bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0628 Patient preferences towards treatment attributes in Inflammatory Bowel Disease: a Brazilian cohort study
Authors: Argollo M , Queiroz N , Kurtz de Mello M , Senra J , Rosa B , Barreto T 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) is a chronic condition of the gastrointestinal tract characterised by recurring inflammation that usually requires life-long treatment. As the therapeutic landscape is rapidly expanding, there is a growing need to understand patient perceptions of treatment-related attributes. This study explored the preferences for treatment attributes in patients with Crohn’s disease (CD) or ulcerative colitis (UC) in Brazil.

Methods
Adult patients from Argentina, Australia, Brazil, Saudi Arabia and Taiwan who self-reported diagnosis of CD or UC participated in an online survey. In a discrete choice experiment, the relative importance of treatment attributes for CD or UC was estimated using conditional and multinomial logit models.

Results
In Brazil, 200 patients completed survey responses (CD, n = 100; UC, n = 100), with mean patient ages of 34.9±7.9 and 36.1±9.4 years, respectively. Most patients were covered by private insurance, and the majority had been exposed to advanced therapies (74% for CD and 62% for UC). These patients were primarily treated at IBD centers and private hospitals, with a higher percentage reporting general good or fair well-being (82% for CD and 85% for UC). Patients with CD ranked long-term remission on maintenance therapy (34.8%), the rate of 1-year remission (26.2%), and the route of administration (22.3%) as the most important attributes. Patients with UC prioritized corticosteroid-free remission after 1 year (30.3%), the route of administration (30.1%), and the rate of mucosal healing after 1 year (16.2%). Both CD and UC patients considered abdominal pain as the most impactful symptom on their daily lives. General and emotional well-being were rated as the first and second most important aspects for improvement through treatment.

Conclusion
Patient preferences for treatment attributes correlate with CD or UC clinical manifestations and management, highlighting the importance of personalised care and shared decision-making to maximize treatment benefits and provide valuable insights for the stakeholders involved from drug development to treatment access.
P0641 Efficacy of Vedolizumab and Ustekinumab Following Cyclosporine Induction in Acute Severe Ulcerative Colitis: A Retrospective Cohort Study
Authors: Harb M , Bazin T , Solene D , Bresteau C , El Khatib M , Bourdillel J , Colas C , Corcos O , Billiauws L , Joly F , Nuzzo A 
Published: January 2025

Abstract

Background
In corticosteroid-resistant acute severe ulcerative colitis (ASUC), second-line treatment involves infliximab or cyclosporine (CYCLO). With increasing antiTNFα exposed patients, CYCLO is often chosen to prevent emergency colectomy but is limited to the induction phase due to tolerability, serving as a bridge until effective maintenance therapy. In this setting, limited data on vedolizumab (VDZ) and ustekinumab (UST) as maintenance make the choice of an optimal bridge strategy challenging. This study aimed to compare the efficacy of VDZ and UST after CYCLO induction in corticosteroid-resistant ASUC.

Methods
This single-center retrospective cohort included all patients hospitalized for ASUC, responding to CYCLO induction, and starting VDZ or UST maintenance. ASUC was defined by modified Truelove and Witts criteria, with response to CYCLO defined by a Lichtiger score reduction to &lt;10 points for 2 consecutive days, with a minimum 3-point decrease by day 7. The primary outcome was colectomy-free survival; secondary outcomes were treatment persistence and safety.

Results
From 2014-2024, 72 ASUC patients received CYCLO. Fourteen were excluded (non-response, tofacitinib [n=6], infliximab [n=3], and/or emergency colectomy [n=11]), leaving 58 CYCLO-responsive ASUC patients (median age 39, IQR 30-58, 60% female), with 46 on VDZ (79%) and 12 on UST (21%). ASUC was related to ulcerative colitis in 81% (68% pancolitis) and Crohn’s in 19%. Disease duration was 7 years (IQR 2-15), with 91% prior biologic exposure, primarily antiTNF. Presentation included Lichtiger score 10 (IQR 10-12), CRP 40 mg/L (22-79), albumin 29 g/L (27-30), fecal calprotectin 874 µg/g (450-1800), UCEIS 7 (5-8), and Mayo endoscopic score 3 (3-3). Colectomy-free survival was 75% at M12 and 69% at M24 with VDZ and 57% at M12 and M24 with UST (p=0.38, figure 1). Treatment persistence was 48% at M12 and 37% at M24 with VDZ, and 42% at M12 and M24 with UST (p=0.51, figure 2). After adjusting for maintenance therapy, disease type, and severity, colectomy risk factors included albumin &lt;27 g/L (HR=3.4; 95%CI:1.2-9.8) and prior tofacitinib exposure (HR=4.3; 95%CI:1.2-15.8). Over a median 37-month follow-up (95%CI:35-40), 34% of patients experienced adverse events, with 19% severe (mainly CYCLO-related), including 2 deep vein thromboses in the VDZ group and 1 infection in the UST group. No deaths occurred.

Conclusion
In this large cohort of biologic-exposed, corticosteroid-resistant ASUC patients, a CYCLO bridge strategy with VDZ or UST avoided colectomy in two-thirds of patients, with almost 50% treatment persistence at 12 months. There was no significant difference in efficacy, persistence, or safety between strategies.
P0658 Comparison of the Efficacy and Safety of Immunomodulator Use in Geriatric and Non-Geriatric Patients with Inflammatory Bowel Disease
Authors: Arı D , Kenarlı K , Bacaksız F , Arı S , Gökbulut V , Öztürk Ö , Özderin Özin Y , Kalkan İ H 
Published: January 2025

Abstract

Background
The patterns of medication use among elderly inflammatory bowel disease patients vary due to several factors. This study aims to present the outcomes of immunomodulator therapy in both geriatric and non-geriatric patient groups, highlighting differences in treatment effectiveness, reasons for discontinuation, and the incidence of side effects between the two groups.

Methods
A retrospective database was established by reviewing the records of inflammatory bowel disease patients aged 18 and older who received immunomodulator therapy at our clinic over a seven-year period. Patients aged 65 years and above were designated as the geriatric cohort. In addition to demographic and clinical variables, disease activity in ulcerative colitis patients was assessed using the Mayo Disease Activity Index and the Rachmilewitz Endoscopic Activity Index, while the Harvey-Bradshaw Index was employed for Crohn’s disease patients.

Results
The study included 102 patients, comprising 44 with ulcerative colitis and 58 with Crohn’s disease. The median age was 66.5 years (range: 23–87), with 54 patients (52.94%) classified as geriatric (≥65 years). Immunomodulator therapy was discontinued due to side effects in 31 patients (30.39%) and due to remission in 11 patients (10.78%). Additionally, 23 patients (24.21%) showed no response to the treatment. No significant differences were observed between the geriatric and non-geriatric groups regarding the type of inflammatory bowel disease, duration of therapy, concomitant treatments, reasons for discontinuation, side effects, malignancy occurrence, malignancy type, or mortality.

Conclusion
With careful patient selection and close monitoring, immunomodulator therapy in elderly inflammatory bowel diseasepatients can achieve similar effectiveness and risk of side effects as observed in younger patient groups.
P0665 Long-term efficacy and dose intensification of ustekinumab in achieving clinical, laboratory, and endoscopic remission in Crohn’s disease
Authors: Dussias N , Melotti L , Vanigli N , Gionchetti P , Rizzello F 
Published: January 2025

Abstract

Background
Although ustekinumab has been evaluated for Crohn’s disease, long-term effectiveness and the benefits of dose intensification for maintaining clinical and endoscopic remission remain underexplored. Dose intensification strategies may be critical for optimizing outcomes in patients not responding to standard regimens. This study addresses these gaps by analyzing the long-term outcomes of ustekinumab treatment and the impact of dose intensification in a real-world setting.

Methods
This retrospective, observational study was conducted at a tertiary referral center, investigating patients with moderate-to-severe Crohn’s disease treated with ustekinumab. We assessed rates of steroid-free clinical remission, endoscopic remission, and normalization of C-reactive protein (CRP) at baseline, 12, 24, 36, and 48 months post-initiation. Outcomes in patients undergoing dose intensification from every 8 weeks to every 6 or 4 weeks due to incomplete response or loss of efficacy were also evaluated. Clinical remission was defined as Harvey-Bradshaw Index (HBI) ≤4, endoscopic remission as SES-CD ≤2, and CRP normalization as ≤0.5 mg/dL.

Results
A total of 251 patients were included in this study. Of these, 228 continued ustekinumab treatment at 12 months, with 43% achieving steroid-free clinical remission. Clinical remission rates at 24, 36, and 48 months were 47%, 50%, and 40%, respectively. Ileocolonoscopy was performed at 12 months in 115 patients, showing that 31.3% achieved endoscopic remission. This trend continued, with endoscopic remission rates of 30.9% at 24 months, 39.1% at 36 months, and 40% at 48 months. Median C-reactive protein levels dropped from 1.75 mg/dL at baseline to 0.42 mg/dL at 12 months and remained below 0.5 mg/dL at 24, 36, and 48 months (0.37, 0.34, and 0.4 mg/dL, respectively). Over the four-year period, 81 patients underwent dose intensification due to loss of efficacy or insufficient response, with 24.7% achieving clinical remission thereafter. An additional 24.7% achieved a reduction of HBI of at least 3 points after dose intensification, while the remaining 50.6% failed treatment. Adverse events led to treatment discontinuation in 2.4% of patients.

Conclusion
Ustekinumab demonstrated significant efficacy in achieving and maintaining clinical, endoscopic, and laboratory remission over four years in patients with moderate-to-severe Crohn’s disease. Dose intensification led to favorable outcomes in approximately half of the patients, demonstrating that it is a viable option in patients with insufficient response or loss of efficacy with the standard dose.
P0672 Comparative Efficacy of Medical Therapies in Reducing the Risk of Post Operative Recurrence in Crohn’s Disease (PORCD): A Systematic Review and Network Meta-analysis
Authors: Shehab M , Alrashed F , Alrashed O , Alyousefi R , Zoughlami A , Lakatos P L , Siddharth S , Allez M , Miguel R , Bessissow T 
Published: January 2025

Abstract

Background
Up to 50% of patients with Crohn’s disease (CD) will require surgery, and 70-90% experience endoscopic recurrence within the first year postoperatively (1). Despite various treatments, there is scant data on the comparative efficacy to prevent recurrence (2). This study aims to compare the efficacy of medical treatments in preventing PORCD.

Methods
A comprehensive literature review was conducted using Medline, Embase, and the Cochrane Library through October 1, 2024. We included RCTs and prospective cohort studies, excluding pediatric studies, single-arm trials, and dose-comparison studies. The primary endpoint was assessing endoscopic recurrence (ER) (RS ≥i2), and secondary outcome was clinical recurrence (CDAI ≥150, Hanauer’s score ≥2, HBI ≥8) at 6, 12, and ≥18 months postoperatively. Frequentist random-effects network meta-analysis was conducted, reporting OR with 95% CI.

Results
A total of 42 studies were included in this meta-analysis, 38 of which were RCTs, with 2,260 patients with CD. At 6 months, ADA showed the lowest ER (SUCRA= 84.5%), followed by VDZ (74.5%). ADA significantly reduced ER compared to thiopurine (OR = 0.33 [95% CI, 0.12–0.91]), probiotics (OR = 0.17 [95% CI, 0.03–0.99]), and vitamin D (OR = 0.07 [95% CI, 0.01–0.37]). VDZ did not significantly differ from thiopurine, ADA or MDZ. At 12 months, IFX (SURCA= 93%) and ADA (SUCRA= 90%) had the lowest ER, with IFX showing significant reductions compared to thiopurine, MDZ, 5-ASA, ornidazole, and herbals (table1). Similar findings were observed at 18 months, with IFX and ADA maintaining the lowest ER rates. For clinical recurrence, no significant differences were observed among therapies at 6 months. However, at 12 months, ADA and IFX were superior to most therapies, including thiopurine, MTX, and budesonide. By 18 months, ADA had significantly less clinical recurrence than IFX (OR = 0.06 [95% CI, 0.01–0.50]).

Conclusion
Anti-TNFs are more effective than other therapies in preventing post-op CD recurrence. VDZ did not outperform thiopurines. Further RCTs are needed to evaluate newer therapies for post-op CD management.

References
1.Spinelli A, Sacchi M, Fiorino G, Danese S, Montorsi M. Risk of postoperative recurrence and postoperative management of Crohn’s disease. World J Gastroenterol. 2011;17(27):3213-3219. doi:10.3748/wjg.v17.i27.3213
2.Fasulo E, D’Amico F, Osorio L, et al. The Management of Postoperative Recurrence in Crohn’s Disease. J Clin Med. 2023;13(1):119. Published 2023 Dec 25. doi:10.3390/jcm13010119
P0674 Development of a screening tool to address dietary habits in persons with IBD in Germany
Authors: Wilke E L , Wiestler M , Middelhoff M , Schult-Hannemann D , Knoedler L L , Ebert M P , Reindl W , Thomann A K 
Published: January 2025

Abstract

Background
Nutrition plays a crucial role in the development and course of disease in patients with inflammatory bowel disease (IBD). However, standardized nutritional assessments are often lengthy and require the expertise of professional nutritionists, leading to a significant gap in the ability to screen for important dietary factors. As a result, these aspects are frequently overlooked in both clinical practice and scientific research. To address this issue, we aim to develop a short screening instrument that can effectively assess dietary and nutritional aspects in patients with IBD. This tool is not intended to replace, but complement standardized assessments, and to enable clinicians and researchers to address dietary and nutritional aspects in situations where these are otherwise disregarded.

Methods
A comprehensive literature review was conducted to identify nutritional factors with regard to their pro- and antiinflammatory characteristics in the context of IBD. Based on this research, a prototype screening tool was developed in collaboration with nutritional experts from 3 German University Hospitals (Mannheim, Munich, and Hannover). The first phase of validation involved an evaluation of the prototype screener by consecutive outpatients at the University Medical Center Mannheim (UMM) to assess its feasibility and acceptance.

Results
Our screening tool contains 28 questions and asks about the frequency of consumption of certain food groups as well as the type of preparation and eating habits with regard to vegetarian or vegan diet, the frequency of meals and the balance and variety of the diet. In the patient evaluation phase, we received feedback from 52 patients (n=37 female, n=36 with Crohn’s Disease, n=51 with remitted or mild disease (1 moderate, none severe). Mean time to complete the screening tool was 9.3 min (SD 7.8). The vast majority of patients stated that they found the screener somewhat or very important (n=47) and somewhat or very easy to understand (n=48), see fig. 1. Seven patients reported that they found at least one question difficult to understand. Ten patients stated that the screener was missing at least one aspect of their dietary habits. No patients reported any unpleasant questions. A global evaluation of the screener according to the German school grading system (from 1 = very good, 6 = very bad) was rated with a mean grade of 1.6.

Conclusion
This newly developed screening tool to semi-quantitatively assess dietary habits and relevant nutritional aspects in IBD was well-accepted and positively evaluated by patients. In the next step, we will adapt the questionnaire according to patient feedback and then initiate the next phase of the validation process in a multicentric setting.
P0676 Inborn Errors of Immunity Associated with Inflammatory Bowel Disease at a Tertiary Care Centre
Authors: Albadawi N , Almuhaya H , Alrossais N , Binzuman G , Alhaddab N , Aljefri N , Alsehaim K , Alshaikh A , Alsoqair S , Arnaout R , Alshareef S , Albawardy B , Alsohaibani F 
Published: January 2025

Abstract

Background
Inborn errors of immunity (IEI) are genetic disorders causing immune dysregulation, often increasing susceptibility to infections, autoimmunity, and inflammation. IEI-associated inflammatory bowel disease (IBD) can mimic classic IBD, which includes ulcerative colitis (UC) and Crohn’s disease (CD). Treatment for IEI-associated IBD is not well-established. This study aims to assess the prevalence, clinical and endoscopic presentation, and treatment outcomes of IBD in IEI patients.

Methods
This is a single center, retrospective study. All patients were ≥ 14-years of age with a confirmed diagnosis of IEI and IBD based on clinical, endoscopic, and histologic evaluations. Primary outcomes included the prevalence, clinical and endoscopic characteristics. The secondary outcomes included IBD treatment response and safety.

Results
Among 390 patients with IEI 36 (18.7%) exhibited gastrointestinal symptoms, with diarrhea being the most prevalent symptom (69.3%, n=25). In the 19 patients who underwent colonoscopy, abnormalities were observed in 9 (47.4%) with ulcerations being the most common finding (33.3%). The prevalence of IEI-associated IBD was 2.3%(n=9), with the most prevalent being CD (55.5%, n=5), followed by UC and IBD-unclassified(22.2%, n=2). Family history of IEI was noted in (55.5%, n=5), while only (11.1%, n=1) had family history of IBD. Chronic diarrhea (88.9%) was the most common clinical presentations. Initial fecal calprotectin levels were &gt;250 in all patients. Colonoscopy was performed on 8 patients (89%), of those (66.7%, n=6) had abnormal finding. Radiological abnormalities such as strictures, fistulas, perianal disease, and abscesses were noted in (55.5%, n=5). Medical treatment included corticosteroids33.3% (n=3), immunosuppressants in 22% (n=2) , biologics including (vedolizumab, Infliximab and Adalimumab) in 33.3% (n=3) and 1 patient received no IBD specific treatment. Clinical response was noted in 3 patients (1 on corticosteroids and 2 on immunosuppressants), with no improvement in those who received biologics. Surgery related to IBD was required in 22.2% (n=2). One patient had cytomegalovirus (CMV) colitis and four developed bacterial infections (none were on biologics). The mortality rate among the IEI-IBD cohort was 44.4%, with no significant associations between mortality and factors such as sex, IBD subtype, history of bacterial GI infections, extra-GI autoimmune disease, prior IBD surgery or age at IBD and IEI diagnosis (Table 1).

Conclusion
The prevalence of IEI-IBD was low but it is associated with a high mortality rate. Chronic diarrhea is the most common presentation and medical therapy success was limited, with improvement in only one-third of patient. Further research of larger cohorts is needed.
P0677 Population-Based Analysis of 30-Day Postoperative Course in Crohn’s Disease Patients Undergoing Primary Bowel Resection
Authors: Poulsen A , Damsgaard Wewer M , Lin V A , Rønne Pachler F , Verlo K A , Rasmussen J , Søe Riis Jespersen H , Surnecheva E , Christiansen D , Holm Hansen E , Møller Nordestgaard R L , Aydemir N , Dige Ovesen P , Filtenborg Brandt C , Gögenur I , Burisch J , Seidelin J 
Published: January 2025

Abstract

Background
Despite a growing array of medical treatment options, resection rates for Crohn’s disease (CD) have decreased over time, while re-resection rates have remained stable at approximately one-third in historical cohorts. This study aimed to assess 30-day postoperative outcomes and complication rates following primary bowel resection in CD patients.

Methods
This study encompassed all CD patients undergoing primary resection in Eastern Denmark from 2010 to 2020 (46% of the Danish population, n=2,730,000). Clinical characteristics, surgical procedures, and complications (Clavien-Dindo classification and Rahbari score) were collected 30 days postoperatively (Figure 1). We used nonparametric statistics (median, interquartile range (IQR), percentages) and assessed complication risk with chi-square tests and multivariate logistic regression.

Results
Primary resection was performed on 631 CD patients due to disease activity. The median age at resection was 35 years (IQR: 25-49) with disease duration of 2 years (IQR: 0-7), and 227 (36%) were smokers. A total of 76 patients (12%) underwent acute resection (&lt;24 hours), while 380 (60%) underwent elective procedures, 349 (55%) had laparoscopic surgery, 479 (76%) received a primary anastomosis (PA), and 94 (15%) were re-admitted. In total, 164 patients (26%) experienced complications within 30 days. Twenty-two (3%) had a Rahbari score of grade C, and two (0.3%) had grade B, and none had grade A. The Clavien-Dindo classification showed grade I: 22 (3%), grade II: 42 (7%), grade III: 95 (15%), grade IV: 4 (0.6%), and only one death (0.2%). Active steroid use (OR 2.26, 95% CI: 1.47–3.45, p&lt;0.001), open surgery (OR 1.60, 95% CI: 1.10–2.34, p=0.015), and resection length &gt;10 cm (OR 2.82, 95% CI: 0.532–51.9, p=0.325) were associated with higher odds, while primary anastomosis reduced risk (OR 0.42, 95% CI: 0.281–0.633, p&lt;0.001). Never received IBD medication (OR 0.76, 95% CI: 0.42–1.30, p=0.336) or being on therapeutic doses of biologics (OR 1.31, 95% CI: 0.87–1.96, p=0.191) was not significantly associated with the risk of 30-day complications, nor were symptom burden (HBI) or smoking status (p=0.670 and 0.250).

Conclusion
CD patients are often diagnosed and primary resected young, facing significant risks within 30 days postoperatively: 15% were readmitted, and one-fourth experienced complications requiring treatment. the Risk of complications was increased by open surgery, resection length &gt;10 cm, and preoperative corticosteroid use, while primary anastomosis reduced the risk. Receiving biologic therapy did not increase the risk of complications.