bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0504 The Impact of Disease Activity and Medications on Pregnancy and Fetal Outcomes in Women With Inflammatory Bowel Disease: A Cohort Study From the IBD-ME Group
Authors: Azzam King Saud University N , Almadi M , Alfarhan H , Altuwaijiri M , Aljebreen A , Alharbi O , Abaalkhail M , Jaran M , Altamimi A , Al Theneyan A , Al Turki N , Alharbi L , AL Ghamdi J , Al Dakhil A , Mosli M ,   IBD-ME Group
Published: January 2025

Abstract

Background
Women with Inflammatory bowel disease (IBD) and their children may face a higher risk of adverse outcomes during and after pregnancy. The primary aim was to examine the association between IBD and adverse pregnancy outcomes: preterm birth, small for gestational age, birth weight, congenital anomalies, and stillbirth. The secondary aim was to assess the impact of maternal IBD and medications used on children’s outcomes: adverse reactions to vaccinations and development of IBD in the offspring up until seven years of age.

Methods
We performed a multicenter retrospective study in Saudi Arabia and Kuwait. Three participating hospitals enrolled women with IBD who gave birth between 2016 and 2023. Information regarding disease characteristics, medication use, pregnancy outcomes, and long-term health outcomes of children until age fourteen was collected.

Results
This study analyzed data from 167 patients with a median age of 37.0 years (IQR: 33.0 to 44.0). Crohn’s disease was the most common type of IBD (51.2%), followed by ulcerative colitis (46.3%). Of note, 42.7% of the women were on mesalamine, while 25.1% of the study population were on both anti-TNF agents and Azathioprine. The most frequent pregnancy outcome was low birth weight (22.5%), and 8.2% of the offsprings were diagnosed with IBD. A history of having six or more pregnancies significantly predicted IBD in an offspring (OR = 4.02, 95% CI, 1.19 to 14.8, p &lt; 0.01). In contrast, disease control before pregnancy significantly reduced the risk of adverse infant outcomes (OR = 0.10, 95% CI, 0.01 to 0.61, p &lt; 0.01). None of the IBD medications predicted poor pregnancy outcomes.

Conclusion
Infants of women with active IBD have an increased risk of prematurity and being small for gestational age. Number of pregnancies was a significant predictor for IBD in an offspring. Controlling disease activity at conception is essential to improve both pregnancy and fetal outcomes.
P0511 Establishing a gastroenterologist-led intestinal ultrasound service in the United Kingdom: outcomes, correlation and patient satisfaction
Authors: Hazel K , De Silva S 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) has been used a tool for assessing IBD in Europe over the preceding decades. Its use globally is increasing. Russells Hall Hospital has one of the first gastroenterologist-led services in the UK. IUS is a non-invasive tool for assessing IBD and potentially reduces the requirement for endoscopy and imaging. It reduces the requirement for multiple patient visits; giving a point-of-care assessment of IBD activity, gastroenterologist review and a management plan in one session. A study by a tertiary UK centre showed projected annual savings of almost £500,000 with the implementation of radiologist-led IUS in their centre.

Methods
To validate our accuracy of diagnosis at IUS, the first 50 patients assessed were offered IUS in addition to endoscopy and/or MRE. This data was collated and our accuracy assessed. We also provided patients with questionnaires, outlining their experience and satisfaction with IUS.

Results
45 patients underwent assessment with IUS and either endoscopy or MRE. 28 (62.2%) were male, with an average age of 44 years. 17 patients had UC (37.8%) and 28 CD (62.2%). The median time to assessment with a second modality was 10 days (0-367 days). 86.7% of patients had IUS first. 18 patients had flexible sigmoidoscopy, 17 colonoscopy and 9 MRE. We showed a correlation of 86.7% between IUS and second modality. Notably, accuracy improved with time as the first 4 of 6 patients without correlation were within the first three months of IUS implementation. Notably, four patients with normal IUS had very mild disease activity at endoscopy with isolated ileal/neo-TI disease (Rutgeert’s i2a) or small aphthae in the left colon. Of patients with an abnormal IUS and normal subsequent assessment, one had a full course of prednisolone between IUS and MRE. From a patient satisfaction perspective, 40 patients completed surveys, with an equal gender split. 85.7% of patients had a CD diagnosis. 64.3% of patients were not aware of IUS prior to their visit. 92.9% found IUS “very easy”. 85.7%, 78.6%, 92.9% and 100% found it “very easy” compared to blood tests, stool tests, MRE and endoscopy, respectively. All patients would have a repeat IUS and 85.7% were extremely satisfied with having an IUS to assess their IBD.

Conclusion
Gastroenterologist-led IUS is a non-invasive and accurate modality for assessing IBD in the UK population. With increasing experience, we improved our accuracy, in keeping with published data and can offer patients IUS as a single modality for monitoring their IBD, potentially offering cost savings for our trust. Overall, patients were extremely satisfied with the service and found it much easier than routine methods of monitoring IBD.
P0512 Predict the risk of acute severe ulcerative colitis based on machine learning algorithm: A multicenter cohort study
Authors: Qiu Y , Rao M , Peng S , Zhang C , Gao X , Cao Q , Ng S C , Chen M 
Published: January 2025

Abstract

Background
Severe ulcerative colitis (UC) is associated with with increasing risk of admission and colectomy. Till now, there are limited number of studies on the predictive models for severe UC especially in Asian population. In this study, we aimed to develop and validate a predictive model for severe UC Chinese patients using machine learning algorithm.

Methods
Patients diagnosed with mild-to-moderate UC were included retrospectively at four tertiary hospitals in China from 2013 to 2016. The primary outcome was severe UC requring admissions within 3 years after diagnosis. The machine learning algorithm were applied to develop and validate a predictive model for severe UC. The model performance was then compared to the well-established one for europeans patients - the Oxford’s model.

Results
Altogether 437 patients with mild-to-moderate UC were included. A total of 67(15.3%) of patients with mild to moderate UC developed severe UC requring hospitalization or surgery within 3 years. The predictive model selected 11 features, including age, gender, disease extent, CRP, ESR, hemoglobin, WBC, platelet, ALB and history of intravenous corticosteroids, immunosuppressor and/or biological agent. The area under receiver operating characteristic curve (AUC) of multilayer perception (MLP) in the internal validation dataset was 0.883. The AUC of MLP model in external validation dataset was 0.897, which was better than both the Oxford’s model (AUC=0.661, P＜0.012) and the model based on Cox’s regression analysis (AUC=0.764, P＜0.001).

Conclusion
The MLP predictive model had excellent discrimination for severe UC patients, which outperformed both the Oxford’s model and the model based on logistic regression analysis.
P0514 Assessing the relationship between physician perspective and subjective disabilities in IBD patients: a comparative study using IBD-Disk and IBD-Q
Authors: Galletti G , Pasta A , Calabrese F , Saturni A , Furnari M , Marabotto E , Giannini E G , Bodini G 
Published: January 2025

Abstract

Background
Inflammatory Bowel Diseases (IBD) are chronic conditions that often affect young patients throughout their lives. Treating patients with IBD, it is essential not only to achieve deep remission (clinical, biochemical, and mucosal) but also to completely restore the patient’s quality of life. Addressing and reducing the cumulative burden of disease, enabling a return to a “normal life,” and preventing disability have become major therapeutic goals in the management of patients with IBD management. Recently, a brief and patient-friendly questionnaire, the IBD-Disk, has been proposed as a tool for monitoring disability in IBD outpatients.
This study aims to assess the relationship between gastrointestinal symptoms, biochemical parameters, and subjective disabilities in patients affected by IBD.

Methods
In this prospective study, we enrolled consecutive patients with IBD who completed the IBD-Disk during an in-person visit. We also recorded demographic data, clinical features, disease activity, biochemical data, and ongoing treatments. Clinical activity was evaluated using the partial Mayo score (p-Mayo) for Ulcerative Colitis (UC) and the Harvey-Bradshaw index (HBI) for Crohn’s disease (CD). The IBD-Q was also administered at the time of evaluation and a cut-off of 170 was considered to define symptomatic remission.

Results
We included 95 patients with IBD (49 males, 51.6%), median age of 52.9 years (IQR 37-61), with 45 (47.4%) having CD and 50 (52.6%) having UC. 76 patients (80 %) of patients were on conventional therapy, and 12.6% were receiving concomitant steroids. At the time of evaluation, 29 (30.5%) patients had clinically active disease, and 31 (32.6%) had biochemically active disease. An inverse linear correlation was found between the IBD-Disk and IBD-Q (r² = 0.66, p&lt;0.001). Patients with clinically active disease had significantly higher IBD-Disk scores (40, IQR 24-60 vs. 26, IQR 10-51, p=0.016) and lower IBD-Q (148, IQR 140-176 vs. 180, IQR 159-200) compared to those in clinical remission. The AUROC for clinical remission for IBD-Disk and IBD-Q were 0.650 (95% CI 0.54-0.76) and 0.755 (95% CI 0.65-0.85), respectively. Among patients in remission, 39.3% had an IBD-Q score below 170, while the median IBD-Disk value was 26 (IQR 10-51). The majority of patients preferred completing the IBD-Disk (71, 74.7%).

Conclusion
Both the IBD-Disk and IBD-Q are associated with objective disease activity, with the IBD-Q demonstrating slightly superior performance. However, most patients preferred the IBD-Disk. Despite achieving satisfying clinical endpoint, doctors often fail to perceive patient’s quality of life.
P0515 The Role of Immunohistochemistry Staining in Diagnosing Cytomegalovirus Disease in the Gastrointestinal Tract
Authors: Chiu C H , Yeh P J , Wu R C , Le P H 
Published: January 2025

Abstract

Background
Accurate diagnosis of invasive cytomegalovirus (CMV) diseases in the gastrointestinal (GI) tract is essential, yet studies evaluating the diagnostic accuracy of Hematoxylin and eosin (H&E) staining and the necessity of immunohistochemistry (IHC) staining in different GI tract locations are limited.

Methods
We analyzed GI tract specimens with both H&E and IHC staining from a pathology database. Patients were divided into two groups: those with suspected CMV infection (HEs) and those without evidence of CMV infection (HEn). Using IHC staining as the gold standard, we calculated the sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of H&E staining.

Results
Among 1,448 specimens, the SE/SP (%) of H&E staining for the entire GI tract, esophagus, stomach, small intestine, and colon were as follows: 76.1%/82.1%, 76.1%/70%, 85.5%/71.7%, 60%/94.2%, and 75%/87%, respectively. The corresponding PPV/NPV (%) were 58%/91.3%, 39.3%/92%, 51.2%/93.5%, 69.2%/91.5%, and 68%/90.4%.

Conclusion
For patients with high clinical suspicion of CMV infection, IHC staining is essential for accurate diagnosis across various GI tract sites.
P0516 Chronic Rhinosinusitis and Inflammatory Bowel Disease: discovering the gut-lung axis- preliminary results from a single-center pilot study
Authors: Maresca R , Del Gaudio A , Iaccarino J , Murgiano M , Sessa G , Frasca P , Mignini I , Baglivo I , Pugliese D , Rigante M , Zavarella M A , Colantuono S , Laterza L , Papa A , Gasbarrini A , Caruso C , Scaldaferri F 
Published: January 2025

Abstract

Background
Inflammatory Bowel Diseases (IBD) are multifactorial and debilitating diseases that significantly impact patients’ quality of life. As it is known, they involve an altered immune system. For this reason, patients with IBD have an increased risk of developing other chronic immune disorders, including chronic rhinosinusitis (CRS). The coexistence of these two conditions can undoubtedly affect patients’ life and disease history. This study aims to define the prevalence of CRS in IBD patients and assess how it affects their quality of life.

Methods
We conducted a prospective, observational, monocentric pilot study. in which we enrolled consecutive IBD under biological therapy. We collected clinical, demographic, and disease history data. Four questionnaires were administered to the patients: the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), EuroQol 5 Dimension 5 Level (EQ-5D-5L), the Short-Form- 36 (SF-36), and the SNOT-22 questionnaire to identify subjective symptoms of CRS. According to the SNOT-22 score, patients were divided into two groups: patients without/mild CRS (group 1, SNOT-22 &lt;30 points) and patients with moderate/severe CRS (group 2, SNOT-22&gt;30 points).

Results
We enrolled 50 IBD patients, of which 48% were affected by ulcerative colitis (UC) and 52% were affected by Crohn’s Disease (CD). Among them, 42% (n=21) of patients were naive to biological therapy, while 48% had failed at least two lines of biological therapy. We observed no statistically significant differences in the mean values of the score of SNOT-22 between naive and multi-failure patients (30.1 and 28.5, respectively, p=0.76). Dividing patients based on the SNOT-22 score, 42% were part of group 1 (absent or mild CRS), and 58% were part of group 2 (moderate/severe CRS).CD patients of group 2 had a significantly higher disease activity, defined according to the Harvey-Bradshaw Index (HBI), compared to group 1 (mean value of 2.3 vs 0.48, p=0.008).We did not observe statistically significant differences in Full Mayo Score between group 1 and group 2 UC patients. The median VAS EQ-5D-5L was compared between Groups 1 and 2 showing a lower score in patients with moderate/severe CRS (66.6 vs. 81.3, p = 0.0019).

Conclusion
CRS is frequent in IBD patients. Those with both conditions have reduced quality of life, more severe symptoms, and worse disease characteristics than those without CRS. Level of some cytokines can induce alterations of gastrointestinal motility in gastrointestinal disorders, due to increased intestinal barrier damage. However, our findings are preliminary, and further studies, clinical evaluations, and specialized laboratory investigations are needed to better understand the gut-lung axis.
P0521 Accuracy of a non-invasive approach in monitoring pediatric inflammatory bowel disease: interim-analysis of a prospective multicenter italian study
Authors: D’Arcangelo G , Gravina A , Colucci A , Raso T , Casertano M , Cenni S , Strisciuglio C , Maccioni F , Oliva S 
Published: January 2025

Abstract

Background
Ileocolonoscopy is the gold standard for diagnosing and monitoring pediatric IBD. However, it has limitations, including high costs, invasiveness, and the inability to visualize the small bowel (SB) and assess transmural involvement. Magnetic resonance enterography (MRE), while not the gold standard, is recognized as a key tool for evaluating the SB. Its limitations include high costs, the requirement for oral contrast—which reduces patient tolerance—and longer procedure times. To provide less invasive monitoring, especially in children, non-invasive methods such as capsule endoscopy (CE) and ultrasound (US) have been developed. We aimed to evaluate the accuracy of these non-invasive techniques (US and CE) in monitoring pediatric IBD.

Methods
This study represents an interim analysis of the prospective multicenter protocol GR-2019-12370621. Consecutive children with IBD were enrolled. At baseline, 6 and 12 months, UC children underwent ileocolonoscopy (IC), CE and US, while CD children underwent IC and EGD, MRE, CE and US. For the terminal ileum in CD and the colon in UC and CD, IC was the gold- standard. For the SB (jejunum, proximal and mid-ileum) MRE was the comparator to assess the presence of active disease. EGD served as the gold standard for duodenum. Sensitivity (Se), specificity (Sp), negative and positive predictive value (NPV and PPV) and accuracy of CE and US were determined for CD and UC in an ITT analysis.

Results
Thirty-one patients (16 CD and 15 UC) were enrolled as of the retrieval date (04/10/2024). For UC, 31 IC, 31 CE and 30 US procedures were performed. In CD, a total of 40 endoscopies, 30 CEs, 12 US procedures, and 36 MREs were available. In UC, CE showed a Se of 85%, Sp 100%, NPV of 87%, PPV of 100%, and an accuracy of 92.8%. The Se, SP, NPV, PPV and accuracy of US were 63%, 100%, 70%, 100% and 80%, respectively. The combination of CE and US increased accuracy up to 93.1% (Table 1).For CD: the combined accuracy of CE and US was 100% for the terminal ileum, 80% for the jejunum, 69% for the proximal ileum, and 75% for the mid ileum. The accuracy of CE for the colon in CD was 82.1% (Table 2).

Conclusion
Non-invasive monitoring achieves an accuracy of 93% compared to endoscopy in UC. For CD, it demonstrates excellent accuracy for the terminal ileum (100%) and fair accuracy for the colon (82.1%) compared to the invasive counterpart. However, reduced accuracy in the small intestine, ranging from 69% to 80%, may be influenced by the lack of a definitive gold standard for this segment. The low PPV of the CE, particularly for jejunum and proximal ileum, could be explained by the detection of mucosal lesion not visible by the comparator (MRE).
P0526 Association of plasma IgA with bowel wall thickness and disease activity in IBD patients assessed by intestinal ultrasound
Authors: Chen Y L , Tsai T 
Published: January 2025

Abstract

Background
IgA, the primary immunoglobulin secreted by gut B cells, plays a key role in defending against pathogen invasion. Elevated plasma IgA levels have been observed in inflammatory bowel disease (IBD) patients, particularly those undergoing biologic therapy. However, direct evidence linking plasma IgA levels to bowel wall inflammation is lacking. This study investigates the relationship between plasma IgA levels and intestinal inflammation, using parameters from intestinal ultrasound (IUS).

Methods
We enrolled 30 IBD patients (20 with ulcerative colitis (UC) and 10 with Crohn’s disease (CD)) for IUS evaluation starting in July 2023. Ultrasound scores were based on the Milan ultrasound criteria (MUC) for UC and the bowel ultrasound score (BUSS) for CD. Plasma levels of ESR, CRP, albumin, IgA, partial Mayo score, and CDAI were collected at baseline, during treatment, and after 52 weeks of advanced therapy (Adalimumab, Vedolizumab, or Tofacitinib). IUS findings and plasma IgA levels were analyzed for correlations with clinical parameters using the Student’s t-test and linear regression.

Results
IUS findings were closely correlated with disease activity. In UC, the MUC score was positively correlated with CRP (P &lt; 0.0001, R² = 0.4888), partial Mayo score (P = 0.0002, R² = 0.3652), and negatively with albumin levels (P = 0.0002, R² = 0.3747). In CD, the BUSS score showed a positive correlation with CDAI (P = 0.0394, R² = 0.2694). Plasma IgA levels were significantly associated with bowel wall thickness (BWT) in both UC and CD (P = 0.0041, R² = 0.1759) (Figure 1). Notably, when BWT exceeded 3.5 mm, plasma IgA levels increased significantly (P = 0.0021) (Figure 2). Interestingly, in CD, plasma IgA was strongly correlated with the BUSS score (P = 0.0001, R² = 0.6585), while no such relationship was observed between MUC score and plasma IgA in UC.

Conclusion
Plasma IgA levels are positively correlated with bowel wall thickness in both UC and CD patients, particularly when BWT exceeds 3.5 mm. In CD patients, IgA levels also show a strong correlation with the BUSS score, highlighting IgA as a potential biomarker for bowel wall inflammation. These findings suggest that plasma IgA could serve as a biomarker of disease activity, particularly in CD, and could aid in monitoring therapeutic response and disease progression in IBD. Further research is warranted to validate these results and explore the potential for IgA-targeted therapies.

References
1.B Lee, J Hsu, T Tsai, A241 Correlation between plasma IgA level and biological therapy in inflammatory bowel disease, Journal of the Canadian Association of Gastroenterology, 2024;doi.org/10.1093/jcag/gwad061.241

Figure 1

Figure 2
P0527 Bowel Ultrasound Scan (BUS) in Pediatric Acute Severe Colitis (ASC): a multicenter prospective study on behalf of the IBD Porto group
Authors: Scarallo L , Alvisi P , Aloi M , Bramuzzo M , Broekaert I , De Laffolie J , Kierkus J , Matar M , Pranzetti A , Renzo S , Velasco Rodríguez-Belvís M , Strisciuglio C , Tasciotti L , Lionetti P ,   IBD Porto Group
Published: January 2025

Abstract

Background
Acute severe colitis (ASC) is a potentially life-threatening event. Optimal timing for second-line treatment in children is mainly based on the clinical score Pediatric Ulcerative Colitis Activity Index (PUCAI) score. The aim of our study was to evaluate the potential role of bowel ultrasound scan (BUS) in predicting short-term treatment outcomes in pediatric ASC.

Methods
This was a prospective longitudinal study, conducted across ten European centers between March 2020 and March 2024. Biologic-naïve children with Ulcerative Colitis hospitalized for ASC, either at diagnosis or at disease relapse, were included. Each patient underwent two BUS, the first one within the first 48 hours of from IVCS intravenous corticosteroids administration and the second one within 5-7 days from treatment initiation. Key metrics assessed included colonic wall thickness (CWT), colonic wall stratification (CWS) and colonic wall blood flow via power Doppler. All the above-mentioned ultrasound parameters were recorded in 4 different segments of the bowel: ascending, transverse, descending, and sigmoid colon. Furthermore, Milan ultrasound criteria (MUC) score was also calculated for each colonic quadrant. Clinical, laboratory, and treatment data were gathered during hospitalization and at 2-, 4-, and 8-weeks follow-up.

Results
59 patients (61% males, median age at ASC: 14.2 years) were included. Almost 60% of patients had pancolitis, 22 (37.3%) experienced ASC at disease onset. Table 1. summarizes patients’ characteristics at ASC. 38 (64.4%) patients failed to respond intravenous corticosteroids (IVCS) and required second-line therapy with infliximab (IFX). Patients who required step-up treatment with IFX had higher colonic wall thickness (CWT) and more frequently an increased vascularization (Limberg score &gt; 2) (p=0.041 and p=0.005, respectively). Furthermore, patients who failed to respond to IVCS and required escalation to IFX had a higher MUC score at firs BUS (p=0.042). Ten patients (16.9%) failed to respond to medical treatment and required short-term colectomy (within 8 weeks of follow-up). Patients who required colectomy had a higher CWT both at first and at second BUS (p=0.033 and p=0.004, respectively). Moreover, patients who responded to medical therapy had higher DeltaCWT (difference between worse CWT at first and at second BUS) compared to those who required surgery (p=0.0018).

Conclusion
BUS may serve as an effective noninvasive tool to predict first-line therapy failure and the need for colectomy in patients with ASC. Its implementation in clinical practice may enable physician to support clinical evaluation and tailor treatment escalation upon patient’s individual characteristics.