Inflammatory Bowel Diseases最新文献

{"title":"Disease phenotype affects treatment of late-onset inflammatory bowel disease: Analysis of a large UK cohort.","authors":"Peter F G Foulser, Laura Martinez-Gili, Sharmili Balarajah, Rohan Sundramoorthi, James L Alexander, Benjamin H Mullish, Julian R Marchesi, Miles Parkes, Timothy R Orchard, Lucy C Hicks, Horace R T Williams","doi":"10.1093/ibd/izag072","DOIUrl":"https://doi.org/10.1093/ibd/izag072","url":null,"abstract":"<p><strong>Background: </strong>The incidence of inflammatory bowel disease (IBD) in older adults is rising. Studies of late-onset (LO) (diagnosis  ≥60 years of age) IBD are contradictory, with some suggesting increased use of corticosteroid and reduced use of advanced therapies. This multicenter study assessed disease phenotype and therapeutic choice in LO-IBD.</p><p><strong>Methods: </strong>Patients recruited to the NIHR IBD BioResource with LO ulcerative colitis (UC) or Crohn's disease (CD) were compared with those with young-onset (YO) (16-39 years of age) and mid-onset (MO) (40-59 years of age) IBD. Medication use and surgeries were assessed in propensity score-matched cohorts.</p><p><strong>Results: </strong>A total of 32 012 patients were studied: 16 930 UC (2247 LO) and 15 082 CD (1409 LO). LO-UC was mostly left-sided, with less isolated proctitis. LO-CD patients had less ileocolonic and perianal disease. Corticosteroid, immunomodulator, and anti-tumor necrosis factor α (anti-TNF) use was lower in LO-UC and LO-CD; however, there was no difference in time to colectomy (LO-UC) or intestinal resection (LO-CD) compared with younger patients. LO-CD patients were more likely to receive vedolizumab and ustekinumab than YO-CD (odds ratio, 0.34 [95% confidence interval, 0.18-0.61] and 0.29 [95% confidence interval, 0.09-0.76], respectively). LO patients with perianal CD were less likely to receive anti-tumor necrosis factor or undergo perianal surgery than YO and MO patients with perianal CD (all P < .01).</p><p><strong>Conclusions: </strong>LO-IBD has a distinct phenotype, with less isolated proctitis (LO-UC) and less ileocolonic and perianal CD. LO-IBD patients had lower corticosteroid, immunomodulator, and anti-tumor necrosis factor use but equivalent colectomy and intestinal resection rates. LO-CD is notable for the higher use of vedolizumab and ustekinumab, suggesting that age, comorbidity, and disease phenotype affect biologic choice in older adults. Research to understand whether differential treatment of older adults is justified is crucial.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-omics-based machine learning model predicts response and guides treatment in Crohn disease: a case study in nutritional therapy.","authors":"Asaf Azulay, Leora Gotesdyner, Yonat Aharoni-Frutkoff, Gili Focht, Yael Talmor, Elhanan Borenstein, Luba Plotkin, Esther Orlanski-Meyer, Raffi Lev-Tzion, Oren Ledder, Dotan Yogev, Amit Assa, Efrat Broide, Anat Yerushalmy-Feler, Jarosław Kierkuś, Tobias Schwerd, Eytan Wine, Dan Turner","doi":"10.1093/ibd/izag060","DOIUrl":"https://doi.org/10.1093/ibd/izag060","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers are needed to predict treatment response and guide therapeutic decisions in Crohn disease (CD). We aimed to develop and validate a multi-omics machine learning (ML) model to predict response to nutritional therapy in pediatric CD.</p><p><strong>Methods: </strong>Treatment-naive children with newly diagnosed CD who were initiating exclusive enteral nutrition (EEN) were prospectively enrolled in this study. Metabolomics and lipidomics were measured in the serum and stool, as well as the fecal microbiome. Following feature selection via minimum redundancy maximum relevance, random-forest models were constructed for single- and multi-omics and performances were evaluated. The models were externally validated in an independent prospective cohort of treatment-naive children and young adults with CD treated with EEN.</p><p><strong>Results: </strong>The discovery cohort consisted of 50 children (mean ± SD age 14.3 ± 2.7 years), of whom 34 (68%) responded to EEN. Combining complementary signals from host metabolism, gut microbiota, and lipid profiles from serum and stool in a multi-omics ML model yielded a model for predicting treatment response (training accuracy 94%; 95% CI, 82%-100%). Key predictive features included serum metabolites (2-hydroxyglutaric acid, Cer[d18:0/22:0], and HexCer[d18:1/d26:1]), fecal metabolites (3-methyladipic acid, DG[16:0 20:0], PC aa C42:2), and microbial taxa (family Bifidobacteriaceae and genus CAG-56). The validation cohort consisted of 21 patients of whom 12 (57%) responded to EEN. The multi-omics model performance achieved an area under the receiver operating characteristic curve (AUROC) of 0.81 (95% CI, 0.6-1.0). Clinical and endoscopic features did not improve the predictive ability of the model.</p><p><strong>Conclusion: </strong>As a proof-of-concept, we showed that integrated multi-omics ML models can predict EEN response in pediatric CD patients, supporting their potential use in precision nutrition and personalized care strategies.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of childhood exposure to antibiotics and the subsequent risk of IBD.","authors":"Ketil Størdal, Svend Andersen, Karl Mårild, Vilhelm Larsson, Henrik Imberg","doi":"10.1093/ibd/izaf324","DOIUrl":"10.1093/ibd/izaf324","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic use in early childhood may alter the developing microbiome and has been proposed as a risk factor for inflammatory bowel disease (IBD). We conducted a systematic review to examine the association between childhood antibiotic use and subsequent risk of IBD.</p><p><strong>Methods: </strong>In a systematic literature search, we identified cohort and case-control studies reporting the association between antibiotic use (exposure age <1 to 17 years) and development of IBD. MEDLINE and EMBASE databases were searched from inception through December 31, 2024. Studies reporting a hazard ratio, odds ratio, or risk ratio (RR) were included. To account for heterogeneity, pooled estimates were calculated using the DerSimonian-Laird random-effects model. Estimates were adjusted for potential confounding as reported in the original studies.</p><p><strong>Results: </strong>We identified 10 studies, of which 8 (n = 2783 cases) reported associations between childhood antibiotics and IBD risk. Additionally, 2 studies on Crohn's disease (CD) and 1 on ulcerative colitis were included in disease-specific analyses. In pooled analyses, antibiotic exposure compared with no exposure was associated with increased risk of IBD (RR, 1.42; 95% confidence interval [CI], 1.23-1.66), CD (RR, 1.59; 95% CI, 1.39-1.81), and ulcerative colitis (RR, 1.23; 95% CI, 1.08-1.40). Heterogeneity was low to moderate (I2 = 0%-35%), and funnel plots did not indicate publication bias (Egger's test, P = .12-.43). Adjustment for infections did not attenuate the association between childhood antibiotic exposure and IBD development.</p><p><strong>Conclusions: </strong>While causal interpretation should be cautious, childhood exposure to antibiotics was associated with an increased risk of later IBD, particularly for CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"990-997"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical response for 12 months or more to the first advanced therapy in IBD decreases long-term risk of hospitalization: a spirited stride….","authors":"Jimmy K Limdi","doi":"10.1093/ibd/izag003","DOIUrl":"10.1093/ibd/izag003","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1011-1013"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CRUCIAL Insights From a Decade Long Retrospective National Audit of Total Abdominal Colectomy Outcomes for Ulcerative Colitis.","authors":"Ian J B Stephens, Brenda Murphy, Lucy Burns, Enda Hannan, Andrew Carroll, Maeve O'Neill, Caroline Drumm, Tom McIntyre, Liam Costello, Ibinabo G Brown, Shadin Abushara, Kysha S X Wong, Jennifer McGarry, Blathnaid Keyes, Matthew G Davey, Abdulrahman Rudwan, Mahmod Bashir, Lena Dablouk, Ahmed Taha, Aisha Mohamed, Kristali Ylli, Abdurazig Salih, Shima Ahmed, Eltahir Eltigani, Ahmed F S Elmakki, Vikram Tewatia, Ola Falade, James Sweeney, Aine O'Neill, Yasmine Roden, Nitish Dasmuth, Desmond P Toomey, Eleanor Faul, David E Kearney, Peter M Neary, Shane Killeen, Emmet Andrews, Colin Peirce, Ronan Cahill, Myles Joyce, Dara O Kavanagh, Paul H McCormick, Seán T Martin, John P Burke","doi":"10.1093/ibd/izaf314","DOIUrl":"10.1093/ibd/izaf314","url":null,"abstract":"<p><strong>Background: </strong>Total abdominal colectomy (TAC) is a key surgical intervention for patients with ulcerative colitis (UC), particularly in the setting of acute severe disease or medically refractory colitis. While international studies have reported outcomes using registry data, these are often limited by diagnostic coding variability and inclusion of a heterogeneous surgical procedure mix.</p><p><strong>Methods: </strong>A retrospective national audit of perioperative outcomes following TAC for UC in Ireland over a 10-year period (2013-2022) was performed. Data were collected at 13 hospitals, from review of clinical records, and validated by trained clinicians. Primary outcomes were 30-day postoperative morbidity and mortality. Secondary outcomes included reoperation, readmission, use of laparoscopy, and length of stay (LoS).</p><p><strong>Results: </strong>A total of 469 patients with a preoperative diagnosis of UC underwent TAC. Median age was 40 years; 64.4% were male. Emergency surgery accounted for 67.3% of cases, with high rates of preoperative medical therapy (steroids 82.6%, biologics 69.3%). Laparoscopy was used in 71.8% of operations. Postoperative morbidity rate was 43.0%, severe morbidity was 11.7%, and 30-day mortality was 0%. Multivariable analysis identified open surgery, steroid use, and acute disease complications as predictors of morbidity and biologic use as protective.</p><p><strong>Conclusions: </strong>This national audit demonstrates low mortality and acceptable morbidity following TAC for UC, with increasing use of laparoscopy over time. The robust, diagnosis-validated data support international standards of care and highlights key predictors of postoperative complications in this population. It identifies elderly, immunosuppressed patients requiring emergency open surgery as the highest risk patient subgroup.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"929-937"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Computed Tomography Colonography Findings of Ulcerative Colitis-Associated Neoplasia.","authors":"Yuta Kaieda, Shinya Sugimoto, Tatsuya Suzuki, Shunsuke Matsumoto, Hiroki Kiyohara, Kaoru Takabayashi, Yusuke Yoshimatsu, Koji Okabayashi, Kohei Shigeta, Ryoya Sakakibara, Yusuke Wakisaka, Soichiro Murakami, Masahiro Jinzaki, Yasushi Iwao, Yohei Mikami, Takanori Kanai","doi":"10.1093/ibd/izaf303","DOIUrl":"10.1093/ibd/izaf303","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography colonography (CTC) is increasingly utilized for the evaluation of colorectal neoplasms. However, in patients with ulcerative colitis (UC), current European Crohn's and Colitis Organisation guidelines recommend CTC only for limited indications, such as the presence of strictures.</p><p><strong>Methods: </strong>This single-center, retrospective observational study included consecutive patients with UC who underwent preoperative CTC and were scheduled for pancolectomy for UCAN between January 2014 and June 2024. Lesion detectability on CTC was assessed in comparison with endoscopic findings, histopathological tumor depth, and morphological characteristics. Multivariable logistic regression was performed to identify factors associated with detectability on CTC.</p><p><strong>Results: </strong>Among 50 patients with 71 histologically confirmed lesions, 49% (35/71) were detectable by CTC. Detection was highest in advanced cancer (100%, 7/7), sessile (80%, 4/5) and depressed (80%, 8/10) morphologies, and lower in non-polypoid types such as superficial elevated (58%, 14/24) and flat (8%, 2/25) lesions. Detection by depth was 29% (12/42) for intramucosal, 75% (9/12) for submucosal, 100% (5/5) for muscularis propria, 73% (8/11) for subserosa/adventitia, and 100% (1/1) for serosal lesions. Flat morphology (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.01-0.27) and intramucosal invasion (aOR, 0.10; 95% CI, 0.02-0.46) were independently associated with non-detection.</p><p><strong>Conclusions and relevance: </strong>Despite preoperative awareness of UCAN, CTC demonstrated limited sensitivity. While CTC may serve a complementary role in selected cases, endoscopy remains essential for comprehensive lesion detection.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"875-883"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic and pathologic findings of esophagogastroduodenal involvement in Crohn disease in Korea: a prospective single-center cohort study.","authors":"Ga Hee Kim, Jihun Kim, Ji Yong Ahn, Sang Hyoung Park, Sung Wook Hwang, Byong Duk Ye, Hwoon-Yong Jung, Suk-Kyun Yang","doi":"10.1093/ibd/izaf320","DOIUrl":"10.1093/ibd/izaf320","url":null,"abstract":"<p><strong>Background and aims: </strong>The characteristics and incidence of esophagogastroduodenal involvement in Crohn disease remain unclear in Korea. In this study we aimed to investigate the prevalence and clinicopathological characteristics of Crohn disease with esophagogastroduodenal involvement.</p><p><strong>Methods: </strong>A total of 115 patients with Crohn disease who underwent esophagogastroduodenoscopy (EGD) with esophageal, gastric, and duodenal biopsies were prospectively enrolled in 2020-2021 at a tertiary care center. Five specimens were obtained-1 each from the esophagus, gastric body, gastric antrum, duodenal bulb, and second duodenal portion-and histologically reviewed.</p><p><strong>Results: </strong>The median patient age was 30.0 years, and 74.8% of patients were male. Based on histological features, 56 patients (48.7%) had esophagogastroduodenal involvement (15 esophageal, 44 gastric, 36 duodenal). Notable histopathological findings included non-caseating granulomas in 8 cases (7.0%), focally enhanced gastritis in 38 cases (33.0%), and lymphocytic esophagitis in 13 cases (10.7%). Endoscopic findings suggestive of esophagogastroduodenal involvement were detected in 94 of 115 patients (81.7%). Typical findings included longitudinal or aphthous erosions (esophagus, 3/115 [2.6%]; stomach, 45/115 [39.1%]; duodenum, 19/115 [16.5%]), longitudinal or aphthous ulcers [duodenum: 4/115 (3.5%)], bamboo-joint-like appearance [stomach: 81/115 (70.4%); duodenum: 3/115 (2.6%)], and scar changes [stomach: 2/115 (1.6%); duodenum: 3/115 (2.6%)]. In multivariable analysis, elevated fecal calprotectin (≥100 μg/g) was associated with esophagogastroduodenal involvement in Crohn disease (odds ratio, 6.57; 95% CI, 1.99-21.66; P <.001).</p><p><strong>Conclusions: </strong>The proportion of esophagogastroduodenal involvement was relatively high among Korean patients with Crohn disease who underwent EGD. In patients with elevated fecal calprotectin, EGD with histopathological examination is recommended to identify esophagogastroduodenal involvement.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"963-971"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal stem cell-derived exosomes derived from induced pluripotent stem cells ameliorate inflammation and promote mucosal healing via miR-34a-5p in Crohn disease.","authors":"Ting Feng, Yun Qiu, Baili Chen, Xuanzhi Huang, Rui Feng, Yao He, Zhirong Zeng, Minhu Chen, Shenghong Zhang","doi":"10.1093/ibd/izag014","DOIUrl":"10.1093/ibd/izag014","url":null,"abstract":"<p><strong>Background: </strong>Crohn disease (CD) is a chronic, recurrent inflammatory bowel disease. Mesenchymal stem cell-derived exosomes (MSC-Exos) have emerged as promising cell-free treatments for CD.</p><p><strong>Objective: </strong>In this study we aimed to investigate the therapeutic effect and potential mechanisms of MSC-Exos derived from induced pluripotent stem cells (iPSCs) (iPSC-MSC-Exos) in patients with colitis.</p><p><strong>Methods: </strong>iPSC-MSC-Exos were administered intraperitoneally to mice with trinitrobenzene sulfonic acid (TNBS)-induced colitis. The colonic stem cell markers Lgr5 and Bmi1, and the proliferation marker Ki-67 were assessed by immunofluorescence. Lamina propria mononuclear cells (LPMCs) were isolated from the mouse colons and analyzed by flow cytometry. Furthermore, microarray analysis was performed to identify the differential expression of micro RNAs (miRNAs) in the iPSC-MSC-Exos. iPSC-MSC-Exos with micro RNA (miR)-34a-5p overexpression (Exo-OE) or knockdown (Exo-KD) were used to treat colitis in the mice. The candidate targets of miR-34a-5p and its downstream signaling pathways were confirmed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blotting.</p><p><strong>Results: </strong>The iPSC-MSC-Exos migrated to the inflamed colon and protected the colon stem cells against inflammatory damage, promoted epithelial cell proliferation, and decreased the infiltration of proinflammatory Th1/9/17, CD4 +  tumor necrosis factor alpha (TNF-α)+, and macrophage cells while increasing anti-inflammatory T-regulatory (Treg) and B-regulatory (Breg) cells to alleviate TNBS-induced colitis in the mice. The therapeutic effect was sustained for 7 days after a single injection. MiR-34a-5p Exo-OE magnified this effect, whereas Exo-KD abolished it. The iPSC-MSC-Exos also inhibited the proliferation and migration of CD4 + LPMCs isolated from patients with CD. The miR-34a-5p expression was significantly elevated in the iPSC-MSC-Exos, which inhibited PPP2R3A expression by directly targeting its 3' untranslated region (3'-UTR). MiR-34a-5p Exo-OE significantly decreased the expression of PPP2R3A while increasing the expression of the Wingless-related integration site (Wnt) signaling ligands of β-catenin (Wnt/β-catenin signaling) and CD44.</p><p><strong>Conclusions: </strong>iPSC-MSC-Exos ameliorated colitis and promoted mucosal healing in a TNBS-induced CD-like model by activating Wnt/β-catenin signaling via miR-34a-5p, which targets PPP2R3A.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"852-868"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated long-term safety of 10-year ozanimod treatment: results from clinical trials in patients with moderate-to-severe ulcerative colitis or relapsing multiple sclerosis.","authors":"David T Rubin, Silvio Danese, Hiroshi Nakase, Ryan C Ungaro, Douglas C Wolf, Olga Alekseeva, AnnKatrin Petersen, Zhaohui Liu, Dimpy Mehra, Anjali Jain, Mark T Osterman, Anthony Krakovich, Jon V Riolo, Erik DeBoer, James Appio, Preetika Sinh, Bruce A C Cree, Jeffrey A Cohen, Peter Irving","doi":"10.1093/ibd/izaf319","DOIUrl":"10.1093/ibd/izaf319","url":null,"abstract":"<p><strong>Background: </strong>Ozanimod is a once-daily oral selective sphingosine 1-phosphate receptor modulator approved for the treatment of moderately to severely active ulcerative colitis (UC) or relapsing multiple sclerosis (RMS). Previous analyses in both indications demonstrated favorable long-term safety profiles of ozanimod. Here we report an integrated analysis of the long-term safety of ozanimod in patients with UC or RMS.</p><p><strong>Methods: </strong>Data were pooled in patients with UC who received ozanimod in phase 2, phase 3, and open-label extension (OLE) trials and in patients with RMS who received ozanimod in an OLE trial after completing any phase 1-3 parent trial. Safety assessments included treatment-emergent adverse events (TEAEs) and laboratory abnormalities.</p><p><strong>Results: </strong>Overall, 3652 patients with UC or RMS had 16 144 patient-years (PY) of ozanimod exposure over 10 years of follow-up. The most common TEAEs were nasopharyngitis, headache, and coronavirus disease 2019. Rates of TEAEs leading to treatment discontinuation (1.4/100 PY) and TEAEs of special interest, including serious infections (1.0/100 PY), herpes zoster (0.5/100 PY), malignancies (0.4/100 PY), bradycardia (0.1/100 PY), sinus bradycardia (0.04/100 PY), complete atrioventricular block (0.01/100 PY), and macular edema (0.1/100 PY), were low. No serious hepatic events or Hy's law cases occurred. Absolute lymphocyte count of < 200 cells/µL was not temporally associated with serious or opportunistic infections.</p><p><strong>Conclusions: </strong>Long-term exposure to ozanimod is well tolerated in patients with moderate to severe UC or RMS, confirming the previously established safety profile of ozanimod.</p><p><strong>Clinical trial registry: </strong>NCT01647516; NCT02435992; NCT02576717.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"954-962"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Intestinal Ultrasound Assessment Predicts Therapy Response: An Easy Tool for Clinical Decision-Making.","authors":"Elena De Cristofaro, Francesca Zorzi, Alice Colella, Luca Basile, Fabiana Castiglione, Antonio Rispo, Anna Testa, Alessia Dalila Guarino, Elisabetta Lolli, Elisa Cuccagna, Giovanni Monteleone, Emma Calabrese","doi":"10.1093/ibd/izaf317","DOIUrl":"10.1093/ibd/izaf317","url":null,"abstract":"<p><strong>Background: </strong>Transmural healing (TH) has emerged as a therapeutic target in Crohn's disease (CD), providing a more comprehensive indicator of deep remission than mucosal healing alone. Intestinal ultrasound (IUS) is a noninvasive method for assessing TH, but its prognostic value remains insufficiently defined.</p><p><strong>Objective: </strong>The aim of this prospective study was to evaluate whether early improvement in IUS parameters during biological therapy could predict TH at 12 months.</p><p><strong>Design: </strong>This is a prospective multicenter study enrolling CD patients initiating biological therapies. IUS and Doppler parameters were assessed at baseline, 3 months, and 12 months. Delta (Δ) represented the variation in ultrasound measurements between baseline and 3 months. TH was defined as normalization of bowel wall features and absence of hypervascularization.</p><p><strong>Results: </strong>A total of 142 CD patients were included. At 12 months, the TH rate was 19%, the IUS response rate was 44%. Patients achieving TH showed a significantly greater ΔBWT than nonresponders (P = .0004). On ROC analysis, a ΔBWT reduction of 1.25 mm predicted TH with 73% sensitivity and 61% specificity. IUS responders had a significantly greater ΔBWT than nonresponders (P < .0001), with the same threshold predicting response with 83% sensitivity and 57% specificity. Notably, the combination of ΔBWT and Limberg score improvement was strongly associated with both TH (OR 13.26; P < .0001) and IUS response (OR 20.9; P < .0001) at 12 months.</p><p><strong>Conclusion: </strong>Early reduction in BWT, especially when combined with Limberg score, is a strong predictor of TH and IUS response at 12 months, supporting the use of early IUS monitoring in clinical practice.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"938-944"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}