bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0966 Fecal calprotectin in Small Bowel Crohn’s Disease: is it a reliable tool?
Authors: Souto M , Ferreira A I , Gonçalves J , Macedo Silva V , Arieira C , Dias de Castro F , Leite S , Cotter J 
Published: January 2025

Abstract

Background
The correlation between fecal calprotectin (FC) levels and small bowel (SB) inflammation in patients with Crohn’s Disease (CD) remains a subject of debate. This study aims to investigate the relationship between FC levels and SB inflammatory activity in patients diagnosed with SB CD.

Methods
We conducted a retrospective study involving patients with SB CD who underwent small bowel capsule endoscopy (SBCE) and FC testing. Patients with colon inflammation were excluded. Participants were categorized into four groups based on their SB inflammatory status: no inflammation (all three SB tertiles showed Lewis Score (LS) &lt; 135); proximal SB inflammation (first and/or second SB tertiles had LS ≥ 135, with no inflammation in the third SB); distal SB inflammation (third SB tertile had LS ≥ 135, with no inflammation in the proximal SB); pan-SB inflammation (both proximal and distal SB showed inflammation).

Results
A total of 87 patients were included in the study, with a median age of 35 years, 75.9% were female. The distribution of inflammation among the patients was as follows: no inflammation in 21.8%; proximal inflammation in 4.6%; distal inflammation in 33.3%; pan-SB inflammation in 40.4%.
FC levels exhibited an ascending trend of median values along the SB axis: no inflammation 58 µg/g (33-180); proximal SB inflammation 65 µg/g (30-127.7); distal SB inflammation 122 µg/g (42-507); pan-SB inflammation 400 µg/g (205-852). Statistically significant differences in FC levels were observed between pan-SB inflammation vs. proximal inflammation (p = 0.01), and distal inflammation (p = 0.014), with no significant differences in LS.
Additionally, FC showed a positive correlation with LS in the second (r = 0.464, p&lt;0.001) and third tertiles (r = 0.435, p&lt;0.001), but no correlation was noted in the first tertile.
FC demonstrated good predictive capacity for identifying inflammation in the distal SB and pan-SB vs. no inflammation and proximal inflammation, with an area under the curve of 0.790 (p &lt; 0.001) and an optimal cutoff value of 229.5 µg/g.

Conclusion
FC levels correlate positively with the presence of SB lesions in the second and third tertiles of the small bowel. However, it is not a reliable marker for detecting inflammation in the first tertile, highlighting the importance of conducting a SBCE in these patients. These findings contribute to the understanding of FC as a diagnostic tool in managing SB CD.
P0968 Comparison of two oral iron formulations for iron deficiency and iron deficiency anemia in inflamatory bowel disease: a multicentric prospective study
Authors: Guimaraes A , Leal T , Carvalho T , Mendes S , Gonçalves A , Leal C , Santos A , Soares J , Arroja B , Rebelo A , Damasceno J , Neves J , Gonçalves B , Rodrigues Â , Vasconcelos H , Gonçalves R 
Published: January 2025

Abstract

Background
The use of oral iron in iron deficiency (ID) and ID anemia in IBD is controversial. Its lower costs and ease of application have to be weighed against the fear of side effects and questions about its efficacy. The aim of this study was to assess the efficacy and tolerability of Sucrosomial® iron in correcting ID and ID anemia in IBD. As a secondary objective we aimed to assess the efficacy and impact of oral iron in correcting ID, ID anemia and disability in IBD.

Methods
This was a prospective and bicentric study. IBD patients diagnosed with ID or ID anemia between november 2022 and november 2023 treated with oral iron were included. Half of the physicians were instructed to prescribe ferric hydroxide-polymaltose complex - Ferrum Hausmann®(FH) - and the others Sucrosomial® iron – Fisiogen Ferro Forte®(FF). The primary endpoint was change in haemoglobin levels and correction of iron studies at 12 weeks after starting therapy, and secondary endpoints were assessing tolerability and disability (IBD-Disk).

Results
Fifty-six patients were included in the study (FH group – 33; FF group – 23). A total of 46 had ID and 10 had ID anemia. Thirteen patients had side effects - FF 13,0% vs FH 30,3% (p=0,132) - leading to iron discontinuation in 6. There was no difference in terms of efficacy between the two iron formulations. After 12 weeks, serum iron (p=0,017) and transferrin saturation index (p&lt;0,001) improved. There was no change in ferritin levels (p=0,804) but there was an improvement in Hb levels (p=0,041) in patients with anemia. IBD-disk scores improved (p=0,004) after treatment and this improvement correlated with increasing serum iron (rs=-0,43; p=0,010) and Hb (rs=-0,50; p=0,002) levels.

Conclusion
Both iron formulations had similar efficacy. There was a trend to fewer side effects in the FF group but this was non-significant. Oral iron replacement improved Hb levels, iron studies and disability after 12 weeks of treatment.
P0970 Associations between diet, faecal and flatulence odour perception and disease activity in patients with inflammatory bowel disease and healthy controls
Authors: Pueschel L , Nothacker S , Kuhn L , Wedemeyer H , Lenzen H , Wiestler M 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) affects gastrointestinal function and may alter faecal odour due to changes in the gut microbiome and metabolism. Given the relationship between diet, gut health and microbiome diversity, exploring the link between dietary habits and faecal odour in IBD seems crucial. This study investigates the associations between dietary behaviour, flatulence and faecal odour perception and disease activity in IBD patients compared to healthy controls (HC).

Methods
From October 2023 to October 2024, a total of 238 IBD (women: 51.3%; CD: 59.7%; remission: 33.5%) patients and 97 HC (women:70.1%) were enrolled at the IBD outpatient clinic of the Hannover Medical School. In addition to a short screening questionnaire for highly processed foods (sQ-HPF), dietary behaviour (Food Frequency Questionnaire (FFQ)), clinical (HBI, PMS) and biochemical (CRP, faecal calprotectin) parameters of disease activity were assessed as well as adherence to a mediterranean diet and changes in bowel movement odour (faecal and flatulence) were collected.

Results
Significant differences in flatulence (p&lt;0.001) and faecal odour perception (p&lt;0.001) were found between IBD patients and HC. Further associations with dietary habits revealed differences between HC and IBD individuals exhibiting strong flatulence odour demonstrating significant associations with the daily intake of carbohydrates (p = 0.007), sugar (p = 0.049), vegetables (p = 0.033), legumes (p = 0.010), and the daily energy intake (kJ) from highly- and ultra-processed foods (p = 0.002 and p = 0.007, respectively). However, the differences between HC and IBD individuals with strong faecal odour were only significant for the daily intake of legumes (p = 0.002).
Further analyses revealed significant associations between flatulence and faecal odour perception and IBD activity (p &lt; 0.001). Subgroup analyses showed significant differences between Crohn’s disease (CD) and ulcerative colitis (UC) patients with and without strong faecal odour, particularly in those with moderate disease activity (p = 0.006 and p = 0.017). Additionally, significant differences in flatulence odour were found between CD and UC patients with moderate (p = 0.008) and severe disease activity (p = 0.041).

Conclusion
In conclusion, significant differences in flatulence and faecal odour perception were found between IBD patients and healthy controls, with dietary associations noted for strong flatulence and faecal odour. Disease activity was strongly associated with both flatulence and faecal odour perception, with notable differences between CD and UC, particularly in moderate and severe disease activity.
P0974 Risk factors for anti-TNFα induced paradoxical psoriasis in Inflammatory Bowel Disease and association with an IL-23 receptor polymorphism: A retrospective study
Authors: Natt N , Gindi M , Gregor J , Ponich T , Chande N , Kim R , Wilson A 
Published: January 2025

Abstract

Background
Anti-tumor necrosis factor (TNF)-α therapy is frequently used to treat inflammatory bowel disease (IBD). Paradoxical psoriasis (PP) is a known adverse effect of this drug class resulting in disfiguring skin lesions that may impact quality of life and lead to treatment cessation. To date, there are no tools to identify individuals who are susceptible to developing PP. Variations in the IL-23 receptor (IL23R) gene have been linked to psoriasis onset and may be implicated in PP. The aims of this study are 1. to study the incidence and outcomes of PP in anti-TNFα treated IBD patients at an academic centre in London, Ontario, Canada and 2. to examine risk factors associated with PP including the IL23R variant (IL23R1142G&gt;A).

Methods
We performed a retrospective study of adult IBD patients treated with anti-TNFα therapies at London Health Sciences Centre between 2012 and 2024. Patient charts were reviewed for clinical variables and disease outcomes from the time of anti-TNFα exposure until treatment discontinuation or last follow-up. Patients’ serum was retrospectively genotyped for the IL23R1142G&gt;A variant.

Results
We identified 496 IBD patients with 570 unique anti-TNFα exposures between 2012 and 2024. 26 patients developed 29 cases of PP while the remaining 473 patients did not develop PP after exposure to 542 anti-TNFα therapies, corresponding to a PP incidence rate of 5.1% in the study population. There was an increased proportion of patients with PP who had a positive family and personal history of psoriasis, though the latter was not significant (Table 1). The IL23R variant was more common in patients who developed PP compared to those who did not (46.2% vs. 5.1%, OR 16.04, 95% CI 6.69-38.41, Figure 1). The average time to develop PP was 9.5 months, with 55% of patients on high-dose anti-TNFα maintenance regimens. Majority of patients had moderate-to-severe disease (72.4%) based on body surface area (BSA) involvement and required treatment cessation (69.0%). All participants had complete resolution of PP following discontinuation of anti-TNFα therapy.

Conclusion
We identified an increased frequency of the IL23R1142G&gt;A variant in patients who developed PP following anti-TNFα exposure compared to those who did not. Personal and family history of psoriasis were also more common in those who developed PP. Future studies should investigate other drug and disease characteristics that may predict those at highest risk for this anti-TNFα drug effect.
P0984 Treatment with allopurinol and low-dose azathioprine during pregnancy in patients with Inflammatory Bowel Disease. A Danish single center experience
Authors: Sivananthan K , Wildt S , Kiszka-Kanowitz M , Pedersen G , Vind I , Nordgaard-Lassen I , Munk Petersen A , Burisch J , Kristensen H , Theede K 
Published: January 2025

Abstract

Background
Low-dose azathioprine in combination with allopurinol (LD-AZA/ALLO) is a widely used treatment option in inflammatory bowel disease (IBD). Data on pregnancy and birth outcomes from exposure to combination therapy are sparse. The aim of this study was to provide data on safety and risk for adverse pregnancy and birth outcomes in women with IBD treated with LD-AZA/ALLO at the Gastrounit, Hvidovre Hospital, Copenhagen.

Methods
The study was a retrospective single center study. Inclusion criteria were established IBD diagnosis and treatment with LD-AZA/ALLO (AZA 50-75 mg/ ALLO 100 mg) during conception and pregnancy between 2013-2023. Data was collected from electronic medical charts and by questionnaire to all included women. Data registered was; demographics, diagnosis, disease characteristics, disease activity, IBD medications and number of pregnancies. Pregnancy outcomes were neonatal characteristics, obstetric complications, lactation and congenital malformations, disease, infections and admission to the hospital during the first year of life.

Results
In all, 44 women with 62 pregnancies (one twin pregnancy) and 59 live births were included. There were 1 spontaneous and 3 provoked abortions due to genetic disorders (1 trisomy 21 and 2 spinocerebellar ataxia). Obstetric complications were present in 8 (13%) pregnancies, (1 pre-eclampsia, 1 HELLP syndrome, 6 hypertension and/or gestational diabetes mellitus). 7 (11%) women had an IBD flare during pregnancy, none resulting in obstetrical complications. 5 (9 %) children were born prematurely, 4 (7 %) had low birth weight. No congenital malformations were reported. One child was born with facial nerve paralysis and later diagnosed with hyper-IgD syndrome. 8 (14 %) were admitted to neonatal ward (hours to days), mainly due to immature lungs.
During the first year of life, one child was admitted to the hospital due to COVID. One child was suspected to have an immune defect, but all symptoms and biochemical abnormalities resolved and interpreted as side effect to LD-AZA/ALLO. 5 children (9%) were treated with antibiotics due to minor infections. In total 84 % of the children were breastfed during LD-AZA/ALLO treatment.

Conclusion
In this large single center experience with 62 pregnancies in women treated with LD- AZA/ALLO, no malformations or indications of increased risk of complications of pregnancy and birth were observed. The majority of children were breastfed and no serious signals or complications were reported first year of life. Treatment with LD-AZA/ALLO during pregnancy and breastfeeding seems safe.
P0988 Dose-Dependent Incidence of Acne in Korean Patients Treated with Upadacitinib
Authors: Lee J , Kim S J , Lee M H 
Published: January 2025

Abstract

Background
Janus kinase inhibitors, like upadacitinib, are associated with drug-induced acne, typically showing a dose-dependent occurrence. While registrational trials reported acne in 3-7% of subjects, real-world data suggest higher rates, especially in non-Western populations. This study assesses the incidence, severity, and management of acne among Korean patients using upadacitinib.

Methods
We conducted a retrospective review of medical records from patients treated with upadacitinib for Inflammatory bowel disease (IBD), Rhematic arthritis (RA) and Atopic dermatitis (AD) at a single academic hospital from October 2021 to October 2024. Data were analyzed to determine the incidence and severity of acne and the effectiveness of various treatment approaches, with a focus on differences among patient groups.

Results
Out of 140 patients (IBD: 17, RA: 17, AD: 106) treated, acne was observed in 31 (22.1%), with a significant dose-response relationship. High-dose recipients (45 mg for IBD) exhibited a 58.8% (10/17) incidence rate, compared to 17.1% (21/213) among those on lower doses (30 or 15 mg for RA or AD). Most acne cases were mild, manifesting as inflammatory papules, and managed effectively with topical therapies. The higher dose group also showed a greater prevalence of facial and truncal acne. Treatment discontinuation due to acne was rare and not dose-dependent, with no cases in the high-dose group. Logistic regression highlighted the 45 mg dose as a significant risk factor for acne.

Conclusion
Korean patients treated with upadacitinib experience higher rates of acne compared to Western populations, particularly with higher doses. Most cases are mild and respond well to treatment, allowing for continued therapy. These findings underline the need for proactive acne management in patients receiving higher doses of upadacitinib

References
1.Temido MJ, Honap S, Bursztejn AC, et al. Drug-Induced Acne in Inflammatory Bowel Disease: A Practical Guide for the Gastroenterologist. Am J Gastroenterol 2024.Online ahead of print.
P0989 Interventions for rheumatological extraintestinal manifestations in Inflammatory Bowel Disease: an umbrella review of systematic reviews
Authors: Nardone O M , Alajmi A , Yuan Y , Jairath V 
Published: January 2025

Abstract

Background
Inflammatory Bowel Disease (IBD) is associated with extraintestinal manifestations (EIMs), commonly affecting the joints, eyes, skin, and liver, and influences treatment selection. We aimed to synthesize evidence from systematic reviews (SRs) with or without meta-analyses on the efficacy of therapeutic options for rheumatological EIMs to better clarify their positioning in the management of IBD

Methods
We searched MEDLINE, Embase, and the Cochrane Database of Systematic inception to May 31 2024 to identify SRs addressing therapeutic interventions for rheumatological EIMs. The exclusion criteria ruled out studies that were not SRs, did not focus on patients with IBD patients, or were unrelated to articular interventions. Screening, selection, and data extraction were performed independently by two authors, with a third author consulted when necessary. Reporting was aligned with PRISMA standards. The quality of SRs was assessed using the AMSTAR-2 tool

Results
We screened 1,436 references and included 10 SRs (2 with meta-analyses) in our analysis. The rheumatological EIMs most commonly reported included arthralgia, peripheral arthropathy, axial arthropathy, spondyloarthritis, and sacroiliitis. Therapeutic interventions included in the SRs were anti-TNF agents, methotrexate (MTX), ustekinumab, (UST) vedolizumab (VDZ), and JAK inhibitors. Treatment efficacy was mainly reported through symptom reduction rates. Quality of the SRs rated from high to very low confidence, with most achieving moderate confidence due to some non-critical weaknesses.
In four SRs anti-TNF therapy showed high response rates for both axial (range 59.1% to 61.8% in a SR) and peripheral spondyloarthritis (range 73.4% to 81.2% in a SR). One SR reported MTX as effective for peripheral enteropathic arthritis. Data on VDZ, UST, and JAK inhibitors were more controversial. One SR reported that UST was effective for arthralgia and psoriatic arthritis. A more recent meta-analysis showed that the improvement of pre-existing joint manifestations was greater in UST-treated patients compared to VDZ-treated patients (54% vs 42%). For tofacitinib, no change in peripheral arthritis was reported by two SRs. Four SRs evaluated treatment-induced rheumatological EIMs, revealing heterogeneous results, particularly with VDZ. However, data from a recent SRs suggest similar rates of new-onset rheumatological EIMs with VDZ and UST (9% vs. 6%)

Conclusion
Anti-TNF therapy appears to be effective in managing both peripheral and axial spondyloarthritis. Given the lack of consistent data on new advanced therapies, prospective studies designed to assess the impact of other advances therapeutics on rheumatological EIMs ,with rigorous endpoint assessment, are needed
P0997 The Rectal Stump during and after subtotal colectomy for Ulcerative Colitis: A scoping review of surgical strategies, medical management options and cancer surveillance recommendations
Authors: Argyriou O , Ghersin I , Stravodimos G , Worley G , Tozer P , Hart A , Sahnan K 
Published: January 2025

Abstract

Background
There are multiple decision nodes, during or after a subtotal colectomy for UC, regarding the management of the rectal stump. Intra-operatively, the retained stump may be closed intraperitoneally in the pelvis, secured at the subcutaneous tissue, or exteriorised as a mucous fistula. Post-operatively, microscopic evidence of proctitis is present in the majority of UC patients.Given the increased risk of cancer in UC, the presence of a retained rectal stump necessitates endoscopic surveillance. The aim of this scoping review was to summarise all available evidence on these 3 aspects of the management of the rectal stump in UC.

Methods
A scoping review of the literature was performed. Relevant studies were identified through a systematic search of Ovid Medline and Embase. Inclusion criteria were adult population and diagnosis of UC. Cohort studies, review articles and guidelines were eligible for inclusion. Articles were screened and reviewed by 2 independent reviewers and conflicts resolved by a 3rd reviewer. The references were grouped according to the subject of interest.

Results
Initial search returned 1267 studies, and after title and abstract screening and full-text screening, 93 studies were found eligible for inclusion in the review. Surgical management of the rectal stump at subtotal colectomy remains controversial. Intra-peritoneal closure has been shown to have higher pelvic sepsis rates, whereas subcutaneous placement results in higher rates of wound infections. A mucous fistula has been shown to have the lowest overall complication rate. Microscopic findings compatible with diversion proctitis develop in most patients, with incidence ranging from 71.4% to 100%. However, only a minority of these patients (30-40%) develop symptoms. Suggested treatments for diversion proctitis include topical mesalamine, corticosteroids or short-chain fatty acids. The overall risk of rectal stump neoplasia in patients with UC after subtotal colectomy is as low as 0.7% (2021 systematic review), with prior colorectal neoplasia being a major risk factor. No universal standardized guidance exists regarding endoscopic surveillance in this patient population.

Conclusion
This scoping review has appraised the latest evidence on 3 crucial stages of the management of the rectal stump in UC. There is still uncertainty about the optimal surgical management of the stump, with different complication profiles. Medical management of diversion proctitis remains a major unmet need, and there are no randomized trials addressing this issue. There are no universally accepted guidelines on endoscopic surveillance of the rectal stump.