bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1072 The influence of anxiety and depression and the online mindfulness interventions on the quality of life among patients with Inflammatory Bowel Disease (IBD) : Web-Based Survey Study
Authors: Hu S , Xu D , Zhu C , Wang Y , Li S , Chen Y , Chen Y , Wang C 
Published: January 2025

Abstract

Background
Patient diagnosed with Inflammatory Bowel Disease (IBD) experience distressing psychological symptoms and a diminished quality of life (QOL). The efficacy and feasibility of online mindfulness intervention for patients with IBD is unknown.We conducted a mobile-delivered mindfulness intervention among IBD patients to study its feasibility and efficacy in lowering their anxiety or depression level and improving their QOL.

Methods
We utilized individuals diagnosed with IBD to investigate the correlation between the severity of depression/anxiety and their QOL. The severity of anxiety and depression symptoms was evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), respectively. QOL was assessed using the Short Health Scale (SHS). The relationship was analyzed through regression analysis. Additionally, a randomized parallel design was employed to conduct the Online MINdfulness-based stress reduction with Daily EXercise (MINDEX) program, and its effects on QOL and psychological symptoms were studied over a period of 2 months.

Results
A total of 521 participants initiated the survey and 484 completed and submitted the survey. More than 80% of the patients experienced severe symptoms of anxiety or depression, as indicated by GAD-7 scores ≥ 10 or PHQ-9 scores ≥ 10. The study found that increases in GAD-7 total scores were significantly associated with increases in SHS total scores, with an R2 value of 0.43 and coefficient of 12.6 (95% CI 9.4-15.7) for UC (Ulcerative Colitis) and R2 value of 0.27 and a coefficient of 10.4 (95% CI 8.8-12.1) for CD (Crohn’s Disease). Similarly, increases in PHQ-9 scores also showed significant correlations with increases in SHS total scores, with an R2 value of 0.37 and a coefficient of 9.2 (95% CI 6.5-11.8) for UC and R2 value of 0.22 and a coefficient of 7.2 (95% CI 5.9-8.6) for CD. However, when depression severity was considered, the significant differences between SHS and PHQ-9 scores disappeared in both UC and CD. Yet, the positive correlation between GAD-7 and SHS scores remained significant in UC. Regarding the MINDEX program, the study included 30 MINDEX patients and 22 control patients who completed the program. After 2 months, the scores of GAD-7, PHQ-9, SHS between MINDEX patients and 22 control patients were not statistically significant (.052 &lt; P &lt; .908).

Conclusion
IBD significantly influenced patients’ anxiety, depression, QOL, and sleep quality. Online mindfulness interventions did not show a significant reduction in anxiety or depression. When formulating personalized treatment plans, it is crucial to take into account the patient’s overall condition to optimize treatment outcomes and enhance the patient’s QOL.
P1075 Evaluation of characteristics of faecal urgency in patients with ulcerative colitis
Authors: Ivány E , Bacsur P , Horvát B , Farkas B , Bálint A , Rutka M , Fábián A , Bősze Z , Farkas K , Szepes Z , Molnár T 
Published: January 2025

Abstract

Background
Bowel urgency is one of the most bothersome symptoms of ulcerative colitis (UC). The Urgency Numerical Rating Scale (U-NRS) measures the degree of faecal urgency experienced over the past 24 hours by patients with UC on a scale of 0-10. We assumed that the scale has a large variance, as patients evaluate their own symptoms differently. The urge may be different quality for two patients with the same score. The score on the U-NRS may be influenced by the individual’s specific perception of symptoms (degree of pain, speed of urge). The objective of our study was to investigate the possible components of urgency using the U-NRS.

Methods
Patients with UC older than 18 years treated at our departments for at least 3 months and having complaints were enrolled in our study. The patients filled out our non-validated questionnaire with questions about fecal urgency (U-NRS), pain level, speed of urge, incontinence and lifestyle characteristics associated with incontinence. Statistical analysis was performed using SPSS program.

Results
205 patients were enrolled, median age was 40 years, the mean of disease duration was 11.8±9.4 years. The mean U-NRS score was 3.2±3.2, 64 patients (31%) had 0 score and 8 (4%) had 10 score. 12% of the patients (n=24) felt most difficult to hold mucus, 38% (n=77) stool and 31% (n=63) other secretions. 9% (n=19) had urge with every stool in the last 24 hours, 35% (n=71) had less than half of defecations. Patient reported outcome (PRO2) had a significant but weak correlation with U-NRS (ͳb=0.348 p=0.000)(Figure 1). The speed of urge defined more the level of urgency than the pain level (R2=0.798, F(1, 203)=803.86 p&lt;0.001, β=0.894 vs R2=0.805, F(2, 202)=417.98, p&lt;0.001, β=0.117). The duration of faeces holding in the last 7 days had significant connection to U-NRS (R2=0.211, F(1, 203)=54.432, p&lt;0.001, β=-0.46). Patients using public restroom at least once during the last week had significantly higher score on U-NRS than other patients (4.6±3.1 vs 2.4±3 p&lt;0.0001). The usage of diapers was also significantly more often in patients with higher U-RNS score (5.2±3.2 vs 2.9±3.1,p&lt;0.0001). Faecal leakage both during the day and night was significiantly higher with higher U-NRS score (p&lt;0.0001 for both)

Conclusion
Urgency is more defined by the speed of urge than the pain. Using public restroom, usage of diapers and faecal leakage are associated with higher U-NRS. Bowel urgency greatly affects the daily life of UC patients, therefore, it has to be taken into count in therapy managing.

Figure 1
P1078 Weight-loss medications and bariatric surgery are infrequently used in obese patients with inflammatory bowel disease in North and East Devon in the United Kingdom (UK)
Authors: Hodges P , Roberts C , Badrulhsisham F , Pamment D , Smith R , Cairnes V , Bewshea C , Kennedy N , Goodhand J , Ahmad T 
Published: January 2025

Abstract

Background
Obesity is increasingly prevalent in patients with IBD and has been linked to non-response to medical therapies and disease progression. In the last decade the management of obesity in the general population has undergone a paradigm shift following the widespread use of medical therapies and bariatric surgery. Few studies have assessed weight loss strategies used by obese patients with IBD.

Methods
We designed a Patient and Public Involvement and Engagement survey to assess past use and future interest in interventions for obesity. We also sought interest in a trial of a licensed weight loss medication as an adjunct to conventional IBD therapy. We used the MyChart application in our electronic patient record (EPIC) to distribute our questionnaire between 6th and 18th November 2024. The response rate was 31% (828/2700): 40.0% [322/828], 52.9% [426/828], 7.1% [57/828] patients were diagnosed with Crohn’s disease, UC and IBDU, respectively. Body mass indices were available in 97% (807/828) patients.

Results
The median [IQR] age was 54.0 (41.0 - 65.0) years, 58.5% (484/828) were female and 92.8% [768/828] were of white European ancestry. Overall, 29.0% (234/807) were overweight and 25.0% (202/807) were obese. 30.7% (254/828) were eligible for a medication for weight management, by having a BMI ≥30 kg/m2 or a BMI ≥27 kg/m2 in addition to one or more weight-related comorbidity. Amongst these patients prior experience with weight loss strategies included: 51.6% (131/254) self-directed dieting; 33.9% (86/254) calorie counting using a smartphone app; 38.2% (97/254) had attended a weight-loss group; 16.1% (41/254) had had advice from a dietician; 2.8% (7/254) had taken part in a formal exercise program; 5.9% (15/254) had used weight loss medications [6 orlistat, 14 GLP-1 agonist] and 1.6% (4/254) had had bariatric surgery. Of 14 patients treated with a GLP-1 agonist, 5 and 9 were prescribed by public and private healthcare professionals respectively.
Amongst patients eligible for pharmacological treatment: 11.4% (29/254) expressed interest in future group-based support; 30.8% (78/254) in a formal exercise program; 37.4% (95/254) advice from a dietitian; 43.3% (110/254) drug treatment and 11.4% (29/254) endoscopic or surgical weight loss procedures. 72.8% (185/254) of patients expressed interest in participating in a trial of a licensed weight loss medication as an adjunct to conventional IBD treatment.

Conclusion
Obese patients living with IBD want access to weight loss interventions. However, previous use of weight loss medications was uncommon and usually accessed through private healthcare. Three quarters of obese patients expressed an interest in a trial of a licensed weight loss medication as an adjunct to conventional IBD therapy.
P1080 Early Biologic Therapy for Inflammatory Bowel Disease in Taiwan: A Single- Center Retrospective Cohort Study
Authors: Wong T C , Liao C Y , Lee C Y , Lin W C , Chang C W , Chen M J , Chang C W 
Published: January 2025

Abstract

Background
As the "top-down" strategy gains increasing importance in the management of IBD, early biological intervention is increasingly recognized as a significant focus in clinical practice. However, compared to Western countries, limited database availability has left this issue unexplored in Taiwan. To this end, we analyzed a 10-year database from a single medical center, focusing on clinical outcomes and colectomy-free survival in patients treated with biologics.

Methods
In this retrospective study, we included IBD patients who had received biologic therapy for more than 6 months between February 2012 and October 2023. Early biologic therapy was defined as initiation within two years of diagnosis. The crude risk of clinical outcomes, such as colectomy, IBD-related emergency room visits, and IBD-related hospitalizations, were analyzed using Kaplan-Meier curves, log-rank test.

Results
A total of 115 consecutive IBD patients who received biologic therapy were enrolled, including 61 patients with UC and 54 with CD. The study was divided into two groups: the early biologic therapy group (n = 43) and the late biologic therapy group (n = 72). 64.3 % of patients were male and the mean diagnostic age was 40.5 ± 16.1 years. The mean duration of the first biologic agent use was longer in patients receiving early biologic intervention. Table 1 presents the other baseline characteristics of both cohorts. During a median follow-up of 8.8 (± 6.1 years), 29.6 % of patients visited the ER after their first biologic treatment, while 26.1 % were hospitalized due to IBD flare-ups. Additionally, eight patients required a colectomy. The analysis revealed a statistically significant difference in the cumulative survival rate for hospitalization (p = 0.048). However, no significant differences were observed in the cumulative survival rates for colectomy (p = 0.166) or emergency room visits (p = 0.048).

Conclusion
Early biologic therapy significantly reduces hospitalization risk in Taiwanese IBD patients. However, it shows no significant link to emergency room visits, possibly due to higher emergency care use in Taiwan. Thus, larger studies are needed to confirm its effectiveness.
P1088 Positive effects of a mindfulness-based intervention on depression, stress and perceived control, but not on disability in patients with Crohn’s disease: results from a randomized controlled trial
Authors: Keersmaekers B , Beeckmans D , Brams S , Vanderbist K , Van den Bosch M , Vermeire S , Verstockt B , Sabino J , Van Diest I , Ferrante M 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) often leads to significant disability and psychological distress, significantly reducing patients’ quality of life. We evaluated the impact of a mindfulness-based intervention on disease-related disability in patients with CD on stable maintenance therapy. Additionally, we wanted to assess the impact of mindfulness on anxiety, depression, stress, disease acceptance, perceived control, and disease activity.

Methods
We conducted a monocentric randomized controlled trial (RCT), where participants were randomly assigned to an immediate intervention group or a waitlist control group that received the same intervention after six months. The IBD Disability Index at baseline (IBD-Disk ≥40 or &lt;40) was used as a stratification factor. Disease activity was assessed through patient-reported outcomes (PRO-2) and biomarkers (faecal calprotectin and C-reactive protein), measured at baseline, at 1.5 and at 3 months follow-up. Psychological factors including anxiety, depression, and stress were assessed with the DASS21 scale. Disease acceptance and perceived control were measured using the SHE model, and mindfulness levels were assessed with the FFMQ-SF. The intervention consisted of a total of four mindfulness group sessions of three hours each over six weeks. The primary outcome was the mean change in the total IBD-Disk score at three months and was analysed using a constrained longitudinal data analysis (cLDA). Based on power calculation (α=0.05, power=0.80), 54 patients had to be randomized.

Results
As shown in Table 1, 56 patients (38% male, median age 49.5 years) were randomized into the immediate intervention group (n=28) or the six-month waitlist control group (n=28). Two patients dropped out in each group before reaching the primary endpoint. Compared to the waitlist, participants in the intervention group showed significant improvements in depression, stress, perceived control, and mindfulness after three months (see Table 2). Although improvements in disease-related disability, anxiety, and disease acceptance showed positive trends, these items did not reach statistical significance. No changes were observed in clinical and biochemical markers of disease activity.

Conclusion
A 6-weeks mindfulness-based intervention can significantly improve depression, stress, perceived control, and mindfulness in patients with CD, with effects sustained 3 months post-intervention. Although numerically better, no significant effects were found on disease-related disability. Further research is warranted to explore the long-term benefits and underlying mechanisms of mindfulness in CD management.
P1090 Increased advanced therapy prescribing correlates with decreased colectomy rates in ulcerative colitis: a twenty-year population-based cohort study in Lothian, Scotland
Authors: Elford A , Constantine-Cooke N , Jenkinson P , Gros B , Plevris N , Lyons M , Ong S , Greenlees N , O’Hare C , Din S , Noble C , Jones G , Arnott I , Lees C 
Published: January 2025

Abstract

Background
The evidence for the impact of increased advanced therapy prescribing on colectomy rates in ulcerative colitis (UC) are conflicting. Our aim was to describe prescribing trends of advanced therapies (biologics and small molecules) for patients with UC in Lothian, UK and colectomy rates (elective and emergency) between January 1st, 2004, to December 31st, 2023.

Methods
Incidence and prevalence data were obtained from the validated Lothian IBD Registry. We identified patients who commenced an advanced therapy using multiple administrative databases, and identified patients who underwent colectomy using the NHS Lothian pathology database, TrakCare theatre lists, NHS Lothian multidisciplinary meetings database, and an inpatient coding database. We collected data by manual review of the electronic health records using the TrakCare (InterSystems Corporation, Cambridge, Massachusetts, USA) system. We used SPSS Version 25 [IBM Inc., Chicago, IL, USA], Prism Version 10.0 [Graphpad Software, San Diego, CA, USA], and R 4.4.0 [R Core Team, Vienna, Austria] for statistical analyses and generation of graphs. We report advanced therapy prescription and colectomy data as both raw numbers and annual incidence rates.

Results
The prevalence of UC increased from 216 to 441 patients per 100 000 population in the twenty years from 2004, culminating in a total of 4115 patients with UC in 2023 (total Lothian population 1 million). We identified 617 patients who had received an advanced therapy (Table 1). Rates of first line advanced therapy increased from 0 per 100 UC patients in 2004 to 5.15 in 2023 (Figure 1). At the conclusion of 2023, 43%, 20%, 9%, and 3% of the advanced therapy exposed patients had received second, third, fourth, and fifth-line advanced therapy, respectively.
We identified 559 patients of the prevalent UC population who had a colectomy, of which 68% were emergency colectomies. Absolute colectomy numbers decreased from 42 in 2004 to 7 in 2023, equating to 2.48 and 0.22 per 100 UC patients. We observed that 66% (339/559) of colectomies occurred in patients with extensive disease (E3), with 68% (355/523) performed for acute severe UC, of which 32% (114/355) occurred within 90 days of diagnosis. A total of 4% (22/559) of colectomies were for cancer (n=14) or dysplasia/suspected cancer (n=8). Colectomies for "chronic active UC refractory to medical treatment" have almost completely disappeared with only 5 colectomies performed for this indication in the last 2 years of follow-up.

Conclusion
We found the incidence of colectomy in the UC population progressively decreased over time, and correlated with an increased use, and number, of available advanced therapies.
P1091 Trends in length of stay and steroid use in patients admitted with Acute Severe Ulcerative Colitis: Impact of intensified or accelerated infliximab dosing
Authors: Bartlett R , Mohamedrashed M , Yogakanthi S , Chew M , Nedumannil L , Pearce R , Lucas S , Chauhan A , Lewis D , Kashkooli S , Garg M 
Published: January 2025

Abstract

Background
The role of intensified (&gt;5mg/kg), accelerated (&gt;1 dose within first 14 days) infliximab (IFX) as rescue therapy in patients with acute severe ulcerative colitis (ASUC) remains controversial. This project evaluated the association between evolving strategies with length of stay, 12-month cumulative steroid burden, colectomy and readmission rates.

Methods
Patients admitted with ASUC between January 2016 and October 2024 to a single tertiary IBD centre were identified and reviewed. IFX rescue therapy was defined as standard dose if up to 5mg/kg or intensified/accelerated if ≥10mg/kg (further categorised as 10mg/kg or ≥20mg/kg) was administered within 14 days of admission. Outcomes assessed included length of stay, 12-month cumulative steroid exposure (in prednisolone mg equivalent), 12-month readmission and colectomy rates.

Results
147 patients (61 [41.5%] female, median age 33 [range 16-87] years) met Truelove and Witts criteria for ASUC. 83 (56.5%) patients required IFX therapy, of whom 29 (34.9%) patients received 5mg/kg IFX dose, 35 (30.1%) patients received 10mg/kg and 19 (22.9%) patients ≥20mg/kg. Disease severity as defined by CRP:albumin ratio was similar between patients receiving 5mg/kg vs 10mg/kg (p=0.880), but higher in those receiving 20mg/kg vs 5mg/kg (p=0.012); vs 10mg/kg (p=0.008). There was an increasing trend in the proportion of patients receiving intensified/accelerated IFX (≥10mg/kg) from 2016-2019 (26.3%) to 2020-2024 (76.5%) (p&lt;0.001). Length of stay was less in patients who received 5mg/kg and 10mg/kg compared to ≥20mg/kg (median 6 vs 6 vs 11 days p=0.001). 12-month cumulative steroid usage was similar in 5mg/kg (median 1850 mg), 10mg/kg (1642.5 [1297.5-1935]mg) and ≥20mg/kg (1600 [1452.5-1715]mg), p=0.135. Readmission (19.2% (5mg/kg), 28.6% (10 mg/kg) and 11.1% (≥20mg/kg), p=0.527) and colectomy (8.7% (5mg/kg), 10.5% (10 mg/kg), 12.5% ≥20mg/kg, p = 0.958) rates were similar across IFX groups. Median length of stay was similar (p=0.193) between 2016-2019 (6 days) and 2020-2024 (6 days). 12-month cumulative steroid exposure (median 1705mg vs 1617.5mg, p=0.282) and readmission rates (15.8% vs 21.2%, p=0.488) remained stable when comparing 2016-2019 and 2020-2024. 12-month colectomy rates[MG1] declined across all ASUC patients (15.8% in 2016-2019 to 1.5% in 2020-2024, p = 0.004), and ASUC patients receiving IFX (21.1% 2016-2019 to 2.8% in 2020-2024, p = 0.025).

Conclusion
Despite higher disease severity, intensified and accelerated dosing for IFX at ≥20mg/kg resulted in similar length of hospital stay, 12-month steroid exposure, readmission and colectomy rates to lower doses. Intensified and accelerated IFX dosing has increased over time, associated with reduction in colectomy rate.
P1092 Real-life durability and utilization of biologics in pediatric inflammatory bowel disease: results from Italian society of pediatric gastroenterology, hepatology and nutrition (SIGENP) IBD registry
Authors: Lega S , Manuela G , D’Arcangelo G , Di Pasquale V , Scarallo L , Ancona S , Fedele F , Zuin G , Graziano F , Norsa L , Gatti S , Illiceto M T , Felici E , Corpino M , Pavanello P , Cozzali R , Alvisi P , Belluca S , Banzato C , Penagini F , Marseglia A , Faraci S , Luini C , Strisciuglio C , Moretti C , Martinelli M , Arrigo S , Lionetti P , Romano C , Aloi M , Bramuzzo M ,   SIGENP IBD Study Group
Published: January 2025

Abstract

Background
Long-term data on the efficacy and safety of biologics in pediatric inflammatory bowel disease (IBD) are crucial for guiding clinicians in optimizing their use. This study aims to evaluate real-life durability, usage patterns, and factors influencing treatment discontinuation in pediatric IBD.

Methods
This registry-based study analyzed data of patients from the IBD registry of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) who started biologic therapy between 2009 and 2022, with a minimum 1-year follow-up.

Results
1184 patients (749 Crohn’s Disease [CD], 437 Ulcerative Colitis or IBD-undetermined [UC/IBD-U]) were retrieved. The median follow-up was 43 months (IQR 28-64). Infliximab was the first biologic in 807 patients (68%) followed by adalimumab in 378 patients (31%). 393 patients (33%) received a second-line biologic, 107 (9%) a third-line and 24 (2%) a fourth-line. At last follow-up, 544 patients (47%) had discontinued the first biologic, with a median time to discontinuation of 14 months (IQR 5-27). Main reasons were loss of response (36%) followed by primary non-response (33%) and infusion reactions (13%). For first-line biologics, treatment durability was superior in patients who received adalimumab compared to infliximab (Figure 1a) and in patients managed with TDM (Figure 2b). In the multivariate analysis risk factors for first biologic discontinuation were age &lt; 6 years (HR 1.8, 95%CI 1.3-2.4), UC/IBD-U (HR 1.4, 95%CI 1.1-1.8), moderate/severe disease activity (HR 1.3, 95%CI 1.1-1.6) and Infliximab vs adalimumab (HR 2.1; 95% CI 1.6-2.7) while the use of TDM emerged as protective, significantly lowering the risk (HR 0.50; 95% CI 0.40-0.63). Combination therapy did not influence biologic durability (HR 0.95; 95% CI 0.77-1.18).

Conclusion
strategies for optimizing treatment efficacy of biologics in pediatric IBD should be tailored considering patients age, IBD type and severity and integrating TDM in patients’ management. The contribution of concomitant immunomodulation in the pediatric setting might be negligible.