bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1118 Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan
Authors: Meng M J , Le P H , Kuo C J , Lai M W , Chiu C T 
Published: January 2025

Abstract

Background
While biologics have significantly improved outcomes in inflammatory bowel disease (IBD), remission rates in refractory cases remain suboptimal. Advanced combination therapy (ACT) presents a potential strategy to overcome this therapeutic ceiling in refractory IBD. Upadacitinib (UPA), an oral selective Janus kinase inhibitor, offers rapid action and low immunogenicity, showing promise in IBD management. However, no studies have evaluated the safety and efficacy of ACT combining biologics and UPA in Asia. This preliminary study aims to address this gap with data from Taiwan.

Methods
This retrospective study included all IBD patients who received ACT with biologics and UPA, followed up at the Chang Gung Inflammatory Bowel Disease Center from July 2020 to August 2024. The primary outcome was clinical response and remission rates at week 4. Secondary outcomes included clinical response and remission rates at weeks 12 and 24, along with safety profiles during the follow-up period. Continuous data were presented as medians with interquartile ranges (IQRs), while categorical data were expressed as frequencies and percentages. Analyses were conducted using IBM SPSS Statistics version 26.

Results
Sixteen IBD patients (7 Crohn’s disease, 9 ulcerative colitis) with prior biologics exposure were enrolled. The median disease duration was 4.5 years [IQR 2.25-9.50]. The most common UPA-based ACT regimen was Ustekinumab (63%), followed by Vedolizumab (25%), Risankizumab (6.25%), and Adalimumab (6.25%) (Table 1). Clinical response rates at weeks 4, 12, and 24 were 88%, 83%, and 100%, respectively. Clinical remission rates at weeks 4, 12, and 24 were 31%, 50%, and 80%, respectively (Figure 1). One patient (6.25%) experienced a minor adverse event (acne), with no major adverse events such as herpes zoster reactivation or major adverse cardiac events reported.

Conclusion
This study is the first in Asia to demonstrate that UPA-based ACT is effective and safe in refractory IBD. However, larger studies are needed to identify predictors of efficacy and assess long-term outcomes of UPA-based ACT.
P1135 Comparing Hypophosphataemia Risk and Complications Between Ferric Carboxymaltose and Other IV Iron Formulations in General and Inflammatory Bowel Disease Populations
Authors: Odah T , Farraye F A 
Published: January 2025

Abstract

Background
Iron deficiency is common in patients with inflammatory bowel disease (IBD), where poor absorption or prior surgery often renders oral iron supplementation ineffective, necessitating intravenous (IV) iron therapy. Hypophosphataemia, particularly associated with ferric carboxymaltose via fibroblast growth factor 23 dysregulation, is a recognized complication of IV iron therapy. It can result in severe outcomes such as rhabdomyolysis, osteomalacia, fractures, and convulsions. This study evaluates the risk of hypophosphataemia between ferric carboxymaltose and other IV iron formulations and its association with complications.

Methods
This retrospective propensity-matched study utilised the TriNetX database, a global repository of de-identified electronic health records. The first analysis compared ferric carboxymaltose to other IV iron formulations (iron sucrose, sodium ferric gluconate, ferumoxytol, ferric derisomaltose), matched on demographics (age, gender, ethnicity) and comorbidities (vitamin D deficiency, malnutrition, malabsorption, diabetes, CKD by stage, alcohol abuse, hyperparathyroidism, corticosteroid, diuretic, antacid, and bisphosphonate use) to assess hypophosphataemia risk. The second and third analyses evaluated hypophosphataemia-related complications in ferric carboxymaltose versus other formulations, both in the general population and in patients with IBD.

Results
We compared 115,242 ferric carboxymaltose patients to those on other IV iron formulations. Ferric carboxymaltose was associated with higher odds of severe (OR: 2.84, 2.22–3.64, p&lt;0.0001) and moderate (OR: 1.37, 1.29–1.46, p&lt;0.0001) hypophosphataemia but lower odds of mild hypophosphataemia (OR: 0.84, 0.79–0.88, p&lt;0.0001). Among 25,586 hypophosphataemic patients, those on ferric carboxymaltose had lower odds of acute complications within 3 months, including muscle weakness (OR: 0.57, 0.47–0.70, p&lt;0.0001), rhabdomyolysis (OR: 0.38, 0.20–0.75, p=0.003), disorientation (OR: 0.53, 0.46–0.61, p&lt;0.0001), convulsions (OR: 0.59, 0.48–0.73, p&lt;0.0001), cardiac arrhythmias (OR: 0.61, 0.54–0.69, p&lt;0.0001), and respiratory failure (OR: 0.57, 0.50–0.64, p&lt;0.0001). Over 2 years, chronic complications such as osteomalacia and fractures (23,508 patients each) showed no differences. In patients with IBD, no significant differences were observed in acute (2,688 each) or chronic complications (2,541 each) between cohorts.

Conclusion
Ferric carboxymaltose was linked to higher odds of severe and moderate hypophosphataemia but fewer acute complications than other IV iron formulations. The reasons for these differences remain unclear and warrant further research to understand the relationship between IV iron, hypophosphataemia, and clinical outcomes.
P1185 Preoperative bowel preparation in Crohn’s disease patients: final results of the prospective observational study
Authors: Iesalnieks I , Bercher M , Schmitz A 
Published: January 2025

Abstract

Background
Mechanical bowel preparation (MBP) in combination with oral antibiotics (OA) might decrease the risk of postoperative morbidity in colorectal surgery. However, there is a lack of data regarding the impact and safety of MBP in Crohn’s disease patients. MBP could even increase the morbidity by causing obstructive symptoms.

Methods
Patients with Crohn’s disease undergoing ileocolic or colorectal resections which were concluded by formation of an anastomosis were included in this prospective observational study. Exclusion criteria were: emergency surgery, no preoperative MBP, presence of colorectal malignancy, mere small bowel resection, simultaneous fecal diversion. The primary endpoint of the study was the occurrence of anastomotic complications (i.e., anastomotic leak, perianastomotic abscess, peritonitis or fistula). Secondary endpoint was occurrence of intraabdominal septic complications. “Incomplete MBP” was defined as an inability to drink the whole amount of scheduled 2 L of polyethylene glycol solution.

Results
284 patients were included. Side effects of MBP (nausea, vomiting, abdominal pain) occurred in 78 patients (29%). Fifty-three patients (19%) were not able to complete MBP. Female sex, emergency hospitalization, decreased hemoglobin level and scheduled ileocolic resection were associated with an incomplete MBP (p&lt;0.05). The incidence of anastomotic complications was 5%, intraabdominal septic complications occurred in 7% of patients. An incomplete MBP was not associated with anastomotic complications or intraabdominal septic complications.

Conclusion
Preoperative MBP is associated with a considerable incidence of side-effects in Crohn’s disease patients. However, intake of lesser amounts of MBP-solution than scheduled was not associated with an increased risk of postoperative morbidity.
P1192 Use of a mobile application for monitoring and communicating with Inflammatory Bowel Disease patients
Authors: Lobato Matilla M E , Chamorro de Vega E , Romero Jiménez R , Ferris Villanueva M , Menchén Viso L A , Marín Jiménez I , Miranda Bautista J , Martinez Lozano H , Herranz Alonso A , Sanjurjo Sáez M 
Published: January 2025

Abstract

Background
Biological therapies and small molecules for patients with Inflammatory Bowel Diseases (IBD) have increased the effectiveness, but also adverse effects (AE) or problems in their administration. In addition, patients have greater formation and communication needs. In 2020, we developed a mobile application (app) to improve communication and monitoring of IBD patients.

Aim and objectives
To assess the implementation of an app for communication and remote monitoring with IBD patients.

Methods
A multidisciplinary group composed of pharmacists, dermatologists, rheumatologists, gastroenterologists, and nurses designed an app for immune-mediated inflammatory diseases (IMID) patients in a tertiary hospital. The app consists of the following modules: Medication, Questionnaires, Adverse Events, Useful Information, Messages, and Patient Profile.
We offered the app to patients who initiated a new biological or small molecule therapy. We performed an observational, longitudinal study to assess the app's impact on medication adherence, safety, and communication. The inclusion period was from December 2020 to May 2024. The inclusion criteria were age ≥ 18 years, diagnosis of IBD, and ownership of a smartphone. Patients with language barriers were excluded.

Results
183 patients were included (median age: 42 years [IQR: 29,5-52,1] and 47.5% were female). Concerning the type of IBD, 73.7% of patients had Crohn's Disease (CD) and 26.3% Ulcerative Colitis (UC). The median follow-up time for app use was 446 (243,5-626,5) days. In the Medication module, 100% of patients registered their biological therapy and 39 % also used this module to record each dose of medication administered. 95,1% adherent according 4-item Morisky Medication Adherence Scale (MMAS-4).
A total of 98 AE were registered. 16,39% of patients registered at least 1 AE. The most frequent AEs were fatigue (28.6%), injection site reaction (16.3%), headache (13.3%), and diarrhea (8.2%). 27,3% of patients used the messages module to communicate with healthcare professionals. The most frequent messages concerned gratitude (34%), logistical and citation issues (20%), doubts about administration (14%), doubts about managing AEs (12%), and drug interactions (8%).

Conclusion
Our app reminds patients to take medication, enables them to record AEs, and helps them communicate with healthcare professionals. More than a third of the patients registered the administration of the biological therapies and 16,39% registered at least 1 AE. The most used functionality was communication with health professionals.
P1195 Ecological momentary assessment of fatigue and depressive symptoms reveals significant daily variability in IBD
Authors: Atanasova K , Bredensteiner M , Starrmann A , Ebert M , Thomann A , Lis S , Reindl W 
Published: January 2025

Abstract

Background
In inflammatory bowel disease (IBD), symptoms of depression and fatigue overlap to great extent, making it difficult for medical practitioners to differentiate between these symptoms and provide patients with proper treatment options. In this study, we prospectively monitored multiple factors including mood, sleep, physical and psychological wellbeing, quality of life and stress perception, and explored the effects of these factors on symptoms of depression and fatigue in IBD. Our aim was to define specific combinations of symptoms helping to better distinguish between depression and fatigue in IBD populations.

Methods
Sixteen patients with IBD provided daily indices of sleep duration and quality as well as ratings of depressive symptoms, fatigue, stress perception, mood and IBD-related symptoms 6 times per day for 7 consecutive days of ecological momentary assessment (EMA) monitoring. Additionally, participants were provided with a series of questionnaires, stool samples were collected, as well as ambulatory physiological monitoring was performed. Multiple linear regression analyses were computed to explore how these specific factors can predict depression and fatigue in IBD. Network analyses were applied to identify and analyse distinct patterns of statistical associations related to depression and fatigue in IBD.

Results
Self-reported sleep quality (pFDR = .034) and feelings of sadness (pFDR = .045) significantly predicted symptoms of depression in IBD, while fatigue could only be predicted by poor sleep quality (pFDR = .030). Network analyses revealed two distinct patterns: symptoms of depression were associated with less positive (pFDR = .024) and more negative affect (pFDR = .012), as well as stronger feelings of tiredness (pFDR = .014) in daily life. Fatigue was characterized by an inability of feeling relaxed (pFDR = .002), more severe tiredness (pFDR = .013) and exhaustion (pFDR = .022).

Conclusion
Our preliminary results indicate that depressive symptoms are associated with the experience of negative emotions in daily life, which could affect patients‘ motivation to engage in activities and social interactions and thus, resulting in a stronger perception of tiredness. In contrast, the manifestation of fatigue in IBD is characterised by a stronger perception of tiredness and exhaustion, but not with the experience of negative affect. Additionally to the improvement of patient’s sleep quality, treatment of depressive symptoms should focus on fostering daily activities linked to positive emotions, while relaxation techniques and regular amount of moderate exercise can be a good treatment option for fatigued patients, if these associations could be found in larger studies as well.
P1208 High Prevalence of Perianal Crohn’s Disease and Distinct Advanced Therapy Persistence in an Arab IBD cohort
Authors: Alahmad M A , Ahmed H A , Alzaabi M N , Omar N M , Ahmed E F , Quraishi M N 
Published: January 2025

Abstract

Background
Perianal Crohn’s disease (PACD) is an aggressive phenotype associated with greater morbidity and treatment complexity. Data on PACD from emerging IBD nations including those in the Middle East are lacking. This study assesses the prevalence, clinical features, prescribing patterns, and treatment persistence of PACD versus non-PACD patients in a cohort of Arab IBD patients.

Methods
An observational analysis of Crohn's disease patients under active follow-up was conducted using the SSMC IBD registry, covering 15 years (prospective data since 2022). Analysed data included disease characteristics and advanced therapy (AT) use. Kaplan-Meier survival analysis compared therapy persistence between groups, and logistic regression identified factors independently associated with PACD.

Results
Among the 206 patients with Crohn’s disease, 74 (35.9%) had perianal Crohn’s disease (PACD), highlighting its significant prevalence in this cohort. Patients with PACD had similar male to female gender ratios and were diagnosed at a slightly younger median age (22 years, IQR: 17–30.75) compared to non-PACD (25 years, IQR: 18–38), though the median age at analysis was similar between the groups. PACD patients were more likely to have ileocolonic disease (64.9% vs. 56.8%) and penetrating behaviour (24.3% vs. 13.6%) but less likely to present with isolated ileal involvement. The mean total advanced therapy (AT) exposure was 1.64 therapies (SD 1.28) in PACD compared to 1.45 therapies (SD 1.24) in non-PACD. First-line anti-TNF therapy, was significantly more common in PACD (64.9% vs. 47.7%), with infliximab alone used in 43.2% of PACD patients compared to 31.1% in non-PACD. Logistic regression analysis identified positive associations between PACD and penetrating behaviour (p=0.032), and first-line anti-TNF therapy use (p=0.02) and negative association younger age at diagnosis (p=0.026). No association was observed with disease location or immunomodulator use. Kaplan-Meier survival analysis revealed showing superior persistence of infliximab in PACD patients compared to non-PACD (log-rank p = 0.021) but not with other ATs, independent of concomitant immunomodulator use.

Conclusion
Perianal Crohn’s disease is common, affecting over a third of our Arab Crohn’s disease patient cohort, with earlier onset, more penetrating behaviour, and increased use of first-line anti-TNF therapies. Infliximab showed better persistence in PACD than non-PACD, highlighting its importance in managing this difficult phenotype. These results stress the necessity for targeted, aggressive treatments to improve PACD outcomes in Arab populations, where data on prescribing practices and therapy efficacy are limited.
P1213 The role of stress in dietary choices and disease outcomes in Inflammatory Bowel Disease
Authors: Acampora M , Usta D , Costa Pereira A , Savarese M , Avedano L , De Rocchis M S , Leone S , Graffigna G 
Published: January 2025

Abstract

Background
The role of nutrition in managing Inflammatory Bowel Disease (IBD) is widely discussed, yet its interplay with stress-related factors influencing eating behaviour and disease management remains complex. Stress-induced eating behaviours, such as increased comfort foods consumption, may exacerbate symptoms and hinder effective disease management, impacting clinical outcomes and quality of life. This study, part of EU-funded MiGut-Health project, assesses the relationship between stress, eating behaviours, and disease management in IBD patients, focusing on comfort food consumption, psychological food involvement, and disease-related factors, including health engagement, stool consistency, and disease activity.

Methods
In August 2024, a cross-sectional study was conducted applying an online survey to a cohort of 2,276 adult IBD patients across Italy. The survey included validated scales: the Patient Health Engagement Scale (PHE-s), Psychological Food Involvement Scale (PFIS), Perceived Stress Scale (PSS-10), Salzburg Stress Eating Scale, Inflammatory Bowel Disease Symptom Inventory (IBDSI-SF), and Bristol Stool Chart, along with items on Comfort Food Consumption. Data analysis involved descriptive analysis and independent samples t-test.

Results
Participants reported moderate perceived stress (mean=17.3 ± 7.75), with 35.5% indicating increased comfort food consumption when stressed, primarily chocolate (23.2%), sweet snacks (22.0%), and savoury snacks (21.0%). Individuals with high stress (32.6%) were more likely to consume fast food (mean=0.4 ± 0.66, p &lt; 0.001) and sweetened beverages (mean=0.7 ± 1.21, p &lt; 0.001). They placed greater importance on comfort food groups for managing stress (mean=2.7 ± 1.17 vs 2.5 ± 1.14, p &lt; 0.001). Disease activity was notably higher in the high-stress group (mean=29.2 ± 15.61 vs. 16.8 ± 11.66, p &lt; 0.001), alongside looser stool consistency (mean=4.8 ± 1.59 vs. 4.3 ± 1.45, p &lt; 0.001). High-stress patients also demonstrated lower health engagement (mean=2.1 ± 0.68 vs. 2.6 ± 0.74, p &lt; 0.001) and reduced psychological food involvement (mean=4.1 ± 1.17 vs. 4.4 ± 1.09, p &lt; 0.001).

Conclusion
Stress significantly shapes eating behaviours and disease management in IBD patients. High stress correlates with increased comfort foods consumption, reduced psychological food involvement, and poorer disease outcomes, including heightened symptoms, looser stool consistency, and diminished health engagement. These findings highlight the complex relationship between stress and disease-related factors, suggesting the need for integrated interventions targeting stress management to improve dietary behaviours and overall disease management in IBD.
P1331 Differences in gut microbiome comparing lifestyle habits between ulcerative colitis patients and healthy controls during COVID-19
Authors: Straume Z , Krumina N , Elbere I , Rozenberga M , Blomniece L , Zidkova L , Rudzite D , Erts R , Megnis K , Krumina A 
Published: January 2025

Abstract

Background
Tobacco smoking and alcohol consumption are leading causes of the global burden of disease and are major contributors to premature mortality. The risk factors like cigarette smoking, and diet preferences have been identified responsible for ulcerative colitis patient’s microbiome alteration.

Methods
In 12-month time (June 2021 to June 2021) 79 ulcerative colitis (UC) outpatients from Riga East Clinical University Hospital and 78 healthy controls were included in a Cross-sectional study. All patients were divided into groups according to medically proven data about COVID-19 status (COVID-19 pos vs. COVID-19 neg) within the last 6 months. Information about smoking, alcohol intake and sports activities, as well as faecal samples, were collected. For taxonomical classifying of the gut microbiome shotgun-metagenome data, MetaPhlAn v.2.6.0 tool was used. In further analysis gut microbiome (mostly bacteria phyla) and related data were analysed with SPSS 20.0.

Results
Of 157 participants, 79 patients with ulcerative colitis and 78 healthy controls. In the UC group were 35 (44.3%) females and 44 (55.7%) males, in controls 63 (80.8%) females and 15 (19.2%) males, p&lt;0.001 with a slight age difference in the UC group 38.3 (8.53) vs. 44.4 (12.8),p=0.001.People in the UC group were slightly taller (169 (8.08) vs. 174 (9.60), p=0.003) and weighed more (69.3 (13.0) vs. 75.5 (14.7), p=0.006). More smokers were reported in the UC group (17 (21.5%) vs. 6 (7.69%) in the control group, p=0.026. UC group respondents admitted smoking cessation in the past more than controls (48 (60.8%) vs.30 (38.5%), p=0.008),median pack years 9.89 (12.7) vs. 2.85 (4.87),p&lt;0.001). In the UC group, smokers had less Euryarchaeota than no smokers (M=0.3;SD=0.7 vs. M=1.0;SD=2.3, p=0.029). Also, there were no statistically significant differences regarding overall alcohol use and gut microbiome. Sports activities were less frequent in the UC group (35 (44.3%) vs. 57 (73.1%), p&lt;0.001). The most common sports activities were gym (10 (12.7%) vs. 21 (27.3%), p=0.037), stretching and yoga (8 (10.1%) vs. 18 (23.1%), p=0.04) and running (11(14.1%) vs. 13 (16.7%),p=0.8). Cycling was equally frequent in both groups 9 (11.5%), p&gt;0.05. There were no statistically significant differences between activity in sports and gut microbiota, though, cyclers had less Verrucomicrobia (M=0.58; SD=1.02 vs. M=1.46; SD=4.07, p=0.04).

Conclusion
More smokers were found in UC group. There were no differences regarding overall alcohol use and gut microbiome. There were no differences between sports and gut microbiota, except cyclers had less Verrucomicrobia.