bluuebunny/crossref_metadata_2025_split huggingface dataset:
P137 The prevalence and severity of sexual dysfunction in male IBD patients: an observational single-center study
Authors: Dal Buono A , Gabbiadini R , Alfarone L , Brunetti A , Solitano V , D'Amico F , Vena W , Pizzocaro A , Armuzzi A 
Published: January 2023

Abstract

Background
Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are lifelong disabling disorders with a significant impact on the quality of life. Previous studies reported sexual dysfunction (SD) could have a remarkable prevalence of about 25-45% in male IBD population, compared to 10-20% in the general population of the same age. However, this topic has not attracted widespread attention, and thus research studies are scarce. The aim of the study was to determine the rate and the severity of SD in a cohort of male IBD patients and to identify the associated risk factors.

Methods
This is an observational single-center study. From July 2021 to June 2022, IBD patients, who were attending scheduled visits, were invited to fill the International Index of Erectile Function (IIEF) questionnaire. Clinical data, including disease behaviour, treatment history and previous surgery, were collected. Both descriptive and inferential statistical analyses were carried out.

Results
A total of 61 male IBD patients, encompassing 33 with CD and 28 UC, were enrolled. Overall, the median age was 33.8 years (range, 19.7 – 63.7); the median body mass index (BMI) was 26.5 kg/m2 (range, 17.6 – 31.9). Almost half of the subjects were active or former smokers (49.1%). The great majority (81.9%) were receiving biological therapies, less than half had an history of IBD-related surgery (42.6%). The median total IIEF score was 64 (range, 18-75). Totally, 25.4% of the included patients reported having erectile dysfunction (ED), according to erectile function subscore. Univariate analysis showed age (p = 0.001), calprotectin levels (p&lt;0.05) and biological therapy duration (p&lt;0.05) as variables significantly associated with total IIEF score; age (p = 0.003) and calprotectin levels (p&lt;0.05) were also significantly correlated with erectile function subscore. At multivariate level, age and calprotectin levels were confirmed to significantly influence both total IIEF score (p = 0.003 and p = 0.002, respectively) and erectile function subscore (p = 0.001 and p = 0.01, respectively).

Conclusion
Nearly a quarter of included IBD patients were found having ED, while rates of 5-15% in healthy subjects of the same age has been previously reported in literature. Based on our results, gastroenterologists should assess the sexual function of IBD patients and, when indicated, prompt referral for andrological investigation should be considered to improve their quality of life.
P139 Inflammatory bowel disease and impairment of working life
Authors: Mtir M , Kchir H , Mechergui N , Cherif D , Debbabi H , Yacoub H , Hassine H , Maamouri N 
Published: January 2023

Abstract

Background
Inflammatory bowel disease(IBD) is a lifelong illness that mainly affects patients of working age with a significant impact on their professional life. In fact, the maintenance and promotion of employees is one of the important social goals and can be considered as a determinants of health for IBD patients.
The aim of the study was to analyze the impact of disease on the working life among IBD patients and to characterize the breadth of challenges they experience in their workplace.

Methods
We conducted a cross-sectional study including working patients followed for IBD, over a 9-months period. We collected sociodemographic, clinico-biological and evolutionary data. We performed a survey among these patients using a self-report questionnairy on employment status, IBD-related difficulties at work and sick leave.

Results
We included 45 patients: 80% Crohn disease and 20% ulcerative colitis. The mean age was 44 years [20-72], the sex-ratio M/F was 0.7 and the average of follow-up was 9 years [1-18]. Civil servants represented 33% of the total population, those in the private sector 47%, and those in the liberal profession 20%. The most important socio-professional category was manual workers with 51%. Thirty-seven patients(82%) developed their disease after being employed with a mean delay of 142 months[2-648]. The average number of working hours per week was 38.84 [9-60]. The majority of the employees worked full time(84%), only seven subjects worked part-time, two of them because of their IBD. One in three patients claimed to have been exposed to at least one harmful agent during their professional career. The main complaint reported by the patients during the daily work was about physical fatigue (69%). The digestive symptoms were mainly abdominal pain(53%) evaluated according to VAS with a mean intensity of 2.8 [0 - 10], subocclusive syndrome(40%), presence of diarrhea(38%), incontinence and fecal impaction(22%) which was worsened by the absence of accessible restrooms(33%). Psychological repercussions such as anxiety and depression were mentioned in 27% of cases. The average absenteeism during the last twelve months was 49.6 days [0-240] and the average number of hospitalization days was 30.7 [0-150]. Twenty patients(44%) claimed that they were subject to a salary restriction because of their illness. Only five people had alreadỳ benefited from a contact with the occupational medicine and health service.

Conclusion
IBD has a negative impact on the working life of patients, due to uncomfortable symptoms, days of absenteeism, and unadapted workplaces, which can affect career plans, professional achievement, and income. Appropriate supports and accommodations to the workplace are needed in order to improve their working experience.
P144 Impact of major medication discontinuation during the first wave of COVID-19 pandemic on the risk of early relapse in patients with inflammatory bowel disease: a French observational retrospective study
Authors: Meunier C , Monte C , Hadjisavvas H , Rozieres A , Roblin X , Venturin C , Gay C , Flourie B , Boschetti G , Danion P , Mathieu N , Charlois A L , Faure M , Nancey S 
Published: January 2023

Abstract

Background
The prevalence of nonadherence to major treatments and the subsequent adverse outcomes in IBD patients during the first wave of COVID-19 pandemic remain scarce.

Aim
to investigate the risk of early disease relapse in a cohort of IBD patients under immunosuppressants and/or biologics who decided themselves to discontinue their IBD-related major treatments without previous medical advice during the first wave of COVID-19 pandemic.

Methods
All consecutive patients with inactive IBD under immunosuppressants and/or biologics who acknowledged having withdrawn their major therapy for IBD without previous medical advice during the first wave of COVID-19 (from March 2020 to December 2020) were enrolled. The primary endpoint was the survival rate without disease relapse. Kaplan-Meier curves were plotted for time from inclusion to IBD relapse and a logistic regression model with uni- and multivariate analyses was performed to identify predictors of relapse after drug discontinuation.

Results
During the study period, among the 862 IBD patients followed as outpatients either treated with infliximab or vedolizumab (outpatient clinics n= 368) or treated with oral azathioprine, adalimumab, golimumab or ustekinumab alone or in combination (n= 494), 54 patients (6.2 %) (42 CD, 12 UC, 28 F, median age 36 years) who had discontinued themselves their IBD-related major therapy without previous medical advice were included. The median duration of drug withdrawal was 7.0 weeks (range 2-24) and the median time to relapse was 9.0 weeks (range 4-20). The most treatments withdrawn were adalimumab (n=19), ustekinumab (n=19), azathioprine (n= 12), golimumab (n=1) and a lesser degree infliximab (n=7) eand vedolizumab (n=6). During the median follow-up period of 24 weeks (range 5-42), 22 out of 54 patients (40.7 %) who discontinued their IBD treatment experienced a relapse in whom 6 requiring administration of oral steroids, 4 hospitalization and 2 IBD-related surgery. By univariate analysis, past IBD related surgery was identified as the only predictor of disease relapse after drug withdrawal (OR=3.3 CI 95 % [1.08-10.38].

Conclusion
In IBD patients, major treatment discontinuation by the patients themselves without medical advices during the first wave of pandemic Covid-19 including the lockdown was associated with a substantial risk of disease relapse occurring in around 4 out of 10 patients and subsequent further risk of need for steroids, hospitalization and surgery. Strategies targeting the adherence to therapy and patient’s informations about the real risks leading to drug discontinuation are of paramount interest, especially during health crisis to minimize such issues.
P146 Stigmatization and resilience in inflammatory bowel disease patients at one-year follow-up
Authors: Broglio G , Lenti M V , Mengoli C , Borrelli De Andreis F , Vernero M , Pitotti L , Padovini L , Delliponti M , Klersy C , Corazza G R , Di Sabatino A 
Published: January 2023

Abstract

Background
Inflammatory bowel disease (IBD), namely ulcerative colitis and Crohn’s disease, is a chronic relapsing immune-mediated condition that may cause an impairment of social functions due to stigmatisation. Resilience instead is associated with an improvement in coping with adversities and thus may counteract the detrimental effects of stigmatisation. We here sought to determine the fluctuation of stigmatisation and resilience in a cohort of patients with IBD at 1-year follow-up.

Methods
This is a prospective, monocentric study conducted in a tertiary referral centre. All patients with IBD were assessed at enrolment and at one-year follow-up. Several clinical and demographic variables were collected. Stigmatisation was assessed through a validated Italian version of the Perceived Stigma Scale for IBD (PSS-IBD), while resilience was assessed through the 25-item Connor Davidson Resilience Scale (CD-RISC25). Also, self-efficacy scale (SEF), and self-esteem scale (SES) were assessed.

Results
In this study, 105 patients were enrolled (46 Crohn’s disease, 59 ulcerative colitis; mean age 47 years ±11, M:F ratio 1:1.2). None of the 4 scales showed a significant variation at one year compared to baseline (median CD-RISC25 64 at baseline vs 61 at follow-up; SEF 31 vs 30; SES 32.5 vs 32; PSS-IBD 0.45 vs 0.45). A statistically significant and inverse correlation was found between CD-RISC25 and PSS-IBD (rho -0.222, p=0.01), SEF and PSS-IBD (rho -0.219, p= 0.01), SES and PSS-IBD (-0.316, p=0.003). CD-RISC25 was found to be positively associated with inactive IBD (p=0.05).

Conclusion
Patients with IBD may perceive stigmatisation due to their disease, and this variable is stable on a long term. Interventions aimed at improving resilience, self-esteem, and self-efficacy may potentially counteract stigmatisation.
P149 Novel capillary blood point-of-care test for adalimumab and infliximab trough levels: Effects of abnormal blood conditions on the test result
Authors: Brosi L , Reinhard C , Anchling L , Afonso J , Schuster T , Gerhold C B , Ricken B 
Published: January 2023

Abstract

Background
Patients suffering from inflammatory bowel disease can be treated with the biologics adalimumab (ADL) or infliximab (IFX). Previous studies demonstrated the usefulness of therapeutic drug monitoring (TDM) to adjust the patient’s biologic concentration individually. Commercially available rapid assays support laboratories in the fast and easy detection of ADL and IFX concentrations but the assays’ dependency on serum as analyte matrix is a general hindrance for TDM, as serum preparation from whole blood is time-consuming and requires laboratory equipment. Patients and clinicians would thus benefit from rapid point-of-care (POC) and easy to use assays that are independent of laboratory equipment. The objective of this project was to expand existing serum lateral flow assays for the analysis of ADL or IFX in capillary blood and investigate potential interactions resulting from the blood matrix.

Methods
ADL and IFX lateral flow serum kits were optimized in such a way that both, capillary blood and EDTA whole blood can be used as analyte matrix by using disposable capillaries for blood collection and for its transfer into dropper bottles that are prefilled with chase buffer. To measure ADL or IFX levels with a POC lateral flow test cassette reader (BÜHLMANN Quantum Blue® Reader) the mixture is then applied on an ADL or IFX lateral flow test cassette. Matrix agreement studies were performed to compare spiked EDTA whole blood and capillary blood samples with serum as reference. Additionally, spiked EDTA whole blood samples were treated to obtain three abnormal blood conditions: Icteric, hemolytic and lipemic blood. Bias in results exceeding 30% relative difference to the untreated sample was considered as an interference.

Results
Spiked blood samples showed good agreement with reference serum samples. A bias of less than 15% at the clinical decision points for ADL (5 µg/mL and 12 µg/mL) and IFX (3 µg/mL and 7 µg/mL) was revealed. Observed relative differences between all tested abnormal blood conditions ranged between -20% and +26% for IFX and -16% and +5% for ADL.

Conclusion
Two POC assays for the determination of ADL or IFX in capillary blood or EDTA whole blood samples were successfully developed and can be used by healthcare professionals with time to results of only 15 minutes and without the need for additional laboratory equipment. No systematic interferences were detected with treated EDTA whole blood samples, which could appear when using blood as analyte matrix. The excellent agreement to serum trough levels shows that the POC adalimumab/infliximab capillary blood assays are ideal for therapeutic drug monitoring analysis at a clinician’s office or an infusion site.
P152 The prevalence of Thiopurine-methyltransferase and NUTD15 in patient with ulcerative colitis: a hospital-based study in central Taiwan
Authors: Wu Y H , Chou J W , Po J H , Wang C P , Cheng K S 
Published: January 2023

Abstract

Background
Thiopurine S-methyltransferase (TPMT) is a cytosolic enzyme involved in the metabolism of these thiopurine drugs. Methylation of thiopurine drugs by TPMT competes with the formation of their active 6-thioguanine nucleotide metabolite, thereby potentially modulating the therapeutic and toxic effects of these drugs. Polymorphisms in TPMT and Nudix hydrolase-15 (NUDT15) have been implicated as the predominant cause of thiopurine-induced leukopenia in the Western and East Asian countries, but the frequency of the risk alleles is lower in Asians. Recently, a variant in the NUDT15 was reported to be associated with early severe leukopenia in Asians. The exact role of these polymorphisms in patients with ulcerative colitis (UC) in Taiwan is uncertain.
The aim of this study was to investigate the prevalence of TPMT and NUDT 15 variants and other characteristics in patients with UC in central Taiwan.

Methods
From January 1980 to November 2022, a total of 172 consecutive patients with UC at the China Medical University Hospital, a tertiary referral center in central Taiwan, were enrolled in this study. Clinical characteristics of patients with UC, including gender, age at diagnosis, disease phenotype and behavior, were collected. We used polymerase chain reaction-restriction fragment length polymorphism method to determine the allelic frequencies of TPMT and NUD15 variants in our UC patients.

Results
A total of 172 patients with UC was enrolled into our current study. The mean diagnostic age of these enrolled patients was 46.1 years (ranging from 21 years to 75 years old). Male accounted for the majority of all patients in our present study (64.5%). Among these 172 patients with UC, TPMT variants were tested in 138 patients, which showed the allelic frequencies of TPMT*1 were 98.5% (136/138) for patients with UC. The allelic frequencies of TPMT*3C were 1.5% (2/138) for patients with UC. No TPMT*2, 3A, 3B, 3D and 4-8 were found in these populations. In addition, NUD15 was tested in 123 patients with UC, which showed normal metabolizer in 109 patients (88.6%, 109/123), intermediate metabolizer in 14 patients (11.4%, 14/123), and poor metabolizer in 0 patient (0%, 0/123).

Conclusion
NUDT15 mutation rate was significantly higher than TPMT polymorphism and reached 11.4%. NUDT15 mutation was associated with thiopurine-induced leukopenia. The measurement of NUDT15 polymorphism can increase the safety of thiopurine dramatically and is a successful example of personalized medicine in the field of UC. Phenotypic TPMT and NUDT15 analysis could be useful to better manage UC therapy with thiopurine.
P156 Submucosa hypertrophy of active UC patients suggests transmural involvement in UC-associated inflammation
Authors: Kucharzik T , Helwig U , Strobel D , Fischer I , Hammer L , Rath S , Maaser C ,   TRUST&UC
Published: January 2023

Abstract

Background
Transmural response and healing assessed by intestinal ultrasound (IUS) have gained relevance as outcome measures with the ability to guide treatment decisions in inflammatory bowel diseases (IBD). Bowel wall thickness (BWT) is the most widely used IUS parameter and encompasses the thickness of mucosa, muscularis mucosae, and submucosa [1]. Recently, the ratio between submucosa/BWT to estimate endoscopic remission was suggested [2] and de Voogd et al. have shown that the submucosa is the most responsive wall layer [3]. However, little is known about the association between submucosa hypertrophy and clinical as well as lab parameters.

Methods
TRUST&UC was a prospective, observational study including 224 UC patients with increased BWT at baseline and active disease (SCCAI ≥ 5) with up to 4 visits (baseline, optional visit at week 2 (W2), W6 and W12). At baseline, patients received therapy intensification according to standard of care. In this post-hoc analysis, 171 patients with a W12 visit ± 4 weeks were included. Overall BWT, mucosa and submucosa thickness were evaluated for the sigmoid colon and stratified for SCCAI, CRP, fecal calprotectin (fCal), and Mayo endoscopic subscore (MES).

Results
Active UC patients in our cohort had a median age and disease duration of 37.1 years (28.9 –50.2) and 3.55 years (0.54 – 10.18), more were male (56.6%, n = 95). At baseline, UC patients presented with a high disease activity reflected by a median SCCAI of 9.00 (7.0-10.0). Mean values for BWT, mucosa, and submucosa were 5.54 mm, 1.7 mm, and 2.32 mm, respectively. Over the study course, mucosa and submucosa thickness were significantly reduced with the most pronounced reduction happening within the first 2 weeks (figure 1). Patients with SCCAI ≤ 2 tended to have a more reduced mucosa and submucosa thickness than patients with SCCAI &gt; 2 (fig 2A, A1). Whilst a similar trend was observed for fCal values (not shown), this effect was found neither for CRP (not shown) nor for MES.

Conclusion
We found that both mucosa and submucosa thickness of active UC patients were reduced as a consequence of therapy intensification. The lack of difference in thickness of both mucosa and submucosa in patients with and without MES improvement might indicate fibrotic alterations in these patients which needs further evaluation. Based on these and previous results of our group, we suggest measuring BWT in conjunction with other established IUS parameters such as colour Doppler signal to assess disease activity in UC.
1-Ilvermark et al. JCC 2022
2-Miyoshi et al. J Gastroenterol 2022
3-de Voogd et al. Gastroenterol 2022
P158 Intestinal Ultrasound at IBD diagnosis predicts surgery – a Copenhagen IBD cohort study
Authors: Madsen G R , Attauabi M , Wilkens R , Ilvemark J F K F , Theede K , Bjerrum J T , Bendtsen F , Seidelin J B , Boysen T , Burisch J 
Published: January 2023

Abstract

Background
The disease course of inflammatory bowel disease (IBD) is heterogeneous and unpredictable. Currently, we are unable to predict which patients will need IBD-related bowel resection in the first year after diagnosis. Intestinal Ultrasound (IUS) has been proven as a non-invasive modality for assessing disease activity in IBD. However, the evidence for IUS as a predictor of disease course is still limited. Here we present novel data on the predictive value of IUS performed at the time of IBD diagnosis.

Methods
Patients with new-onset IBD are currently being included in the ongoing multicentre prospective inception cohort study, the IBD Prognosis Study (May 2021 – April 2023). IUS is performed at the time of diagnosis and the patients are followed prospectively. Patients with proctitis are not assessed with IUS. The International Bowel Ultrasound Segmental Activity Score (IBUS-SAS) is calculated for the most inflamed segment with a high score indicating severe disease activity. IBUS-SAS (0-100) incorporates the bowel wall thickness (BWT), bowel wall stratification, colour Doppler signal, and inflammatory fat. Surgery was defined as an IBD-related bowel resection. Patients treated with corticosteroids for &gt; 72 hours or with any IBD-treatment &gt; two weeks prior to IUS were excluded from analysis. In this abstract, we report our preliminary results after including patients for 16 months.

Results
IBUS-SAS at diagnosis was available in 133 patients (out of 242 included). 68 patients were diagnosed with Crohn’s disease (CD) (ilieal: 22, colonic: 23, ileocolonic: 23) and 65 patients were diagnosed with ulcerative colitis (UC) or unclassified IBD (left-sided colitis: 20, extensive colitis: 45). Median follow-up was 226 days. During follow-up 10 patients underwent surgery (7.5%). These included 4 patients with UC (extensive colitis: 3, left-sided colitis: 1) and 6 patients with CD (ileal: 2, colonic: 2, ileocolonic: 2). Mean IBUS-SAS at diagnosis was 92.6 among patients who underwent surgery during follow-up vs. 48.8 for patients who did not undergo surgery (p&lt;0.0001). Distribution of scores is shown in Figure 1. Mean BWT at diagnosis was 8.3 mm among patients who underwent surgery during follow-up vs. 5.0 mm for patients who did not undergo surgery (p&lt;0.0001). In total, 12 patients had an IBUS-SAS &gt; 90 at diagnosis and among these 7 (58.3%) were operated during follow-up. Figure 2 shows a Kaplan-Meier Curve of surgical free survival stratified by IBUS-SAS at diagnosis.

Conclusion
IUS activity at diagnosis of IBD seems to have the capability to predict short term risk of IBD-related surgery. Our results suggest IUS might be used at diagnosis to identify patients at high risk of IBD-related surgery.