bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0703 Risk factors and nomogram for massive postoperative gastrointestinal bleeding in patients with Crohn’s disease: a multicenter retrospective study
Authors: Zhang M , Ding Z , Wang Y , Li Y 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) is a chronic inflammatory disease that is prone to complications such as intestinal obstruction and perforation, which often require surgical treatments. Massive postoperative gastrointestinal bleeding (MPGB) is a severe complication with a high mortality rate, deteriorating postoperative recovery and disease prognosis. However, there are few related studies and it lacks effective prevention measures. Therefore, we conducted a multicenter study to explore the risk factors for MPGB in CD patients.

Methods
This study was a multicenter retrospective case-control study. Inclusion criteria included: patients diagnosed with CD; aged over 16 years old; underwent gastrointestinal surgery. Exclusion criteria included: patients with massive gastrointestinal bleeding before surgery. Massive gastrointestinal bleeding is defined as: hemodynamic impairment, requiring active fluid resuscitation; decreased hemoglobin concentration, requiring blood transfusion or surgical treatment; with symptoms of gastrointestinal bleeding. The included patients were divided into a case group and a control group. By comparing medical information between two groups, risk factors for MPGB were identified through logistic regression analysis, and a nomogram was constructed.

Results
From January 2018 to February 2024, a total of 170 CD patients were included, including 34 patients with MPGB and 136 matched controls. Univariate logistic regression analysis showed that for albumin (P=0.001, OR=0.89), nutrition risk screening (NRS2002) scale (P=0.003, OR=1.61), predictive nutritional index (PNI) (P=0.005, OR=0.92), number of previous surgeries (P&lt;0.001, OR=2.39), history of gastrointestinal bleeding (P&lt;0.001, OR=8.75), international normalized ratio (INR) (P=0.004, OR=1.60), and abnormal liver function (P=0.049, OR=6.29) (P＜0.05), the difference between two groups was statistically significant. Multivariate logistic regression analysis further revealed that NRS2002 (P=0.022, OR=1.53), history of gastrointestinal bleeding (P=0.005, OR=5.71), number of previous surgeries (P&lt;0.001, OR=2.43), and INR (P=0.011, OR=1.61) were associated with an increased risk of MPGB. Based on these results, a nomogram was constructed. The training and validation group achieved an area under the curve (AUC) value of 0.87 and 0.73 respectively with well-fitted Hosmer-Lemeshow calibration curves.

Conclusion
The risk of MPGB in CD patients will be increased with a history of gastrointestinal bleeding, more previous surgeries, a higher NRS2002 score, and a higher INR value. Strengthening the perioperative nutritional status management of CD patients may prevent the MPGB. Besides, we conduct a nomogram model, which can effectively predict the risk of MPGB in CD patients.
P0705 Features of optimal disease control in Crohn’s disease and Ulcerative Colitis: Views on IBD Expectations and Well-being by Patients and Treatment providers
Authors: Rubin D T , Potts Bleakman A , Orleck K , Hibi T , Bernstein M , Kearns K , Patel A , Folian S , Kayhan C , Baygani S , Flynn E , Favia A , Knight H , Castellano G , Schreiber S 
Published: January 2025

Abstract

Background
With the expanding array of therapeutic options for Crohn’s disease (CD) and ulcerative colitis (UC), there is an increasing need to examine features of optimal disease control that reflect patient priorities. Views on IBD Expectations and Well-being - Patients and Treatment providers (VIEW-PT): an analysis based on the IBD Disease Specific Programme (DSP)™, aimed to identify features of optimal disease control in CD and UC, with inclusion of patient and healthcare professional (HCP) perspectives.

Methods
An iterative 3-Stage approach was used to identify features of optimal disease control in CD and UC (Table 1). In Stage 1, features of optimal disease control were identified by gastroenterologist (GI) advisors, a targeted literature search, and exploratory analyses of the Adelphi Real World IBD DSP. In Stage 2, features from Stage 1 were prioritized by patient advisors and additional features recommended for inclusion. In Stage 3, GI and advanced practice provider (APP) advisors provided further input on relevance of the expanded list of features, terminology, and categorisation. Features mentioned unprompted by patient, GI or APP advisors were cross-referenced to earlier stages and included if identified by ≥4 sources (see details in Table 1). GI and APP advisors provided feedback on similarities and differences of features of optimal disease control for CD vs UC.

Results
In Stage 1, nine features were identified as most relevant in defining optimal disease control in CD and UC: bleeding, bowel movement frequency, bowel urgency, endoscopic healing, fatigue, pain, quality of life, sleep disturbance, and steroid use. Faecal incontinence and mental health were added in Stage 2 following patient input. GI and APP advisors confirmed relevance of the 11 features in Stage 3; extraintestinal manifestations and biomarkers were added based on advisor recommendation and recurrence at earlier stages. Terminology was finalised and features ordered based on advisors’ recommendations, categorised as symptoms, functional outcomes, or markers of inflammation (Figure 1). GI and APP advisors advocated to include the same features for CD and UC, acknowledging expected variation in prioritisation by indication and across individual patients.

Conclusion
By considering a range of sources and including patient perspectives, optimal disease control in CD and UC was found to be a multi-faceted concept, incorporating symptoms, functional outcomes, and markers of inflammation. Patient advisors highlighted the importance of faecal incontinence and mental health, which may be overlooked in clinical practice. This robust framework of optimal disease control can be adopted to aid with development of individual IBD management plans in clinical practice.
P0709 Patient Satisfaction with Subcutaneous versus Intravenous Vedolizumab: A Prospective Observational Study
Authors: Herrera De Guise C M , Serra-Ruiz X , Céspedes Martínez E , Mayorga Ayala L , Robles Alonso V , Lastiri Gonzalez E , Oller E , Pérez Martínez Z , Casellas F , Borruel Sainz N 
Published: January 2025

Abstract

Background
Vedolizumab (VDZ) is a selective biologic agent that is available in both intravenous (IV) and subcutaneous (SC) forms for maintenance treatment. The SC route offers advantages such as the convenience of self-administration, although some patients may prefer the IV route. The aim of our study was to determine patients’ preferences and satisfaction with their treatment when switching to VDZ SC or continuing with an IV administration.

Methods
A prospective, observational study was conducted in patients with inflammatory bowel disease (IBD) receiving VDZ IV who were in clinical remission. Patients had the option to continue with VDZ IV or switch to SC and were grouped according to their preference. A baseline visit (before the switch) and another at 24 weeks were conducted. During both visits, patients completed the treatment satisfaction questionnaire (SATMED-Q) and quality of life questionnaire (IBDQ9). Clinical activity, treatment adherence, adverse effects, general bloodwork, and fecal calprotectin were also analyzed.

Results
Forty-one IBD patients were included, 43% of which were women, and 63% had ulcerative colitis. Almost half (41%) continued with VDZ IV while 59% switched to SC. There were no differences in gender, type, or characteristics of IBD between the groups. However, the age of patients in the SC group was significantly younger than that of the IV group (median 46 [32-63] vs. 66 [59-77] p=0.03). Fewer patients in the SC group had previously received IV biologics (SC 31% vs. IV 69%, p=0.012). The median SATMED-Q before the switch was lower in the SC group (SC 53 [40-61] vs. IV 61 [46-64], p=0.032), as was the IBDQ9 (SC 65.5 [59.4-68.5] vs. IV 70.8 [68.5-77.1], p=0.037). At 24 weeks, there were no differences in SATMED-Q or IBDQ9 scores or disease clinical activity. Drug persistence and frequency of adverse events were similar in both groups. Vedolizumab levels increased significantly in the SC group at 24 weeks (p=0.041).

Conclusion
Switching to VDZ SC showed similar treatment satisfaction to VDZ IV at 24 weeks in IBD patients, with comparable clinical outcomes and safety profiles. There was a clear preference for subcutaneous administration among younger patients and those without previous IV treatment. This suggests that patient demographics and prior treatment experiences can influence the choice of administration route. The lack of significant differences in clinical outcomes, quality of life scores, and treatment satisfaction between the SC and IV groups at 24 weeks highlights the clinical equivalence of these two administration routes for maintenance therapy in IBD.
P0711 The Effect of Extraintestinal Manifestations Presence on Treatment Persistence in IBD Treatment
Authors: Koç Ö , Eroglu Z , Yılmaz V , Acehan M F , Guvenir S T , Toruner M 
Published: January 2025

Abstract

Background
Inflammatory Bowel Disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a chronic, relapsing inflammatory disorder of the gastrointestinal tract. A significant portion of patients also experience extra-intestinal manifestations (EIMs) that involve various organ systems beyond the intestines. EIMs are often present at the onset of disease or may develop later during the course of IBD, and their severity can vary, influencing overall disease prognosis and quality of life. Effective management of IBD requires a holistic approach that not only addresses the intestinal inflammation but also anticipates and treats these extra-intestinal complications.
In this study we aimed to investigate the role of EIM presence on anti-TNF treatment persistence in IBD therapy.

Methods
This was a single center, retrospective cohort analysis of patients with IBD either received adalimumab or infliximab as a first line biologic treatment. A total of 673 patients were included to this analysis. Demographic information such as gender, age, Montreal classification, EIM presence, smoking and prior medications were noted from patients electronic medical records. Weighted Kaplan-Meier and Cox models were used to assess the outcomes.

Results
Out of 673 patients, 426 patients had Crohn’s disease, 240 patients had ulcerative colitis and 7 patients had indeterminate colitis. Overall, 379 pateints received adalimumab and 294 patients received infliximab as first line biologic treatment for IBD. While 272 patients had EIM, 349 patients did not have EIM accompanying their IBD. EIM presence was not concluded in 52 patients from their medical charts. Smoking and family history were not different between patiemnts with and without EIM. However, female patients had statistically more EIM (51.3% vs. 38.1%, p&lt;0.05) and patients with Crohn’s disease had statistically more EIM (49.4% vs 34.5%, p&lt;0.05). Anti-TNF drug persistence was significantly higher in patients with EIM when compared to patients with no EIM (Figure 1). This difference was independent of the type of anti-TNF medication used. However, in patients with ulcerative colitis the difference became more significant, while in Crohn’s disease patients although there is trend, the difference was not significant. The concomitant use of immunomodulator drugs did not make any impact.

Conclusion
In IBD patients, anti-TNF medication persistence was observed to be significantly longer in those with EIM. This difference was significantly greater in ulcerative colitis patients compared to Crohn’s patients. This difference was independent of the concomitant medication use.
P0712 Feasibility of a smart toilet seat for the measurement of physiological parameters in active Ulcerative Colitis: A pilot study.
Authors: Hazeleger L , Verbiest V , Hamers J , Groenendaal W , Wentink E , Duijvestein M 
Published: January 2025

Abstract

Background
Management of inflammatory bowel disease (IBD) remains largely reactive, with limited ability to predict or prevent flares. Passive remote monitoring of physiological parameters could provide objective data on IBD activity and facilitate the development of algorithms for early flare detection. OnePlanet Research Center has developed the smart toilet seat, a novel device that noninvasively measures several physiological parameters during a toilet visit (Figure 1). In this study, we aimed to 1) evaluate feasibility of using the smart toilet seat for home monitoring for ulcerative colitis (UC) 2) measure physiological parameters in UC patients starting new medical treatment during a flare using the smart toilet seat.

Methods
We installed the smart toilet seat at the homes of eight patients with active UC starting new treatment for a period of 8 weeks. Patients were instructed to use the smart toilet seat as they would use their regular toilet, and indicate their toilet visit and stool consistency using remote control buttons. Measurements included number of toilet visits, toilet visit duration, stool consistency, heart rate and perianal temperature. Disease activity was measured weekly using an app-based self-reported Simple Clinical Colitis Activity Index (SCCAI) and faecal calprotectin (FC) (CalproSmart Self Test).

Results
33 patients were contacted for participation, of which eight patients with active UC were included (24%). Next to maintenance therapy with aminosalicylates, patient started with various types of treatment (Table 1). Median FC was 1107 µg/g (range &lt;77 – &gt;1500 µg/g (lower and upper levels of detection)) at week 1 and below the lower limit of detection (&lt;77 µg/g (&lt;77 – &gt;1500 µg/g)) at week 8. 1431 visits to the Smart toilet seat were recorded, of which 326 were defaecation visits. Median toilet visit duration for all visits and defaecation visits was respectively 1.8 and 4.2 minutes. Between week 1 and week 8, a median change of -6 (range -19, 4) in weekly bowel frequency was measured by the Smart toilet seat and median change in weekly SCCAI was -2 (range -4.5, -0.5) (R2 = 0.75). All participants indicated they would use the Smart toilet seat in the future if it would give their gastroenterologist or general physician more insight into their disease.

Conclusion
Our study shows it was feasible to measure stool frequency and multiple physiological parameters using a smart toilet seat in a population of UC. Future research is aimed to identify relevant parameters measured by the smart toilet seat that are related to the development of IBD flares, which could serve as basis for predictive models.
P0713 Feasibility of a Physical Activity intervention in Patients with IBD - the PASIBO Study
Authors: Poulsen A , Thomsen T , Villumsen M , Søe Riis Jespersen H , Blædel Hansen A , Appel Esbensen B , Jess T , Højgaard Allin K , Aadahl M 
Published: January 2025

Abstract

Background
Recent studies suggest that physical activity (PA) may improve the quality of life and relieve fatigue in patients with inflammatory bowel disease (IBD). However, there is no consensus as to what type of PA intervention should be offered to patients with IBD and barriers related to stigmatization and disease symptoms calls for an individually tailored approach. We developed a PA intervention involving patients, health professionals and other stakeholders in a co-creation process. This study aims to determine the feasibility and acceptability of a tailored PA intervention in adult men and women with IBD, focusing on recruitment, retention and outcome assessments.

Methods
In a randomized, controlled feasibility study, 30 patients with IBD were recruited from Digestive Disease Center, Bispebjerg Hospital, Copenhagen and randomized to an intervention (n=15) or a control (n=15) group. The 20-week intervention comprised group-based education, four nurse-led motivational interviews and three optional components (individual physiotherapy session, exercise ‘buddy’ and/or exercise videos). Outcome assessments at baseline and after 20 weeks, included accelerometer-measured PA, patient-reported outcomes, cardiometabolic biomarkers and anthropometrics. Interviews with participants informed intervention acceptability.

Results
A total of 164 participants were screened to enroll 30 patients with IBD. Hereof 47% were women, mean age was 39.7 years (SD 13.7), and 57% had Crohn’s disease, while 43% had ulcerative colitis (table 1). Participants in the intervention group were slightly younger, were more often co-habiting, more frequently employed and had more co-morbidity than participants in the control group (table 1). All participants completed the 20-week outcome assessment, and all 15 intervention participants completed the four motivational sessions, setting personalized goals. The most common goals were increasing active transportation and daily walking. Most participants chose to add videos or a physiotherapy session, while none selected the exercise ‘buddy’ option. Interviews highlighted the importance of the personalized approach and the focus on the full PA spectrum. The chosen outcome measures appeared feasible, and findings pre/post intervention indicated a potential beneficial impact of PA on fatigue and Quality of life in the intervention group (Table 2).

Conclusion
The study showed that an individually tailored PA intervention focusing on motivation and opportunities to increase PA in daily life is feasible and acceptable. The results are informing a subsequent, adequately powered, multi-centre trial.
P0716 Comparison of vedolizumab and ustekinumab treatment persistence in anti-TNF experienced perianal Crohn’s Disease patients: A Single Center Experience
Authors: Eroglu Z , Acehan M F , Koç Ö , Yılmaz V , Toruner M 
Published: January 2025

Abstract

Background
Perianal Crohn’s disease (CD) is a particularly challenging and debilitating complication of Crohn’s disease. This can lead to significant morbidity, including chronic pain, and recurrent infections, all of which severely impact a patient’s quality of life. Biologic therapies, particularly tumor necrosis factor (TNF) inhibitors, such as infliximab and adalimumab, have become central to the management of this condition due to their ability to target key inflammatory pathways driving both intestinal and extra-intestinal disease. In addition to Anti-TNF agents, other biologics such as integrin inhibitors (e.g., vedolizumab) and interleukin inhibitors (e.g., ustekinumab) have shown promise in treating refractory or complex perianal Crohn’s disease. In this study, we aimed to compare the persistence rates of vedolizumab and ustekinumab in anti-TNF experienced perianal Crohn’s disease patients.

Methods
This was a single center, retrospective cohort analysis of Anti-TNF treatment experienced Crohn’s disease patients either received vedolizumab or ustekinumab as a treatment. A total of 176 patients were included to this analysis. Demographic information such as gender, age, Montreal classification, smoking and prior medications were noted from patients electronic medical records. Weighted Kaplan-Meier and Cox models were used to assess the outcomes.

Results
Out of 176 Crohn’s disease patients, 128 patients had perianal Crohn’s disease. 41.5% of the patients were female, where as 33.7% of the patients had extraintestinal manifestations and 41.7% of the patients had fistulizing disease. EIM was less frequent in fistulizing disease (26% vs. 39.2%, p&lt;0.05), concomitant azathioprine use was more frquent in fistulizing disease (58.9% vs. 34.3%, p&lt;0.05) and fistulizing disease patients were predominantly male (67.3% vs 32.7%, p&lt;0.05). Use of vedolizumab and ustekinumab did not different in fistulizing disease. In general cohort, the persistence rate was higher in ustekinumab treated group (Figure 1) where as in fistulizing disease group there was no statistically difference in persistence rate between two treatment arm (Figure 2).

Conclusion
To conclude, there is a shorter drug persistence rate in fistulizing Crohns disease when compared to non-fistulizing Crohn’s disease even with concomitant azathioprine use. While there was a longer drug persistence rate in the ustekinumab arm compared to the vedolizumab arm in the overall group, no significant difference was observed between both treatment arms in the fistulizing subgroup.

Figure : 1

Figure 2:
P0718 Ulcerative Proctitis: Adherence to Guidelines and confirmation of clinical, biochemical and endoscopic remission in phenotypically E1 patients.
Authors: Malkopoulos A , Gluch A , Kakkadasam Ramaswamy P , Mohsen W 
Published: January 2025

Abstract

Background
Ulcerative proctitis is a subtype of Ulcerative colitis in which only the rectum is affected. Despite the length of inflammation and ulceration being significantly less than that observed in other ulcerative colitis phenotypes, the clinical impact on patients can be considerable.
Our aim was to review clinician adherence to British Society of Gastroenterology (BSG) guidelines in the management of phenotypically E1 patients with active proctitis in a tertiary hospital outpatient setting. The secondary objective was to evaluate rates of biochemical, clinical and endoscopic remission at 6-18 months post endoscopy.

Methods
Retrospective data was collected from endoscopy reports from a single Australian tertiary centre over a 2-year period between 2022 to 2024. Patients included in this cohort were all above the age of 18 with active proctitis identified on endoscopy. Those who were not phenotypically E1 were excluded. Review of the electronic integrated medical system was then conducted to determine if management was in line with BSG guidelines. Evidence of biochemical, clinical and/or endoscopic remission status at 6-18 months post endoscopy finding were also reviewed. Clinical remission was defined as SCCAI score &lt;2 , endoscopic remission was defined as UCEIS score of ≤ 1 and biochemical remission was defined as CRP ≤ 5 +/- faecal calprotectin ≤ 50.

Results
A total of 875 colonoscopies and/or sigmoidoscopies were identified with the impression of ulcerative colitis in the report. Of these 172 scopes showed proctitis. Among these, 74 of these patients were phenotypically E1 with no prior evidence of more extensive disease. Exclusion of 6 inpatients and 12 repeat procedures resulted in a total analysis of 56 patients (Figure 1).
Fifty percent of patients (n=28) were treated in line with current BSG Guidelines (initial and maintenance).
Eighty percent (43 of 56) of the patients reported clinical remission within 1 year. Biochemical remission was confirmed in 73.2% (41) of patients. Of the 56 patients, thirty were assessed for endoscopic remission within 18 months. Thirteen (43%) of these had proven endoscopic remission within 18 months of diagnosis.

Conclusion
Adherence to BSG guidelines was observed in 50% of cases, highlighting significant variability in the management of proctitis in an outpatient setting. A substantial proportion of patients reported complete clinical and biochemical remission within the 18 months. A relatively lower rate of confirmed endoscopic remission, suggests that this group of patients may be undertreated.