Inflammatory Bowel Diseases最新文献

{"title":"Current evidence for first-line advanced therapies in pediatric ulcerative colitis: a critical review.","authors":"Toshihiko Kakiuchi","doi":"10.1093/ibd/izag203","DOIUrl":"https://doi.org/10.1093/ibd/izag203","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic landscape of pediatric ulcerative colitis (UC) has evolved substantially with the introduction of multiple advanced therapies, creating new challenges in selecting the most appropriate initial treatment. While infliximab has long served as the reference biologic, biologics with different mechanisms of action and small-molecule therapies have expanded therapeutic options. However, the pediatric evidence supporting first-line advanced therapy remains heterogeneous across currently available agents.</p><p><strong>Methods: </strong>This review critically summarizes the current pediatric evidence supporting first-line advanced therapies for UC, focusing on anti-tumor necrosis factor therapy, vedolizumab, ustekinumab, selective interleukin-23 inhibitors, and other emerging advanced therapies. We evaluate the maturity, characteristics, and direct applicability of the available evidence to biologic-naïve pediatric patients and discuss the major limitations of the current literature.</p><p><strong>Results: </strong>Among currently available therapies, anti-tumor necrosis factor therapy, particularly infliximab, is supported by the most comprehensive prospective pediatric evidence. In contrast, evidence for vedolizumab, ustekinumab, and selective IL-23 inhibitors has accumulated more recently and remains comparatively limited. Across all therapeutic classes, direct comparative studies in biologic-naïve pediatric patients are lacking, and evidence supporting individualized treatment selection remains insufficient.</p><p><strong>Conclusions: </strong>Current pediatric evidence supports the efficacy of multiple advanced therapies and has characterized important safety outcomes; however, evidence establishing therapeutic efficacy should be distinguished from evidence directly informing first-line treatment selection. Future pediatric research should increasingly generate comparative and predictive evidence that informs which effective advanced therapy should be selected first and for whom.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136523","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":"Differential long-term efficacy of biologic and small-molecule therapies by disease location in moderate-to-severe luminal Crohn's disease: a systematic review and network meta-analysis.","authors":"Sóley Poulsen Dalsgarð, Kavini Kalinga Bandara Pkb, Jakob Benedict Seidelin, Jacob Tveiten Bjerrum, Mohamed Attauabi","doi":"10.1093/ibd/izag177","DOIUrl":"https://doi.org/10.1093/ibd/izag177","url":null,"abstract":"<p><strong>Background and aims: </strong>Treatment efficacy in Crohn's disease (CD) may vary according to disease location. We aimed to evaluate the long-term efficacy of biological and small molecule therapies in moderate-to-severe luminal CD stratified by CD location.</p><p><strong>Design: </strong>We conducted a systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials (RCTs) in adults (aged ≥18 years) with moderate-to-severe CD (Crohn's Disease Activity Index [CDAI] 220-450), identified through PubMed, Embase, and CENTRAL to August 12, 2025. Predefined outcomes included clinical remission (CDAI < 150) and endoscopic response (≥50% reduction in Simple Endoscopic Score-CD (SES-CD) at week 52 (range, 44-56 weeks), stratified by Montreal disease location and trial design.</p><p><strong>Results: </strong>Eighteen RCTs (including 4697 patients) evaluating adalimumab, infliximab, vedolizumab, ustekinumab, mirikizumab, risankizumab, guselkumab, and upadacitinib were included. Clinical remission rates were lowest in isolated ileal disease, and only guselkumab regimens (200 mg/100 mg: relative risk, 3.4 [95% CI, 1.3-8.9]) were statistically superior to placebo for maintenance of clinical remission at week 52. In isolated colonic disease, upadacitinib 30 mg ranked highest in re-randomized trials and with significant location-dependent differences (efficacy ratio [EF] for colonic vs ileal is 4.6 [95% CI, 1.7-12.6], EF for ileocolonic vs ileal is 3.45 [95% CI, 1.2-9.6]), consistent with endoscopic response rates. No location-dependent differences were observed for other agents.</p><p><strong>Conclusion: </strong>Relative efficacy of advanced therapies in luminal CD varied by disease location. These findings support consideration of disease location in personalized treatment decision-making to improve clinical outcomes.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136508","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":"Infliximab intensification in acute severe ulcerative colitis: The next question is patient selection.","authors":"Deloshaan Subhaharan, Waled Mohsen, Pradeep Kakkadasam Ramaswamy","doi":"10.1093/ibd/izag206","DOIUrl":"10.1093/ibd/izag206","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127526","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":"Author's reply: 'Endoscopy in immune checkpoint inhibitor colitis: what should we measure?'","authors":"Myrthe R Naber, Mick J M van Eijs, Fiona D M van Schaik","doi":"10.1093/ibd/izag202","DOIUrl":"https://doi.org/10.1093/ibd/izag202","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127512","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":"Enterotype-based stratification identifies clinically distinct microbial subtypes in inflammatory bowel disease.","authors":"Seungpyo Hong, Kwang Woo Kim, Yeram Im, Jaeyoung Jang, Dae Hee Cheon, Eun Kyoung Lee, Yoo Min Han, Jun Won Park, Hyun Jung Lee, Hyunsun Park, Seong Jin Jo, Donghyun Kim, Hyoun Woo Kang, Jong Pil Im, Eun Soo Kim, Ji Won Kim, Byeong Gwan Kim, Joo Sung Kim, Seong-Joon Koh","doi":"10.1093/ibd/izag176","DOIUrl":"https://doi.org/10.1093/ibd/izag176","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBDs) are heterogeneous disorders in which gut microbial dysbiosis may influence disease activity and clinical outcomes. However, it remains unclear whether microbiome-based stratification identifies clinically relevant IBD subtypes.</p><p><strong>Methods: </strong>We profiled the gut microbiome of a cohort comprising patients with IBD (n = 260), at-risk individuals (n = 166), and healthy control individuals (n = 57) using 16S rRNA gene amplicon sequencing. Unsupervised clustering was used to define gut microbial enterotypes. Associations with clinical characteristics and outcomes, including fecal calprotectin levels and medication step-up, were evaluated. Statistical and machine learning approaches were applied to identify enterotype-specific microbial signatures.</p><p><strong>Results: </strong>Four enterotypes were identified and labeled according to their most discriminative genera: Faecalibacterium and Blautia, Prevotella, Phocaeicola, and Bifidobacterium with reduced Faecalibacterium (Bif + Faec-low). Faecalibacterium and Blautia and Prevotella were enriched in healthy control individuals, Phocaeicola was enriched in at-risk individuals, and Bif + Faec-low was enriched in patients with IBD. The Bif + Faec-low enterotype was associated with lower body mass index, higher fecal calprotectin levels, and an increased risk of medication step-up (hazard ratio, 1.71; 95% confidence interval, 1.10-2.66). Microbial composition and network analyses identified distinct enterotype-specific taxa and hub genera, suggesting functional divergence among enterotypes.</p><p><strong>Conclusions: </strong>Gut microbial enterotypes are associated with distinct clinical phenotypes and treatment escalation in IBD, and exhibit enterotype-specific microbial community structures and alterations across disease states. Enterotype-based stratification may provide a clinically relevant framework for assessing risk assessment and guiding personalized disease management.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109230","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":"Readability and quality of online inflammatory bowel disease pregnancy resources: authors' reply.","authors":"Simone Chin, Kathryn Demase, Crispin Corte, Darren Wong, Ralley Prentice, Peter De Cruz","doi":"10.1093/ibd/izag152","DOIUrl":"https://doi.org/10.1093/ibd/izag152","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109222","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":"Pleiotropic anti-inflammatory effects of CB2R inverse agonism on chronic intestinal disease.","authors":"Colm B Collins","doi":"10.1093/ibd/izag189","DOIUrl":"https://doi.org/10.1093/ibd/izag189","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109252","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":"Between-visit care represents a substantial and underrecognized component of health care utilization in pediatric inflammatory bowel disease.","authors":"Jeannie S Huang, Laura E Bauman, David Katibian, David Brent Polk","doi":"10.1093/ibd/izag097","DOIUrl":"10.1093/ibd/izag097","url":null,"abstract":"<p><strong>Background: </strong>Children with inflammatory bowel disease (IBD) require substantial health care engagement, yet traditional utilization metrics underestimate the scope of care by omitting between-visit clinical activity such as electronic messaging, telephone encounters, and results review. Pediatric-specific data describing this hidden workload remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal cohort study of youth aged 0 to 22 years diagnosed with IBD between 2015 and 2024 at a tertiary care center. Eligible patients had ≥ 6 months of primary care prior to diagnosis and ≥ 6 months of gastroenterological follow-up postdiagnosis. From the shared electronic health record, we quantified outpatient visits, emergency care, and procedures, as well as between-visit care (portal messages from patients, telephone encounters, and clinician-patient review of results) from prediagnosis through long-term follow-up. Events were aggregated into 6-month epochs relative to diagnosis and stratified by disease severity using validated symptom indices. Predictors of between-visit care were evaluated using generalized linear mixed-effects modeling.</p><p><strong>Results: </strong>Among 226 patients (median age 12 years; 57% male), health care utilization increased markedly during peri-diagnostic epochs. Between-visit care rose from a median of 1 event per 6 months > 1 year prediagnosis to 64 events in the year following diagnosis, and the number of these events remained persistently elevated thereafter. Higher disease severity was strongly associated with increased between-visit care. In multivariable analysis, postdiagnosis epochs, moderate-severe disease activity, and later diagnostic year independently predicted increased between-visit care (all P < .0001).</p><p><strong>Conclusions: </strong>Between-visit care represents a substantial and clinically meaningful component of pediatric IBD management, underscoring the need for workforce planning, reimbursement models, and digital innovations to address this largely invisible clinical workload.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1949-1956"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224695","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":"Prevalence of inflammatory bowel disease across states: estimates based on claims database.","authors":"Hansol Kang, Kate L Karlin, Colleen M Brensinger, Orna G Ehrlich, Michael D Kappelman, Alan Moss, James D Lewis","doi":"10.1093/ibd/izag076","DOIUrl":"10.1093/ibd/izag076","url":null,"abstract":"<p><p>Data derived from our previously published pooled administrative claims database analysis were applied to estimate race-weighted state-specific prevalences of inflammatory bowel diseases in the United States to support public health, clinical, and research initiatives at the state and regional level.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2061-2065"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963535","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":"Timing of complementary food introduction is not associated with inflammatory bowel disease risk: A prospective birth cohort study.","authors":"Ida Sigvardsson, Johnny Ludvigsson, Tereza Lerchova, Henrik Imberg, Ketil Størdal, Karl Mårild","doi":"10.1093/ibd/izag093","DOIUrl":"10.1093/ibd/izag093","url":null,"abstract":"<p><strong>Background: </strong>Complementary feeding (ie, food introduction besides formula or breast milk) imprints on the developing gut microbiome and immune system, which may have durable influences on disease risk. This study aimed to prospectively assess the association between the timing of complementary feeding and subsequent inflammatory bowel disease (IBD) risk.</p><p><strong>Methods: </strong>We followed 94 238 participants from the All Babies in Southeast Sweden (ABIS) (n = 11 947) and the Norwegian Mother, Father and Child (MoBa) (n = 82 291) cohorts from birth (1997-2009) through 2023 (mean age 16.5 [MoBa] to 25.2 [ABIS] years). National patient registers identified IBD diagnoses. The timing of complementary food introduction (<4, 4-5, or ≥6 months) was assessed using early-life food diaries and questionnaires. Latent class analyses identified 4 patterns across introductions of major food groups (eg, cereals and dairy). Cox regression estimated hazard ratios (aHRs) for IBD adjusted for socio-demographics and parental IBD. Sensitivity analysis additionally adjusted for breastfeeding duration, formula feeding, and perinatal factors.</p><p><strong>Results: </strong>Over 1 562 350 person-years of follow-up, 400 participants developed IBD (ABIS, n = 124; MoBa, n = 276). Overall timing of complementary food introduction was not associated with IBD (<4 months: aHR, 1.04 [95% CI, 0.67-1.60]; 4-5 months: aHR, 0.83 [95% CI, 0.63-1.10] vs ≥6 months). Also, aHRs for IBD by latent class analyses-defined introduction patterns approached 1. Results were consistent across cohorts, sensitivity analyses, and Crohn's disease and ulcerative colitis subtypes.</p><p><strong>Conclusions: </strong>The findings from this binational birth cohort study indicate that neither the timing nor the pattern of complementary food introduction is a major risk factor for later development of IBD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1937-1948"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210686","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}