bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0439 Ultrasound transmural healing reduces the risk of relapse in Crohn’s disease patients with endoscopic mucosal healing: results of a prospective study
Authors: Yzet C , Brazier F , Derval E , Pricope D , Vaneslander P , Dejour V , Diouf M , Ollier A , Fumery M 
Published: January 2025

Abstract

Background
The STRIDE II guidelines recognize endoscopic healing as one of the main therapeutic targets in Crohn’s disease (CD). Nevertheless, transmural healing could reduce the risk of long-term complications. The aim of this study was to assess the risk of long-term complications in CD according to the degree of endoscopic and ultrasound healing.

Methods
We conducted a prospective study that included all patients with CD in clinical remission who underwent colonoscopy with endoscopic healing (CDEIS &lt;4) and intestinal ultrasound (IUS) within 4 weeks between September 2019 and September 2022. IUS transmural healing was defined by a parietal thickness &lt; 3 mm on all digestive segments (colonic and ileal) without colour doppler signal.
The primary endpoint was CD relapse, defined as the need for drug intensification, initiation of corticosteroid therapy, CD-related hospitalization, development of a perianal and luminal fistula or abscess, or the need CD-related bowel surgery. Patients were followed up at least every 6 months for two years.

Results
A total of 93 patients were included, the majority of whom were women (53%) with ileocolic location (43%). The median disease duration was 12 years (IQR, 4-19) and 71% patients were treated with anti-TNF. Ultrasound transmural healing was observed in 73% (68/93) of patients. After a median follow-up of 22.5 months [IQR, 19.3-23.7], relapse was significantly higher among patients without IUS transmural healing (48% vs. 18% p = 0.007). Relapse rate at 6 and 12 months were significantly higher among patients without IUS transmural healing (22% vs. 9% and 22% vs. 13%; p = 0.019). In multivariate analysis, the risk of relapse was 5 times higher without IUS transmural healing (HR 5.5 (2.1-14.2) p &lt; 0.001).

Conclusion
IUS transmural healing was associated with a lower risk of relapse among patients with endoscopic healing and could be considered as a non-invasive therapeutic target in CD.
P0542 Systematic Liver Biopsies in IBD Surgery: A Unique Insight into Silent Hepatic Abnormalities
Authors: Elommal H , Koulali H , Elmqaddem O , Zazour A , ismaili Z , Kharrasse G 
Published: January 2025

Abstract

Background
Systematic liver biopsies during IBD-related surgeries are rare but provide a unique opportunity to uncover silent hepatic abnormalities. This study evaluates the utility of systematic biopsies, Fibroscan, and biochemical markers in detecting liver abnormalities in IBD patients.

Methods
A retrospective cohort of 31 IBD patients who underwent systematic liver biopsies was analyzed. Factors evaluated included age (&gt;40 years classified as elderly), sex, disease type and activity, treatment status, inflammatory markers (CRP, hemoglobin, platelets), liver function tests (ALT, AST, Gamma-GT, bilirubin, alkaline phosphatase, albumin, TP), and nutritional status (BMI). Statistical analyses included Mann-Whitney U for group comparisons and logistic regression for predictive modeling.

Results: Biopsy Findings
35.5% of biopsies were abnormal, with two cases of cholangitis sclérosante primitive (CSP) diagnosed exclusively by biopsy.
CSP was silent, with no prior biochemical or clinical signs, and biochemical anomalies emerged months post-diagnosis.
Predictive Factors:
Age &gt; 40 years: p = 0.091 (trend toward significance).
Platelet count: p = 0.060 (trend toward significance).
Anti-TNF therapy: p = 0.061.
Fibroscan (kPa) and other liver markers (ALT, AST, bilirubin): non-significant.

Conclusion
Systematic liver biopsies revealed critical hepatic abnormalities that would have been missed by biochemical tests or Fibroscan. Biopsies should be considered in high-risk IBD surgeries, especially for elderly patients or those on anti-TNF therapy. Future research should explore broader implementation of this practice.
P0543 Impact of disease clearance on the disease course in Ulcerative Colitis patients in clinical remission over a ten-year follow-up
Authors: Telli P , Ataş O , Çelik A O , İstemihan Z , Nuriyev K , Rustamzada A , Genç Uluçeçen S , Dağcı G , Yağlı M A , Gurbanov A , Ağargün B F , Çavuş B , Çifcibaşı Örmeci A , Akyüz F , Demir K , Beşışık S F , Kaymakoğlu S 
Published: January 2025

Abstract

Background
Despite being in clinical remission, ulcerative colitis (UC) patients continue to have a risk of disease flare-ups. Although endoscopic and histological evaluations are considered the gold standard for follow-up, the value of histological inflammation in predicting disease flare-ups in clinically remitted patients is not clearly known. This study aimed to investigate the relationship between histological inflammation and disease flare-ups in UC patients in clinical remission.

Methods
Adult patients with UC, no history of colectomy, followed up in our outpatient clinic, and in clinical remission were included in the study (total Mayo score &lt; 2). Biopsy reports from colonoscopies performed during clinical remission were examined for histological activity. The follow-up period was defined as 10 years, based on the last clinical remission recorded in the outpatient clinic records. The Nancy histological index (NHI) was used as the histological activity score. Patients with NHI &lt; 2 were considered to be in histological remission. The temporal relationship between histological inflammation and the first clinical flare-up was evaluated using Spearman correlation analysis.

Results
A total of 53 patients, including 26 women and 27 men, with a diagnosis of UC in clinical remission were included in the study. The mean age of the patients was 51.5 years. While 28 patients were in endoscopic remission, 25 were followed up as endoscopically active. Among the 28 patients in endoscopic remission, 15 were in histological remission, and 13 were histologically active. Flare-ups were observed after a median of 18.0 months in patients with endoscopic remission and 10.0 months in those with endoscopic activity (p=0.07). Flare-ups were observed after a median of 96.0 months in patients with histological remission and 10.5 months in those with histological activity (p&lt;0.05). A negative correlation was found between histological inflammation and disease flare-up (r=-0.381, p&lt;0.05).

Conclusion
The risk of disease flare-ups is higher in patients who do not achieve disease clearance (i.e., those who are histologically active even in endoscopic remission).

References
1.Marchal-Bressenot A, Scherl A, Salleron J, Peyrin-Biroulet L. A practical guide to assess the Nancy histological index for UC. Gut. 2016;65(11):1919-1920.
2.Wang H, Fewings I, Bornman L, Shadbolt B, Fadia M, Subramaniam K. Histologic remission (NANCY Index) is superior to endoscopic mucosal healing in predicting relapse free survival in patients with ulcerative colitis in clinical and endoscopic remission. Journal of Clinical Gastroenterology. 2023;57(5):494-500.
P0551 Diagnostic Accuracy of Low-Cost Blood Test Inflammatory Markers in Severe Ulcerative Colitis
Authors: Sadek A , Salim A , Afifi A , Ibrahim N , Salem S 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) is a long-standing inflammatory disease with remission and exacerbation courses. Early detection of relapses, flares, disease activity changes, and treatment responses is key to optimising patient management. The evidence about the usefulness of low-cost blood test inflammatory markers concerning UC disease activity is still limited. This study aimed to evaluate the diagnostic accuracy of low-cost serum inflammatory markers in monitoring UC activity.

Methods
This cross-sectional study was conducted in the inflammatory bowel disease (IBD) clinic, Zagazig University Hospital, Egypt. Faecal calprotectin and low-cost serum inflammatory markers including C-reactive protein (CRP), C-reactive protein-albumin ratio (CAR), lymphocyte-monocyte ratio (LMR), mean platelets volume-lymphocyte ratio (MLR), mean platelets volume-platelets ratio (MPR), neutrophil-lymphocyte ratio (NLR), platelets-lymphocyte ratio (PLR), red cell distribution width-platelet ratio (RPR), and systemic immune-inflammation index (SII) were measured.

Results
The area under the curve (AUC) of CRP, CAR, Faecal calprotectin, LMR, SII, and MPR in the diagnosis of severe UC were 0.85, 0.85, 0.84, 0.81, 0.83, and 0.80 respectively (Figure I). CRP, CAR, Faecal calprotectin, NLR, LMR, SII, Albumin, MPR, and RPR were independent predictors for Mayo score grade 3 (Table I).

Conclusion
low-cost serum inflammatory markers such as CRP, CAR, LMR, SII, and MPR showed diagnostic accuracy in monitoring severe UC activity.
P0554 Machine Learning-Based Interpretation of Unstructured Radiology Reports for Objective Scoring of Inflammation and Stenosis in IBD: A Nationwide Study From the epi-IIRN
Authors: Badash Z , Gavrielov N , Hagopian T , Cytter Kuint R , Dotan I , Loewenberg Weisband Y , Ben-Tov A , Zacay G , Matz E , Focht G , Turner D , Freiman M ,   epi-IIRN study group
Published: January 2025

Abstract

Background
Systematic interpretation and quantification of inflammation and stenosis in inflammatory Bowel Disease (IBD) from radiology reports of CT and MR enterography exams are challenging due to their unstructured nature, often leading to variability and reduced reproducibility. This study leverages data from the epi-IIRN nationwide cohort to develop and evaluate machine-learning-based scores for inflammation and stenosis derived from these unstructured radiology reports.

Methods
We identified radiology reports for IBD-diagnosed patients within the nationwide epi-IIRN cohort, which encompasses data from Israel’s four HMOs, covering 98% of the population. Using our in-house HSMP-BERT natural language processing (NLP) platform, we extracted radiological indicators related to inflammation, stenosis, and location, including wall thickening, enhancement, lumen narrowing, and dilation across specified regions: jejunum, ileum, caecum, colon, sigmoid, and rectum.
We developed and evaluated a machine-learning model to predict both categorical (no, mild, and moderate or severe) and VAS (0-100) scores of global inflammation and stenosis, using physician-based scoring as the reference standard. A 5-fold cross-validation experimental setup was applied to assess model performance. Evaluation metrics included accuracy, F1 score, Cohen’s kappa, AUC, PPV, and NPV for categorical scores, and RMSE, r2 and MAE for VAS-like scores.

Results
The dataset included 9658 reports from 7389 patients with a mean age of 36.4±17.6 years, of whom 49% were male. In the annotated subset (500 reports), inflammation severity was distributed as approximately 37% no, 34% mild, and 29% moderate or severe, while stenosis severity was distributed as 72% no, 15% mild, and 13% moderate or severe.
Table 1 summarizes key metrics for inflammation and stenosis, including accuracy, PPV, NPV, F1, and Cohen’s kappa for categorical scores, and RMSE, r2, and MAPE for VAS-like scores, averaged over 5 folds with mean [95% CI].
Main results showed strong performance for both inflammation and stenosis predictions: for inflammation, mean accuracy/F1/kappa/AUC/NPV/PPV/r2/RMSE/MAE were 0.786/0.782/0.676/0.914/0.897/0.775/0.629/13.57/8.571, and for stenosis these values reached 0.912/0.906/0.793/0.955/0.959/0.837/0.760/8.431/3.270.
Figure 1 illustrates the joint distribution of predicted versus ground truth VAS-like scores, with both axes spanning the full range of 0 to 100 as defined by physician-based scoring.

Conclusion
This study demonstrates the feasibility of machine-learning models for mass scoring of inflammation and stenosis from unstructured radiology reports of IBD patients, enabling reliable mass tagging of CTE and MRE as well as determining disease phenotype in large populations.
P0635 Degree of interest in using a cognitive-behavioral therapy application for fatigue management and related factors among outpatients with inflammatory bowel disease
Authors: Tanaka M , Kawakami A , Wakai S , Takai M , Sakagami K , Ito H 
Published: January 2025

Abstract

Background
Fatigue is a common symptom in patients with inflammatory bowel disease (IBD) and is associated with a diminished quality of life. Previous research has demonstrated the effectiveness of fatigue management programmes that use cognitive behavioural therapy (CBT) or other psychotherapies. CBT is often face-to-face and individually time consuming, and there are personnel challenges in its implementation in real-world clinical settings. This study aimed to understand the needs of Japanese patients with IBD regarding fatigue management and explore the characteristics of those willing to use CBT applications (apps).

Methods
This study involved secondary analysis of data from 488 patients treated at a specialised IBD clinic in Japan. Patient characteristics, such as sex, age, disease duration, interest in CBT programmes, and interest in CBT apps for fatigue management (each assessed on a 7-point ordinal scale from 0 for not interested to 6 for very interested), and the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) scale score were included in the survey. Data on blood parameters and disease activity, as determined by Crohn’s activity index and the partial Mayo score, were obtained from medical records.

Results
Among the participants, 85% were in clinical remission, 58% had Crohn’s disease (CD), and 66% were male. Forty-five percent of the patients were affected by moderate or high levels of fatigue (FACIT-F score &gt; 40). The mean score for interest in the CBT programme was 3.3 ± 1.9, with 69% expressing moderate or greater interest (scores ≥ 3). Interest in the CBT app averaged 2.5 ± 1.9, with 50% expressing a moderate level of interested or higher. Interest in the CBT programme was significantly higher among females and those with greater levels of fatigue (lower FACIT-F scores) or lower levels of emotional well-being. Significant factors associated with higher interest in the CBT app included female sex and greater levels of fatigue.

Conclusion
Interest in CBT for fatigue management among patients with IBD was moderate, with higher levels of interest observed in patients experiencing greater levels of fatigue, particularly among females. CBT apps offer a promising alternative for addressing fatigue, potentially enhancing accessibility and convenience in clinical settings. Future strategies incorporating CBT apps may help meet the needs of those with limited access to in-person therapies.
P0640 Development and characterization of LQ080, a novel extended half-life bispecific TL1A/IL-23 p19 single domain antibody for the treatment of IBD
Authors: Wan Y , Zhu M , Gai J , Huang Y , Hu Y 
Published: January 2025

Abstract

Background
Despite the effectiveness of current anti-TL1A treatments, unmet needs remain for effective therapeutics for IBD. Therapies simultaneously neutralizing TL1A and IL-23 might be better choices owing to their synergistic anti-inflammatory effects in the pathogenesis of IBD.

Methods
TL1A and IL-23 single domain antibodies (sdAbs) were selected from immunized sdAb Phage display libraries. A human whole blood-based assay measuring IFNγ secretion was used to assess functional blockade of TL1A. Mouse splenocytes based assay measuring mouse IL-17 release was used to evaluate functional blockade of IL-23. Dextran Sulfate Sodium (DSS) induced mouse bowel inflammatory model was used to judge the in vivo effect of anti-TL1A antibodies. Synergistic anti-inflammatory effect was evaluated in mouse dermatitis model. Half-life extension was measured via pharmacokinetic analysis in non-human primate (NHP) given a single bolus of LQ080 by subcutaneous administration.

Results
The TL1A sdAb, which binds to both soluble and membrane-bound TL1A in a pH dependent pattern, potently blocked TL1A/DR3 while leaving the TL1A/DcR3 binding undisturbed and illustrated better IFNγ release in human whole blood induced by TL1A than RVT-3101 and PRA023. In DSS model, the TL1A sdAb also demonstrated better anti-inflammation effect than RVT-3101. The TL1A/IL-23 p19 biparatropic sdAb, LQ080, showed better IFNγ secretion inhibition than RVT-3101 and PRA023, and better inhibition of mouse IL-17 induction than Risankizumab and Guselkumab. Synergistic effects were found using LQ080 in both IFNγ release inhibition in human PBMCs induced by IL-23 and TL1A and in the mouse dermatitis model. The half-life of LQ080 significantly extended of 2-3 folds in non-human primate (NHP) compared to that of RVT-3101. Besides, LQ080 did not form large immune complex in vitro when mixed with TL1A and IL-23. Moreover, LQ080 did not stimulate the release of pro-inflammatory cytokines in the cytokines release assay.

Conclusion
The TL1A sdAb demonstrated better bioactivity than RVT-3101 and PRA023. LQ080, a TL1A/IL-23 p19 biparatropic sdAb, illustrated synergistic anti-inflammation effect both in vitro and iv vivo for its simultaneous neutralization of TL1A/DR3 and IL-23/IL-23R pathways, which would greatly improve the clinical results of IBD patients. The pH dependent TL1A binding makes LQ080 very different from other anti-TL1A mAbs. LQ080 demonstrated extended half-life in NHP making infrequent dosing possible for IBD treatment. No large immune complex formation when mixed with TL1A and IL-23 would make LQ080 safer when administrated by SC route. Overall, LQ080 is a promising TL1A/IL-23 p19 sdAb for IBD treatment.
P1101 Real-world effectiveness and safety of Risankizumab in Crohn’s Disease
Authors: McShane C , Olivera Sendra P A , Kim J , Milgrom R , Stempak J , Nguyen G , Weizman A V , Croitoru K , Gallinger Z , Huang V , Steinhart H , Targownik L , Lee S H , Silverberg M 
Published: January 2025

Abstract

Background
Data on real-world therapy outcomes for the use of risankizumab in Crohn’s Disease (CD) remain limited. We aimed to assess the real-world effectiveness and safety of risankizumab therapy in CD.

Methods
A retrospective study was carried out at a tertiary referral centre on patients started on risankizumab for CD between February 2019 and November 2024. Primary outcomes included: rates of clinical response and clinical remission at weeks 12, 28, and 52, and rates of endoscopic improvement by week 52. Clinical response was defined as a treatment response recorded in the chart as “complete response” or “partial response”, clinical remission was defined as remission status recorded as “in remission”, and endoscopic improvement as an endoscopic assessment of normal, inactive or mild disease. Secondary outcomes included treatment persistence (patients who did not discontinue treatment during follow-up), changes in Harvey Bradshaw Index (HBI), SES-CD score, CRP, faecal calprotectin, and adverse events. Kaplan-Meier analysis was used for survival probabilities, and Mann-Whitney test compared group differences.

Results
The study cohort included 122 patients. The median duration of follow-up was 38.7 weeks (IQR 24.4-61.5). Clinical response rates at week 12, 28, and 52, were 78%, 69%, and 77% respectively. Clinical remission rates at week 12, 28, and 52 were 32%, 38%, and 37% respectively. Endoscopic improvement by week 52 was seen in 26% of patients who underwent endoscopy (n=35). There was no difference in rates of treatment persistence in the ustekinumab exposed group (n=45). In the overall cohort, there was no difference in median HBI score at baseline and the pre-defined time points. Median SES-CD score reduced from baseline (8 [IQR 6-11]) to week 12 (3 [0-3], p=0.009) and week 28 (6 [3-7], p=0.015). No differences between baseline SES-CD score and week 52 were seen. Median faecal calprotectin levels reduced from baseline (766μg/mg [IQR 318-1500]) to week 12 (427μg/mg [232-1096], p=0.04), week 28 (332μg/mg [59-1435], p=0.04), and week 52 (200μg/mg [54-900], p=0.048). There was a non-statistical trend towards reduction of CRP over the same time period. 13% (n=16) discontinued therapy in the follow-up period, 11 due to therapy failure, 3 due to adverse events and, 2 due to patient preference. There were 39 reported adverse events; 6 disease-related, 15 infectious (1 serious). There were 2 pregnancies during the follow-up period, with one early-term delivery and the second ongoing.

Conclusion
In a real-world setting risankizumab is an effective and safe therapeutic option in CD. Clinical effectiveness is comparable to other biologic therapies for CD. No new significant adverse events were identified.
P1111 Infliximab is not Superior to Vedolizumab for the Treatment of Moderately to Severely Active Ulcerative Colotis with PR3-ANCA Positive : A Retrospective Multicentre Real-World Study
Authors: Yu Q , Yiyu C , Chen Y , Zhu L 
Published: January 2025

Abstract

Background
Current literature presents conflicting findings about the efficacy of Infliximab (IFX) versus vedolizumab (VDZ) in patients with moderately to severely active ulcerative colitis (UC). Patients with UC who are positive for anti-neutrophil cytoplasmic antibodies(ANCA) are known to respond poorly to IFX1-3 and VDZ4. We aimed to evaluate the comparative efficacy and safety of IFX versus VDZ in moderately to severely active UC patients with Proteinase 3-ANCA(PR3-ANCA) positive.

Methods
This retrospective multicentre real-world study was conducted in three centers in Hubei, China. Patients with moderate to severe active ulcerative colitis (UC) who are positive for PR3-ANCA were allocated to either the Vedolizumab (VDZ) group (n=19) or the Infliximab (IFX) group (n=26) depending on the biologics they received. The endpoints assessed at week 22 included clinical remission(primary endpoint), clinical response, endoscopic response, and endoscopic remission. Inverse probability of treatment weighting (IPTW) was employed to ensure the reliability and robustness of the clinical outcomes.

Results
In the original cohort, IFX was not superior to VDZ in terms of clinical remission (23.08% vs. 42.11%, P=0.173), clinical response (65.38% vs. 63.16%, P=0.878), endoscopic response (57.69% vs. 63.16%, P=0.712), and endoscopic remission (11.54% vs. 26.32%, P=0.253). Additionally, similar outcomes were observed in the IPTW cohort: for clinical remission (23.26% vs. 35.89%, P=0.384), clinical response (68.68% vs. 60.29%, P=0.583), endoscopic response (58.48% vs. 60.29%, P=0.912), and endoscopic remission (14.18% vs. 22.75%, P=0.494) when comparing IFX to VDZ.

Conclusion
IFX is not superior efficacy compared to VDZ in moderately to severely active UC patients with PR3-ANCA positive.

References
1.Yoshida A, Matsuoka K, Ueno F, Morizane T, Endo Y, Hibi T. Serum PR3-ANCA Is a Predictor of Primary Nonresponse to Anti-TNF-α Agents in Patients with Ulcerative Colitis. Inflammatory intestinal diseases. May 2021;6(2):117-122. doi:10.1159/0005153612.
2.Ferrante M, Vermeire S, Katsanos KH, et al. Predictors of early response to infliximab in patients with ulcerative colitis. Inflammatory bowel diseases. Feb 2007;13(2):123-8. doi:10.1002/ibd.200543.
3.Jürgens M, Laubender RP, Hartl F, et al. Disease activity, ANCA, and IL23R genotype status determine early response to infliximab in patients with ulcerative colitis. The American journal of gastroenterology. Aug 2010;105(8):1811-9. doi:10.1038/ajg.2010.954.
4.Liefferinckx C, Minsart C, Cremer A, et al. Early vedolizumab trough levels at induction in inflammatory bowel disease patients with treatment failure during maintenance. European journal of gastroenterology & hepatology. Apr 2019;31(4):478-485. doi:10.1097/meg.0000000000001356