bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0538 Histologic remission predicts relapse in patients with Ulcerative Colitis
Authors: Lopes S , Teixeira M , Tomás D , Sequeira C , Teixeira C , Gamito É , Alves A L 
Published: January 2025

Abstract

Background
Histologic remission is not currently established as a formal treatment target in ulcerative colitis (UC). However, growing evidence indicates that histologic activity is associated with increased rates of relapse, hospitalization, and colectomy1.
We aimed to evaluate the predictive value of histologic remission in UC patients and its potential role in guiding disease management.

Methods
A unicentric retrospective study was conducted, including all patients with UC who achieved endoscopic remission (Mayo Endoscopic Subscore ≤1) on colonoscopy between January 2020 and June 2023. Histologic remission was defined as the absence of neutrophils in the lamina propria or epithelium. Clinical activity was assessed using patient reported outcomes (PRO-2) for stool frequency or rectal bleeding (PRO-2&gt;0). Clinical relapse was defined as the need for therapy optimization, switching therapy, or corticosteroid use.
Factors associated with relapse were assessed using chi-square tests for categorical variables and t-tests for continuous variables. A binary logistic regression model was applied to further evaluate these associations.

Results
A total of 90 patients were included (58% male; mean age: 55 ± 15 years), with a median disease duration of 15±9 years. Among patients in endoscopic remission, 61% had a Mayo endoscopic subscore of 0, and 39% had a score of 1. Histologic remission was observed in 74% of patients (table 1).
During follow-up, 23% (n=21) of patients experienced a relapse. Histologic activity was statistically associated with a higher risk of clinical relapse (p=&lt;0.001). No differences were found in relapse rates between patients with Endoscopic Mayo Subscores of 0 or 1 (p=0.073). Younger age (p=0.009), shorter disease duration (p=0.002), and previous failure of advanced therapies (p=0.049) were also associated with a higher risk of clinical relapse. Multivariate analysis identified histologic remission as the sole independent predictor of relapse (odds ratio: 0.173, 95% CI: 0.053–0.571, p=0.004).

Conclusion
These observational data suggest that histologic remission may predict clinical relapse in patients with UC. In this cohort, histologic remission was identified as the sole predictor of relapse, outperforming endoscopic remission.

References
Lobatón T, Bessissow T, Ruiz-Cerulla A, De Hertogh G, Bisschops R, Guardiola J, Van Assche G, Vermeire S, Ferrante M. Prognostic value of histological activity in patients with ulcerative colitis in deep remission: A prospective multicenter study. United European Gastroenterol J. 2018 Jun;6(5):765-772. doi: 10.1177/2050640617752207.
P0540 Assessment of Metabolic-Associated Liver Disease in Patients with Crohn’s Disease in Long-Term Remission
Authors: Amiama Roig C , Cristina S F , Laura G R , Jose Luis R G , Maria S A , Eduardo M A , Joaquin P C , Irene G D , Carmen A C , Maria Dolores M A 
Published: January 2025

Abstract

Background
Previous studies have shown that patients with Crohn’s disease(CD) have an increased risk of metabolic liver disease(MASLD) even in the absence of cardiovascular risk factors. This increased prevalence is attributed to the inflammatory bowel activity itself.
However, there is less evidence on whether CD could be an independent risk factor for MASLD in patients in long-term remission

Methods
A cross-sectional study was conducted, including two cohorts: one of patients with CD in deep remission and another of healthy controls. All participants underwent blood tests, abdominal ultrasound with shear wave elastography(SWE) and FibroScan®. Additionally, CD patients were evaluated to determine clinical, biochemical, and radiological remission(using intestinal ultrasound). Only patients with CD in clinical remission for at least one year, and not receiving immunosuppressive or biological treatments, were included.
Patients with clear predisposing risk factors to metabolic liver disease(such as corticosteroid treatment or diabetes) were excluded

Results
47 patients were included: 29 controls(61.7%) and 18 with CD in remission(38.3%). The baseline characteristics are summarized in Table1.
Regarding the CD remission: Harvey index median was 0(IQR 0-1). Faecal calprotectin mean was 38.8 µg/g(IQR 20.7-57.4), C-reactive protein mean was 0.6mg/dL(IQR 0.5-2.1), and intestinal ultrasound showed normal bowel wall thickness in all patients.
The lipid and liver profile is presented in Table2.
Considering all included patients, regardless of the presence of steatosis, Fibroscan values were significantly higher in the control group compared to CD patients, although there were no advanced fibrosis in either group(4.9kPa vs 4.1kPa,p=0.04). This was consistent with SWE data(4.3 kPa vs 4.15 kPa), although this difference did not reach statistical significance(p=0.58). ATI values were 0.54 in controls vs 0.58 in CD patients(p=0.38).
Considering only patients with steatosis, there was no greater prevalence of steatosis among patients with CD(23.5%) compared to controls(20.8%),p=0.84. By ultrasound, all cases were classified as mild steatosis, except for one patient who was reported as severe, belonging to the CD group.
In our sample, among patients with steatosis, those with CD were more frequently diagnosed with dyslipidaemia(75%) compared to controls(0%),p=0.018.
Fibroscan values were lower in patients with CD and steatosis(3.9kPa) compared to controls(5.3kPa),p=0.26. Similar to SWE (4.02kPa vs 4.56kPa, p=0.43) and ATI(0.73 vs 0.69,p=0.74) values

Conclusion
In our experience, there is no increased prevalence of MASLD in CD in the absence of activity, and when present, it may be secondary to underlying cardiovascular risk factors, as in our case was dyslipidaemia
P0546 Surgical recurrence following repeated ileocolic resection for Crohn’s disease: a retrospective single center cohort study
Authors: Haanappel A , Moojen T , Vlug M , Hompes R , Buskens C , Bemelman W 
Published: January 2025

Abstract

Background
Surgical recurrence after primary ileocolic resection (ICR) for CD is common. (1) However, data on long-term outcomes following first resection of the neoterminal ileum (re-ICR) are scarce. The present study evaluated the risk on surgical recurrence following first re-ICR in CD patients. In addition we aimed to assess changes in medical treatment strategies and its effect on postoperative outcomes.

Methods
A retrospective cohort study was conducted in the Amsterdam UMC, including all CD patients undergoing first re-ICR between 2000-2021. The primary outcome was the need for re-ICR due to disease recurrence at the neoterminal ileum. Two time periods were created to assess changes in surgical recurrence and short-term outcomes over time, C1: 2000-2009 and C2: 2010-2021.

Results
in total, 110 patients were included, comprising 69 females (62.7%) with a median age at time of re-ICR of 39 years (IQR 30.0 – 50.3). Time from primary ICR to re-ICR increased significantly over time. Most patients presented with stricturing disease at time of first re-ICR (64.5%). Rates of surgical recurrence were 13.0% and 24.9% after 5 and 10 years, respectively. Over time an increased use of prophylactic biological use was observed (C1: 16.4% vs C2: 41.7%, p=0.004). Over time, no significant differences in 5-year, and 10 year surgical recurrence rates were observed between C1 and C2, (12.5% vs 11.5%, p=0.636), and (28.6% vs 18.7%, p=0.341), respectively.

Conclusion
This study demonstrated an overall 10-year surgical recurrence rate of 24.9% in patients undergoing first re-ICR. Over time, postoperative disease management has evolved towards increasing use of biological therapy. However, no significant difference in surgical recurrence rates over time have been observed.

References
1.Beelen EMJ, van der Woude CJ, Pierik MJ, Hoentjen F, de Boer NK, Oldenburg B, et al. Decreasing Trends in Intestinal Resection and Re-Resection in Crohn’s Disease: A Nationwide Cohort Study. Ann Surg. 2021;273(3):557-63.

Figure 1. Kaplan-Meier curve for surgical recurrence according to time period, log-rank: p= 0.450
P0547 Use of MUC score in the activity evaLuation by Pediatric intestinal ultrasound and their corrElation with other clinical and ultrasounD scores (ULPED)
Authors: Parra Izquierdo V , Ernest Suarez K , Argollo M , Frías-Ordoñez J , Orduz G , Cubillos S , Vargas M , Verstockt B 
Published: January 2025

Abstract

Background
Inflammatory bowel diseases (IBD) are diagnosed during childhood and adolescence in up to 20% of patients. Invasive studies are mandatory for diagnosis, but monitoring strategies should ideally be non-invasive to reduce anxiety and stress, especially in children. Hence, intestinal ultrasound (IUS) is increasingly being used as a cheap, noninvasive tool for monitoring disease activity in children with IBD. However, scoring systems have mostly been developed and validated for adults. We aimed to evaluate the performance of the Milan Ultrasound Criteria (MUC) and simple pediatric activity ultrasound score (SPAUSS) in pediatric ulcerative colitis (UC) patients, and correlate them with the PUCAI (Pediatric Ulcerative Colitis Activity Index) score.

Methods
Patients &lt;18 years with an established diagnosis of UCwere prospectively enrolled in Colombia. IUS assessment was performed (including measurement of Bowel Wall Thickness and Colour Doppler Sign), with subsequent collection of Mayo endoscopic score (MES) and PUCAI scores (The information was recorded with data from a colonoscopy performed ± 30 days). Appropriate uni- and bivariate analyses were performed, as well as Pearson correlation.

Results
Sixteen ambulatory pediatric patients with UC (50.0% girls median age 13.3 years [9-17], median disease duration 5.1 years [0.7-13.7]) were enrolled. The PUCAI score has a significant statistical relationship with MES (p=0.001) and the MUC (p=0.001). Likewise, the PUCAI score was associated with the presence of a Doppler signal (p=0.001). The SPAUSS score correlated strongly with the MUC score (r=0.938), (p=0.001). The median MUC score in children with MES 0-1 versus MES≥2 was 3.08 and 6.87 respectively. Based on additional ROC analysis (Figure 1), we propose a MUC cutoff of 4.85 with 100% sensitivity and specificity to differentiate MES 0-1 from MES≥2 (p=0.003) (Figure 2).

Conclusion
The MUC score in pediatric UC patients correlates well with endoscopic disease activity and with the SPAUSS score. We propose a MUC score cutoff of 4.85 for pediatric UC patients. Larger, independent studies are needed to confirm this cutoff, which is different to the MUC 6.2 cutoff in adult UC patients.
P0550 Introducing Intestinal ultrasound in the UK NHS – the first 6-months
Authors: Ali N , Flower A , McCoubrie P , Gupta V , Griffiths L , Murray S , Meade S 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) has been integrated into inflammatory bowel disease (IBD) practice outside of the UK for several years. The NHS has been slow to adopt this and there is ongoing scepticism with regards to its utility.

Methods
We performed a retrospective service evaluation to demonstrate the utility of IUS in the NHS. IUS was requested additionally to tests performed as standard of care to enable internal audit. We assessed the proportion of cases where IUS altered decision making. Secondary outcomes included the additional value of IUS to faecal calprotectin (fcal) and the accuracy of IUS in terms of the presence, activity and extent of disease. Similar to the METRIC study,1 IUS accuracy was determined after accounting for all available investigations performed in each patient and recorded as a binary outcome. Where pathology was missed, changes in management were recorded. Data collected included demographic, disease phenotype, body mass index, pregnancy, indication for IUS and scan adequacy.

Results
We performed 74 IUS on patients with: Crohn’s disease (53) [L1–40; L3–13; B1–11; B2–32; B3–10; p1], ulcerative colitis (17) [E1–2; E2–5; E3–10] and suspected CD (4). Mean age 45.5 years; 45 (61%) female, mean BMI 25.2, pregnant [mean 29/40 weeks] 7 (9.4%). Indications included disease flare (34, 46%), asymptomatic with raised fcal (4, 5%) or disease monitoring (36, 49%). In total, 10 (13%) were deemed inadequate due to (gravid uterus obscuring view [3, 4%), BMI &gt;26 (4, 5%), difficult scan (3, 4%). All 10 patients had mild (6, 8%) or quiescent disease (4, 5%). Table 1 shows the outcomes of the remaining 64 scans. In 52/64 (81%) cases the IUS altered immediate treatment decisions. In 38/64 cases, the IUS added additional value compared to using the subsequently resulted fcal alone. The presence, activity and extent of disease was concordant with standard tests (92%, 92% and 62% of cases, respectively). Missed pathology requiring alternative treatment was identified in 6/63 (9.5%) cases (mild aphthous ulceration seen on VCE [normal MRE] [4], lymphoma [1] and ileorectal anastomotic stricture [1]). The latter two cases required cross-sectional imaging irrespective of the IUS result. Time to definitive treatment decision was reduced by an average of 57 (24-92) days.

Conclusion
Despite limited experience in IUS, our outcomes are similar to results from the METRIC trial. The NHS should expedite the adoption of IUS to avoid invasive/expensive tests, add value to the clinical consultation and streamline IBD care.

References
Taylor SA, Mallett S, Bhatnagar G, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn’s disease (METRIC): a multicentre trial. Lancet Gastroenterol Hepatol 2018;3(8):548-558. (In eng). DOI: 10.1016/s2468-1253(18)30161-4.
P0553 MRI neurophenotype reflecting brain-gut interactions to predict intestinal disease progression in patients with Crohn’s disease
Authors: Zhang R , Shen X , Huang L , Feng S T , Mao R , Li X 
Published: January 2025

Abstract

Background
There is considerable recent interest in the role of brain-gut axis in the pathogenesis and manifestations of Crohn’s disease (CD). We developed a multimodal neuroimaging-based model to characterize the neurophenotype of CD patients and predict intestinal disease progression, using multi-omics data to demonstrate its validity.

Methods
This prospective study enrolled 109 CD patients who underwent baseline tests (including multimodal neuroimaging, psychological scales, MR enterography, ileocolonoscopy) and fecal/blood samples collection within one week. The neurophenotype of patients with different intestinal inflammation levels was characterized using a radiomics model, developed from 13 out of 13,870 neuroimaging features. This neurophenotype in predicting disease progression during follow-up was evaluated using Kaplan-Meier curves and Cox regression analysis. Multi-omics data (including fecal microbiome, fecal/blood metabolomics, intestinal/blood-brain-barrier permeability, and blood neurotransmitter) were used to elucidate how this neurophenotype reflecting brain-gut interactions (see Graphic Abstract in Fig 1).

Results
The model enabled accurate characterization of neurophenotypes in patients with different intestinal inflammation levels in training and test cohorts (AUC=0.824-0.842, both P&lt;0.05). Neurophenotype was the most important predictor of disease progression (HR=29.05, P=0.033), surpassing psychological traits (HR=0.95-1.09, all P&gt;0.05). Multi-omics analysis revealed that elevated intestinal inflammation was correlated with increased intestinal permeability and specific gut microbiota (e.g., Enterococcus) and metabolites (e.g., caproic acid), which collectively contributed to high-risk neurophenotype (all P&lt;0.05). High-risk neurophenotype subsequently associated with intestinal disease progression by establishing correlations with six blood neurotransmitters (e.g., tryptophan) (all P&lt;0.05).

Conclusion
The neurophenotype varies among CD patients with different intestinal inflammation levels and can predict intestinal disease progression. Multi-omics data offer biological evidence to support its validity. Our neurophenotype characterization model effectively illuminates these brain changes and accurately stratifies their neurophenotypic risk, paving the way for the implementation of new strategies to initiate transformative advancements.

References
N/A
P0558 An Integrative Blood-Based Risk Score Predicts Development of Crohn's Disease
Authors: Ungaro R , Rajauria P , Torres J , Porter C , Magee J , Agrawal M , Dervieux T , Gnjatic S , Colombel J F , Petralia F 
Published: January 2025

Abstract

Background
Individual blood markers have been associated with future risk of Crohn's disease (CD). However, there is a need to understand which combination of biomarkers will be most predictive to facilitate CD prevention trial recruitment. We aimed to develop and validate a blood-based integrative risk score for CD development.

Methods
We analyzed data from 200 patients with CD and 100 age, sex, and race-matched healthy controls (HC) from PREDICTS, a nested case-control study of US active-component service members (ACSM). Longitudinal serum samples were collected at four time points up to 6+ years prior to diagnosis. Anti-microbial antibodies (Prometheus), proteomic markers (Olink inflammation panel), and anti-granulocyte macrophage-colony stimulating factor autoantibodies (anti-GM-CSF) were assayed in each sample. Participants were randomly divided into equal sized training and testing sets. Time-varying trajectories of marker abundance were estimated for each biomarker. Logistic regression modeled disease status as a function of each marker for different time points and multivariate modeling was performed via logistic lasso regression. A risk score to predict CD onset within 2 years was developed using penalized mixed-effects logistic regression. Prediction models were fit on the testing set and predictive performance evaluated via receiver operating characteristic (ROC) curves and area under the curve (AUC).

Results
The AUCs of individual markers were dynamic over time, with some having stable predictive capacity and others increasing or decreasing closer to time of diagnosis (Figure 1A). The AUCs for a model combining antibodies (Prometheus and anti-GM-CSF) and proteins were consistently above 0.8 starting 4 years prior to diagnosis, primarily driven by proteomic markers (Figure 1B). An integrative model predicting CD onset within 2 years incorporated 10 biomarkers and significantly associated with CD onset (Figure 1C). The model resulted in an AUC of 0.87 with a specificity of 99% and positive predictive value of 84% at a classification threshold of 0.7 (Figure 1D). Stratifying the integrative model scores into quartiles revealed a clear gradient in CD incidence within 2 years, increasing from 2% in the first quartile to 57.7% in the fourth quartile (Figure 1E). The relative risk (RR) for developing CD among ACSM in the top quartile, compared to the lower quartiles, was 10.4 (95% CI 6.9, 15.6).

Conclusion
An integrative blood-based model combining anti-microbial antibodies and proteins predicts onset of CD. Serologic and proteomic markers have dynamic changes years before diagnosis, highlighting the varying preclinical phases of CD and how leveraging biomarker dynamics can predict time to diagnosis.

Figure 1
P0559 Endoscopic healing at 1-year and association with long-term quality of life in ulcerative colitis: A pooled clinical trial analysis adjusting for 1-year clinical remission status
Authors: Sanon M , Neff-Baro S , Gauthier A , Kachroo S , Wirth D , Eisele L , Naessens D 
Published: January 2025

Abstract

Background
Therapeutic goals and clinical guidelines in inflammatory bowel disease have evolved to include endoscopic outcomes being a key prognostic parameter in disease management. STRIDE-II guidelines are comprised of clinical and patient-reported outcome remission, along with biomarker normalization and endoscopic healing. While available publications have correlated achievement of endoscopic outcomes with long-term outcomes, few if any have adjusted for clinical remission status. The objective of this analysis was to assess the impact of endoscopic healing at the end of 1-year and 2-year quality of life while adjusting for clinical remission status at 1-year using clinical trial data.

Methods
Data from four randomized ulcerative colitis clinical trials (UNIFI:NCT02407236, PURSUIT:NCT01863771, ACT-1:NCT00036439, ACT-2:NCT00096655) were pooled to assess the impact of endoscopic healing at 1 year on patients’ quality of life as assessed by the Inflammatory Bowel Disease Questionnaire (IBDQ). This post-hoc analysis assessed endoscopic healing at the end of maintenance (EOM) (~42 weeks) and IBDQ remission in the long-term (LTE) duration (~126 weeks). Endoscopic healing was based on endoscopy sub-score of the Mayo score = 0 or 1 and IBDQ remission was defined as IBDQ total score&gt;=170. Patients without LTE IBDQ data and placebo treated patients were excluded. Multivariate analyses with trial as a random effect were conducted and adjusted for treatment arm during maintenance, clinical remission status at end of maintenance (EOM), and endoscopic healing at EOM.

Results
A total of 591 patients had available endoscopy and clinical remission status at EOM. The percentage of patients with endoscopic healing reaching LTE IBDQ remission was 80.7% whereas 56.2% of those without endoscopic healing reached IBDQ remission. Results of the multivariate analyses showed that endoscopic healing at EOM was significantly associated with higher odds of LTE IBDQ remission with an OR of 1.78 and a corresponding p value below 0.05.

Conclusion
This analysis used clinical data from robust trials and adjusted for patients’ clinical remission status at the end of maintenance to isolate the benefit of endoscopic healing in predicting long-term outcomes in UC. Endoscopic healing is significantly associated with a higher likelihood of experiencing a better quality of life.