Crohn's & Colitis 360最新文献

{"title":"Patient Recruitment Strategies for Behavioral Clinical Trials in Adults with Inflammatory Bowel Diseases: An Analysis of the ADEPT (Addressing Disability Effectively with Psychosocial Telehealth) Randomized Controlled Trial.","authors":"Kanika Malani, Chung Sang Tse, Sumona Saha, Megan Lutz, Sasha Taleban, Samir A Shah, Hannah Fiske, Melissa Hunt, Lily A Brown, Robert Kuehnel, Brittaney Bonhomme, S Alandra Weaver, Raymond K Cross, James D Lewis, Sara Nicole Horst","doi":"10.1093/crocol/otaf033","DOIUrl":"10.1093/crocol/otaf033","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the effectiveness of different methods to recruit patients with inflammatory bowel disease (IBD) into a randomized controlled trial (RCT).</p><p><strong>Methods: </strong>630 participants were recruited into a multicenter RCT using electronic medical record (EMR) bulk messaging, in-person study discussion with a clinician, or a hybrid method combining the above approaches.</p><p><strong>Results: </strong>Bulk EMR messaging alone had the highest recruitment and response rates, required the least amount of time to implement, and incurred the lowest cost as compared to the in-person and hybrid recruitment methods.</p><p><strong>Conclusions: </strong>Digital health technology can enhance the recruitment of patients with IBD into randomized controlled trials.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf033"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093143","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":"Pregnant Pause? Not for IBD Care-A Single Tertiary Care Center Prospective Cohort Study Affirming IBD Management in Pregnancy.","authors":"Elizabeth Squirell, Gregory Rosenfeld, Brian Bressler, Susanna Meade, Natasha Klemm, Victoria Chen, Elisabet Joa, Yvette Leung","doi":"10.1093/crocol/otaf029","DOIUrl":"10.1093/crocol/otaf029","url":null,"abstract":"<p><strong>Background: </strong>This study examined Inflammatory Bowel Disease (IBD) management and outcomes during pregnancy in a tertiary care setting, focusing on disease activity, medication use, and maternal and neonatal outcomes.</p><p><strong>Methods: </strong>A prospective cohort study followed 287 women with IBD through 291 pregnancies from 2017 to 2023 at a single tertiary care center, collecting data preconception, during each trimester, and postpartum.</p><p><strong>Results: </strong>The study observed a 92.7% live birth rate. Seventy-four percent of individuals were in clinical remission preconception, and disease activity increased throughout pregnancy, particularly in ulcerative colitis (UC) patients (peaking at 37% in the second trimester), while remaining stable in CD patients. UC, disease duration <5 years, and preconception activity correlated with higher disease activity during pregnancy. Biologic use remained stable without significant impact on outcomes. Preterm delivery (6.7%) and small for gestational age infants (7%) rates reflected baseline population risk. Steroid use was associated with higher preterm delivery rates. Gestational hypertension (6.9%) and diabetes (9.4%) rates were similar to population norms. Maternal adverse events were higher in women 40 or older (OR 3.893).</p><p><strong>Conclusions: </strong>This study reaffirms the safety of continued medical therapy for IBD throughout pregnancy in a tertiary care, prospective cohort. Increased disease activity throughout pregnancy was evident, particularly in UC. Despite higher rates of disease activity amongst those with UC, outcomes were similar in those with CD vs UC-suggesting that disease activity measures have limitations in CD and pregnancy, or there is some mild inherent risk of CD in pregnancy outcomes irrespective of disease activity.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf029"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119154","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":"A Guide to De-escalation of Combination Therapy in Inflammatory Bowel Disease: A Retrospective Cohort Study.","authors":"Adam A Saleh, Rajdeepsingh Waghela, Shayan Amini, Joshua Moskow, Malcom Irani, Christopher Fan, Kerri Glassner, Bincy P Abraham","doi":"10.1093/crocol/otaf026","DOIUrl":"https://doi.org/10.1093/crocol/otaf026","url":null,"abstract":"<p><strong>Background: </strong>Advanced combination therapy with biologics and small molecules has seen more widespread implementation for inflammatory bowel disease (IBD). However, there is a paucity of data available to guide the successful de-escalation of combination therapy following the achievement of disease remission. Therefore, we pursued this retrospective study to evaluate our center's approach to de-escalation of these patients.</p><p><strong>Methods: </strong>IBD patients undergoing de-escalation of combination biologic therapy from May 2017 to March 2023 with a follow-up visit were included. The need for re-escalation, steroid therapy, and hospitalization at follow-up was compared between the de-escalation method, adherence, patient demographics, disease characteristics, and measures of disease activity.</p><p><strong>Results: </strong>Fifty IBD patients underwent de-escalation, with a median age of 35.7 years. All 50 patients had a follow-up visit within a median of 168 (111) days. Patients were divided into two groups with 12 (24%) patients requiring re-escalation of therapy and 38 (76%) able to maintain or further de-escalate. Of those that required re-escalation, 3 (25%) required the use of systemic steroids and none required hospitalization for IBD. Non-adherence to the de-escalation plan significantly correlated with the need for re-escalation (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Patient adherence and the number of prior failed biologic therapies were identified as potential risk factors for re-escalation. The type of agent being de-escalated (biologic or Janus kinase inhibitors [JAKi] did not correlate with the need for re-escalation).</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf026"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985058","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":"Efficacy of Filgotinib in Moderate to Severe Ulcerative Colitis: A Prospective Study Using Partial Mayo Score, Ulcerative Colitis Endoscopic Index of Severity, and Geboes Histopathology Score.","authors":"Yoshiyuki Shirouzu, Hideki Ishibashi, Masayoshi Kage, Yutaro Mihara, Yuka Sakakibara, Kazuyoshi Nagata, Asami Suzuki, Toshihiro Ohmiya, Tomoko Irie, Yasumi Araki, Keiichi Mitsuyama, Hidetoshi Takedatsu, Toshihiro Noake","doi":"10.1093/crocol/otaf030","DOIUrl":"10.1093/crocol/otaf030","url":null,"abstract":"<p><strong>Background/aims: </strong>Filgotinib (FIL), a Janus kinase inhibitor, shows clinical efficacy in moderate to severe ulcerative colitis (UC), but no prospective studies have examined endoscopic and histopathological outcomes. This study aimed to evaluate the therapeutic efficacy of FIL in moderate to severe UC using the Partial Mayo Score (PMS), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Geboes Histopathology Score (GHS).</p><p><strong>Methods: </strong>Twenty-two patients with clinically moderate to severe refractory UC were enrolled. Remission was defined as PMS 0, UCEIS 0, and GHS < 2.0 (sigmoid and rectum). Achievement rates were prospectively evaluated at 12, 24, and 52 weeks after FIL initiation compared to baseline.</p><p><strong>Results: </strong>Among the 22 patients, comprising Biologic-Naïve (BN, <i>n</i> = 12) and Biologic-Experienced (BE, <i>n</i> = 10) cohorts, achievement rates were highest for PMS 0, followed by UCEIS 0, and lowest for GHS < 2.0. Partial Mayo Score 0 achievement for BN/BE was 75% (<i>P</i> = .001)/50% (<i>P</i> = .031) at 12 weeks, 75% (<i>P</i> = .003)/70% (<i>P</i> = .016) at 24 weeks, and 75% (<i>P</i> = .002)/70% (<i>P</i> = .016) at 52 weeks. Ulcerative Colitis Endoscopic Index of Severity 0 achievement for BN/BE was 58.3% (<i>P</i> = .008)/20% (<i>P</i> = .016) at 12 weeks, 41.6% (<i>P</i> = .019)/40% (<i>P</i> = .016) at 24 weeks, and 50% (<i>P</i> = .002)/50% (<i>P</i> = .016) at 52 weeks. Geboes Histopathology Score < 2.0 (sigmoid) achievement for BN/BE was 25%/0% at 12 weeks, 33.3%/10% at 24 weeks, and 25%/10% at 52 weeks. Geboes Histopathology Score < 2.0 (rectum) achievement for BN/BE was 50%/0% at 12 weeks, 41.6%/20% at 24 weeks, and 33.3%/40% at 52 weeks.</p><p><strong>Conclusions: </strong>Filgotinib appears to be an effective treatment for UC, demonstrating potential for achieving not only clinical remission but also endoscopic and histopathological remission.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf030"},"PeriodicalIF":1.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093140","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":"From Food Fears to Food Freedom: How Do We Best Manage Restrictive Eating in Inflammatory Bowel Disease?","authors":"Madison Simons, Kelly Issokson","doi":"10.1093/crocol/otaf019","DOIUrl":"https://doi.org/10.1093/crocol/otaf019","url":null,"abstract":"<p><p>Prior research has estimated the rates of avoidant/restrictive food intake disorder (ARFID) to be between 10% and 54% in patients with inflammatory bowel disease (IBD). However, recently published studies have questioned the ability of providers to differentiate the presence of ARFID in patients with gastrointestinal (GI) symptoms and highlighted the relationship between ARFID and food literacy, which may reflect poor cognitive or psychological flexibility to navigate dietary restriction. We suggest the discourse around ARFID has neglected the neurological basis of fear conditioning as to how and why patients develop fear around eating in the setting of severe postprandial symptoms. In this review, we discuss the role of the amygdala in post-ingestive learning and how this needs to shape the approach to dietary liberalization for the highest likelihood of success. We provide specific strategies for practice when working with patients who experience significant fear of eating, including the framework for and development of appropriate exposure hierarchies to guide the reintroduction process. We encourage collaboration with dietitians and psychologists trained in gastroenterology when possible.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf019"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995146","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":"The Durability of Anti-TNF Therapy for Crohn's Disease Is Higher in Anti-TNF Naïve Patients and Increases With Proactive Therapeutic Drug Monitoring.","authors":"Robert Gilmore, Richard Fernandes, Tamar Schildkraut, Riddhi Joshi, Lyman Lin, Sara Vorgin, Amirah Etchegaray, Aathavan Shanmuga Anandan, George Tambakis, Moshe Loebenstein, Yoon-Kyo An, Jakob Begun, Emily K Wright","doi":"10.1093/crocol/otaf028","DOIUrl":"https://doi.org/10.1093/crocol/otaf028","url":null,"abstract":"<p><strong>Background: </strong>Antitumor necrosis factor (TNF) dose escalation is performed to improve therapeutic response and optimize outcomes in patients with Crohn's disease (CD). We aimed to describe the durability of anti-TNF therapy in patients with CD receiving escalated anti-TNF therapy, along with the overall durability of anti-TNF treatment between patients managed with a proactive versus reactive therapeutic drug monitoring (TDM) approach.</p><p><strong>Methods: </strong>We undertook a retrospective multicentre cohort study. One center practiced proactive TDM with a weekly virtual TDM clinic, while the other practiced reactive TDM. Patients receiving escalated infliximab or adalimumab therapy for CD from January 2015 to April 2022 were included. Durability was defined as the time from biologic start to cessation for treatment failure.</p><p><strong>Results: </strong>About 239 patients (45% female, median age 39) meeting criteria for inclusion were identified. About 165 patients were included in the proactive TDM cohort and 74 in the reactive TDM cohort.Anti-TNF naïve patients had significantly higher durability of therapy when compared with the anti-TNF exposed patients for both overall durability (<i>P</i> = .045) and durability postescalation (<i>P</i> = .017). The proactive TDM cohort had significantly higher durability when compared with the reactive cohort for both overall durability (<i>P</i> = .001) and durability postescalation (<i>P</i> = .002).</p><p><strong>Conclusions: </strong>This multicentre, retrospective cohort study illustrates the importance of dose escalation as a therapeutic strategy in IBD care. The durability of anti-TNF therapy is superior in anti-TNF naïve compared to exposed patients and can be improved further by proactive TDM to guide dose optimization.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf028"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967860","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":"Questionnaire Survey of Japanese Patients With Inflammatory Bowel Disease and Physicians on Shared Decision-Making in Advanced Therapy: A Web-Based PAIR Survey.","authors":"Fumihito Hirai, Takayuki Matsumoto, Keita Imai, Yuki Goda, Yuki Fujimitsu, Toshifumi Kajioka, Masami Oiwa, Tomoki Honjo, Masaaki Higashikawa, Masato Ueno","doi":"10.1093/crocol/otaf014","DOIUrl":"https://doi.org/10.1093/crocol/otaf014","url":null,"abstract":"<p><strong>Background/aims: </strong>With the recent increase in available treatment options for inflammatory bowel disease (IBD), shared decision-making has gained considerable importance. To address potential disparities in patient and physician priorities, we conducted a survey to clarify these perspectives.</p><p><strong>Methods: </strong>Patients with IBD and physicians treating IBD were asked to complete an online questionnaire focused on key factors influencing drug selection and preferred drug administration methods.</p><p><strong>Results: </strong>Responses were obtained from 400 patients (327 with ulcerative colitis and 73 with Crohn's disease) and 155 physicians. Among the factors in drug selection, physicians assigned significantly higher importance scores for experience with the drug than did patients. The expected time to onset of drug effects was significantly different between patients and physicians. Regarding preferences for drug administration method, patients and physicians assigned the highest acceptability scores for once-daily oral administration. For intravenous and subcutaneous routes, patients' scores were significantly lower than those of physicians' scores. Notably, 86.0% of patients and 62.0% of physicians preferred oral administration as the most preferred method. However, preferences varied based on treatment experience: 34.7% of patients with prior experience with subcutaneous injection preferred this method.</p><p><strong>Conclusions: </strong>Patients and physicians generally shared similar priorities for drug selection; however, physicians emphasized their experience with the drug over patient preferences. Although the number of patients with prior treatment experience preferred intravenous or subcutaneous injections, oral formulations remained the preferred choice for both patients and physicians.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf014"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965038","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":"Oral Extraintestinal Manifestations of Inflammatory Bowel Disease: The Temporal Relationship Between Oral and Intestinal Symptoms.","authors":"Lauren Loeb, Marketa Janovska, Yaohua Ma, Roy Rogers, Francis A Farraye, Alison Bruce, Victor Chedid, Manreet Kaur, Katherine Bodiford, Jana G Hashash","doi":"10.1093/crocol/otaf027","DOIUrl":"10.1093/crocol/otaf027","url":null,"abstract":"<p><strong>Objectives: </strong>Oral extraintestinal manifestations (OEIMs) of inflammatory bowel disease (IBD) may impact IBD treatment. The aims of this study were to: (1) determine which OEIMs are most prevalent among patients with IBD, (2) investigate the presence of a temporal association between GI luminal disease activity and OEIMs, and (3) determine how often changes in therapeutic management of IBD are needed in the presence of OEIMs.</p><p><strong>Study design: </strong>A retrospective cohort study was performed for adult patients with IBD evaluated between January 2017 and November 2021 with at least 1 oral complaint. Demographic data were collected from the charts of these patients. Kruskal-Wallis test for continuous measures and Fisher's Exact test for categorical measures were used.</p><p><strong>Results: </strong>A total of 116 patients with IBD who had presented with at least 1 oral finding during the study time period were identified. Aphthous ulcers were the most common oral presentation in both Crohn's disease (CD) (85.1%) and ulcerative colitis (UC) (75.0%). OEIMs were associated with CD activity in the small intestine (<i>P</i> = .004) and colon (<i>P</i> < .001). UC pancolitis was associated with OEIMs (<i>P</i> = .002). In 32.7% of patients, OEIMs led to either an increase in dose or frequency of IBD therapy. In an additional 16.4% of patients, new systemic agents were started because of the OEIMs.</p><p><strong>Conclusions: </strong>This study provides evidence that patients with IBD may develop OEIMs synchronous with IBD flares and may require escalation of IBD therapy when OEIMs occur.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf027"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972635","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":"Ethnic Disparities in the Management of Inflammatory Bowel Disease in Israel and Impact on Outcomes.","authors":"Elad Boaz, Oren Ledder, Ariella Bar-Gil Shitrit, Amir Dagan, Michael R Freund, Benjamin Koslowsky, Rona Lujan, Shira Greenfeld, Revital Kariv, Yiska Loewenberg Weisband, Natan Lederman, Eran Matz, Iris Dotan, Dan Turner, Shlomo Yellinek","doi":"10.1093/crocol/otaf025","DOIUrl":"https://doi.org/10.1093/crocol/otaf025","url":null,"abstract":"<p><strong>Background: </strong>In this nationwide study, we aimed to explore healthcare services utilization, medical management, and disease outcomes of inflammatory bowel diseases (IBD) across the 2 major ethnic groups in Israel.</p><p><strong>Methods: </strong>We utilized a cohort including all patients diagnosed with IBD in Israel since 2005. The primary outcome was steroid dependency, with secondary outcomes including use of biologics, time to surgery, and hospitalizations. Outcomes were controlled for possible inherent differences in disease course and phenotype.</p><p><strong>Results: </strong>Of the 32 491 included patients, 18 252 (56%) had Crohn's disease (CD) and 14 239 (44%) had ulcerative colitis (UC); 10% were Arabs and 90% were Jews. Jewish ethnicity was associated with lower rates of steroid dependency compared to Arab ethnicity in both CD (HR = 0.7 [95% CI, 0.6-0.8]) and UC (HR = 0.7 [95% CI, 0.6-0.8]). The risk of IBD-related surgery in CD was higher in the Arab group at both 3 and 5 years (13% vs. 10%, 16% vs 14%, respectively, <i>P</i> = .005). Arabs had more frequent IBD-related hospitalizations than Jews at 5 years (28% vs. 19% with at least 2 hospitalizations, <i>P</i> < .001). In contrast, Jewish ethnicity was associated with more frequent use of biologics during the first year from diagnosis in patients with CD (HR = 1.3 [95% CI, 1.1-1.6]) but not with UC.</p><p><strong>Conclusions: </strong>Arab ethnicity is associated with higher rates of hospitalizations, steroid dependency, and surgeries, and, on the other side, with lower utilization of biologics. Healthcare practitioners and policymakers should address potential cultural and systemic barriers in healthcare delivery in order to improve care across all populations.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf025"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986578","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":"Global Patterns of <i>Clostridioides difficile</i> Infection in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Prevalence, Epidemiology, and Risk Factors.","authors":"Dominic Amakye, Paddy Ssentongo, Swapnil Patel, Shannon Dalessio, Smriti Kochhar, Arsh Momin, Kofi Clarke","doi":"10.1093/crocol/otaf024","DOIUrl":"https://doi.org/10.1093/crocol/otaf024","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) is a well-recognized complication of inflammatory bowel disease (IBD) that has been associated with poor clinical outcomes. The objective of this study is to characterize the global incidence, risk factors and outcomes of CDI in patients with IBD.</p><p><strong>Methods: </strong>A search of MEDLINE/PubMed, Scopus, and Cochrane Database of Systematic Reviews was conducted for studies published between January 1960, and March 2024. Random-effect models were employed to estimate the incidence of CDI in the IBD population. Risk factors and outcomes were estimated using random effects meta-regression and subgroup analysis.</p><p><strong>Results: </strong>Twenty-eight articles from 11 countries on 3 continents, comprising 796, 244 patients with IBD were included. The overall CDI rate was 8.84% (95% CI, 5.91%-13.03%). The rate of CDI was slightly higher in Asia at 11% (95% CI, 6.7%-18.44%) compared to the North America (USA and Canada) at 7.85% (95% CI, 3.80%-15.51%) and Europe, where the incidence, was 7.92% (95% CI, 3.87%-15.51%). A univariable random-effects meta-regression model demonstrated that male gender (odds ratio [OR], 1.18; 95% CI, 1.00-1.40) and older age (OR, 1.06; 95% CI, 0.99-1.15, per one-year increase in age) were factors associated with higher CDI incidence in the IBD population. CDI testing by PCR compared to enzyme immunoassay was associated with higher rates of CDI (OR, 4.70; 95% CI, 01.39-15.90). No association was observed between length of hospital stay and CDI.</p><p><strong>Conclusions: </strong>One in 10 patients with IBD were positive for CDI. Increasing age and male population were associated with higher risk of CDI.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf024"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980834","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}