Crohn's & Colitis 360Pub Date : 2025-07-20eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf008
John R Campion, Emma McCormick, Kate Finn, Aine Keogh, Linda Duane, Rakhi Jose, Laurence J Egan, Eoin Slattery, Mary Hussey
{"title":"Barriers, Drivers, and Outcomes in Transitioning Patients With Inflammatory Bowel Disease From Intravenous to Subcutaneous Infliximab.","authors":"John R Campion, Emma McCormick, Kate Finn, Aine Keogh, Linda Duane, Rakhi Jose, Laurence J Egan, Eoin Slattery, Mary Hussey","doi":"10.1093/crocol/otaf008","DOIUrl":"https://doi.org/10.1093/crocol/otaf008","url":null,"abstract":"<p><strong>Background: </strong>Data are limited on patients' experience of transition to subcutaneous treatment. This study aimed to determine what factors affect the decision to transition, to assess clinical outcomes and to elucidate patients' experience of transition.</p><p><strong>Methods: </strong>This was a longitudinal, observational study carried out at University Hospital Galway, a tertiary referral center in Ireland, from November 2022 to December 2023. The drivers and barriers for patients eligible for transition were measured using a questionnaire with 21, 5-point Likert items. Clinical, biochemical, and patient-reported parameters were assessed at week 8 and week 26. Patients completed a survey at week 26 on their experience of treatment with subcutaneous Infliximab.</p><p><strong>Results: </strong>Eighty of 144 eligible patients agreed to transition. Treatment persistence was 93.7% at week 26. There was no significant change in mean clinical, biochemical or patient-reported parameters at week 26. In multivariate analysis, there was higher probability of transition among patients with wholly publicly funded healthcare (OR = 3.53, 95% CI, 1.18-11.68). Among those who transitioned, the strongest drivers cited were lifestyle factors while among patients who declined transition, most commonly cited barriers included reduced contact with healthcare professionals. At week 26, 96.1% of respondents reported being able to contact the IBD team when necessary and 87.3% of respondents were satisfied with their monitoring.</p><p><strong>Conclusions: </strong>Understanding patients' attitudes toward transition is essential to design a service that meets their needs. Services must be adequately resourced in order to ensure that patients treated with subcutaneous biologics continue to have ready access to high-quality care.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf008"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-07-09eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf031
Britt Christensen, Michael Scharl, Brian Bressler, Zaeem Khan, Yuliya Halchenko, Celine Gisler, Pravin Kamble, Shashi Adsul, Zeinab Farhat, Marc Ferrante
{"title":"Real-World Clinical Effectiveness and Safety of Vedolizumab and Ustekinumab in Biologic-Naïve Patients With Early or Late Crohn's Disease: Results From the EVOLVE Expansion Study.","authors":"Britt Christensen, Michael Scharl, Brian Bressler, Zaeem Khan, Yuliya Halchenko, Celine Gisler, Pravin Kamble, Shashi Adsul, Zeinab Farhat, Marc Ferrante","doi":"10.1093/crocol/otaf031","DOIUrl":"10.1093/crocol/otaf031","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the real-world effectiveness and safety of vedolizumab and ustekinumab as first-line biologics in patients with Crohn's disease (CD), by disease duration.</p><p><strong>Methods: </strong>EVOLVE Expansion (ClinicalTrials.gov, NCT05056441) was a retrospective medical chart review study in Australia, Belgium, and Switzerland. Biologic-naïve patients with CD (≥18 years old) initiated first-line biologic treatment with vedolizumab or ustekinumab. Cumulative rates of clinical response, remission, mucosal healing, and treatment persistence were assessed over 36 months. Outcomes were compared between patients with early (≤2 years) and late (>2 years) disease at biologic initiation. Serious adverse events (SAEs), serious infections (SIs), and healthcare resource use (HCRU) were evaluated.</p><p><strong>Results: </strong>In early (<i>n</i> = 249) and late (<i>n</i> = 371) CD subgroups, there were no significant differences over 36 months between vedolizumab and ustekinumab in the cumulative rates of clinical response (early CD, 81.6% vs 80.7%; <i>P</i> = .31; late CD, 83.7% vs 86.5%; <i>P</i> = .31) or clinical remission (early CD, 87.9% vs 85.0%; <i>P</i> = .74; late CD, 91.1% vs 90.6%; <i>P</i> = .96). In patients with early CD, mucosal healing rates were significantly higher with vedolizumab than ustekinumab at both 24 (<i>P</i> = .02) and 36 months (<i>P</i> = .03). Treatment persistence was significantly higher with ustekinumab versus vedolizumab over 36 months in patients with late CD, but similar in patients with early CD. There were no significant differences in SAEs, SIs, or HCRU.</p><p><strong>Conclusions: </strong>Both vedolizumab and ustekinumab are effective treatment options for early- and late-stage CD. Over 36 months, mucosal healing rates in patients with early CD were significantly higher with vedolizumab than with ustekinumab.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf031"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-07-09eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf037
Nabeel Khan, Ramaswamy Sundararajan, Nadim Mahmud
{"title":"Long-Term Effectiveness and Safety of Tofacitinib in a Nationwide Veterans Affairs Cohort of Ulcerative Colitis Patients.","authors":"Nabeel Khan, Ramaswamy Sundararajan, Nadim Mahmud","doi":"10.1093/crocol/otaf037","DOIUrl":"10.1093/crocol/otaf037","url":null,"abstract":"<p><strong>Background: </strong>There is limited real-world data on the long-term effectiveness and safety of tofacitinib among ulcerative colitis (UC) patients, especially among the elderly. Our aim was to evaluate these parameters among UC patients who had remained on the drug 1 year after initiation of therapy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study, utilizing the US National Veterans Affairs Healthcare System, including patients with UC who received tofacitinib. The primary endpoint was effectiveness at the end of follow-up. The secondary endpoint was to evaluate if the effectiveness was different among the elderly compared to the young. Adverse events associated with the drug, like herpes zoster, major adverse cardiovascular events, deep vein thrombosis, as well as infections and malignancy during follow-up were also assessed.</p><p><strong>Results: </strong>In total, 159 patients were included in the study, among whom 51 were in the elderly group and 108 were in the younger group. The median duration of follow-up was 1.47 years (range, 0.01-5.49 years). Effectiveness of tofacitinib among the cohort was 56.60% (90 out of 159 patients). The effectiveness was higher in the elderly (<i>P</i> = .005).</p><p><strong>Conclusion: </strong>In this nationwide cohort of UC patients, the effectiveness of tofacitinib was seen in a little over half the number of patients, with higher rates of effectiveness reported among the elderly. No new safety concerns were raised, especially among the elderly.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf037"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-07-02eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf034
Lauren Loeb, Alexander Hochwald, Michael F Picco, Johanna L Chan, Jana G Hashash, Ryan Chadha, Francis A Farraye, Jami A Kinnucan
{"title":"Cannabis use in Patients With Inflammatory Bowel Disease is Associated With Longer Endoscopic Duration and Endoscopic Inflammation.","authors":"Lauren Loeb, Alexander Hochwald, Michael F Picco, Johanna L Chan, Jana G Hashash, Ryan Chadha, Francis A Farraye, Jami A Kinnucan","doi":"10.1093/crocol/otaf034","DOIUrl":"10.1093/crocol/otaf034","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) often experience symptoms refractory to available treatments, prompting the use of alternative therapies like cannabis. Previous studies have shown cannabis users require higher levels of sedation for procedures. The anti-inflammatory effects of cannabis have been studied with mixed conclusions. We aimed to investigate if patients with IBD who reported cannabis use required more resources for endoscopic procedures and were more likely to have endoscopic inflammation.</p><p><strong>Methods: </strong>This is a retrospective case-control study of adult patients with IBD between November 2018 and November 2022 at a tertiary academic medical center undergoing endoscopic evaluation of acute complaints related to IBD. Cases were matched for age, sex, and body mass index.</p><p><strong>Results: </strong>There were 124 patients with IBD with 62 patients reporting cannabis use and 62 patients without reported cannabis use. There was a significant difference in endoscopy duration (<i>P</i> < .001) and endoscopic inflammation (<i>P</i> = .044) between groups. There was no significant difference in recovery room length of stay (<i>P</i> = .15), IBD treatment during time of endoscopy (<i>P</i> = .84), stricture (<i>P</i> = .53), propofol dose administered when adjusted for procedure duration (<i>P</i> = .082), or endoscopic duration between cannabis users with and without endoscopic inflammation (<i>P</i> = .194).</p><p><strong>Conclusions: </strong>IBD cannabis users had longer endoscopic durations and were more likely to exhibit inflammation on endoscopic evaluation compared to cannabis non-users. Our study underscores the importance of medication reconciliation for more accurate resource allocation. Additionally, federal expansion of cannabis research is needed for randomized control trials to fulfill the presently unmet need for data on patient outcomes.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf034"},"PeriodicalIF":1.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-28eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf042
Jason J Wilson, Barry Lynch, Nathan Graham, Conor M McClean, Mark A Tully
{"title":"Patterns and Correlates of Sedentary Behavior and Physical Activity in Individuals With Crohn's Disease: A Cross-Sectional Study.","authors":"Jason J Wilson, Barry Lynch, Nathan Graham, Conor M McClean, Mark A Tully","doi":"10.1093/crocol/otaf042","DOIUrl":"10.1093/crocol/otaf042","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that being physically active could offer a range of benefits for people living with Crohn's disease. However, the extent to which physical activity may provide benefits in terms of quality of life, mental health, and well-being requires further elucidation. This study aimed to highlight patterns and explore the correlates of sedentary behavior and physical activity in individuals living with Crohn's disease.</p><p><strong>Methods: </strong>Adults living with Crohn's disease from Ireland and the United Kingdom completed an online survey. Participants completed questions on: demographic characteristics; physical activity; sedentary behavior; Crohn's disease severity; quality of life; anxiety and depressive symptoms; and mental well-being. Multiple linear regression analysis explored the correlates of sedentary behavior and physical activity.</p><p><strong>Results: </strong>One-hundred and eleven individuals (median age = 40.0 [31.0-48.0] years; 77% female) completed the survey. For sedentary behavior, median time was 9.14 (7.43-11.25) hours/day and the only significant correlate was age (β = -0.07, <i>t</i>(107) = -2.65, <i>P</i> = .01). For total physical activity, the quality of life physical health domain was the only significant correlate (β = 29.14, <i>t</i>(107) = 2.53, <i>P</i> = .01).</p><p><strong>Conclusions: </strong>Higher levels of sedentary behavior were associated with lower age, potentially due to the type of occupations of younger participants (ie, office-based jobs). Higher total physical activity levels were associated with higher quality of life physical health domain scores, which demonstrates the potential role physical activity might have in improving quality of life in individuals living with Crohn's disease. Both sedentary behavior and physical activity might be beneficial lifestyle variables to target for health improvement in this population.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf042"},"PeriodicalIF":1.8,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-27eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf023
Elena Céspedes-Martínez, Virginia Robles-Alonso, Xavier Serra-Ruiz, Claudia Herrera-De Guise, Luis Mayorga-Ayala, Sonia García-García, María Larrosa-García, Francesc Casellas, Natalia Borruel
{"title":"Dashboard-Guided Anti-TNF Induction: An Effective Strategy to Minimize Immunogenicity While Avoiding Immunomodulators-A Single-Center Cohort Study.","authors":"Elena Céspedes-Martínez, Virginia Robles-Alonso, Xavier Serra-Ruiz, Claudia Herrera-De Guise, Luis Mayorga-Ayala, Sonia García-García, María Larrosa-García, Francesc Casellas, Natalia Borruel","doi":"10.1093/crocol/otaf023","DOIUrl":"10.1093/crocol/otaf023","url":null,"abstract":"<p><strong>Background: </strong>Proactive therapeutic drug monitoring facilitates early dose optimization to prevent primary and secondary failure to antitumor necrosis factor (TNF). We aimed to investigate the impact of dashboard-guided induction dosing strategy on anti-TNF durability and immunogenicity.</p><p><strong>Methods: </strong>We conducted a single-center cohort analysis of patients with Crohn's disease (CD) and Ulcerative colitis (UC) who initiated treatment with infliximab or adalimumab between January 2020 and March 2023. Induction was prospectively personalized using a pharmacokinetic model-guided dosing strategy, with drug measurements at week 2, 6, and 14, and the first dose adjustment occurred in week 4. Data were recorded retrospectively. We assessed treatment durability, pharmacokinetic outcomes, clinical remission (CR), and endoscopic remission (ER), at both weeks 24 and 56. Multivariate analysis and Kaplan-Meier curves were used to compare outcomes.</p><p><strong>Results: </strong>We enrolled 147 patients (92 CD /55 UC). Anti-TNF drug survival probability was 85.00% after a year. Seventy-seven percent of patients were prescribed an intensified dose in the first year, which was associated with improved drug durability. Only 1 patient out of 147 developed antibodies to adalimumab, none to infliximab. After 24 and 52 weeks of treatment 92.5% (136/147) and 72.78% (107/147) of patients achieved CR, respectively. ER was observed in 59.39% (79/133) of patients. The use of immunomodulators or carriage of HLA DQA1*05 variant was not associated with adverse treatment or pharmacokinetic outcomes.</p><p><strong>Conclusions: </strong>Optimizing anti-TNF induction with a dashboard-guide dosing strategy proves to be a valuable approach to enhance treatment durability and clinical outcomes in inflammatory bowel disease patients. Immunogenicity appears to be mitigated by the model, which even mitigates the impact of immunomodulators and overcomes HLA DQA1*05 effect.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf023"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-19eCollection Date: 2025-04-01DOI: 10.1093/crocol/otaf036
Benjamin Sahn, Ross M Maltz, Joel R Rosh
{"title":"Children With Inflammatory Bowel Diseases are Disadvantaged by Current Drug Approval Policies: A Call for Urgent Change.","authors":"Benjamin Sahn, Ross M Maltz, Joel R Rosh","doi":"10.1093/crocol/otaf036","DOIUrl":"10.1093/crocol/otaf036","url":null,"abstract":"<p><p>Treatment of pediatric inflammatory bowel disease (IBD) is significantly hindered by the lack of US Food and Drug Administration-approved biologic and small-molecule medications. This review explains the burdens faced by children with IBD because of this problem and appraises the marked historical timeline differences in medication approval between adults and children with IBD. The authors follow with an in-depth focus on the pointed disparity in approved therapies for children with IBD compared to children with rheumatologic immune-mediated diseases, highlighting the differences in stringency of evidence that has been used to gain medication approval for children with rheumatologic diseases. The editorial concludes with a call for change in regulatory agency protocols, to adopt a modernized strategy that will expedite the approval of advanced therapies for children with IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf036"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-14eCollection Date: 2025-04-01DOI: 10.1093/crocol/otaf043
Remo Panaccione, Faye Chan-Diehl, Simin Baygani, Deborah A Fisher, Richard E Moses, Britta Siegmund, Alissa Walsh, Taku Kobayashi, Parambir S Dulai, Simon Travis
{"title":"Fecal Calprotectin and C-Reactive Protein Association With Histologic and Endoscopic Endpoints in Mirikizumab-Treated Patients With Ulcerative Colitis.","authors":"Remo Panaccione, Faye Chan-Diehl, Simin Baygani, Deborah A Fisher, Richard E Moses, Britta Siegmund, Alissa Walsh, Taku Kobayashi, Parambir S Dulai, Simon Travis","doi":"10.1093/crocol/otaf043","DOIUrl":"10.1093/crocol/otaf043","url":null,"abstract":"<p><strong>Background: </strong>Fecal calprotectin (FC) and C-reactive protein (CRP) are noninvasive biomarkers used in ulcerative colitis (UC) clinical trials; however, thresholds defined as \"normal\" in trials may be higher than \"normal\" thresholds typically used in clinical practice. We assessed the relationship between FC and CRP improvement in the \"normal\" range across different cutoff thresholds for patients with moderately to severely active UC treated with mirikizumab.</p><p><strong>Methods: </strong>Patients achieving clinical response to mirikizumab in LUCENT-1 (Weeks 0-12) proceeded to LUCENT-2 (Weeks 12-52 [52 weeks of continuous mirikizumab]). Associations between FC and CRP levels at multiple thresholds and histologic-endoscopic mucosal improvement (HEMI) and histologic-endoscopic mucosal remission (HEMR) at Weeks 12 and 52 were assessed by Fisher's exact test. Least squares means of FC and CRP changes from baseline at Weeks 12 and 52 were calculated using analysis of covariance with HEMI or HEMR status as factors and baseline FC or CRP values as covariates.</p><p><strong>Results: </strong>At Weeks 12 and 52, greater proportions of patients with FC thresholds of ≤250, ≤150, ≤100, and ≤50 µg/g, and CRP thresholds of ≤6 and ≤5 mg/L, achieved HEMI and HEMR compared with those not achieving HEMI and HEMR. Changes from baseline in FC and CRP at Week 12 and FC at Week 52 were greater in patients who achieved HEMI and HEMR compared with those not achieving these endpoints.</p><p><strong>Conclusions: </strong>These results show that FC and CRP analyses may contribute to a noninvasive monitoring strategy in clinical practice.ClinicalTrials.gov numbers: NCT03518086, NCT03524092.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf043"},"PeriodicalIF":1.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-10eCollection Date: 2025-07-01DOI: 10.1093/crocol/otaf039
Maureen Kelly, Abigail Meyers, Kate Carmody, Michele Rubin
{"title":"Crohn's & Colitis Foundation's Advanced Practice Provider Preceptorship in Inflammatory Bowel Disease: Addressing the Knowledge Gap.","authors":"Maureen Kelly, Abigail Meyers, Kate Carmody, Michele Rubin","doi":"10.1093/crocol/otaf039","DOIUrl":"10.1093/crocol/otaf039","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) management has become increasingly complex and specialized education for advanced practice providers (APPs) is limited. The Crohn's & Colitis Foundation's Advanced Practice Provider Preceptorship was developed to educate IBD APPs to minimize this knowledge gap.</p><p><strong>Method: </strong>APP applicants were chosen based on their limited IBD knowledge and experience. Accepted applicants spent 3 days in an IBD center observing and learning. Pre- and post-surveys evaluated satisfaction, increase in knowledge, and confidence to manage IBD. A 3-month survey assessed mentorship and changes in practice.</p><p><strong>Results: </strong>Data measurement assessed satisfaction, knowledge, and confidence. The program grew from one participant in 2017 to 15 participants in 2023, with the maximum number of participants at 16 in 2021. From 2018 to 2023, knowledge and confidence from pre- to post-program improved. From 2018 to 2022, more than 75% of participants reported feeling \"well-versed\" to \"extremely well-versed\" in IBD knowledge after completion of the program. From 2019 to 2023, greater than 90% of participants reported feeling \"moderately to very confident\" or \"completely confident\" post-program.</p><p><strong>Conclusions: </strong>The Crohn's & Colitis Foundation's APP Preceptorship, a program for APPs with limited IBD knowledge and experience, is associated with program satisfaction and improved knowledge and confidence in treating IBD. Unexpected outcomes include changes in individual practices and ongoing mentorship. Continuation of this program will further enhance the IBD education of future APPs.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf039"},"PeriodicalIF":1.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Crohn's & Colitis 360Pub Date : 2025-06-05eCollection Date: 2025-04-01DOI: 10.1093/crocol/otaf032
Talal Dahab, Luca Stocchi, Amit Merchea, Dorin T Colibaseanu, Francis A Farraye, Kelly L Mathis, David A Etzioni, David H Bruining, Michael F Picco
{"title":"Pathologic Rate of Cancer After Surgery for Dysplasia Detected on Chromoendoscopy for Inflammatory Bowel Disease.","authors":"Talal Dahab, Luca Stocchi, Amit Merchea, Dorin T Colibaseanu, Francis A Farraye, Kelly L Mathis, David A Etzioni, David H Bruining, Michael F Picco","doi":"10.1093/crocol/otaf032","DOIUrl":"10.1093/crocol/otaf032","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of the study was to investigate the characteristics of patients who underwent surgery for dysplasia detected during chromoendoscopy (CE) surveillance for inflammatory bowel disease (IBD) and the incidence of cancer in the surgical specimen.</p><p><strong>Methods: </strong>A retrospective review of medical records of all patients with dysplasia on a background of underlying IBD diagnosed through CE was carried out at a tri-site enterprise tertiary referral center between 2006 and 2019. We aimed to assess the clinical characteristics of patients requiring surgery for dysplasia and the incidence of cancer in the surgical specimen.</p><p><strong>Results: </strong>Out of 219 patients with dysplasia on CE, 35 underwent surgery for dysplasia (16%). Indications for surgery were multifocal disease (<i>n</i> = 6), endoscopically unresectable lesions (<i>n</i> = 13), visible HGD (<i>n</i> = 7) and unifocal invisible LGD (<i>n</i> = 9). Out of 35 patients requiring surgery, 5 were found to have adenocarcinoma, one of whom with stage IIIB disease received postoperative chemotherapy. No patient with a pathologic diagnosis of adenocarcinoma had any evidence of recurrent disease after a mean postoperative follow-up of 32 months.</p><p><strong>Conclusions: </strong>While the incidence of cancer at the time of surgery for IBD-related dysplasia is not negligible, the rate of node-positive disease is low.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf032"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}