Inflammatory Bowel Diseases最新文献

{"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}

{"title":"Before the engine stalls: confronting the invisible workload in pediatric IBD.","authors":"Richard Kellermayer","doi":"10.1093/ibd/izag100","DOIUrl":"10.1093/ibd/izag100","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2069-2071"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251391","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":"Diet quality, gut microbiome, and inflammatory signatures in Puerto Rican adults with Crohn disease: a multidimensional analysis.","authors":"Lymarie M Díaz-Díaz, Lianeris Estremera-Rodriguez, Mayra Rojas-Correa, María Del Carmen Quintana, Camilla Madziar, Dylan C Hickey, Daniela Vargas Robles, Yoshimarie Méndez, Amanda Santiago, Derick Bermudez, Barbara Olendzki, Esther A Torres, Ana Maldonado-Contreras","doi":"10.1093/ibd/izag161","DOIUrl":"10.1093/ibd/izag161","url":null,"abstract":"<p><strong>Background and aims: </strong>Diet is increasingly recognized as a modifiable factor influencing gut microbiome and outcomes in Crohn disease (CD), yet data in underrepresented populations remain limited. We evaluated diet quality, dietary patterns, gut microbiome composition, inflammatory markers, and patient-reported outcomes in adults with CD from Puerto Rico.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 60 adults with CD enrolled prior to dietary intervention in a parent study. Dietary intake was assessed using 24-hour recalls and evaluated using the Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), and exploratory dietary pattern analysis. The gut microbiome was assessed by shotgun metagenomic sequencing. Clinical outcomes included fecal calprotectin, C-reactive protein (CRP), a 96-cytokine panel, short Crohn Disease Activity Index (sCDAI), and short Inflammatory Bowel Disease Questionnaire (sIBDQ). Associations were evaluated using unadjusted and adjusted models with false discovery rate (FDR) correction.</p><p><strong>Results: </strong>Overall diet quality was poor and characterized by low intake of fruits, vegetables, whole grains, and fiber, alongside high intake of saturated fat, added sugars, and animal-derived protein. Four dietary patterns were identified: vegetable-rich, dairy-rich, fruit-rich, and coffee/sweetener-rich. Participants adhering to the fruit-rich pattern exhibited the highest diet quality scores. Higher HEI-2015 scores were associated with greater gut microbial diversity and differences in overall microbiome composition. Participants with greater adherence to the vegetable-rich pattern showed modest increases in microbial diversity. Exploratory analyses suggested that higher fruit intake and adherence to a fruit-rich dietary pattern were associated with lower fecal calprotectin and CRP levels, whereas adherence to a vegetable-rich pattern was associated with better health-related quality of life (HRQoL) and adherence to a coffee/sweetener-rich pattern was associated with a worse symptom burden. However, no associations between dietary metrics and inflammatory markers, cytokines, or clinical outcomes remained significant after FDR correction. Most participants were in clinical remission despite substantial impairment in HRQoL.</p><p><strong>Conclusions: </strong>Adults with CD in Puerto Rico exhibited poor diet quality that was associated with gut microbial diversity and exploratory differences in clinical outcomes. While these findings support the influence of diet on the microbiome and clinical outcomes, larger longitudinal studies are needed to determine whether dietary improvements can influence disease outcomes this underrepresented population.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1993-2003"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827850","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":"Quality of healthcare delivery in inflammatory bowel disease pregnancy: a scoping review.","authors":"Simone Chin, Kathryn Demase, Crispin Corte, Darren Wong, Ralley Prentice, Peter De Cruz","doi":"10.1093/ibd/izag064","DOIUrl":"10.1093/ibd/izag064","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is associated with an increased risk of adverse pregnancy outcomes. The number of individuals affected by IBD during their reproductive years is expected to increase in parallel with rising disease prevalence. Increasing disease burden and costs of care threaten access to quality health care delivery. Quality of healthcare describes how healthcare delivery services achieve desired evidence-based patient-reported and clinical outcomes. Given that IBD has implications for patients during pregnancy, a dedicated exploration of how quality of care may be optimized for this patient group is warranted. In this scoping review, we apply a framework assessing structural, process, and outcome indicators to examine the current quality of healthcare in IBD pregnancy, identify and discuss barriers to achieving quality care, and systematically appraise the existing models used to provide care for IBD patients during their pregnancies.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2025-2049"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689943","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 and radiological outcomes of ustekinumab in pediatric perianal Crohn's disease: a multicenter retrospective study from the Pediatric IBD Porto Group of ESPGHAN.","authors":"Ido Orlin, Balsam Younis, Marco Gasparetto, Anat Yerushalmy-Feler, Lorenzo Norsa, Christiane Sokollik, Pejman Rohani, Kristýna Zárubová, Giulia D'Arcangelo, Saverio Pochesci, Ana Lozano-Ruf, Kaija-Leena Kolho, Anne Griffiths, Firas Rinawi","doi":"10.1093/ibd/izag091","DOIUrl":"10.1093/ibd/izag091","url":null,"abstract":"<p><strong>Background: </strong>Perianal Crohn's disease (pCD) is a severe pediatric phenotype with high morbidity. Although antitumor necrosis factor (TNF) agents are first-line therapy, remission is not achieved in a subset of patients. We aimed to evaluate clinical and radiological outcomes of ustekinumab (UST) in pediatric patients with pCD.</p><p><strong>Methods: </strong>This is a multicenter retrospective study including pediatric patients with pCD treated with UST between 2016 and 2023. Primary outcomes were clinical and radiological remission at predefined time points. Clinical remission was defined as absence of fistula drainage without antibiotics or unplanned perianal interventions. Radiological remission was defined as a Pediatric MRI-Based perianal Crohn's Disease (PEMPAC) score of <10 on pelvic MRI.</p><p><strong>Results: </strong>Fifty patients were included, of whom 2 were anti-TNF-naive. The median age at UST initiation was 15 years (IQR 12.4-16.2). Clinical remission was observed in 46% (23/50; P = .006 vs baseline), 48% (23/48; P = .036 vs baseline), and 42% (19/45; P = .13 vs baseline) at weeks 26, 52, and 104, respectively. Radiological remission was 29% (10/34) and 30% (13/43) at weeks 52 and 104, respectively (both P < .01 vs baseline). In multivariable analysis, higher baseline PEMPAC scores were independently associated with lower odds of both clinical (P < .01; OR 0.88, 95% CI 0.68-0.95) and radiological remission (P < .01; OR 0.81, 95% CI 0.62-0.94).</p><p><strong>Conclusions: </strong>UST was associated with perianal clinical remission in a substantial proportion of pediatric patients, approaching 50% at 1 year, and radiological healing in about one-third at 2 years, supporting its potential role in pediatric pCD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1871-1879"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143191","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":"Reply: \"Comments on incidence estimates and rural ascertainment in the Kinta Valley IBD follow-up study\".","authors":"Ida Hilmi, Xin-Hui Khoo, David Yi-Vern Kwong, Phei Oon Tan, Suh Yu Cheong, Ruben Skantha, Andrew Seng Boon Chua, Harjinder Singh, Theng Hean Ng, Wai Hong Kong, Choon Heng Wong, Raja Affendi Raja Ali","doi":"10.1093/ibd/izag155","DOIUrl":"10.1093/ibd/izag155","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2075"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759757","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":"Modulating immune toxicity in ulcerative colitis using a small molecule RAB27A inhibitor.","authors":"Meital Ben-David-Naim, Dan Bijaoui, Naomi Iluz, Julian Adams, Daryl C Drummond, Yatin Mankan, Christina H Eng, Jeremy W Herzog, Simon Gray, Ryan Balfour Sartor, Zvi G Fridlender, Seth J Salpeter, Zvi Granot","doi":"10.1093/ibd/izag170","DOIUrl":"10.1093/ibd/izag170","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence has shown that ulcerative colitis patients with increased neutrophil biomarkers are linked to complicated disease and refractory response. In the pathology of colitis, neutrophils are recruited to the colon and yield acute damage via reactive oxygen species (ROS), degranulation, and neutrophil extracellular traps (NETosis). RAB27A is a regulator of intracellular membrane trafficking and has been shown to play a role in neutrophil activation by enabling the increased release of proteolytic granules and ROS. Studies have shown significant upregulation of RAB27A expression in biopsies of moderate and severe ulcerative colitis patients, while preclinical studies genetically deleting RAB27A in ulcerative colitis models have shown improved outcomes.</p><p><strong>Methods: </strong>To evaluate the impact of RAB27A inhibition in ulcerative colitis and lower activated neutrophil toxicity in the disease, we developed IMYX-3, a first-in-class small molecule oral inhibitor of RAB27A activity and applied it to the study of diseased neutrophils and models.</p><p><strong>Results: </strong>IMYX-3 lowers neutrophil ROS, degranulation, NETosis, and cytokine secretion. Preclinical efficacy was demonstrated in dextran sulfate sodium and Il10-/- mouse models, in which IMYX-3 treatment led to improved colon length, reduced systemic inflammation, lower levels of activated neutrophil function, and comparable disease outcomes compared with standard-of-care control mice. In vitro toxicity profiling as well as pharmacokinetic and toxicology studies in rodents and canines showed a favorable drug profile, with no significant adverse events observed at doses up to 30 times the predicted therapeutic range.</p><p><strong>Conclusion: </strong>IMYX-3 effectively inhibits RAB27A activation in neutrophils, yielding improved outcomes in preclinical disease models with no major safety concerns.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2004-2015"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792605","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":"The missing evidence: Stricturing Crohn's disease in clinical trials, a systematic review.","authors":"Elettra Merola, Daniele La Rocca, Mariano Scaglione, Giovanni Mario Pes, Maria Pina Dore","doi":"10.1093/ibd/izag079","DOIUrl":"10.1093/ibd/izag079","url":null,"abstract":"<p><strong>Background: </strong>Stricturing Crohn's disease (CD) represents a major cause of morbidity, with limited prospective data addressing response to treatment. We performed a systematic review to evaluate the efficacy of biologic and small-molecule therapies in stricturing CD and to assess the role of imaging modalities in diagnosing and monitoring bowel stenoses.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Scopus, and Web of Science through August 26, 2025. Prospective studies, including randomized controlled trials and prospective observational cohorts, reporting outcomes in adult patients with stricturing CD treated with biologics or small molecules were included. Risk of bias was assessed using the RoB 2 and ROBINS-I tools.</p><p><strong>Results: </strong>Of 22 306 records identified, 7 publications corresponding to 10 prospective studies (6 randomized controlled trials, 4 nonrandomized studies) were included. All studies evaluated biologic therapies, predominantly anti-tumor necrosis factor agents; no prospective trials specifically assessed small-molecule therapies in stricturing CD. Due to methodological heterogeneity, a meta-analysis was not appropriate. Across studies, biologic therapy was associated with clinical improvement and, in selected cohorts, reductions in inflammatory activity and need for surgery. Response appeared to vary according to stricture severity, with lower rates in nonpassable lesions. Intestinal ultrasonography and magnetic resonance were investigated in 4 studies, showing reductions in bowel wall thickness.</p><p><strong>Conclusions: </strong>Prospective evidence for medical therapy in stricturing CD is limited and restricted to anti-tumor necrosis factor α agents. Imaging plays an important role in characterization and monitoring but lacks a standardized fibrosis assessment. Dedicated phenotype-specific trials and validated imaging biomarkers are needed to optimize management of stricturing CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1898-1909"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147928981","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}