Crohn's & Colitis 360最新文献

{"title":"Evaluation of a pharmacist directed treat to target approach in patients with inflammatory bowel disease receiving upadacitinib or risankizumab.","authors":"Justin Han, Archariya Puangampai, Bernice Man, Huda-Marie Kandah, David T Rubin, David K Choi","doi":"10.1093/crocol/otag026","DOIUrl":"10.1093/crocol/otag026","url":null,"abstract":"<p><strong>Background: </strong>An evolving strategy to enhance quality of life and remission rates in inflammatory bowel disease (IBD) is the treat-to-target approach. This approach offers a structured algorithm for therapeutic interventions, yet its implementation faces challenges, such as administrative burden and limited resources. This study elucidates the pharmacist's role in the treat-to-target approach.</p><p><strong>Methods: </strong>Retrospective chart review was conducted from August 7 to December 15, 2023. Patients ≥ 18 years of age, diagnosed with IBD, initiated on upadacitinib or risankizumab were included. \"Treat-to-target\" was defined as serial communication and monitoring of symptoms, clinical response, and laboratory values at predefined time points after starting therapy. A pharmacist-led follow-up protocol was conducted by an embedded IBD clinical pharmacist who assessed successful therapy initiation, medication adherence, steroid use, adverse effects, clinical disease activity, need for clinic visits, and lab monitoring at 2, 4, 8, 12 weeks, 6 months, and 12 months after therapy initiation.</p><p><strong>Results: </strong>It was found that 227 patients initiated upadacitinib, and 210 initiated risankizumab. The overall success rate in reaching patients for through the pharmacist-directed follow-up protocol was 84%. The IBD Pharmacist made 3512 interventions, the most common being therapy continuation and lab monitoring recommendations. Therapy discontinuations were observed, particularly between 12 weeks and 6 months post-initiation.</p><p><strong>Conclusions: </strong>We demonstrate a high participation rate to a pharmacist-led follow-up and monitoring protocol for patients receiving upadacitinib and risankizumab therapy. These findings underscore the importance of pharmacist-led interventions in ensuring continuity of care and tracking patient progress with IBD therapies, which are key elements of a successful treat-to-target strategy.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag026"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927274","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":"Comparison of IBD-related outcomes in patients with obesity treated with GLP-1 receptor agonists versus bariatric surgery.","authors":"M Housam Nanah, Arjun Chatterjee, Hisham Wehbe, Miguel Regueiro","doi":"10.1093/crocol/otag027","DOIUrl":"10.1093/crocol/otag027","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The global prevalence of obesity is rising, paralleled by an increase in IBD (inflammatory bowel disease). While studies examining the impact of obesity on IBD have yielded conflicting results, some suggest that obesity may increase adverse outcomes, whereas BS (bariatric surgery) has been associated with improved IBD outcomes in patients with obesity. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a less invasive alternative to BS for managing obesity, with recent studies indicating potential benefits for IBD outcomes. However, GLP-1 RAs have not been directly compared with BS in patients with obesity and IBD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort analysis using TriNetX, a database aggregating data from over 200 healthcare organizations across the United States. Adult patients with IBD were identified using ICD-10 codes. The cohort was divided into two groups: patients with obesity and IBD prescribed GLP-1 RAs (dulaglutide, semaglutide, liraglutide, lixisenatide, exenatide, albiglutide, or tirzepatide) who had not undergone BS, and patients with obesity and IBD who underwent BS but had not received GLP-1 RAs. To ensure active exposure, GLP-1 RA use required at least two prescriptions separated by at least 1 month. Propensity score matching was performed based on demographics, comorbidities, and IBD medications. Categorical variables were compared using chi-square tests, and continuous variables were compared using independent &lt;i&gt;t&lt;/i&gt;-tests. Effect estimates were reported as odds ratios (ORs) with 95% confidence intervals (CIs), with statistical significance defined as &lt;i&gt;P&lt;/i&gt; &lt; .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 17142 patients with obesity and IBD were identified, including 12965 patients treated with GLP-1 RAs and 4177 patients who underwent BS. Patients in the GLP-1 RA group were older at index (56.7 vs 52.9 years). They also had higher rates of comorbidities, including diabetes (64.3% vs 31.5%), chronic kidney disease (19.6% vs 14.1%), and nicotine dependence (20.4% vs 19.1%), but lower rates of alcohol use disorder (2.3% vs 4.6%), compared with the BS group. The GLP-1 RA group also had higher baseline use of IBD-related medications, including corticosteroids, immunomodulators, and biologic therapies. After propensity score matching, 3478 patients were included in each cohort. Despite a higher post-intervention BMI (body mass index) (34.5 vs 33.4 kg/m&lt;sup&gt;2&lt;/sup&gt;; &lt;i&gt;P&lt;/i&gt; &lt; .0001) and shorter follow-up, patients treated with GLP-1 RAs demonstrated significantly lower odds of lower extremity deep venous thrombosis (OR 0.24, 95% CI, 0.16-0.35), pulmonary embolism (OR 0.27, 95% CI, 0.17-0.41), Clostridioides difficile infection (OR 0.22, 95% CI, 0.14-0.34), intestinal obstruction (OR 0.21, 95% CI, 0.15-0.29), abdominal pain (OR 0.34, 95% CI, 0.28-0.42), nausea (OR 0.42, 95% CI, 0.35-0.50), constipation (OR 0.44, 95% CI, 0.37-0.53), colectomy (O","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag027"},"PeriodicalIF":1.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873551","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":"Providing care at a most vulnerable time.","authors":"Paula Prieto Tizzard, Shervin Rabizadeh, Joel R Rosh","doi":"10.1093/crocol/otag030","DOIUrl":"10.1093/crocol/otag030","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag030"},"PeriodicalIF":1.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811920","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 and safety of ABBV-154 in patients with moderately to severely active Crohn's disease: a phase 2b, randomized, double-blind, placebo-controlled trial.","authors":"Walter Reinisch, Laurent Peyrin-Biroulet, Geert D'Haens, Andreas Sturm, Jaclyn K Anderson, Izabella Messina, Dilek Arikan, Alissa Zimmerman-Bennett, Julie Parmentier, Tian Feng, Ronilda D'Cunha, Andreas Lazar, Edouard Louis","doi":"10.1093/crocol/otag014","DOIUrl":"10.1093/crocol/otag014","url":null,"abstract":"<p><strong>Background: </strong>ABBV-154 is an antibody-drug conjugate of adalimumab and a proprietary glucocorticoid receptor modulator. This phase 2b randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of ABBV-154 versus placebo in patients with moderately to severely active Crohn's disease who had inadequate response to or were intolerant of prior biologic therapy.</p><p><strong>Methods: </strong>Patients were randomized 1:1:1:1:1 to ABBV-154 induction groups: 150 mg IV at week 0, then 80 mg SC at week 2 and every other week (EOW); 300 mg IV at week 0, then 230 mg SC at week 2 and EOW; 600 mg IV at week 0, then 530 mg SC at week 2 and EOW; 600 mg IV at week 0, then 530 mg SC at weeks 4 and 8, and placebo at weeks 2, 6, and 10; or placebo. The primary endpoint was achievement of endoscopic response per SES-CD by central review at week 12. Adverse events were monitored throughout.</p><p><strong>Results: </strong>Of 265 planned patients, 106 were randomized and treated until completion, discontinuation, or early study termination by the sponsor. At week 12, greater proportions of patients treated with ABBV-154 achieved endoscopic response versus placebo (7.1%, 33.3%, 28.6%, and 27.3% across the induction groups vs. 0%; data reported as observed). Adverse events were comparable across all ABBV-154 groups and slightly higher than placebo through week 12.</p><p><strong>Conclusions: </strong>ABBV-154 was well tolerated and demonstrated proof-of-concept for efficacy in patients with moderately to severely active Crohn's disease. Results should be interpreted with caution due to early study termination.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag014"},"PeriodicalIF":1.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765108","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":"Feasibility and clinical utility of home-based fecal immunochemical testing for self-monitoring of disease activity in ulcerative colitis.","authors":"Yuki Aoyama, Toshihiro Inokuchi, Sakiko Hiraoka, Mikako Ishiguro, Shoko Igawa, Keiko Takeuchi, Masahiro Takahara, Junki Toyosawa, Yasushi Yamasaki, Hideaki Kinugasa, Motoyuki Otsuka","doi":"10.1093/crocol/otag025","DOIUrl":"10.1093/crocol/otag025","url":null,"abstract":"<p><strong>Background: </strong>Home-based quantitative fecal calprotectin testing has been used to improve the prognosis of ulcerative colitis (UC) patients. However, its cost and the need for specific measurement devices limit accessibility. This study explored the potential of the home-based fecal immunochemical test (FIT) for self-monitoring in patients with UC.</p><p><strong>Methods: </strong>In this prospective cohort study, we recruited patients in clinical remission who were scheduled for colonoscopy between October 2020 and October 2021. We evaluated the correlation between home-based qualitative FIT results obtained using a commercially available kit and hospital-based quantitative fecal markers, endoscopic activity, and treatment intensification. We also assessed the feasibility of continued home-based FIT.</p><p><strong>Results: </strong>Among the 54 enrolled patients, 38 tested negative and 16 tested positive using the home-based FIT. The FIT-negative patients had significantly lower hospital-based FIT and fecal calprotectin levels than the FIT-positive patients (<i>P</i> < .0001 and <i>P</i> = .0029, respectively). The accuracy of home-based FIT for predicting endoscopic remission was 0.83, which was comparable to that of hospital-based FIT (0.85) and fecal calprotectin (0.79). None of the 38 FIT-negative patients required intensification of treatment. Among the 20 patients eligible for continued home-based FIT, the adherence rate over one year was 97.0% (82.1%-100%). Notably, none of the 8 FIT-negative patients experienced clinical relapse, whereas those with at least one FIT-positive showed a higher tendency for clinical relapse (<i>P </i>= .055).</p><p><strong>Conclusions: </strong>Home-based FIT is a feasible, accurate, and well-accepted tool for monitoring remission in UC and is comparable to hospital-based fecal markers (UMIN000040572).</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag025"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249602","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":"Incidence and prevalence of immune-mediated extraintestinal manifestations in pediatric inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Ruben J Colman, Sudheer K Vuyyuru, Virginia Solitano, John K MacDonald, Jessica Le, Amanda Ricciuto, Roberta Berard, Javed A Mohammed, Christopher Ma, Vipul Jairath, Eileen Crowley","doi":"10.1093/crocol/otag024","DOIUrl":"10.1093/crocol/otag024","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated extraintestinal manifestations (IM-EIMs) are common in pediatric inflammatory bowel disease (pIBD). This systematic review and meta-analysis aimed to summarize the incidence and prevalence of IM-EIMs in pIBD.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, CENTRAL, and clinicaltrials.gov were searched up to May 6, 2024, for studies that included pIBD (2-17 years) patients diagnosed with IM-EIMs. Primary outcomes included the incidence and prevalence of IM-EIMs among pIBD. Meta-analysis included pooled proportions of IM-EIMs using DerSimonian-Laird random-effects model.</p><p><strong>Results: </strong>The pooled proportion of IM-EIMs overall was 10% (95% CI, 8%-12%; I² = 97.2%) among 65 pIBD studies (35 343 patients). The pooled proportion of IM-EIMs was 10% (95% CI, 7%-13%; I² = 94.8%) among 37 Crohn's disease (CD) studies (7657 patients), compared to 11% (95% CI, 7%-15%; I² = 93.3%) among 39 ulcerative colitis (UC) studies (4698 patients). Enthesitis was the highest reported individual IM-EIM (23%, 95% CI, 4%-50%; I² = 94.7%) in pIBD. Arthritis was the second highest reported individual IM-EIM (8%, 95% CI, 6%-10%; I² = 96%) in pIBD, followed by primary sclerosing cholangitis (PSC) in UC (5%, 95% CI, 4%-7%; I² = 81%). Uveitis, pyoderma gangrenosum, autoimmune hepatitis, and PSC in CD were the lowest reported IM-EIMs at 1% or less. The largest difference in proportions between IBD phenotypes was PSC, which was 4% higher in UC than CD.</p><p><strong>Conclusions: </strong>While musculoskeletal manifestations are common, fewer than 5% of pIBD patients experience ophthalmological, dermatological, and liver IM-EIMs. The small number of studies resulted in significant methodological and statistical heterogeneity. Multicenter collaborative efforts are needed to systematically describe the epidemiology of IM-EIMs in pIBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag024"},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765133","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":"Inflammation significantly alters mucosal transcriptomic signatures in pediatric inflammatory bowel disease.","authors":"Alexander Schnell, Xinyi Wei, Jan Bossenz, Iryna Manuilova, Jan Christoph, Ida Allabauer, Merle Classen, Adrian P Regensburger, Joachim Woelfle, Ramona Erber, André Hoerning","doi":"10.1093/crocol/otag023","DOIUrl":"10.1093/crocol/otag023","url":null,"abstract":"<p><strong>Objectives and study: </strong>Crohn's disease (CD) and ulcerative colitis (UC) share common features of inflammation to a greater extent in children than in adults. However, histopathological scoring systems of mucosal inflammation are usually available only for either one of these entities. The IBD-DCA score is the first of its kind to incorporate both into one scoring system but still lacks validation in pediatric IBD.</p><p><strong>Methods: </strong>An existing data of a multiplexed gene expression analysis of mucosal biopsies of 25 patients diagnosed with either CD (<i>n</i> = 16) or UC (<i>n</i> = 9) were evaluated according to the IBD-DCA score for distribution (D0-2), chronicity (C0-2) and activity (A0-2) of inflammation by an experienced pathologist. The scoring results were used to stratify the degree of mucosal inflammation of these patients into either low (0-3) or high (4-6) DCA scores. Subsequently, analysis for differentially expressed genes (DEG) between the low and high inflammation group was performed.</p><p><strong>Results: </strong>Scoring revealed 7 low and 9 high DCA samples for CD, whereas for UC only high DCA were scored. DEG analysis revealed 130 upregulated genes in the high DCA group compared to the low DCA group. 11 genes were identified as hub genes playing a pivotal role in immune regulation, among those several cyto- or chemokines (IL1B, CCL20, CXCL1/2), costimulatory receptors (IL2RA, CD80, TLR2) and modulatory proteins like PD-L1 and IDO1.</p><p><strong>Conclusion: </strong>Our results indicate that inflammatory activity rather as assessed by the IBD-DCA score rather than the underlying disease entity significantly alters the transcriptomic signature in mucosal specimens of pediatric IBD patients.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag023"},"PeriodicalIF":1.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765066","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":"Influenza vaccine uptake among patients with inflammatory bowel disease: comparable outcomes between telemedicine and in-person care.","authors":"Mazen Almasry, Trevor L Schell, Luke Richard, Francis A Farraye, Mary S Hayney, Freddy Caldera","doi":"10.1093/crocol/otag022","DOIUrl":"10.1093/crocol/otag022","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) receiving immunosuppressive therapies are at increased risk of vaccine-preventable diseases, including influenza. Despite recommendations for annual influenza vaccination, uptake remains suboptimal. The COVID-19 pandemic prompted a surge in telemedicine (Tele-M) use, raising concerns about its impact on vaccination rates due to reduced in-person interactions. This study aimed to assess the impact of IBD-specific Tele-M on influenza vaccine uptake and identify predictors of vaccination in patients with IBD.</p><p><strong>Methods: </strong>This single-center retrospective study evaluated influenza vaccine uptake among adult patients with IBD seen between September 2021 and April 2022. Patients were categorized into two groups: Tele-M only and ≥1 in-person visit. Vaccination status was confirmed using the Wisconsin Immunization Registry. Primary outcome was influenza vaccination frequency by visit type, while secondary outcomes evaluated the impact of Tele-M on other vaccinations and predictors of influenza vaccine uptake.</p><p><strong>Results: </strong>Among 547 patients, 53.2% received Tele-M only, and 46.8% had ≥1 in-person visit. Influenza vaccine uptake was similar between the Tele-M only and ≥1 in-person visit groups (69.0% vs. 75.1%, respectively, <i>P</i> = .11). The uptake of pneumococcal, hepatitis B, and zoster vaccines was also comparable. Predictors of higher influenza vaccine uptake included age ≥65, female sex, receipt of ≥3 COVID-19 vaccines, and previous influenza vaccination.</p><p><strong>Conclusions: </strong>IBD-specific Tele-M did not adversely affect influenza vaccine uptake among patients with IBD. These findings highlight the importance of ensuring vaccination compliance irrespective of healthcare delivery modes. Collaboration among healthcare providers is crucial to improve vaccination rates in patients with IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag022"},"PeriodicalIF":1.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765089","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":"Child and parent perspectives in IBD management: a literature review and qualitative study.","authors":"Jennifer C deBruyn, Lara Hart, Gail MacKean, Nicole Staples, Amy Lee, Karen V MacDonald, Deborah A Marshall","doi":"10.1093/crocol/otag020","DOIUrl":"10.1093/crocol/otag020","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic landscape and treatment goals for pediatric inflammatory bowel disease (IBD) continue to evolve. However, there remains a paucity of literature capturing the experiences and preferences of children with IBD and their parents on IBD management.</p><p><strong>Methods: </strong>We conducted a literature review and qualitative study to describe perspectives and preferences of children with IBD and their parents regarding IBD treatment, treatment goals, and decision-making in IBD management. Articles were identified in MEDLINE and key study characteristics and findings were summarized to inform qualitative interviews. Children with IBD (11-18 years of age) and their parents were recruited through purposive sampling from a gastroenterology clinic for semi-structured telephone interviews until code saturation was reached in thematic analysis.</p><p><strong>Results: </strong>In the literature review, 207 records were identified with nine studies ultimately included. Important aspects of IBD treatment included treatment efficacy, symptomatic improvements, and associated risks and side effects. Parents of children with IBD were concerned about the risks and preferred treatments with fewer long-term adverse effects; adolescents with IBD focused on immediate quality-of-life and short-term benefits. Ten parents and nine children with IBD (2.7-7.9 years disease duration) participated in interviews. Five major themes emerged: (1) overall impact of IBD and its management; (2) IBD treatment goals; (3) considerations for IBD management decisions on treatment; (4) considerations for IBD management decision on testing; and (5) shared decision-making.</p><p><strong>Conclusions: </strong>Our findings highlight how children and parents contextualize the importance of IBD management within their lives, and draw attention to the need for personalized, patient-centered care and meaningful shared decision-making.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 1","pages":"otag020"},"PeriodicalIF":1.8,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13019527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572201","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":"Early proactive therapeutic drug monitoring with ustekinumab therapy in pediatric Crohn's disease: data from the prospective Canadian children IBD network.","authors":"Amanda Ricciuto, Hayley E McKay, Jennifer C deBruyn, Eileen Crowley, Peter C Church, Hien Q Huynh, Anthony R Otley, Ayub Shaikh, David R Mack, Nicholas Carman, Wael El-Matary, Rilla Schneider, Eytan Wine, Thomas D Walters, Anne M Griffiths","doi":"10.1093/crocol/otag019","DOIUrl":"10.1093/crocol/otag019","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab dosing information for pediatric Crohn's disease (CD) is limited.</p><p><strong>Aims: </strong>To examine ustekinumab pharmacokinetic and effectiveness data in a largely bio-naïve cohort, focusing on early (week 8) levels.</p><p><strong>Methods: </strong>Children in the prospective Canadian Children IBD Network initiating intravenous (IV) ustekinumab for CD with a week 8 level were evaluated. Disease activity was assessed by corticosteroid-free clinical remission (CSFR), biochemical CSFR, and mucosal healing (MH) by colonoscopy or fecal calprotectin <150 µg/g beyond 16 weeks. We compared drug levels by weight group (</≥40kg) and outcome, using receiver-operating characteristic (ROC) curves to identify optimal week 8 levels.</p><p><strong>Results: </strong>Amongst 58 children (19 < 40 kg, 81% bio-naïve, median (interquartile range [IQR]) follow-up 11.5 [7.6-16.0] months), the IV loading dose for those <40kg (median 9.1 [8.6-10.2] mg/kg; 253 (239-268) mg/m²) was greater than for those ≥40kg (median 6.1 [5.4-6.5] mg/kg; 218 ([78-237] mg/m², <i>P</i> < .001). However, week 8 levels were similar (<i>P</i> = .26). This was most striking in those with low albumin. Of 34/58 (59%) without escalation to 4 weekly dosing, 43%, 35%, and 19% exhibited CSFR, biochemical CSFR, and MH, respectively, during established maintenance. Median week 8 levels were roughly 5-6 µg/g vs 7-10 µg/g in patients not achieving vs achieving favorable outcomes, while ROC analysis indicated levels 8-9 µg/mL were associated with improved outcomes.</p><p><strong>Conclusions: </strong>Children <40 kg required more IV ustekinumab (median 9 mg/kg; 250 mg/m²) to achieve similar week 8 levels as children ≥40kg receiving conventional adult 6 mg/kg weight-tiered induction. Higher week 8 levels were associated with favorable later outcomes.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 1","pages":"otag019"},"PeriodicalIF":1.8,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519842","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}