Timothy McAuliffe, Jessica K Salwen-Deremer, Corey A Siegel
{"title":"Disparities in Access and Treatment for Rural Patients With Inflammatory Bowel Disease: A Survey of Inflammatory Bowel Disease Patients and Providers.","authors":"Timothy McAuliffe, Jessica K Salwen-Deremer, Corey A Siegel","doi":"10.1093/ibd/izaf090","DOIUrl":"https://doi.org/10.1093/ibd/izaf090","url":null,"abstract":"<p><strong>Background: </strong>With the increasing complexity of inflammatory bowel disease (IBD) care, the integration of IBD specialist gastroenterologists and multidisciplinary teams (MDTs) is becoming more important. However, access to these services is not widely available. This study sought to evaluate the needs of rural and urban IBD patients and providers in the setting of complex IBD care.</p><p><strong>Methods: </strong>Questionnaires were administered to IBD patients, advanced practice providers (APPs), and gastroenterologists throughout the United States from September through November 2023 on topics including access to care, IBD specialists, and MDTs. Statistical analyses included t-tests, chi-square tests, analysis of variance tests, and regression.</p><p><strong>Results: </strong>The analysis included 100 rural and 100 urban patients, 20 rural and 50 urban APPs, and 35 rural and 50 urban gastroenterologists. Rural patients were more likely to be receiving no therapy for IBD and less likely to receive advanced therapies (P = .001, P < .001, respectively). Rural patients reported less use of IBD multidisciplinary care and providers identified reduced access to multidisciplinary providers for rural patients. All patients had high interest in maintaining relationships with their current IBD provider while receiving care through a consulting MDT. Providers expressed strong interest in MDTs, with rural gastroenterologists reporting greater interest than urban gastroenterologists (P = .004).</p><p><strong>Conclusions: </strong>These results demonstrate disparities between rural and urban patients' treatments and access to specialty IBD care. Rural patients and providers are supportive of collaborating with IBD specialists and MDTs. These results can help guide the implementation of innovative IBD care models in the setting of an increasingly complex IBD landscape.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021345","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":"AI-Assisted IBD Severity Classification: A Critical Perspective on Current Evidence and Next Steps.","authors":"Shubham Kumar, Rachana Mehta, Ranjana Sah","doi":"10.1093/ibd/izaf103","DOIUrl":"https://doi.org/10.1093/ibd/izaf103","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998356","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}
Grace C Lovett, Julien D Schulberg, Amy L Hamilton, Emily K Wright, Tom R Sutherland, Alyson L Ross, Michael A Kamm
{"title":"Crohn's Disease Stricture Response to Treatment Assessed with Magnetic Resonance Imaging and Intestinal Ultrasound: STRIDENT Randomized Trial.","authors":"Grace C Lovett, Julien D Schulberg, Amy L Hamilton, Emily K Wright, Tom R Sutherland, Alyson L Ross, Michael A Kamm","doi":"10.1093/ibd/izaf073","DOIUrl":"https://doi.org/10.1093/ibd/izaf073","url":null,"abstract":"<p><strong>Background: </strong>Transmural healing is emerging as a key treatment target in Crohn's disease. This study aimed to determine the role of magnetic resonance imaging (MRI) and intestinal ultrasound (IUS) in the assessment of the radiologic response of Crohn's disease strictures to treatment.</p><p><strong>Methods: </strong>The STRIDENT (Stricture Definition and Treatment) study was a randomized controlled trial of (2:1) intensive high-dose adalimumab combined with a thiopurine vs standard dose monotherapy adalimumab in patients with stricturing Crohn's disease. Clinical response was defined as a reduction in the Obstructive Symptom Score at 12 months. Intestinal ultrasound was performed at baseline, 4, 8, and 12 months and MRI at baseline and 12 months. This study examines secondary outcomes of stricture resolution and changes in stricture morphology with treatment.</p><p><strong>Results: </strong>Of 77 patients, 52 were in the intensive treatment group and 25 in the standard therapy group. Clinical response was achieved in 56 of 77 patients (73%). Complete stricture resolution occurred in 17 patients on IUS (29%) and 16 patients on MRI (22%). Stricture improvement occurred in 23 of 59 patients on IUS (39%) and 24 of 72 patients on MRI (33%). Bowel wall thickness improved at 12 months on both IUS (P < .0001) and MRI (P < .001) and was significantly lower in clinical responders (IUS P = .003) and those with fecal calprotectin < 100 µg/g (IUS P < .001; MRI P = .001).</p><p><strong>Conclusions: </strong>Radiologic severity of Crohn's disease strictures can improve with drug treatment, with complete stricture resolution observed in some. Intestinal ultrasound and MRI are effective modalities for monitoring the treatment response in patients with stricturing Crohn's disease (STRIDENT Drug Therapy Study: NCT03220841).</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963523","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}
Sara Albert, Pilar Marqués, Ángela Algarra, Esther Blanc, María Jesús Pérez, José Richart, José María Paredes
{"title":"Monitoring Structural Bowel Damage in Patients With Crohn's Disease Using Intestinal Ultrasonography: Can It Be Reversed by Biological Treatment?","authors":"Sara Albert, Pilar Marqués, Ángela Algarra, Esther Blanc, María Jesús Pérez, José Richart, José María Paredes","doi":"10.1093/ibd/izaf100","DOIUrl":"10.1093/ibd/izaf100","url":null,"abstract":"<p><strong>Background: </strong>Currently, medical therapy of Crohn's disease (CD) can reduce the progression of some forms of structural bowel damage (SBD), but it does not prevent it. Once SBD has developed, it is important to assess the potential of medical treatments to reverse this damage.</p><p><strong>Aims: </strong>To determine whether transmural healing (TH), assessed by intestinal ultrasonography (IUS), can be achieved with medical treatment in CD patients with SBD compared to those without.</p><p><strong>Methods: </strong>A prospective, longitudinal, observational study was conducted to compare IUS monitoring at 3 and 12 months of treatment between CD patients with SBD prior to treatment and those with an inflammatory pattern.</p><p><strong>Results: </strong>Three months after starting treatment, patients without SBD had a significantly higher TH rate than those with SBD (25.8% vs 7.8%, respectively; P = .004). However, after 12 months, the TH rate was not significantly higher in patients without SBD compared to those with SBD (34% vs 26.6%, respectively; P = .317). During these 12 months, the need for corticosteroids, hospitalizations, and surgical resection was significantly higher in the SBD group.</p><p><strong>Conclusions: </strong>Biological treatment can reverse SBD in CD, but hospitalizations and surgery rates remain higher in this group.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022478","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}
Michelle Chae Min Lee, Armin Farahvash, Petros Zezos
{"title":"Response to the Letter to the Editor: \"AI-Assisted IBD Severity Classification: A Critical Perspective on Current Evidence and Next Steps\".","authors":"Michelle Chae Min Lee, Armin Farahvash, Petros Zezos","doi":"10.1093/ibd/izaf096","DOIUrl":"https://doi.org/10.1093/ibd/izaf096","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020426","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}
Christoph Teichert, Suzanne I Anjie, Toer W Stevens, Bayda Bahur, Kurtis R Bray, Krisztina B Gecse, Geert R D'Haens
{"title":"Clinical Utility and Accuracy of Point-of-Care Testing for Anti-TNF Drug Monitoring and Loss of Response.","authors":"Christoph Teichert, Suzanne I Anjie, Toer W Stevens, Bayda Bahur, Kurtis R Bray, Krisztina B Gecse, Geert R D'Haens","doi":"10.1093/ibd/izaf101","DOIUrl":"https://doi.org/10.1093/ibd/izaf101","url":null,"abstract":"<p><strong>Background and aims: </strong>Point-of-care tests (POCT) enable immediate measurement of anti-TNF blood concentrations. This study examined the association between loss of response (LOR) to infliximab (IFX) or adalimumab (ADL) and serum concentrations measured with POCT and enzyme-linked immunosorbent assay (ELISA) in inflammatory bowel disease (IBD) patients.</p><p><strong>Methods: </strong>Patients with IBD with stored IFX or ADL serum samples were recruited. POCT was conducted, agreement with ELISA was evaluated using Bland-Altman plots. The primary endpoint was LOR defined as change in therapy, IBD-related surgery, new actively draining fistula, and/or endoscopic deterioration. ROC curves and quartile analysis assessed the association between concentrations and LOR.</p><p><strong>Results: </strong>A total of 176 patients were included (92 IFX/84 ADL, 154 Crohn's disease, and 22 ulcerative colitis). Median follow-up time was 20 months (interquartile range 9-38). LOR occurred in 37/84 (44%) ADL users and 55/92 (60%) IFX users. Median serum concentrations were significantly lower in LOR patients compared with sustained response, measured by both techniques for ADL (POCT: 6.45 vs 13.48 µg/mL, P <.001; ELISA: 4.80 vs 8.80 µg/mL, P <.001) and IFX (POCT: 2.39 vs 6.50 µg/mL, P <.001; ELISA: 1.70 vs 4.40 µg/mL, P <.001). Quartile analysis revealed that higher serum concentrations were associated with maintained response. ROC curve analysis demonstrated good or excellent discrimination for POCT and ELISA in association with LOR (AUC IFX: POCT = 0.82, ELISA = 0.76; AUC ADL: POCT = 0.82, ELISA = 0.81; all P <.0001). An overestimation of serum concentrations with POCT was observed.</p><p><strong>Conclusions: </strong>Serum ADL and IFX POCT concentrations are comparable to ELISA and associated with LOR, indicating its clinical utility.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984536","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":"The Way Forward in the Diagnosis and Treatment of IBDU in Children: A Global Perspective and Multidimensional Exploration.","authors":"Guilin Bai, Shengfeng Wang, Yuexia Zhang","doi":"10.1093/ibd/izaf104","DOIUrl":"https://doi.org/10.1093/ibd/izaf104","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009854","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}
Partha Pal, Mohammad Abdul Mateen, Rajesh Gupta, Manu Tandan, D Nageshwar Reddy
{"title":"Multifaceted Endoscopic Approach (Stricturotomy, Balloon Dilation, Fistulotomy, and Seton Placement) Guided by Intestinal Ultrasound to Avert Surgery in Complicated Crohn's Disease During Lactation.","authors":"Partha Pal, Mohammad Abdul Mateen, Rajesh Gupta, Manu Tandan, D Nageshwar Reddy","doi":"10.1093/ibd/izaf076","DOIUrl":"https://doi.org/10.1093/ibd/izaf076","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978791","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}