Crohn's & Colitis 360最新文献

{"title":"Previous Exposure to Advanced Therapies in Acute Severe Ulcerative Colitis: A New Risk Factor for Colectomy?","authors":"Maria Paz Gimenez Villamil, Paulo Gustavo Kotze","doi":"10.1093/crocol/otaf054","DOIUrl":"10.1093/crocol/otaf054","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf054"},"PeriodicalIF":1.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111976","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}

{"title":"Management of Severe Ulcerative Colitis with Ambulatory Intravenous Corticosteroids (MOSAIC): A Treatment Approach to Avoid Hospitalization in Immunocompromised Patients.","authors":"Sabrina L Chen, Nicole Arima, Kendall Beck, Uma Mahadevan, Sara Lewin","doi":"10.1093/crocol/otaf053","DOIUrl":"10.1093/crocol/otaf053","url":null,"abstract":"<p><strong>Introduction: </strong>Acute severe ulcerative colitis (ASUC) typically requires hospitalization for intravenous (IV) corticosteroid treatment and monitoring. In response to the need to reduce inpatient stays, especially during the COVID-19 pandemic, outpatient treatment models have gained interest. This study evaluated the feasibility, safety, and patient satisfaction of outpatient IV corticosteroid treatment for ASUC.</p><p><strong>Methods: </strong>We conducted a prospective cohort feasibility pilot study at a single academic center between May 2021 and October 2022. Fifteen adults with ASUC were enrolled and self-selected either outpatient or inpatient IV corticosteroid treatment. All participants received daily laboratory monitoring and symptom assessments for 14 days, with follow-up for 1 year. Primary outcomes included 90-day colectomy and 30-day readmission rates. Secondary outcomes included clinical activity scores, symptom and care satisfaction, and feasibility metrics.</p><p><strong>Results: </strong>Ten patients received outpatient care, and 5 were hospitalized. No patients in either group required colectomy within 90 days. One outpatient and no inpatients required colectomy within 1 year. Thirty-day readmission occurred in 30% of outpatients and 40% of inpatients. Clinical activity scores and satisfaction with food and sleep were similar between groups at baseline and on day 14. Initial care satisfaction was lower in the outpatient group but equalized by day 14. Outpatient care required significant coordination but was successfully delivered without adverse safety outcomes.</p><p><strong>Discussion: </strong>Outpatient IV corticosteroid treatment for select patients with ASUC is feasible, safe, and associated with comparable clinical outcomes and patient satisfaction compared to inpatient care. This model may offer a cost-effective alternative to hospitalization.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf053"},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014111","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}

{"title":"Effect of glucagon-like peptide-1 receptor agonists on major adverse cardiovascular events in patients with inflammatory bowel disease.","authors":"Michael Saadeh, Apoorva Krishna Chandar, Sadeer Al-Kindi, Vu Quang Nguyen, Revital Gorodeski Baskin, Jeffry Katz, Fabio Cominelli, Miguel Regueiro, Emad Mansoor","doi":"10.1093/crocol/otaf056","DOIUrl":"10.1093/crocol/otaf056","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf056"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014065","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}

{"title":"Outcomes of Outpatient Advanced Therapy Exposed Patients Hospitalized With Severe Ulcerative Colitis.","authors":"Badr Al-Bawardy, Eman Al Sulais, Fatimah AlHarthi, Gamal Mohamed, Mariam S Mukhtar, Ailsa Hart, Tim Raine","doi":"10.1093/crocol/otaf055","DOIUrl":"10.1093/crocol/otaf055","url":null,"abstract":"<p><strong>Background: </strong>Contemporary characteristics of hospitalized patients with ulcerative colitis (UC) may differ from historic standards in terms of prior drug exposure and disease severity. The impact of these differences on outcomes is unclear. This study aimed to assess inpatient UC outcomes according to prior outpatient drug exposure and measures of disease severity.</p><p><strong>Methods: </strong>This was a multicenter, retrospective study of adult patients (age ≥ 18 years) hospitalized for severe UC. The primary outcome was the colectomy rate among outpatient advanced therapy exposed (ATE) vs advanced therapy naïve (ATN) patients. Secondary outcomes included length of hospitalization and need for rescue medical therapy.</p><p><strong>Results: </strong>A total of 370 patients were included with 86 (23%) in the ATE group and 284 (77%) in the ATN group. In the ATE group, 21 patients (25%) required colectomy vs 26 (9%) in the ATN group (<i>P</i> < .001). Median hospital length of stay was 6 days (IQR: 4-9) in both groups (<i>P</i> = .96). Rescue medical therapy was required in 107 (38%) patients in the ATN group vs 36 (42%) in the ATE group (<i>P</i> = .49).Colectomy was associated with ATE status (<i>P</i> = .0002), Mayo UC endoscopic sub-score of 3 (<i>P</i> = .002), higher C-reactive protein (<i>P</i> = .04), lower albumin (<i>P</i> = .0002), and female sex (<i>P</i> = .03). On multivariable analysis, only low albumin was independently associated with colectomy (<i>P</i> = .001).</p><p><strong>Conclusions: </strong>Outpatient ATE was associated with an increased risk of colectomy among hospitalized patients with severe UC. On multivariable analysis, low albumin was independently associated with the risk of colectomy. This suggests that higher colectomy rates observed in ATE patients may reflect underlying differences in disease severity.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf055"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111983","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}

{"title":"Therapeutic Drug Monitoring in Pediatric Inflammatory Bowel Disease: A Nationwide Survey of Anti-TNF Therapy Practices, Attitudes, and Barriers.","authors":"Ruben J Colman, Jennifer L Dotson, Melissa Mock, Kelly Sandberg, Shehzad Saeed, Peter Margolis, Jasbir Dhaliwal","doi":"10.1093/crocol/otaf050","DOIUrl":"10.1093/crocol/otaf050","url":null,"abstract":"<p><strong>Background: </strong>Proactive therapeutic drug monitoring (TDM) for tumor necrosis factor alpha antagonist (anti-TNF) therapy in adult inflammatory bowel disease (IBD) remains controversial, with inconsistent findings from clinical trials and meta-analyses. Pediatric societal guidelines endorse the implementation of proactive TDM. However, the integration of TDM into clinical practice by pediatric gastroenterologists has not been characterized. This study was undertaken to delineate the practice patterns, attitudes, and barriers associated with anti-TNF TDM among pediatric gastroenterologists across the United States.</p><p><strong>Methods: </strong>A 28-item questionnaire was developed based on prior adult surveys and current pediatric literature, undergoing 3 rounds of iteration. The survey was comprised of physician demographics, center demographics, TDM practice behavior questions and case-scenarios. The survey was deployed through the ImproveCareNow Learning Health System Network between February and June 2023.</p><p><strong>Results: </strong>Among 380 invitees, 256 (77%) completed the questionnaire. Among respondents, 67% (171) were academic-affiliates, and 55% (140) were female. There was notable variability in the number of patients with IBD seen per practice. All respondents reported using TDM for infliximab, and the majority for adalimumab, and the vast majority utilizing a proactive TDM approach. The principal barriers to TDM implementation were insurance denials, cost, and logistical challenges. More respondents indicated they would initiate TDM during infliximab induction for severe ulcerative colitis than for Crohn's disease.</p><p><strong>Conclusions: </strong>In contrast to the adult literature, most pediatric gastroenterologists report undertaking proactive TDM for anti-TNF agents in IBD management. Precision dosing tools reflective of an individual's pharmacokinetics are desired and need to be further studied.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf050"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014071","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}

{"title":"Clinical Characteristics of Patients With Ulcerative Colitis and Small Intestinal Malignancy.","authors":"Caroline G Olson, Michael Picco, Francis A Farraye, Jana G Hashash, Jami Kinnucan","doi":"10.1093/crocol/otaf041","DOIUrl":"10.1093/crocol/otaf041","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have examined small intestinal dysplasia and cancer in Crohn's disease; however, there is limited information on ulcerative colitis (UC). We describe characteristics of small intestinal dysplasia and cancer in patients with UC. In this study, we aimed to identify common characteristics between patients with UC that were diagnosed with small intestinal malignancy.</p><p><strong>Methods: </strong>Electronic medical records were reviewed for 3 tertiary referral centers to identify patients with a diagnosis of UC and small intestinal dysplasia or cancer between 2010 and 2023. Data collection included demographics, family history of gastrointestinal malignancy, UC diagnosis date, duration and location of disease, prior UC medical treatment or surgery, diagnosis of primary sclerosing cholangitis (PSC), PSC-related complications, and details of cancer or dysplasia. Descriptive statistics were performed.</p><p><strong>Results: </strong>Thirty-five patients (60% male, mean age of diagnosis 39.3 ± 21.5 years old) were identified with UC and subsequent small intestinal dysplasia or cancer. Most had pancolitis (74.3%) or pancolitis with backwash ileitis (8.57%). Half underwent surgery for their UC, and half of these had the cancer or dysplasia found at the time of surgery. Ileal dysplasia was found in 2 patients (5.71%), duodenal adenocarcinoma in 2 (5.71%), ileal adenocarcinoma 2 (5.71%), duodenal carcinoid in 4 (11.4%), ileal carcinoid in 24 (68.6%), other duodenal neuroendocrine tumor in 1 (2.86%). Primary sclerosing cholangitis was diagnosed in 5 patients (14%), and 3 required liver transplants.</p><p><strong>Conclusions: </strong>Small intestinal dysplasia and cancer are rare in this population. Most patients with small intestinal cancer or dysplasia were male, Caucasian, and had a history of extensive colitis. Ileal carcinoid had the highest incidence. Gastroenterologists should be aware of this finding in patients with UC.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf041"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783699","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}

{"title":"Inflammatory Bowel Disease Advice Lines: A Scoping Review.","authors":"Naomi Hare, Christine Norton, Peter Irving, Wladyslawa Czuber-Dochan","doi":"10.1093/crocol/otaf051","DOIUrl":"10.1093/crocol/otaf051","url":null,"abstract":"<p><strong>Background and aims: </strong>Telephone or email advice lines offer a service that bridges primary and specialist care provision, supporting the needs of those living with an unpredictable disease course. This scoping review aimed to systematically synthesize published evidence with regard to Inflammatory Bowel Disease advice line services and to identify gaps in research to inform further work.</p><p><strong>Methods: </strong>A scoping review was undertaken in accordance with the patterns, advances, gaps, evidence, and research framework. Databases searched included CINAHL, PubMed, and EMBASE. Inclusion/exclusion criteria were applied by 2 reviewers independently. Data were collected using a predefined matrix, from which the framework was applied as a means of systematically collating patterns, advances, gaps, evidence, and research recommendations.</p><p><strong>Results: </strong>Seventeen full-text publications and 22 abstracts published between 2006 and 2023 were included. Four overarching patterns were identified: advice lines as a complex intervention, drivers for advice line encounters, patient outcomes, and economic impact of advice lines.</p><p><strong>Conclusions: </strong>The current evidence landscape lacks empirical research supporting the clinical and economic effectiveness of advice lines. Inflammatory bowel disease advice lines are commonly a nurse-led service functioning as a complex intervention, supporting both administrative and clinical issues. They appear pivotal in preventing use of acute services and escalating or re-directing care, including treatment, investigation, and advice. Further research should focus on robust clinical and economic evaluation for patients and services, exploring patient experience of advice line services, including barriers and facilitators, and characterizing those who do not currently access the service.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf051"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111937","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}

{"title":"CC360 Pearl: Interacting with Industry for the New Gastroenterologist.","authors":"Benjamin Click, David Fudman","doi":"10.1093/crocol/otaf049","DOIUrl":"10.1093/crocol/otaf049","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf049"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945956","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}

{"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":"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}

{"title":"Optimizing Nutrition Education in a Dedicated Inflammatory Bowel Disease Clinic.","authors":"Thomas W Fredrick, June Tome, Camille A Kezer, Krista R Kerlinske, Lindsey E Sefried, Sunanda V Kane","doi":"10.1093/crocol/otaf045","DOIUrl":"10.1093/crocol/otaf045","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) frequently ask their providers for nutritional or dietary recommendations; however, providers are limited in both time and knowledge to adequately address their questions. In this single-center study, we sought to improve provider experiences with nutrition counseling for patients seen in a dedicated IBD clinic.</p><p><strong>Methods: </strong>To understand the current state, providers, including gastroenterology fellows, attendings, and advanced practice providers were surveyed regarding their experiences with nutritional recommendations in a dedicated IBD clinic. Following the pre-intervention survey, we worked with registered dieticians on how to address key concerns and developed an informational handout based upon current guidelines. After displaying handouts in clinical workspaces for 5 weeks, providers were surveyed again to evaluate their response.</p><p><strong>Results: </strong>All 22 respondents (100%) in the pre-intervention survey either agreed or strongly agreed that IBD patients have unique nutritional requirements. A majority (72%) strongly agreed that the clinic would benefit from more access to dieticians. Additionally, 41% of providers either strongly disagreed or disagreed that they had enough time to address nutritional concerns. Post-intervention, 57% of respondents (8/14) reported that they found the handouts helpful. A significant number of providers reported improvement in their comfort level discussing nutrition and dietary recommendations with IBD patients, with tmean Likert score increasing from 3.5 to 4.1 (<i>P</i> = .01).</p><p><strong>Conclusion: </strong>In this quality improvement study, we identified key issues preventing providers from addressing patient desire for nutritional counseling and developed a novel awareness campaign that significantly improved provider confidence in discussing nutritional recommendations with their IBD patients.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf045"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945886","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}