Crohn's & Colitis 360最新文献

{"title":"Long-term drug persistence and clinical outcomes of ustekinumab in Crohn's disease: a multicenter real-world study from the Hokkaido phoenix cohort.","authors":"Takahiro Ito, Atsuo Maemoto, Nobuhiro Ueno, Mikihiro Fujiya, Toshifumi Ashida, Daisuke Hirayama, Yoshihiro Yokoyama, Satoshi Motoya, Masanao Nasuno, Hiroki Tanaka, Takehiko Katsurada, Hiroshi Nakase","doi":"10.1093/crocol/otag059","DOIUrl":"10.1093/crocol/otag059","url":null,"abstract":"<p><strong>Background: </strong>Although ustekinumab (UST) is effective in Crohn's disease (CD), long-term real-world data beyond 5 years and its effects on extraintestinal manifestations remain limited. We evaluated UST's long-term effectiveness and safety in CD.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled 317 CD patients who initiated UST between May 2017 and February 2023 at seven institutions in Japan. The primary outcome was the UST continuation rate. The secondary outcomes included factors affecting the continuation rates, surgery-free survival, endoscopic remission rates, improvement in perianal and extraintestinal manifestations, and adverse events.</p><p><strong>Results: </strong>UST continuation rates at 1, 3, and 5 years were 87.6%, 69.6%, and 66.8%, respectively, with 43 patients followed beyond 5 years (maximum 6.1 years). Multivariate analysis identified week-8 albumin ≥3.3 g/dL (HR 0.30; 95% CI, 0.12-0.72; <i>P</i> = .007) and week-8 C-reactive protein (CRP) ≥0.33 mg/dL (HR 2.05; 95% CI, 1.14-3.69; <i>P</i> = .016) as independent predictors of continuation. Endoscopic remission rates improved significantly from baseline (10%) to week 52 (19%, <i>P</i> < .01) and week 104 (30%, <i>P</i> < .01). Among perianal fistula cases (<i>n</i> = 60), 28% achieved clinical fistula remission and 37% showed improvement. Resolution or improvement was observed in 76% of arthritis and 86% of psoriasis-like lesion cases. The surgery-free survival rate at 5 years was 85.1%. The adverse event rate was 10.7%.</p><p><strong>Conclusions: </strong>UST demonstrated favorable medium- to long-term effectiveness and safety in CD patients with limited follow-up data beyond 5 years. Week-8 albumin and CRP levels may serve as early predictive biomarkers but require external validation in independent cohorts.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag059"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367163","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 efficacy and safety of hyoscyamine, dicyclomine, and desipramine in the treatment of irritable pouch syndrome-a retrospective cohort study.","authors":"Hayden Vaughn, Mille D Long, Edward L Barnes, Hans Herfarth","doi":"10.1093/crocol/otag063","DOIUrl":"10.1093/crocol/otag063","url":null,"abstract":"<p><strong>Background: </strong>Patients with ileal pouch-anal anastomosis (IPAA) frequently experience high bowel frequency and abdominal pain that are disproportionate to endoscopic inflammation, a condition often termed irritable pouch syndrome. Although antispasmodic agents and neuromodulators are widely used in irritable bowel syndrome, real-world data supporting their effectiveness and durability in patients with pouches remain limited.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of IPAA patients followed at a pouch clinic between 2014 and 2025. Patients treated with hyoscyamine extended release (ER), dicyclomine, or desipramine for high bowel frequency or abdominal pain were included. Patients could receive multiple therapies sequentially over time. Clinical response was determined by physician-documented symptom improvement. Treatment persistence was assessed using electronic medical record prescription data.</p><p><strong>Results: </strong>Among 219 eligible patients, 329 treatment courses were analyzed: 143 hyoscyamine ER, 80 dicyclomine, and 106 desipramine. In patients with high bowel frequency, 235 treatment courses resulted in clinical improvement in 68.5% of patients receiving hyoscyamine ER, 65.0% of those receiving dicyclomine, and 63.5% of those receiving desipramine. For abdominal pain (94 treatment courses), improvement for hyoscyamine ER, dicyclomine, and desipramine was observed in 61.5%, 68.3%, and 76.2% of courses, respectively. Approximately 60% of treatment courses persisted beyond one year. Long-term persistence (≥3 years) was highest with dicyclomine (48.7%), followed by desipramine (38.7%) and hyoscyamine ER (37.8%). Adverse events were infrequent and consistent with known safety profiles.</p><p><strong>Conclusions: </strong>Antispasmodic agents and low-dose neuromodulators are associated with meaningful symptom improvement in patients with irritable pouch syndrome, supporting their role as adjunctive therapies for pouch-related functional symptoms.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag063"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359772","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":"Stoma formation and associated risk factors in patients with Crohn's disease in an Austrian tertiary referral hospital: a retrospective explorative study of long-term follow-up.","authors":"Christian Primas, Stefan Riss, Jagoda Pokryszka, Adrian Frick, Jurij Maurer, Stefanie Dabsch, Philipp Schreiner, Walter Reinisch, Lili Kazemi-Shirazi, Christopher Dawoud, Nikolaus Pedarnig, Hubert Angermann, Clemens Dejaco, Michael Trauner, Gottfried Novacek, Thomas Waldhör","doi":"10.1093/crocol/otag064","DOIUrl":"10.1093/crocol/otag064","url":null,"abstract":"<p><strong>Background: </strong>The cumulative probability of patients with Crohn's disease (CD) requiring a stoma at a tertiary center is unknown. We sought to evaluate the time to stoma formation after diagnosis as well as risk factors for stoma formation in CD patients.</p><p><strong>Methods: </strong>This is a retrospective, longitudinal cohort study on consecutive patients with CD at an Austrian tertiary referral university center. In brief, patients with CD were identified and disease-specific data were captured prior to June 2023. The probability of stoma-free survival by subgroups of various potential risk factors was assessed by means of Kaplan-Meier estimates (Log-rank test).</p><p><strong>Results: </strong>Of 1267 CD patients, 142 (11.2%) underwent a stoma formation (80 ileostomies, 62 colostomies), of which 51 (35.9%) were permanent stomas. The probability of stoma-free survival at 10 and 20 years after diagnosis was 92% and 86%, respectively. Ileocolonic and colonic location, penetrating behavior, and perianal disease were associated with a higher risk for stoma formation (each <i>P</i> < .001). If these risk factors coincided, the probability of stoma-free survival at 10 and 20 years after diagnosis was only 76.4% and 67.2%, respectively. Patients diagnosed from 2000 onward had a trend for a lower stoma risk than patients diagnosed earlier (<i>P</i> = .084).</p><p><strong>Conclusions: </strong>The coincidence of colonic or ileocolonic involvement, penetrating behavior, and perianal fistulas significantly reduced the probability of stoma-free survival to 68% 20 years after diagnosis. Identification of these risk factors for stoma formation may help identify patients at risk and thus raise awareness for this group.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag064"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344057","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":"Paradigm shift in inflammatory bowel disease management-advanced therapy utilization, persistence, and outcomes in a United Arab Emirates cohort during 2015-2025.","authors":"Hosameldin Abdelrahman Ahmed, Mohamed Nasir Alzaabi, Thaer Khaleel Swaid, Shaima Wasim Khan, Maitha Al Hosani, Noorah Al Hosani, Maryam A Alahmad, Nadeen Mamon Omar, Enas Fouad Ahmed, Ishtiaq Ahmed, Kishore Kumar Chitra Kumar, Laurette L Bukasa, Tine Jess, Mohammed Nabil Quraishi","doi":"10.1093/crocol/otag057","DOIUrl":"10.1093/crocol/otag057","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic landscape for inflammatory bowel disease (IBD) has expanded rapidly beyond anti-tumor necrosis factor (anti-TNF) agents. We characterized the evolution of advanced therapy utilization, persistence, and outcomes in a United Arab Emirates (UAE) cohort during 2015-2025.</p><p><strong>Methods: </strong>This prospective registry study from a tertiary IBD facility in the UAE included 508 patients (333 Crohn's disease [CD], 175 ulcerative colitis [UC]). Advanced therapies were grouped by mechanism of action. We compared prescribing patterns between \"Pre-2023\" and \"2023 and Beyond\" eras. Treatment persistence was analyzed using Kaplan-Meier methods and Cox proportional hazards models.</p><p><strong>Results: </strong>Of 508 patients, 380 (74.8%) received advanced therapy. In CD, first-line anti-TNF use fell from 76% (pre-2023) to 42% (2023+), with anti-IL-23 agents emerging as a major first-line option (32%). Median time to first advanced therapy decreased dramatically: CD from 23.0 to 2.0 months (<i>P</i> < .0001) and UC from 37.0 to 3.0 months (<i>P</i> < .0001). Anti-IL-23 agents demonstrated significantly superior persistence in CD first-line therapy (<i>P</i> = .011 vs. anti-TNF). In multivariable analysis, anti-IL-23 therapy was associated with significantly lower discontinuation risk (HR: 0.35, 95% CI: 0.19-0.64, <i>P</i> = .0008). Infliximab persistence appeared to improve over time, with significantly better 1-year persistence in 2024+ versus 2018-2019 (pairwise <i>P</i> = .020; overall trend <i>P</i> = .05). A shift in UC second-line prescribing was also observed (<i>P</i> = .048). Early surgery rates were low across both eras (CD: 6.5% vs. 3.9%; UC: 2.5% vs. 1.9%) with no significant difference in 35-month surgery-free survival, though this analysis was underpowered.</p><p><strong>Conclusions: </strong>IBD management in the UAE has undergone a rapid paradigm shift since 2023, characterized by earlier therapy initiation and diversification away from anti-TNF dominance, particularly in CD. Superior persistence of anti-IL-23 agents in our cohort is consistent with this evolution in clinical practice and supports their further evaluation.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag057"},"PeriodicalIF":1.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410713","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":"Considerations in reviewing network meta-analyses of heterogeneous clinical trial designs: a methodological review in Crohn's disease and ulcerative colitis.","authors":"Christopher Ma, Eric B Collins, Si-Tien Wang, Yixi Teng, Warren Stevens, Remo Panaccione, Dolly Sharma, Namita Joshi, Pierre A Morisset, Raja Atreya, Gil Y Melmed","doi":"10.1093/crocol/otag050","DOIUrl":"10.1093/crocol/otag050","url":null,"abstract":"<p><strong>Background: </strong>Network meta-analysis (NMA) is a common approach to synthesizing efficacy and safety data from randomized controlled trials (RCTs). Within the last 5 years, there has been an increase in the number of published NMAs in the clinical literature. One potential risk of this trend is the acceptance of NMA findings with translation into therapeutic decisions for daily clinical practice without first critically assessing the validity of the method's core assumptions, including trial exchangeability and homogeneity.</p><p><strong>Methods: </strong>We use the recent surge in NMAs of advanced therapies for Crohn's disease (CD) and ulcerative colitis (UC) as a case study to illustrate the risks of overly permissive interpretation practices toward NMA methods and findings. We first highlight the potential violations of core NMA assumptions posed by known sources of heterogeneity across trials in CD and UC, and then outline several methodological strategies, ranging from data handling techniques to meta-regression, that can help to address or mitigate these violations.</p><p><strong>Results: </strong>We put forward a checklist for users of NMAs to aid the interpretation of their results in the context of both methods and study inclusion/exclusion.</p><p><strong>Conclusions: </strong>While NMAs offer important insights into the relative treatment effects of different therapies and useful guidance to healthcare decision-makers, it is important that readers and users of NMA publications carefully review and critically evaluate the methods and results to ensure potential biases introduced by cross-trial heterogeneity are sufficiently mitigated and transparently documented, and that the results of any given NMA are interpreted within the context of the wider literature.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag050"},"PeriodicalIF":1.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351031","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 association between 6-thioguanine nucleotide levels, adalimumab exposure, immune response, and drug clearance.","authors":"Andres Yarur, Jonathan C Lo, Bincy Abraham, Stephen Hanauer, Thierry Dervieux","doi":"10.1093/crocol/otag053","DOIUrl":"10.1093/crocol/otag053","url":null,"abstract":"<p><strong>Background: </strong>Thiopurines are associated with improved infliximab pharmacokinetics (PK), but their impact on adalimumab PK and immunogenicity is not well defined. This study examined associations between 6-thioguanine (6-TGN) levels and antibodies to adalimumab (ATA), adalimumab drug levels (ADL), and adalimumab clearance (CL).</p><p><strong>Methods: </strong>Using a large clinical laboratory database, we included adults with Crohn's disease or ulcerative colitis treated with thiopurines and adalimumab who had RBC 6-TGN and adalimumab concentrations measured within 30 days. ATA, ADL, and CL were assessed using drug-tolerant assays and nonlinear mixed-effects modeling. A 6-TGN threshold of ≥125 pmol/8 × 10⁸ RBCs was used. Logistic regression was performed to calculate odds ratios (ORs).</p><p><strong>Results: </strong>We analyzed 1194 specimens from 1100 patients; ATA positivity was 3.7%. Compared with 6-TGN ≥125 pmol/8 × 10⁸ RBCs, lower 6-TGN was associated with higher odds of ATA formation (>1.7 U/mL; OR = 2.55), lower odds of ADL ≥10 µg/mL (OR = 0.58), and lower odds of low CL (< 0.318 L/d; OR = 0.55). Compared with every-other-week dosing, weekly dosing produced higher ADL (13.1 vs 8.9 µg/mL; <i>P</i> < .01) but also higher CL (0.425 vs 0.302 L/d; <i>P</i> < .01). Within each dosing interval, higher 6-TGN levels were associated with lower prevalence of ATA (<i>P</i> < .05) and a higher chance of achieving ADL ≥10 µg/mL (<i>P</i> < .01) and CL < 0.318 L/d (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Higher 6-TGN levels are associated with reduced immunogenicity, higher adalimumab drug levels, and lower clearance. Thiopurine may enhance adalimumab PK and support a more favorable therapeutic response.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag053"},"PeriodicalIF":1.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344037","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 characterization and healthcare burden of difficult-to-treat inflammatory bowel disease in Latin America: a real-world registry-based study.","authors":"Jesus K Yamamoto-Furusho, Renata Fróes, Cristina Flores, Domingo Balderramo, Juan Sebastian Lasa, Tárcia Nogueira Ferreira Gomes, Sócrates Bautista Martínez, Guillermo Veitia, Beatriz Iade-Vergara, Norma Nathaly Parra-Holguín, Amanda Yaeza Ferreira, Milene Fernandes, Vera Vicente, Fabian Juliao-Baños","doi":"10.1093/crocol/otag058","DOIUrl":"10.1093/crocol/otag058","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is increasing across Latin America (LATAM). We aimed to determine the frequency and characteristics of difficult-to-treat IBD (DTT-IBD) in this region, using international consensus criteria.</p><p><strong>Methods: </strong>A retrospective study using data from IBD registries across 11 LATAM countries: the EPILATAM-IBD study (9 countries), the Brazilian national IBD registry, and 2 Argentinian single-center registries. Adults with ulcerative colitis (UC), Crohn's disease (CD), or unclassified IBD were included. DTT-IBD was defined as meeting at least one of the following criteria: failure of ≥2 advanced mechanisms of action, chronic antibiotic-refractory pouchitis, CD recurrence after ≥2 resections, or complex perianal CD. Comparisons between DTT and non-DTT groups were performed using Mann-Whitney and Chi-square/Fisher exact tests (<i>P</i> < .05).</p><p><strong>Results: </strong>Among 5699 patients with complete data [40% CD, median disease duration 9 years (Q1-Q3: 5-15)], 747 (13%) met DTT-IBD criteria. DTT prevalence was higher with CD (30%) than among patients with UC (2%). Complex perianal disease predominated in DTT-CD (91%), whereas failure of ≥2 advanced mechanisms of action predominated in DTT-UC (93%). Compared to non-DTT patients, those with DTT-IBD were younger at symptom onset [median age 24 (19-34) years] and IBD diagnosis [26 (21-37) years], and had longer time to diagnosis (<i>P</i>-value<.001). DTT-CD was associated with penetrating behavior (39%) and ileocolonic disease (46%); DTT-UC with extensive colitis (83%).</p><p><strong>Conclusions: </strong>DTT-IBD affected 13% of patients treated in LATAM, with nearly one-third of individuals with CD presenting more severe phenotypic features. These findings highlight the need for comprehensive IBD care strategies in this complex patient population.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag058"},"PeriodicalIF":1.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419412","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":"Anti-OmpC antibodies in Crohn's disease and ulcerative colitis: evidence from a systematic review and meta-analysis.","authors":"Ramy Sekla, Aleena Sammar, Amil Shah, Funmilayo Oludiran, Muhammad Sohaib, Mena Tawfik","doi":"10.1093/crocol/otag056","DOIUrl":"10.1093/crocol/otag056","url":null,"abstract":"<p><strong>Objective: </strong>Anti-OmpC antibodies target the <i>Escherichia coli</i> outer membrane porin C. Their diagnostic and prognostic roles in inflammatory bowel disease (IBD) remain uncertain. We systematically assessed their prevalence, diagnostic accuracy, and clinical associations in Crohn's disease (CD) and ulcerative colitis (UC).</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis (PROSPERO CRD420251066959) of 31 studies including ∼11 000 participants with CD, UC, and controls. Random-effects models estimated pooled prevalence, odds ratios (OR), sensitivity, specificity, diagnostic odds ratios (DOR), and summary receiver operating characteristic curves. Subgroup and sensitivity analyses were performed by assay cutoff, and publication bias was evaluated with funnel plots, Egger's regression, and trim-and-fill.</p><p><strong>Results: </strong>For CD, 11 studies compared patients with controls; 8 using standardized ELISA cutoffs showed a strong association (OR = 6.99, 95% CI 3.99-12.23; I² = 58%). For UC, 11 studies yielded OR = 4.75 (95% CI 2.82-7.99; I² = 37%). Pooled prevalence was 36.9% in CD and 26.8% in UC. Diagnostic accuracy showed modest sensitivity (CD 0.39; UC 0.30) but high specificity (CD 0.89; UC 0.88), with area under the curve values of 0.76 and 0.77. In CD, OmpC positivity was associated with complicated phenotype (OR = 2.77) and surgery (OR = 2.41), but not with location, activity, or extra-intestinal manifestations.</p><p><strong>Conclusions: </strong>Anti-OmpC antibodies are strongly associated with CD and show a supportive but less consistent association in UC, with high specificity but limited sensitivity. In CD, OmpC positivity is associated with complicated disease behavior and increased odds of surgery, although these findings should be interpreted cautiously given the observational nature of the included studies. Incorporation into multi-marker serological panels may enhance diagnostic confidence and risk stratification.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag056"},"PeriodicalIF":1.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351056","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":"Associations between fatigue, physical fitness, and physical activity in patients with inflammatory bowel disease.","authors":"Karlijn Demers, Bart C Bongers, Sander M J van Kuijk, Guy Plasqui, Zlatan Mujagic, Daisy M A E Jonkers, Marieke J Pierik, Laurents P S Stassen","doi":"10.1093/crocol/otag052","DOIUrl":"10.1093/crocol/otag052","url":null,"abstract":"<p><strong>Aim: </strong>Fatigue is a common and debilitating symptom in patients with inflammatory bowel disease (IBD) and may be linked to physical fitness and physical activity. However, their interrelationships are not fully understood. More objective knowledge is needed to guide physical interventions to reduce fatigue. This study aimed to investigate the association of physical fitness and physical activity with fatigue in patients with IBD. Additionally, the association between physical fitness and physical activity was investigated.</p><p><strong>Methods: </strong>Patients with IBD in remission or with mild-to-moderate disease activity were included. Fatigue was defined as a score of ≥35 on the subjective fatigue subscale of the checklist individual strength. Physical fitness measurements were performed using gold standard methodologies for body composition, cardiorespiratory fitness, muscular strength, muscular endurance, and flexibility. Physical activity was quantified using accelerometry.</p><p><strong>Results: </strong>In total, 53 patients were included, of whom 17 (32.1%) experienced fatigue. Fatigued patients exhibited a higher fat-mass index (<i>P </i>= .014), lower cardiorespiratory fitness (<i>P </i>= .017), and less quadriceps muscular endurance (<i>P </i>= .026, <i>P </i>= .008). No differences were observed in physical activity. Multiple linear regression showed that fat-mass index and cardiorespiratory fitness independently predicted fatigue (<i>P </i>= .029, <i>P </i>= .012). Significant correlations were found between fatigue and physical fitness, but not with physical activity.</p><p><strong>Conclusions: </strong>Reduced physical fitness was associated with fatigue in patients with IBD, suggesting that enhancing physical fitness could help alleviate fatigue. Physical activity was not associated with fatigue or physical fitness, indicating that simply increasing physical activity may have limited impact on reducing fatigue or improving physical fitness in this population.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag052"},"PeriodicalIF":1.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600029","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":"Combined bowel urgency, clinical outcomes, and quality of life improvement in mirikizumab-treated ulcerative colitis: a step toward comprehensive disease management.","authors":"Stefan Schreiber, Jianmin Wu, Yajie Duan, Anthony Keohane, Seyedehsan Navabi, David T Rubin","doi":"10.1093/crocol/otag051","DOIUrl":"10.1093/crocol/otag051","url":null,"abstract":"<p><strong>Background: </strong>With increasing emphasis on patient-centric care, treatment goals for ulcerative colitis (UC) now include bowel urgency (BU), stool frequency, and rectal bleeding (RB) resolution, enhancement of overall well-being, and endoscopic remission (ER). This analysis evaluated the impact of adding BU improvement to clinical remission, defined by the modified Mayo score (RB, stool frequency, ER), on quality of life assessed by the Inflammatory Bowel Disease Questionnaire (IBDQ). The effect of mirikizumab on achieving combined clinical, BU, and IBDQ remissions was also evaluated in the LUCENT-1 and -2 trials.</p><p><strong>Methods: </strong>In LUCENT-1, patients were randomized 3:1 (mirikizumab to placebo) every 4 weeks. At Week 12, mirikizumab responders were re-randomized 2:1 (mirikizumab to placebo) for 40 additional weeks in LUCENT-2. BU improvement was assessed using clinically meaningful improvement (Urgency Numeric Rating Scale [UNRS] ≥3-point change) and BU remission (UNRS = 0 or 1). The impact of mirikizumab on achieving single and combined outcomes was determined at Weeks 12 and 52.</p><p><strong>Results: </strong>Significant IBDQ improvement at both timepoints (<i>P ≤ </i>.01) was observed by achieving both BU improvement and clinical remission versus clinical remission alone. Significantly more mirikizumab-treated patients achieved single and combined endpoints of clinical, BU, and IBDQ remissions versus placebo (<i>P ≤ </i>.05).</p><p><strong>Conclusions: </strong>The addition of BU improvement in patients who had already attained clinical response or remission is associated with greater quality of life. Mirikizumab delivered comprehensive benefit for patients with UC by relieving BU symptoms, resolving endoscopic inflammation, and enhancing overall well-being concurrently.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag051"},"PeriodicalIF":1.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327429","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}