Crohn's & Colitis 360最新文献

{"title":"Optimizing 5-Aminosalicylic Acid Maintenance Treatment in Ulcerative Colitis from the Patient and Physician Perspective: A Cross-sectional Multicenter Study.","authors":"Takahiro Amano, Takeo Yoshihara, Tsutomu Nishida, Yuko Sakakibara, Takuya Yamada, Satoshi Hiyama, Yoko Murayama, Naoto Osugi, Hideharu Ogiyama, Koji Nagaike, Yuki Arimoto, Shoichiro Kawai, Toshio Yamaguchi, Shinji Kitamura, Hiroyuki Ogawa, Satoshi Egawa, Shuji Ishii, Takashi Kizu, Masato Komori, Yuri Tsujii, Akiko Asakura, Taku Tashiro, Mizuki Tani, Yuriko Otake-Kasamoto, Ryotaro Uema, Yoshiki Tsujii, Takahiro Inoue, Shinichiro Shinzaki, Hideki Iijima, Yoshito Hayashi, Tetsuo Takehara","doi":"10.1093/crocol/otaf038","DOIUrl":"10.1093/crocol/otaf038","url":null,"abstract":"<p><strong>Background: </strong>There are currently no standardized guidelines for optimizing 5-aminosalicylic acid (5-ASA) maintenance treatment, particularly in patients with ulcerative colitis (UC) who have achieved clinical remission (CR). Therefore, this study examined the perspectives of patients and physicians regarding 5-ASA dose reduction and medication adherence to optimize maintenance treatment.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from February 2023 to May 2023 at 19 institutions and included patients with UC and physicians. The participants' perspectives were assessed using an anonymous questionnaire.</p><p><strong>Results: </strong>This study included 369 patients with UC (female, 43.1%; age, > 60 years, 29.3%; CR, 88.9%). Preference to reduce the 5-ASA dose and low medication adherence were observed in 46.1% and 16.0% of patients, respectively. Low medication adherence (odds ratio [OR]: 3.43, 95% confidence interval [CI]: 1.67-7.03) was associated with the preference to reduce the 5-ASA dose. Multivariate analysis for factors associated with low medication adherence revealed age < 60 years (OR: 10.25, 95% CI: 3.58-29.38), no intractable disease subsidy (OR: 2.63, 95% CI: 1.09-6.35), dosing frequency ≥ 2 times/day (OR: 9.04, 95% CI: 3.67-22.25), and preference to reduce the 5-ASA dose (OR: 2.57, 95% CI: 1.16-5.70) as significant. Among 153 physicians, 62.7% had > 10 years of experience, and 51.0% regularly verified adherence, with experience being a significant factor (OR: 2.01, 95% CI: 1.10-3.68).</p><p><strong>Conclusions: </strong>Factors influencing medication adherence with 5-ASA included patients' desire for dose reduction and physicians' lack of experience. Improving communication with patients and enhancing education for physicians could help optimize treatment with 5-ASA.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf038"},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607752","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":"Sex Disparities in Treatment Trajectories of Inflammatory Bowel Disease Are Associated With Diagnostic Delay.","authors":"Lea Pueschel, Melanie Bathon, Ursula Seidler, Heiner Wedemeyer, Henrike Lenzen, Miriam Wiestler","doi":"10.1093/crocol/otaf040","DOIUrl":"10.1093/crocol/otaf040","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic delay (DD) is a common finding in inflammatory bowel diseases (IBD). The reasons and effects of this delay are frequently underestimated, particularly in the context of sex. Our aims were to examine the impact of delayed diagnosis in IBD, with a particular focus on sex disparities.</p><p><strong>Methods: </strong>We performed a single-center, cross-sectional study at a tertiary referral center, including patients with IBD. The data was collected between August 2020 and June 2024.</p><p><strong>Results: </strong>A total of 247 individuals with IBD were included in this study, with 53% identifying as female and 51% having Crohn's disease. Probability estimators revealed an effect of a DD on the cumulative advanced drug therapy probability in women (p_Log-Rank = 0.045). Further analysis of the interaction between therapeutic regimens and DD revealed significant differences between the sexes. Women with a longer latency in their diagnosis were more frequently treated with steroids only compared to men. Entity-specific DD was further identified as a risk factor for steroid-only treatment in women with IBD (OR: 2.6; 95% CI, 1.11-5.98; <i>P</i> = .028). Additionally, a notable disparity in quality of life was observed between women who exhibited DD and men, with the former demonstrating a significantly reduced quality of life.</p><p><strong>Conclusions: </strong>A delayed diagnosis has a significant impact on IBD treatment trajectories, with a notable sex-related effect observed especially in women. Therapeutic needs in female patients with IBD seem underestimated, particularly in instances where a DD is present.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 3","pages":"otaf040"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642045","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 Spectrum of Psychiatric Comorbidity in Individuals With Inflammatory Bowel Disease.","authors":"Kianna Cadogan, Ruth Ann Marrie, Lesley A Graff, Renee El Gabalawy, Murray W Enns, James M Bolton, Jitender Sareen, Charles N Bernstein","doi":"10.1093/crocol/otaf035","DOIUrl":"10.1093/crocol/otaf035","url":null,"abstract":"<p><strong>Background: </strong>Research on psychiatric comorbidity in inflammatory bowel disease (IBD) has focused mostly on anxiety and depression. This study aimed to describe the spectrum of psychiatric disorders experienced by individuals with IBD and their overlap.</p><p><strong>Methods: </strong>Participants were enrolled in a prospective 3-year longitudinal study that assessed psychiatric comorbidity in immune-mediated inflammatory disease. Lifetime prevalence of psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID-IV), as the DSM-IV was the prevailing classification at the time of study design. Diagnosis was aligned with DSM-5 categorization where possible with available data. Psychiatric burden was categorized as no psychiatric conditions, 1, 2 or 3 or more psychiatric conditions.</p><p><strong>Results: </strong>Of 154 IBD participants (62%female, 63% Crohn's disease) 57% had at least one psychiatric comorbidity with 27% having >1 psychiatric diagnosis. The prevalence was major depressive disorder (MDD, 41.7%), anxiety disorders (39.6%; grouped as per DSM-5), substance use disorder (SUD, 16.2%), posttraumatic stress disorder (5.3%), obsessive-compulsive disorder (4.9%), and bipolar disorder (2.0%). Of participants with MDD and a comorbid psychiatric disorder, nearly half had SUD. Of those with >1 psychiatric disorder >70% had MDD and a comorbid anxiety disorder. Persons with ≥1 psychiatric comorbidity were more likely to be current smokers (<i>P</i> < .001) and to have higher IBD disease activity scores (<i>P</i> = .005) than those without a psychiatric comorbidity.</p><p><strong>Conclusions: </strong>Over half of adults with IBD had >1 diagnosed psychiatric comorbidity from a range of 10 different psychiatric disorders identified. Further research should assess the temporal relationship of IBD and the various psychiatric presentations to better understand the trajectory of co-occurrence, and therapy which may concurrently address the psychiatric disorder and the IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"7 2","pages":"otaf035"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505065","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":"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":"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}