bluuebunny/crossref_metadata_2025_split huggingface dataset:
P609 Significant variations in practice in managing mild-Crohn’s disease: results from the 2021 Y-ECCO-ClinCom survey
Authors: Dart R , Irving P 
Published: January 2022

Abstract

Background
Epidemiological data suggests Crohn’s disease (CD) runs a mild course in a third of patients. Furthermore, the AZTEC study demonstrated that 30% of patients with uncomplicated CD responding to initial therapy remain in clinical remission at one year when maintained by placebo (Gastroenterology 2013;145:766). There are no proven maintenance strategies other than immunosuppression in CD. ECCO does not recommend maintenance therapy in those newly diagnosed with uncomplicated disease achieving remission with steroids, however in the absence of prognostic biomarkers treatment decisions can be difficult, risking over treatment for some. This questionnaire aimed to explore clinicians’ prescribing strategies and attitudes toward patients with mild CD.

Methods
A questionnaire was devised in conjunction with the Y-ECCO and ClinCom committees and distributed to attendees to the 2021 virtual ECCO conference.

Results
124 complete responses were obtained from gastroenterologists 54%, gastroenterology trainees 29% with surgeons/nurses comprising most of the remainder. 61% respondents were from university hospitals, 33% general hospitals and 6% private clinics, 79% of whom practise in Europe.
Approaches to induction and maintenance of remission were investigated in ileocolonic and isolated colonic CD (table and figure). Budesonide and or systemic steroids are often used for induction of remission in both CD subtypes, however a range of therapeutics are also used, with only one respondent taking a wait and see approach in colonic but not ileocolonic CD. In both CD subtypes &gt;50% of patients who achieve steroid-induced remission would be maintained using immunosuppression with either an immunomodulator or biologic, whereas 28% and 6% (ileocolonic) and 20% and 19% (colonic) would watch and wait/treat with 5-ASA respectively, representing significant variation in practise. 80% respondents felt development of complicated disease was unlikely in these patients, despite this, 60% would treat with maintenance therapy. 55% respondents felt that mild CD was easy to manage, however 45% felt neutral or negative towards managing mild CD; the management approach undertaken by either group of respondents was equally varied.

Conclusion
Current practise does not reflect ECCO guidance, likely due to uncertainties over the natural history of disease and the difficulty in predicting complications. Perception of the difficulty of managing mild CD did not appear to influence treatment decisions. Patients with mild CD comprise a significant proportion of our patients, yet management may be less clear cut than for aggressive disease and further work on risk stratification and management algorithms may avoid over-treatment of patients who may never develop complications.
P620 Differences in illness perceptions of Inflammatory Bowel Disease (IBD) between Healthcare Practitioners (HCPs) and patients in a UK tertiary IBD centre
Authors: Duff A , Dawson P , Pavilidis P 
Published: January 2022

Abstract

Background
The common sense model of illness (Leventhal et al 1997) suggests that illness perceptions influence coping strategies and outcomes. Negative perceptions of IBD are associated with poorer psychological and physical health, quality of life (Polak et al, 2019) and adherence (van der Have et al, 2016). There are differences among healthcare professionals in how they view IBD (Dickman et al, 2011) however, it is unknown how perceptions of illness vary between patients and HCPs

Methods
All patients with IBD who were referred to IBD psychology clinic were asked to complete Brief Illness Perception Questionnaire (BIPQ, Broadbent et al, 2006) as part of their assessment.
HCPs as part of the same team were asked to complete 5 items adapted from the BIPQ (How long do you think your patients will have IBD, how much control do think is possible with IBD, how much do you think treatment can help, how much do you feel that you understand IBD and how much do you feel IBD affects patients emotionally) and asked for 3 causes of IBD.
Descriptive statistics and Mann-Whitney tests were performed as well as a thematic analysis (Braun & Clarke, 2006) of the causes.

Results
Data was available for 148 patients and 24 HCPs (11 doctors and 13 other HCPs).

There were no significant differences between HCPs and patients in their views of illness duration or their understanding of IBD. However, patients felt that disease control was less likely and treatment effectiveness was less helpful than HCPs. HCPs felt that patients were more emotionally impacted by IBD than patients themselves.

There was a difference in how each group ranked the themes. All HCPs identified genetics, whereas many fewer patients did. Patients were more likely to identify psychological, environmental and lifestyle as being important, were more likely to say that the cause was unknown or to not respond to the question.

Conclusion
Our findings suggest a disconnect between the views held by patients and HCPs as to the underlying cause of their IBD as well as our ability to achieve disease control with effective medical therapy. This highlights the importance of open communication with and education of patients from their first encounter with HCPs and throughout their disease course. It is worth noting that all patients included had been referred to the IBD psychology service and are more likely to have had a difficult disease course or persistent symptoms which may explain the difference in views on treatment and remission.
P645 Ileocecal resection in paediatric Crohn’s disease based on the Hungarian Paediatric IBD Registry
Authors: Müller K , Bajzat D , László S S 
Published: January 2022

Abstract

Background
Despite optimized treatment, almost one-third of the patients with IBD develop
complications such as fistulae, strictures, and abscesses, thus need surgical treatment within 5 years of diagnosis. In paediatric Crohn’s disease surgery may be considered when a patient has active disease despite optimized medical treatment.
The aim of our study was to evaluate the practice of surgical interventions in paediatric Crohn’s disease regarding indications, postoperative therapy and follow-up endoscopy in Hungary.

Methods
We performed a retrospective analysis based on the database of the Hungarian Paediatric IBD Registry (HUPIR). The HUPIR is a prospective, nationwide registry launched in 2007. Data of patients who underwent ileocecal resections between January 2010 and December 2019 were included in the analysis. We applied descriptive statistical methods to characterise the cumulative incidence of surgical resections, the urgency of the interventions, postoperative complications and follow-up endoscopies.

Results
Altogether 943 newly diagnosed CD patients were reported between 2010 and 2019, among them 55 (6%) had ileocecal resection of 99 children with CD who underwent (10%) surgical interventions within 2.15 years mean follow-up period. Surgical data of ileocecal resections were available in 47 (85%) cases (mean age: 14.5 years, male:20). Disease localization at diagnosis was ileocecal in 38% and ileocolonic in 40.2%. The mean time between diagnosis and surgical intervention was 21.2 months (0–62). The ileocecal resection was elective in 37 (78.7%), and laparoscopic resection was performed in 17 cases (36%). Frequency of early postoperative complication was 8.5% (4/47), which was not associated with the urgency of the intervention, the technique, preoperative corticosteroid or anti-TNF treatment. Only the third of the patients (17/47, 36%) had colonoscopy within 6 months after resection.

Conclusion
Based on the HUPIR the number of surgical ICR is lower than in earlier reports reflecting a different approach. The early complication rate was low despite the low number of interventions. In a middle-income country, it is a question why surgical intervention are lower compared to international. Paediatric gastroenterologists seem to prefer conservative therapy probably due to the lack of experienced paediatric IBD surgeons.
P666 Trend of Lower gastrointestinal Endoscopy in Patients with Inflammatory Bowel Diseases: A Nationwide Population-Based Study in South Korea
Authors: Kim S , Lee S , Han K , Soh H , Koh S J , Lee H J , Im J P , Kim J S 
Published: January 2022

Abstract

Background
Endoscopy plays an essential role in the diagnosis and management of inflammatory bowel disease (IBD). Although the interval of endoscopy is important to assess the disease status of IBD, there are limited research date on the real-world use of endoscopy in patients with IBD. Therefore we aimed to evaluate the current status of lower gastrointestinal (GI) endoscopy in IBD patients.

Methods
We conducted a nationwide, retrospective, observational cohort study using the Korean national health insurance claims data. The endoscopy cohort with IBD was defined as an IBD population who underwent at least one colonoscopy or sigmoidoscopy between 2010 and 2019. We evaluated the annual number of lower GI endoscopy use, including colonoscopy and sigmoidoscopy in the IBD prevalent patients. In addition, we analyzed the trend of endoscopy use stratified by year after diagnosis in the patients with newly diagnosed IBD between 2010 and 2017 and the logistic regression modeling was used to estimate odds ratios and 95% confidence intervals for endoscopy, compared with never having had endoscopy, by demographic factor and therapeutic medications used for IBD.

Results
The analysis included 54,634 IBD patients (34,633 male and 20,001 female), among whom 24,577 (44.94%) underwent lower GI endoscopy. During a mean follow-up of 4 years, endoscopy was performed the most in the first year after diagnosis, and it showed a decreasing trend after that. Multivariate analysis showed that IBD patients with biologics and small molecules received more endoscopy than patients without the medication (hazard ratio [HR] 27.671, 95% confidence interval [CI] 11.296–67.783). In Crohn’s disease, increased number of biologics and small molecules correlated with increased number of endoscopy (HR 1.049, 95% CI 0.981–1.122 for single biologic; HR 2.343, 95% CI 1.726–3.182 for two or more biologics). In ulcerative colitis, however, only the use of biologics and small molecules, not the number of medication, correlated with increased number of endoscopy (HR 23.26, 95% CI 9.489–57.02). IBD patients with steroid (HR 1.562, 95% CI 1.509–1.61) and 5-aminosalicylic acid (HR 1.622, 95% CI 1.537–1.711) were received more endoscopy than patients without the medication.

Conclusion
Endoscopy was performed more frequently in the first one year after diagnosis with IBD. Also, this study demonstrated significant association between the use of endoscopy and the biologics/small molecules administered for IBD.
P670 Familial Inflammatory Bowel Disease is associated with a more adverse disease compared to sporadic cases
Authors: Boaz E , Ariella B G S , Menachem S , Eran G , Petachia R , Shlomo Y , Koslowsky B 
Published: January 2022

Abstract

Background
A family history increases the risk for inflammatory bowel diseases (IBD). However, data on differences in phenotypic characteristics and severity among patients with a strong family history of IBD are both scarce and controversial. The aim of the present study was to compare the phenotypic features of IBD patients with 4 or more affected first-degree relatives with sporadic cases of IBD.

Methods
Patients with familial and sporadic IBD were identified from the institutional IBD database. IBD Patients with at least 4 first-degree affected relatives were selected for analysis and were compared to non-matched sporadic cases with IBD chosen randomly from our local database. The sporadic cases had a first and second degree negative family history of IBD. Comparison for type of IBD [Crohn’s disease (CD) vs. ulcerative colitis (UC)], age at onset as well as for disease extent, behavior, perianal disease, extraintestinal manifestations (EIM), and indicators of severe disease (i.e., need for biological agents and surgery) were analyzed.

Results
Thirty six patients with familial IBD (29 Crohn’s disease (CD), 7 ulcerative colitis (UC)) were compared to 88 sporadic IBD patients (61 CD, 24 UC, 3 IBD-unclassified). Disease duration was 10.1 ± 8.3 in the familial and 8.1 ± 7.3 years in the sporadic cases, p=0.18. The familial cases were younger at diagnosis (19.1± 8.6 vs. 25.7 ± 11.8, P &lt; 0.003). Patients with familial compared to sporadic IBD were significantly more likely to require steroid treatment (84.8% vs. 54.5%, P &lt; 0.002) biological treatment (91.6%, vs. 63.6%, P &lt; 0.002) or surgery (25%, vs. 11.4%, P = 0.056), respectively.

Conclusion
IBD with a very strong positive family history is associated with younger age at onset and a more adverse IBD phenotype compared to sporadic IBD.
P673 Trends in inflammatory bowel disease infections and vaccinations in the past four decades - a high-level text mining analysis of PubMed publications
Authors: Lahat A , Klang E 
Published: January 2022

Abstract

Background
Many therapeutic options for inflammatory bowel disease emerged during the last decades, along with the rise in disease prevalence and incidence. These new treatments exposed patients to various potential infections and promoted pre-treatment screening and vaccination. We aimed at assessing the published literature on different prophylactic screening and vaccination options in that period.
Special attention was attributed to latest data assessing covid-19 vaccinations.

Methods
We have queried PubMed for all available IBD-related entries published during 2000–2020. The following data were extracted for each entry: PubMed unique article ID (PMID), title, publishing journal, abstract text, keywords (if any), and authors’ affiliations.
Two gastrointestinal specialists decided in consensus on a list of terms to classify entries. The terms belonged to four groups: Opportunistic Infections, prophylactic screening, prophylactic vaccinations/treatment, regular vaccines. Annual trends of publications for the years 1980–2020 were plotted for different screening, vaccinations, and infections types. The slopes of publication trends were calculated by fitting regression lines to the annual number of publications.

Results
Overall, 98,339 IBD entries were published between 1980 and 2020. Of those, 10,128 entries belonged to one of the four investigated groups. Entries concerning opportunistic infections showed the sharpest rise, with 22 entries and 1980 to 623 entries in 2020 (slope 3.6, p&lt;0.001). Entries concerning prophylactic screening rose from 10 entries in 1980 to 204 entries in 2020 (slope 1.4, p&lt;0.001). Both entries concerning prophylactic vaccinations/treatments and regular vaccines did not show a significant rise (slope 0.08, and slope 0.22, respectively). Publications’ trend is shown in figure 1.
Figure 1- publication trends of vaccines and opportunistic infections in IBD patients during the past four decades

During COVID 19 pandemic a total of 44 publications were identified. Of them. 37 were relevant to vaccines and immune reaction. 19 publications (51%) were guidelines/recommendations, 14 (38%) assessed immune reaction to vaccination, most of them (11, 61%) to mRNA vaccines.
Results are shown in figure 2.
Figure2- publication trends of COVID 19 vaccines during the pandemic

Conclusion
According to publications trend analysis, during the past two decades, publications regarding opportunistic infections and prophylactic screening increased stteply compared to the two decades during pre- biologic area.
During COVID -19 pandemic most publications included vaccinations’ recommendations and guidelines, and only 38% included real-world data assessing reaction to vaccinations. More research is needed.
P694 COVID-19 vaccination rate and willingness of an additional dose among inflammatory bowel disease patients receiving biologic therapy
Authors: Ramos Lopez L , Carrillo-Palau M , Alonso-Abreu I , Reygosa C , Hernández-Buylla N , Amaral C , Hernández A , Benítez-Zafra F , Pérez-González F , Quintana-Díaz H , Hernández-Guerra M 
Published: January 2022

Abstract

Background
Vaccination against COVID19 prevents its severe forms and associated mortality and offers a promising action to control this pandemic. In Spain, by October 2021, 87.9% of the target population, including IBD patients had received the complete vaccination regimen. In September 2021, an additional dose of vaccine was approved in patients with immunosuppression including IBD patients on biologic agents. We evaluated the vaccination rate and additional dose willingness in this group of-at risk patients.

Methods
A single-center, cross-sectional study was performed among IBD patients on biologic agents and elegibles for an additional dose of COVID19 vaccine between 19th October and 12th November 2021. Patients were identified by the list provided by the Pharmacy service. IBD clinical characteristics and type of vaccine and date of administration were checked in medical records. Acceptance and adverse effects of vaccination were evaluated after telephone or face-to-face survey in these IBD patients.

Results
Out of a total of 344 patients, 269 patients (46.1% male; mean age 47±16 years; crohn′s disease n=198/ ulcerative colitis n=66/ indeterminate colitis n=5) received at least one vaccine dose and were included. The patients were on Infliximab (40.9%), Ustekinumab (29.7%), Adalimumab (20%), and Vedolizumab (8.9%). Co-treatment with immunosuppressors was used in 73.2% of patients. Only 15 (5.6%) patients refused the COVID19 vaccine: 26.7% for fear of vaccine`s adverse effects, 33.3% for doubts about a “new-design” vaccine and 40% for conviction (COVID19 pandemic denial). 46.7% of the cases would not change their opinion, but 33.3% would re-consider after discussing with their doctor and/or receiving information on the adverse effects of the vaccine. Previous to the additional dose, COVID19 vaccination was present in 94.4% of patients (n=254) (complete regimen using Pfizer 63%,Astra-Zeneca 15.4%, Moderna 12.2% and Janssen in 9.4% of patients, respectively). 42.7% of patients personally requested the appointment for initial dose of vaccination and 59.1% contacted the IBD Unit to discuss the decision to be vaccinated. Adverse effects occurred in 53.9% of the cases after the standard vaccination regimen, mainly pain in the arm (40%). Up to 94.1% of the patients agreed for an additional dose and 57.2% had already received the additional dose at the time of the assessment.

Conclusion
IBD patients on biological agents and at high-risk for COVID19 accept the vaccine as well as an additional dose if recommended. Physicians in charge of IBD units should provide information and confidence in the use of the vaccine in these IBD patients. Remains to be studied the impact of the additional dose of vaccine in these patients.
P713 Gut microbiota alterations after bowel preparation amongst inflammatory bowel disease patients
Authors: Rutka M , Szántó K , Bacsur P , Resál T , Jójárt B , Bálint A , Ari E , Kintses B , Fehér T , Asbóth A , Pigniczki D , Bor R , Fábián A , Farkas K , Maléth J , Szepes Z , Molnár T 
Published: January 2022

Abstract

Background
Bowel preparation prior to colonoscopy is a routine procedure and supposed to be safe. However, the exacerbation of the complaints could be observed in numerous cases after colonoscopy in patients with inflammatory bowel disease (IBD, Crohn’s disease CD, ulcerative colitis UC). Therefore, our study aimed to investigate the short- and long-term changes of the fecal microbiota composition influenced by the bowel preparation with sodium-picosulphate and magnesium-oxide.

Methods
IBD patients (inactive or mild) preparing for colonoscopy with bowel preparation were enrolled in the study. Control group (HC) consisted of non-IBD patients who were recommended to undergo colonoscopy due to abdominal complaints. Clinical data, blood and stool samples were collected before colonoscopy (point A), 3 days later (point B) and 4 weeks later (point C) to assess disease activity and the changes of the gut microbiome. Fecal microbiota structure was determined by sequencing V4 region of the 16S rRNA gene. Microbiome structure was determined at family level. Statistical analysis included differential abundance analysis and Mann-Whitney test, values of p&lt;0.05 were considered significant.

Results
41 patients (9 CD, 13 UC, 19 HC) were enrolled in our study. After the bowel preparation, alpha diversity in the CD group was lower compared to UC(p=0.01) and control(p=0.02) patients at point B. Alpha diversity of UC patients was significantly higher than CD (p‹0.01) and control (p=0.03) groups at point C. Alpha diversity of UC patients increased from point A to C (p=0.04). However, a decreasing tendency in alpha diversity was observed in patients with CD at A to C period (p=0.26). These changes couldn’t be observed in the control group. Beta diversity showed slight differences between the IBD groups and the control group. After bowel preparation, beta diversity of CD patients immediately (from A to B) changed p=0.03), while beta diversity of UC patients seems to continually change from point A to C(p=0.03). Based on the differential abundance analysis, Clostridiales and Pseudomonadaceae families increased, while Bifidobacteriaceae, Carnobacteriaceae, Veillonellaceae and Pasteurellaceae families decreased in CD patients compared to the HC at point B. The most growing families in HC group were Brucellaceae, Moraxellaceae and Alcaligenaceae at A to B period.

Conclusion
Our findings may suggest that bowel preparation can result in a significant change in faecal microbial composition in IBD. Microbial alterations recovering earlier in UC patients due to changed mucosa. Reduced alpha diversity and altered abundance in CD may have potential role in disease exacerbation. Further examinations are needed to clarify our pilot results.