bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1093 Personalized Tasty&Healthy whole-food diet for maintaining remission in children and adults with Crohn’s disease: results from the MyTasty open-label trial
Authors: Plotkin L , Aharoni Frutkoff Y , Shavit Z , Focht G , Livovsky J , Buchuk R , Lev-Zion R , Ledder O , Assa A , Sigall Boneh R , Weiss B , Slae M , Dotan I , Kierkuś J , Broide E , Griffiths A , Naftali T , Aloi M , Yerushalmy-Feler A , Schwerd T , Reifen R , Turner D ,   T&H
Published: January 2025

Abstract

Background
The Tasty&Healthy™ (T&H) diet offers a flexible alternative to exclusive enteral nutrition (EEN) for inducing remission in Crohn’s disease (CD). Unlike CDED, it excludes processed foods, gluten, red meat, and most dairy but does not rely on formula or mandatory ingredients. The "MyTasty" trial aimed to assess the effectiveness and feasibility of T&H for maintaining remission in children and adults with CD, with gradual reintroduction of gluten and dairy

Methods
Patients with CD (4-37 years of age) who entered deep remission (i.e. MINI index &lt;8 and wPCDAI&lt;12.5/CDAI&lt;150) with dietary treatment during one of the two induction RCTs of T&H (TASTI-MM and TASTI-E), were enrolled in this 16-week, open-label maintenance trial. Participants followed T&H with gradual reintroduction of gluten, milk, and other dairy products monthly, dictated by home-based fecal calprotectin (FC). FC increase by &gt;30% suggested failure of the new food and thus it was excluded again.

Results
Altogether, 43 patients (mean age 16±5.8 years, 10 adults, median disease duration 1.5 months [IQR 0.49–2.95]) were enrolled, with 34 (79%) completing the 16-week dietary period. At week 16, 32/43 (75%) had FC&lt;250, 32/43 (75%) had normal CRP, 34/43 (79%) had MINI-index&lt;8 (implying mucosal healing), 37/43 (86%) were in clinical remission (wPCDAI &lt;12.5/CDAI &lt;150), and 21/43 (49%) achieved deep remission (clinical remission, normal CRP, and FC&lt;250, figure 1).
Of the 34 completing the study, 19 (55%) successfully introduced gluten, milk, and dairy without increases in inflammation markers, and 2 introduced all three but with an FC increase at week 16. Among others, 6 tolerated milk/dairy but not gluten, 1 tolerated only milk, 3 tolerated gluten but not milk/dairy, and 2 tolerated gluten and milk but not other dairy. Only one patient tolerated no additions, staying on the unmodified T&H diet. Among 13 patients where a specific food caused &gt;30% baseline FC increase, re-exclusion reduced FC to pre-change levels in 12 (92%).
Nutritional analysis showed T&H patients met &gt;90% of Dietary Reference Intakes (DRI) for key macro- and micronutrients, except calcium and potassium. Additionally, 19 (55%) reported improved satisfaction with food-related life compared to the unmodified T&H diet period.

Conclusion
Overall, 49% of patients whose remission was previously induced by nutritional therapy, successfully maintained deep remission with the whole-food Tasty&HealthyTM diet over 4 months. We show the feasibility of personalized dietary treatment with home kits of FC, allowing for dietary flexibility in most patients. Oral calcium supplement may be needed with T&H.
P1094 Serum Chitinase 3-like-1 (CHI3L1) is correlated to fecal calprotectin levels in IBD patients during pregnancy
Authors: Schweistein H , Rave A , Glusman Bendersky A , Ollech J E , Ariella B G S 
Published: January 2025

Abstract

Background
Monitoring inflammatory bowel disease (IBD) activity during pregnancy remains a challenge due to limitations of non-invasive markers. Although fecal calprotectin is considered a reliable marker, its utility is constrained by limited patient adherence and accessibility. Blood-based markers provide a more convenient alternative, however, standard markers like CRP and ESR have reduced reliability in pregnant IBD patients. Serum chitinase-3-like-1 (CHI3L1) is a promising candidate biomarker due to its association with intestinal inflammation and its elevated levels in IBD patients.The aim of this study is to investigate whether serum CHI3L1 levels can reliably indicate disease activity in pregnant IBD patients by comparison with standard markers, including calprotectin, CRP, and ESR.

Methods
Pregnant IBD patients were recruited from our multidisciplinary IBD-MOM referral clinic for this IRB-approved, prospective observational study. Blood samples were collected for CHI3L1, CRP, and ESR levels during elective clinic visits, while stool samples were used to measure calprotectin levels. Each visit was classified as a distinct sample for analysis. Correlations between CHI3L1 and other inflammatory markers were assessed.

Results
A total of 124 samples from 80 pregnant IBD patients were collected, including 90 samples from 58 patients with Crohn’s disease (CD) and 34 samples from 22 patients with ulcerative colitis (UC). The mean participant age was 30.52±5.84 years and mean gestational age at enrollment was 21.69±9.41 weeks. Samples were distributed across pregnancy trimesters, with 33 in the first, 49 in the second, and 42 in the third trimester. Significant positive correlations were observed among several inflammatory markers. Serum CHI3L1 levels showed the strongest correlation with calprotectin (r = .366, p = .008), suggesting its potential as an alternative inflammation indicator. CHI3L1 also had a moderate correlation with ESR (r = .358, p = .001) and a strong correlation with CRP (r = .614, p &lt; .001). CRP exhibited a moderate positive correlation with ESR (r = .478, p &lt; .001), while no significant correlation was found between CRP and calprotectin (r = .208, p = .101).

Conclusion
The findings suggest that serum CHI3L1 is a potential biomarker for monitoring disease activity in pregnant IBD patients, particularly as it correlates with fecal calprotectin. CHI3L1 may offer a practical, non-invasive alternative to traditional markers, improving disease monitoring during pregnancy when access to reliable indicators is limited. Further research is warranted to validate CHI3L1 as a standard marker in this patient population and to explore its utility in clinical settings.
P1098 The Clinical Spectrum of Acute Severe Ulcerative Colitis in the Biologic Era
Authors: Singh D.M. A , Luthra M , Bhardwaj A , Mahajan R , Sharma R , Singh D , Jain D , Goyal O , Mehta V , Kaur K , Gupta Y , Midha V , Sood A 
Published: January 2025

Abstract

Background
Acute severe ulcerative colitis (ASUC) is a time critical situation requiring urgent intervention. Limited data exist on the evolving clinical spectrum of ASUC in the era of advanced therapies.

Methods
This prospective cohort study included 145 adult patients hospitalized with ASUC between January 2020 and June 2024. ASUC was defined by the modified Truelove and Witts (TW) criteria. Demographics, disease characteristics, including disease severity, probable precipitating factors, and corticosteroid failure rates were recorded.

Results
The median age of patients was 36 (26-48.5) years with 63 (43.4%) females. Most patients had left-sided colitis (53.1%). The median disease duration was 2 (IQR 1-4) years, with 91 (62.7%) patients presenting with ASUC within the first year of diagnosis of UC. One-third of the patients had previous exposures to biologics and small molecules. The most commonly reported probable precipitants of ASUC were poor compliance with treatment (n=43, 29.6%), antibiotic use (n=35, 24.1%), high perceived stress (n=32, 22.1%), and Clostridioides difficile infection (n=19, 13.1%). Forty (27.5%) patients were non-responders to intravenous corticosteroids. Twenty-nine (20%) patients received medical rescue therapy (infliximab, n=14[48.27%], cyclosporine A, n=6[20.68%], and tofacitinib, n=9 [31.03%]). Four (2.75%) patients underwent colectomy.

Conclusion
In this cohort of ASUC patients, poor treatment compliance, antibiotic use, stress, and C. difficile infection were common precipitants of flare-ups. Nearly one-third of patients required medical rescue therapy, and a small proportion underwent colectomy.
P1109 Evaluation of patient-reported outcome measures (PROMs) of IBD patients who completed upadacitinib induction period
Authors: Kav Prof. T , Unal N , Bakkaloglu O K , Kani T , Akpinar A , Akincioglu P , Eskazan T , Balamir M , Dagci G , Sendur İ N , Buyuktorun I , Barutcu S , Bengi G , Cavus B , Oruc N , Atug O , Dincer D , Hatemi A I , Erzin Y Z , Tezel A , Toruner M , Celik A F , Akyuz F 
Published: January 2025

Abstract

Background
Patient-reported outcome measures (PROMs) are used to assess the effectiveness of treatments received by patients in terms of clinical response in inflammatory bowel disease (IBD). We aimed to evaluate the perceived clinical response from the patient’s perspective using PRO2, IBD Control Questionnaire (ICQ) and Visual Analogue Scale (VAS) at the end of induction therapy in patients treated with upadacitinib. We also aimed to evaluate the correlation of PROMs with biochemical response.

Methods
We included IBD patients who underwent upadacitinib induction therapy from 01/07/2024 to 01/10/2024 in ten centers. ICQ and VAS assessments (Higher scores are better) were used in conjunction with CRP levels and PRO2 assessments (Lower scores are better) performed at baseline and at the end of induction treatment.

Results
A total of 75 patients who completed the induction phase were included, 52% were female and 50.7% were treated for Crohn’s disease (CD). Treatment was switched in 54.7% of patients due to uncontrolled chronic disease, in 42.7% for loss of response and in 2.7% for drug side effects. PRO2 mean scores were changed from 4.86 ± 3.06 to 1.67 ± 1.28 (p&lt;0.05) and 18.61 + 10.42 to 7.36 + 5.10 (p&lt;0.05) for ulcerative colitis (UC) and CD respectively. At the end of induction treatment, 47.2% of UC group and 66.7% in the CD group were classified as in clinical remission according to PRO2 scores. The rate of patients reporting side effects was 30.7%. Acne and skin rashes were reported more frequently (13.2 %). According to the visual analog scale, 80% of the patients reported improvement in their condition (p&lt;0.05), and the mean VAS score and IBD control score were 71.9 and 13.7 (p&lt;0.05) for patients in remission in the UC group and 70 and 14.7 (p&lt;0.05) in the CD group compared to active patients. ICQ scores and VAS were negatively correlated with PRO2 scores and CRP levels (p&lt;0.05 for both pairs). On the other hand both scores were not correlated with CDAI and mayo scores (p&gt;0.05).

Conclusion
In this real-life cohort of patients treated with upadacitinib, 80% report a significant improvement in their condition. ICQ and VAS can be used to understand patients’ perspective on treatment efficacy. Conventional activity scores probably not helpful for early assessment of clinical activity compared to PROMs.
P1121 Longterm Outcomes of Balloon Assisted Endoscopic Stricture Dilation in Patients with Small Bowel Crohn’s Disease: A Tertiary Referral Center’s Retrospective Experience
Authors: Halloran B , Bowron J , Fazal A , Kroeker K , Wong K , Hoentjen F , Parsons D , Peerani F , Gozdzik M , Wasilenko S , Zepeda-Gomez S 
Published: January 2025

Abstract

Background
The natural history Crohn’s disease (CD) can be complicated by strictures. Balloon-assisted endoscopy (BAE) has significantly improved the ability to assess and treat small bowel CD, allowing for stricture dilation to improve patient symptoms and potentially delay or avoid surgery.
We present a single-centre CD cohort of patients that have undergone BAE for stricture dilation. We assess procedural success, outcomes and safety, evaluate factors associated with a risk of requiring surgical management.

Methods
All patient who underwent BAE for CD from the period oof April 2012 to January 2024 were assessed and recorded. Within this group, we identified patients who had undergone assessment and/or dilation of structuring CD. Patient demographic and procedural details were extracted. Long-term outcomes, including requirement for repeat dilation and requirement for surgery were recorded from time initial of initial BAE as surrogates for the durability of dilation in these patients. Patients required surgery post initial BAE were compared to the non-surgical group.

Results
At the University of Alberta Hospital, out of 532 BAE procedures in 231 patients, 157 pt underwent 282 BAE procedures with 629 strictures dilated. In our cohort, 16 strictures were non-traversable and 3 were failed dilations. We had a &gt; 95% successful dilation rate. One perforation occurred requiring emergent surgery (n=1).
65 pts required surgery and 92 pts were managed with dilation. and pharmacotherapy. Overall, 28/65 patients were active smokers (43.08%) in the surgical group vs. 24/92 (26.09%). Biologic use was comparable (76.9% vs 73.9%). The average minimum diameter dilated was lower 15.2 mm (+/- 0.25) vs 16.2 mm(+/- 0.16) in the surgical group. Non-traversable strictures post-dilation was higher in the surgical group (14.72% vs 9.20%).
A total 65 patients undersent surgery with an average time of 32.22 months (excluding emergent/urgent surgeries) from index BAE and avg 8.79 months from most recent BAE. There was a total of 3 emergent surgeries (&lt;24 hours from BAE to surgery, including one perforation from intraprocedural complication), 7 urgent surgeries (&lt;30 days from BAE to surgery).

Conclusion
Based on this cohort, the majority of patients with CD strictures CD can be successfully managed with BAE stricture dilation, and in those requiring surgery the average time from initial BAE to surgery was 32 months. BAE stricture dilation may play an important role in preventing emergent/unplanned surgical interventions and preventing surgeries in select patients.
Although this study is currently descriptive, further data analysis of this group is ongoing currently.
P1132 Patterns and predictors of steroid use in people with IBD in routine care across ANZ
Authors: Rivas C , Su W K , Wilson W , Ng W , Ghaly S , Walker G , Forbes A , Su H , Schultz M , Lawrance I , Dutt S , Brett L , Begun J , Lynch K , Andrews J M , Connor S 
Published: January 2025

Abstract

Background
Despite known side effects, oral steroid use (Hydrocortisone) remains prevalent in the management of inflammatory bowel disease (IBD). We hypothesize that steroid use is multifactorial – historical practices, easy access, and quick response, are some factors that may explain the “overuse” of these medications. We sought to quantify and explore patterns and predictors of steroid use in real world IBD care.

Methods
Crohn’s Colitis Care (CCCare) is a cloud-based IBD-specific electronic medical record (EMR) used in Australia and New Zealand. Deidentified data prospectively entered by clinicians and consumers were retrospectively analysed, including people with an IBD assessment in the last 14 months. Data were extracted on 15th August 2024. Steroid exposure was defined as short (1-28 days), moderate (29-56 days), or prolonged (&gt;56 days). Recency was defined as recent (within 365 days), previous (365-1085 days), or no exposure. Stepwise logistic regression was used to explore relationships amongst steroid use and demographic and/or disease characteristics.

Results
In 5441 eligible people, most had Crohn’s disease (CD) 3136 (57.6%), 2165(39.7%) had ulcerative colitis (UC) and 135 (2.4%) IBD-unspecified (IBD-U); 50.2% were female; median age was 42 years (IQR 56-32) and 43.9% were non-smokers. Only 994 people had steroid exposure (18.3%). In those exposed, median oral steroid daily dose was 0.22 mg (IQR 3.2-6.8); median oral steroid total dose was 246.1mg (IQR 351.2-69.2), and median annualized total steroid dose was 18.6 mg (IQR 31.6-13.3). Up to 10 courses of steroids were prescribed per person. IBD diagnosis, age, previous IBD surgery, stoma surgery, IBD therapy and age at disease onset reached statistical significance. Compared to people with UC, those with CD had less likelihood of both recent steroid exposure and prolonged exposure (OR 0.78, P=0.014 & OR 0.72, P=0.018 respectively). Adults between 20-29 years had a much higher likelihood of both recent and prolonged exposure compared to people &gt; 70 years (OR 6.67, P=0.000 & OR 6.58, P=0.000 respectively). People on advanced therapies had a greater chance of both recent and prolonged exposure compared to people on 5-ASA alone (OR 1.65, P=0.05 & OR 1.71, P=0.000). Age at diagnosis reached statistical significance for steroid use parameters (OR 1.03, P=0.000), but with only modest effect size.

Conclusion
In this large real-world cohort, the majority had no recent steroid exposure. In those exposed, younger people, those with UC, and those with more active disease had higher likelihood of prolonged exposure. This suggests that steroid use may be further reduced by proactive tailoring of effective therapies for those with UC and focusing on disease control in younger people with IBD.
P1133 Safety and effectiveness of indigo naturalis for induction of remission in children with mild to moderate ulcerative colitis: a prospective open-label trial
Authors: Yogev D , Weintraub Y , Ledder O , Matar M , Krauthammer A , Shavit-Brunschwig Z , Salomon N , Assa A , Turner D , Orlanski-Meyer E , Shouval D 
Published: January 2025

Abstract

Background
Indigo naturalis (QingDai, QD) is effective in inducing remission in adults with ulcerative colitis (UC). However, data in pediatrics is limited and potential pulmonary hypertension and hepatitis remain a concern. In this prospective open-label study, we aimed to evaluate the efficacy and safety of QD for pediatric UC.

Methods
Children aged 4-18 years with mild-moderate UC (Pediatric Ulcerative Colitis Activity Index [PUCAI] 10-60) on stable medication, and not receiving steroids or biologics, were treated with QD for 6 weeks. Initial doses were weight-based (500/750/1000 mg/day for 20-30/30-40/40+ kg, respectively) with possible dose escalation at week 3. Echocardiography was performed at baseline and week 6. The primary outcome was corticosteroid-free remission at week 6 defined as PUCAI&lt;10 and a ≥10-point reduction in PUCAI. Results were analyzed using intention-to-treat.

Results
Twenty children were enrolled (age 13.6±2.4 years, disease duration 7 [3-12] months, 50% female); all were treated at baseline with oral 5-ASA regimens. Two discontinued QD early (UC exacerbation, poor compliance), 18 completed the study and 9 required dose escalation at week 3. Clinical remission was achieved in 13 patients (65%). Calprotectin levels &lt;250mg/kg and &lt;100mg/kg at week 6 were observed in 13 (65%) and 10 (50%), patients, respectively. Significant reduction compared to baseline were noted in both PUCAI (30 [15-40] vs. 5 [5-15], p&lt;0.01) and calprotectin (588 [305-1,137] vs 97 [44-438], p=0.03). Adverse events included headache (4 patients), vomiting (1) and nausea (1) and did not lead to treatment discontinuation. Mild transient hepatitis was noted in a single patient at week 3, and another patient had minimal ALT elevation at week 6. There was no evidence of pulmonary hypertension at week 6.

Conclusion
QD is effective in inducing remission in biologic-naïve children with mild-moderate UC. Headache was the most common adverse event; pulmonary hypertension was not observed. Additional efficacy and safety studies are required to determine whether QD can be used for maintenance.
P1151 6-month real-world results from the prospective FilgoColitis study on clinical effectiveness and psycho-social outcomes
Authors: Plachta-Danielzik S , Bokemeyer B , Hellms T , Landry W , Kahl M , Ehehalt R , Zimmermann L , Schiffelholz A , Efken P , Reiner J , Fajardo Salmon S , Wenske T , Schreiber S 
Published: January 2025

Abstract

Background
Treatment options for patients with ulcerative colitis have increased considerably in recent years. Here, we present the 6-month results on clinical effectiveness and psycho-social outcomes of the ongoing FilgoColitis study in patients with ulcerative colitis (UC) starting new treatment with filgotinib (FIL) in a real-world setting.

Methods
FilgoColitis is a prospective, multicentre, non-interventional, 24-month observational study in patients with active UC and newly introduced FIL therapy. Disease activity (clinical response: reduction of pMayo by ≥3 points from baseline to month 6 and a reduction of at least 30% or reaching remission at month 6; clinical remission (CR): pMayo ≤ 1 plus a bleeding subscore=0; steroid-free remission: CR and no systemic use of steroids or oral budesonide), quality of life (QoL) (sIBDQ and EQ-5D), and fatigue level (FACIT-F) will be analyzed. In a subgroup, the daily step count was recorded using the SensMotion® thigh accelerometer for at least 3 days after each visit (n=21).

Results
202 patients were enrolled in the study. After excluding missing outcomes, 164 patients were available for the 6-month analysis. Of these, 61.0% were male, and the median time since diagnosis was 8.0 years. Before treatment with FIL, 85.4% of patients had received biologic or small molecule therapies, and 57.3% had used immunosuppressants. Treatment persistence at month 6 was 87.2% (Fig. 1). After 6 months of treatment with FIL, the clinical response and remission rate were 59.2% and 41.7%, respectively (mITT (switchers=outcome failures), Table 1). There was no significant difference in clinical remission between biologic-naïve and biologic-experienced patients (41.7% vs 41.4%). Looking at week-10 responders only, the response rate at month 6 was 85.0%, and the remission rate was 58.8%. QoL improved significantly, with median EQ-VAS scores increasing from 64 to 80 at month 6 (p&lt;0.001), and sIBDQ scores improving from 42.0 to 56.0 (p&lt;0.001). Fatigue scores improved significantly from baseline to month 6 of FIL therapy (FACIT-F score part I: 8.0 vs 5.0, p&lt;0.001). In patients who were in remission at month 6, the daily number of steps measured was higher than in patients who were not in remission (9918 (4861-11048) vs 5959 (4747-6323)). The steps measured during the night also differed between these two groups: 196 (142-559) vs 293 (164-479). This was consistent with asking the patients if they had nocturnal stools (0% vs 42.9%).

Conclusion
In this real-world study, FIL showed a clinical response rate of 59% and a clinical remission rate of 42% at month 6 in patients with active UC, demonstrating a further improvement compared to the induction phase. QoL was also significantly improved.