propensity Score of Seroconversion After Two Doses Of SARS-CoV-2 Vaccine in IBD Patients And Liver Transplant Recipients
Authors: Indellicati G , Rendina M , Todeschini A , Lillo C , Castellaneta A , D'Uggento A M , Di Leo A , Principi M 
Published: January 2023

Abstract

Background
Suboptimal anti-Sars-Cov2 vaccine response has been demonstrated during immunosuppressive treatments. Liver Transplant Recipients (LTRs) and Inflammatory Bowel Disease (IBD) patients are different setting of populations who are both undergoing immunosuppressive treatments.
In this work, we pooled and compared, retrospectively, these two populations to evaluate anti-SARS-CoV2 seroconversion after the second dose of vaccination. Different comorbidities and therapies outcomes have been explored as well.

Methods
The antibody titres standardized of the two cohorts have been analysed. Matched patients of both populations for comorbidities and therapies with application of propensity score have been investigated.

Results
240 LTRs and 424 IBD patients were analysed. Most have received an mRNA based vaccine (BNT162b2 or mRNA-1273: 99.1%). The seroconversion rate of 84% for LTRs and 93% for IBD patients was recorded. To multivariate analysis, hypertension (OR 2.8618, 95% CI 1.0012 to 8.1802), the mycophenolate administration (OR 2.9733, 95% CI 1.1820 to 7.4794) and the steroid use (OR 5.4531, 95% CI 1.0706 to 27.7761) were significantly associated with reduced seroconversion in LTRs cohort; meanwhile, the older age (OR 1.0369, 95% CI 1.0076 to 1.0670) and the thiopurine consumption (OR 2.9484, 95% CI 1.0089 to 8.6166) with that in IBD population. After Propensity Score Matching application, the seroconversion rates, not statistically different, of 86% for LTRs and 92% for IBD patients were found. Hypertension (OR 2.73, 95%CI 1.1258 to 6.6138), diabetes (OR 3.16, 95% CI 1.1888 to 8.4217), age &gt; 65y (OR 2.93, 95% CI 1.1712 to 7.3153) and the female sex (OR 2.54, 95% CI 1.0963 to 5.9104) were correlated with reduced seroconversion in both populations.

Conclusion
After Propensity Score Matching, the seroconversion rates of IBD and LTR patients were not statistically different. Hypertension, diabetes and age &gt; 65y revealed a significant influence on seroconversion and the female showed a reduced seroconversion in comparison to male.