bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0912 Factors associated with adherence to the Mediterranean diet in patients with Ulcerative Colitis after pouch surgery
Authors: Elial-Fatal S , Pfeffer-Gik T , Shelly S , Pauker M H , Friedenberg A , Cohen S , Barkan R , Ollech J , Yanai H , Wasserberg N , White I , Dotan I , Godny L 
Published: January 2025

Abstract

Background
Dietary interventions are increasingly used in managing inflammatory bowel diseases (IBD). Effectiveness often depends on patient adherence. We aimed to assess the nutritional and clinical feasibility of a Mediterranean diet (MED) based nutritional education program (IBDMED) in patients with ulcerative colitis (UC) after pouch surgery.

Methods
Patients who underwent pouch surgery due to ulcerative colitis and who were clinically inactive were randomly assigned to either (A) Intervention group – IBDMED program including MED based dietary counseling and weekly phone calls with study dietitian, access to an application with dietary information, recipes, online chat and fitness trackers, or (B) Standard of care dietary counseling for 8 weeks. Patient adherence was assessed using a predefined IBDMED score during the intervention and at 1-year follow-up (NCT04082559)

Results
A total of 32 patients after pouch surgery (median age- 50 (35.7-64.7) years, median BMI- 24.9 (22.7-29.1) Kg/m2, female gender 40.6%) underwent an 8-week nutritional intervention (group A: n=18, group B: n=14). Highest satisfaction score (5/5) was rated in both groups (88.9% vs. 71.5%, p=0.21). Reduction in number of bowel movements was comparable across groups (22.2% vs. 14.3%, p=0.57), with a trend towards a greater improvement in stool consistency in the intervention group (44.4% vs. 14.3%, p=0.07). The magnitude of dietary change was higher in the intervention group with 66.6% reported significant changes in their dietary habits vs. 21.4% in the control group (p=0.01). Increased consumption of the IBDMED recommended food components was reported to be significantly higher in the intervention group for vegetables, olive oil and yogurt (p&lt;0.05 for all, Figure 1). Notably, effect on lifestyle behaviors of patients’ family members was reported in 44.4% in the intervention group vs. 21.4% in the control group (p=0.17). Factors contributing to increase adherence to the intervention were weekly phone calls with the dietitians (100%), followed by the IBDMED daily questionnaire and fitness trackers (both 83.3%), online chat with the dietitians (50%), weekly progression reports (33.3%) and online recipes (22.2%). Finally, IBDMED adherence score at 1-year follow-up tended to be higher in the IBDMED group (11.7 + 2.1 vs. 9.8 + 2.4, p=0.07, n=22).

Conclusion
The IBDMED program is feasible and effective in improving diet composition and stool consistency in patients after pouch surgery and inactive disease. Improved adherence to dietary intervention is associated with personal interactions with a dietitian and the use of digital support tools.
P0913 Characteristics of patients with very late-onset ulcerative colitis: A single-center retrospective study
Authors: Ito A , kouroku M , Yonezawa M , Tani K , Futatsuki R , Ogawa S , Shigeki Y , Nakai Y 
Published: January 2025

Abstract

Background
Very late-onset ulcerative colitis (UC) has become prevalent in recent years. The differences between very late-onset, late-onset, and early-onset ulcerative colitis have not yet been studied.

Methods
The clinical characteristics, steroid side effects, remission rates, and surgical rates of UC patients were retrospectively studied. Patients were allocated to three groups according to age at diagnosis: very late-onset group (≥ 65 years), late-onset group (50–64 years) and early-onset group (≤ 49 years). Surgery rates, within 1-2 years of diagnosis, were examined in terms of number of cases.

Results
Clinical characteristics such as admission age, duration of disease, history of cancer, days to diagnosis, clinical activity on admission, hemoglobin level on admission, and steroid use were significantly different between the three groups. The adverse effects of steroids were significantly more common in the very late-onset group. The remission induction rate differed significantly between the three groups: early onset, 390 (83.6%); late onset, 84 (71.7%); very late onset, 22 (67.7%).
Significant differences were found in surgery rates within 1-2 years of diagnosis: surgery rates within 1 year of diagnosis, early-onset: 10 cases (3.5%), late-onset: 2 cases (3.4%), very late-onset: 3 cases (14.2%). Surgery rate 2 years after diagnosis, early-onset: 12 cases (4.2%), late-onset: 6 cases (10.3%), very late-onset: 5 cases (23.8%) (P &lt; 0.05) (Figuer1).

Conclusion
In this study, there were no significant differences in the use of non-steroidal medications among the three groups. Our findings indicate that an older age of onset of UC is associated with more steroid side effects, lower remission rates, and a higher rate of surgery within 1–2 years of diagnosis, suggesting that very late-onset UC is more refractory than early-onset UC. We hypothesize that age-related immune changes may explain this finding.
P0919 Correlation between trough levels of risankizumab and clinical and biological remission in patients with moderate to severe Crohn’s disease: a retrospective multicenter study (RISE-CD)
Authors: Sequier L , Altwegg R , Barrau M , Bozon A , Nancey S , Boschetti G , Roblin X , Caillo L 
Published: January 2025

Abstract

Background
Inflammatory bowel disease management has evolved in recent years, with the emergence of new biotherapies such as risankizumab,(RZB) an interleukin (IL) 23 p19 inhibitor, with demonstrated efficacy in moderate-to-severe Crohn’s disease.
While the relationship between trough levels and clinical remission is well established for anti-TNF alpha agents, it has yet to be demonstrated for new molecules of interest. The aim of this study was to investigate the correlation between RZB trough levels and clinical and biological remission at 6, 12 and 18 months.

Methods
This retrospective multicenter study included patients with moderate-to-severe Crohn’s disease from 4 centers, who were being treated with RZB after failure of all other approved biotherapy lines. Clinical activity, assessed by the Harvey-Bradshaw Index (HBI) and biological activity with CRP and fecal calprotectin, as well as serum RZB levels by Elisa technique (Biosynex) were collected. The primary endpoint was clinical and biological remission at 12 months, defined as HBI &lt; 4, CRP &lt; 5 mg/L and fecal calprotectin &lt; 250 µg/g of stool. Secondary objectives were the correlation between RZB levels and clinical and biological remission at 6 and 18 months, treatment persistence, and safety.

Results
Overall, 43 patients were included in 4 centers. Most patients had ileocolic Crohn’s disease (44.7%), 50% had ano-perineal lesions, 23.7% had extra-intestinal manifestations and 71.7% had a history of bowel resection. Six patients (15.8%) were receiving a combination of advanced therapies with upadacitinib or golimumab. At 12 months, 30.2% of patients were in clinical and biological remission (n=13) and had significantly higher RZB trough levels than patients who were not in remission (8.26 ± 4.66 vs. 4.44 ± 2.37 respectively; p=0.002). The ROC curve identified an optimal risankizumab trough levels threshold of 7.7 µg/mL for predicting clinical and biological remission at 12 months (sensitivity 61.5%; specificity 92%). At 6 and 18 months, 11.7% (n=5) and 34.9% (n=15) of patients were in clinical remission and had significantly higher RZB trough levels. At 6 months, 12 months and 18 months, 43 (100%), 38 (88.4%) and 31 (72%) patients were still on RZB. No patient developed anti-risankizumab antibodies.

Conclusion
In our multicenter study, with the largest number of patients analyzed to date, trough levels of risankizumab were correlated with clinical and biological response at 12 months in patients with moderate-to-severe Crohn’s disease, in line with data from previous single-center studies but larger prospective studies are still needed.
P0923 Impact of Inflammatory Bowel Disease on Women’s Health
Authors: Bhardwaj A , Singh D M A , Sharma R , Bansal N , Singh D , Midha V , Sood A 
Published: January 2025

Abstract

Background
Inflammatory bowel disease presents chronic challenges that disrupt physical well-being and create significant psychosocial stressors. Despite known gender-specific issues, data on how IBD affects women, particularly in a socio-cultural context, remain limited.

Methods
We conducted a cross-sectional study with 202 women diagnosed with IBD, recruited from a tertiary care center in north India. Participants were subjected to a structured questionnaire covering health domains influenced by IBD, including menstrual and reproductive health, sexual function, social dynamics, mental health, financial burdens, and access to healthcare services in a face-to-face interview.

Results
The median age of participants was 41 years, with a median disease duration of 5 years. Menstrual irregularities were reported by 50%, and 57% females experienced severe menstrual pain. Among sexually active participants, 82.5% showed signs of sexual dysfunction. Reproductive concerns were prevalent, with 55.4% worried about heritability, while only 2.5% received guidance on cervical cancer screening. The median SICC-IBD score of 0.6 (0.4-0.6) indicated substantial social impacts, with family and societal stigma reported by 43% of participants, leading to strained relationships and decreased quality of life. Financial concerns were notable, with nearly 25% of monthly income being spent on IBD medications. Mental health concerns were significant; 95% reported moderate-severe stress, and 70% had symptoms suggestive of moderate to severe anxiety or depression. (Figure 1)

Conclusion
IBD significantly impacts the lives of women beyond clinical symptoms, affecting menstrual, sexual, and reproductive health, and exacerbating social, mental, and financial strains. Limited access to healthcare support and social stigmatization further complicate disease management. Addressing these unique challenges requires holistic and multidisciplinary interventions that incorporate reproductive health counseling, mental health support, and tailored socio-cultural interventions to improve the overall well-being of women with IBD. This study underscores the need for gender-specific approaches in managing IBD in resource-limited settings.
P0924 Efficacy and Safety Assessment of Ustekinumab in Postoperative Crohn’s Disease Patients in China
Authors: Xianzong M , Jia Y , Linyan Z , Xinmei Z , Xingzhao H , Ling L , Xuchun Z , Feng T 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) poses a significant risk of postoperative recurrence (POR), complicating management, and data on the use of Ustekinumab (UST) in postoperative CD patients in China is limited. This study evaluated the efficacy and safety of UST in preventing POR.

Methods
This multicenter, retrospective observational study involved postoperative CD patients from four Chinese tertiary hospitals, all of whom had at least two high-risk recurrence factors. Patients who failed anti-TNF-α treatments or Vedolizumab switched to UST as non-first-line therapy, while others received UST as first-line treatment at least two weeks post-surgery. Efficacy was evaluated using endoscopic success (Rutgeerts score) and clinical disease activity (Harvey-Bradshaw Index [HBI]), with safety determined by adverse events after a minimum follow-up of 24 weeks.

Results
This study included 53 patients with a mean age of 36.8 years. Significant improvement in the Rutgeerts score was observed (p &lt; 0.001). The remission rate (i0) increased from 0.0% to 32.1% post-treatment. Notable changes were seen in i1 (from 5.7% to 32.1%) and i2 (from 49.1% to 28.3%), while severe disease cases (i3 and i4) declined significantly. Overall, the endoscopic success rate was 83.0%. Similarly, the HBI score significantly improved (mean ± SD: 6.1 ± 2.5 before vs. 2.4 ± 1.7 after, p &lt; 0.001). The median HBI decreased from 6.0 to 2.0, with remission rates rising from 18.9% to 90.6%, while active disease cases fell from 81.1% to 9.4% (p &lt; 0.001). The percent of 90.3 in the first-line group experienced a decrease in their Rutgeerts score, compared to 72.7% in the second-line group, though this difference was also not statistically significant (p = 0.093). A significant difference was noted in HBI scores (p = 0.016), with the first-line group’s mean at 1.9 ± 1.3 being significantly lower than the second-line group’s 3.1 ± 1.9. The median HBI followed this trend, with values of 2.0 for the first-line and 3.0 for the second-line group. The mean BMI increased from 19.9 ± 3.8 to 21.1 ± 3.7, though not significantly (p = 0.078). Nutritional status improved, as indicated by increased mean albumin (41.3 ± 15.2 vs. 43.7 ± 15.3, P = 0.043) and hemoglobin levels (116.6 ± 24.9 vs. 125.9 ± 23.9, P = 0.019). Only one adverse event, secondary kidney function impairment, was reported.

Conclusion
UST exhibited significant efficacy in preventing POR of CD with a favorable safety profile, whether used as a first-line or non-first-line treatment. Our research provided essential evidence from an Eastern population regarding the effectiveness and safety of UST in postoperative CD patients.

References
Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis. 2020. 14(1): 4-22.
P0926 The impact of anti-integrin αvβ6 antibody positivity on clinical characteristics and treatment outcomes with biological agents in pediatric IBD: a single-center retrospective study
Authors: Oue H , Takeuchi I , Hiejima E , Tanioka A , Komorizono R , Maeda Y , Nihira H , Shiokawa M , Shimizu H , Arai K 
Published: January 2025

Abstract

Background
Anti-integrin αvβ6 antibody (V6Ab) has emerged as a promising diagnostic marker for differentiating ulcerative colitis (UC) from Crohn’s disease (CD) in adult. However, approximately 30% of pediatric-onset CD cases reportedly exhibited V6Ab positivity. The impact of V6Ab on the clinical characteristics and treatment response of pediatric inflammatory bowel disease (IBD) remains unknown. This retrospective single-center study aimed to investigate the clinical characteristics and relevance of V6Ab in pediatric IBD as a pilot study.

Methods
We retrospectively reviewed the records of 60 children with IBD whose V6Ab status was measured (V6Ab+CD: 22 cases, V6Ab-CD: 17 cases, V6Ab+UC: 18 cases, V6Ab-UC: 3 cases). Associations between V6Ab and reclassification of diagnosis, perianal lesions, endoscopic and clinical activity scores, and anti-TNF failure were analyzed. V6Ab positivity was defined as an optical density (O.D.) &gt;0.2525 at 450 nm. Clinical remission was determined by a weighted Pediatric Crohn’s Disease Activity Index (wPCDAI) ≤2, while endoscopic remission was based on a Simple Endoscopic Score for Crohn’s Disease (SES-CD) ≤2. Anti-TNF failure referred to discontinuation due to insufficient efficacy, excluding cases related to side effects.

Results
13 V6Ab+CD cases were initially diagnosed as UC and later reclassified to CD based on the revised-Porto criteria. The prevalence of perianal lesions was significantly lower in V6Ab+CD compared to V6Ab-CD (3/22 vs 11/18, respectively, p&lt;0.05). Furthermore, UC-like colonic findings, such as granular mucosa and loss of vascular pattern, were significantly more common in V6Ab+CD than in V6Ab-CD (22/22 vs 3/18, respectively, p&lt;0.05). Anti-TNF failure occurred in 10/17 V6Ab+CD cases was significantly higher than that in UC (1/9, p&lt;0.05) but comparable to V6Ab-CD (8/13, p&gt;0.99). Among CD cases treated with ustekinumab (UST) following anti-TNF failure, V6Ab+CD demonstrated a significantly higher endoscopic remission rate (5/7) compared to V6Ab-CD (0/6, p&lt;0.05), even though clinical remission rates did not differ significantly between the groups. (7/7 vs 5/6, respectively, p&lt;0.05)

Conclusion
V6Ab+CD cases may have a higher risk of anti-TNF failure compared to V6Ab+UC. Additionally, ustekinumab (UST) appears to be effective for V6Ab+CD patients who experience TNF failure. These findings suggest the potential of V6Ab as a valuable biomarker for precision medicine. Further analyses from ongoing multi-center prospective studies in Japan are eagerly awaited.
P0928 Patient endotypes in ulcerative colitis revealed by longitudinal symptom trajectories under therapy
Authors: El Houjjaji C , Paun A , McBride J , Schreiber S , Mueller-Breckenridge A J 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) poses unique challenges in patient care. Although therapies have led to better outcomes, only 20-30% of patients enter remission, and even fewer sustain it over time. A critical need remains in addressing three key areas: i) predicting which patients will enter remission, ii) tailoring treatments to individual patient needs, and iii) identifying novel therapeutic targets that can sustain long-term remission. Symptom trajectories under therapy offer an accessible approach to addressing these challenges and this work investigates their alignment with molecular responses to assess their clinical value.

Methods
Using a reverse translation approach, this study analyses longitudinal data from the etrolizumab phase 3 trials to gain insights into the UC patient population. Symptom response trajectories of 437 UC patients were tracked over 54 to 66 weeks using the partial Mayo Clinical Score (pMCS). Through unsupervised clustering of pMCS, we identified distinct subpopulations based on their patterns of disease activity. Clinical outcomes within these clusters were then examined, allowing us to uncover significant predictors of rapid and sustained remission. Molecular profiling using gene expression data was then performed, revealing the biological mechanisms that differentiate these patient groups and providing insights into their treatment responses.

Results
Our analysis revealed five distinct patterns of disease response and progression, from patients achieving rapid and deep remission to those with persistently high disease activity. These five symptom-based subgroups match closely with traditional clinical endpoints. We found that predictors of sustained remission, such as elevated albumin levels, low endoscopic scores, and reduced markers of inflammation (faecal calprotectin and C-reactive protein) aligned with these subgroups. In addition, molecular profiling highlighted specific differences in gene expression and immune cell activity, notably showing that patients with deep remission had an enrichment of anti-inflammatory signalling pathways, suggesting a biological basis for their favourable outcomes.

Conclusion
Longitudinal monitoring of symptom trajectories offers a non-invasive, easily measured and reliable proxy for early assessment of the likelihood of achieving deep, sustained remission in UC patients. These symptom patterns show strong concordance with endoscopic, laboratory, and molecular remission profiles. This approach aligns with the principles of personalised medicine by enabling i) dynamic symptom monitoring ii) application in Phase II trials to guide drug development by assessing if a patient is on the right path toward therapeutic success and iii) identification of novel therapeutic targets.
P0931 Induction treatment with upadacitinib is associated with high rate of clinical response in patients with refractory Inflammatory Bowel Disease
Authors: Kitsou V , Ioannou A , Kokkotis G , Chalakatevaki K , Laoudi E , Leonidakis G , Michopoulos S , Zampeli E , Bamias G 
Published: January 2025

Abstract

Background
Upadacitinib is an oral selective Janus kinase-1 (JAK1) inhibitor, that has been approved for the treatment of moderate to severe Ulcerative Colitis (UC) and Crohn’s Disease (CD). The recommended induction dose is 45 mg once daily for 8 weeks for UC and 12 weeks for CD, followed, thereafter, by a maintenance dose of 15 mg or 30mg (for patients with refractory, severe or extensive disease). Our study aims to capture the experience of two tertiary centers on upadacitinib use in refractory UC and CD.

Methods
This is an ongoing, prospective cohort study. Demographic and disease-related data were collected at baseline. Our primary endpoint is clinical response (CR) at the end of induction, defined as &gt;50% decrease in Patient Reported Outcomes (PROs) and secondary endpoints were steroid-free clinical remission (sf-CRem) and treatment persistence. SPSS23 was used for the statistical analysis.

Results
The baseline characteristics of our patients are presented in Table 1. At drug initiation, 35.4% were receiving concomitant corticosteroids. The induction period has been concluded by 23/26 patients with UC and 17/21 patients with CD, of whom 22 (95.7%) and 13 (76.5%) respectively commenced maintenance treatment. The primary endpoint of CR was achieved by 19 out of 20 (95%) patients with clinically active UC and 11 out of 16 (68.8%) patients with clinically active CD at baseline. Sf-CRem was achieved by 21/23 (91.3%) patients with UC and 13/17 (76.5%) with CD. The majority of patients with either UC (86.4%) or CD (84.6%) commenced maintenance therapy with a 30 mg dose. Adverse events occurred in 22.9% of patients in our cohort, with acne being the most frequently reported (12.5%). One patient (2.1%) experienced herpes simplex infection and two (4.2%) an increase in their lipid levels, requiring initiation of antihyperlipidemic therapy. No serious adverse events have been reported.

Conclusion
In our cohort of patients with Inflammatory Bowel Disease who were refractory to multiple advanced treatments, upadacitinib has been shown to be an effective and safe therapeutic option for induction of remission. Most patients with medically refractory IBD in our cohort have received increased maintenance Upadacitinib dosage.