Intestinal Research最新文献

{"title":"Population-based screening colonoscopy in Korea: balancing benefits and limitations.","authors":"Hyoung Il Choi, Jae Myung Cha","doi":"10.5217/ir.2025.00188","DOIUrl":"10.5217/ir.2025.00188","url":null,"abstract":"<p><p>Population-based colonoscopy screening is considered one of the most effective strategies for reducing the incidence and mortality of colorectal cancer. Its major strength lies in its dual benefits: early detection of colorectal cancer and prevention via the removal of precancerous lesions. Colonoscopy has a high sensitivity and provides a full colonic evaluation in a single session, thereby reducing the need for frequent testing. However, this approach has notable limitations. Colonoscopy is an invasive procedure associated with rare but serious complications such as perforation and bleeding. Participation rates tend to be lower than those of noninvasive methods like fecal immunochemical tests. Additionally, implementing colonoscopy as a populationbased tool requires significant resources, including trained endoscopists, endoscopy facilities, and financial investments. The quality of colonoscopy may also vary depending on the operator's skill and adherence to guidelines. Given these trade-offs, population-based colonoscopy screening must be carefully evaluated in terms of cost-effectiveness, feasibility, and public acceptance within each country's healthcare system. Therefore, population-based colonoscopy screening should be approached with a balanced understanding of its benefits and limitations to ensure cost-effectiveness, feasibility, alignment with each country's healthcare infrastructure, and integration with existing screening programs.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"417-427"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804454","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":"Escalation to biologics after corticosteroids in patients with newly diagnosed Crohn's disease in Japan: a claims analysis from 2010 to 2021.","authors":"Minoru Matsuura, Annabelle Yoon, Jun Miyoshi, Tadakazu Hisamatsu","doi":"10.5217/ir.2025.00059","DOIUrl":"10.5217/ir.2025.00059","url":null,"abstract":"<p><strong>Background/aims: </strong>A previous health insurance claims study of Japanese patients with newly diagnosed Crohn's disease (CD) reported an increase in \"step-up\" approach from 2010 to 2020, with biologic use in the first year remaining stable. This study examined systemic corticosteroid (SCS) use for newly diagnosed CD in Japan and compared patients who were escalated (\"step-up\") and were not escalated to biologics.</p><p><strong>Methods: </strong>This retrospective longitudinal cohort study used health insurance claims data (JMDC database). Patients diagnosed with CD from 2010 to 2020 who had no CD-related claims for ≥ 1 year before index, were traceable for ≥ 1 year after index, and treated with ≥ 1 pre-defined treatment were included. Patients classified by SCS and/or biologic use within 1 year after diagnosis were compared.</p><p><strong>Results: </strong>Of 823 patients, 379 (46.1%) received SCS in the first year; of these, 43.5% escalated to biologics (step-up group) and 56.5% did not (SCS group). The proportion of patients receiving SCS increased from 25.8% in 2010-2011 to 55.5% in 2020; proportion escalated to biologics increased from 33.8% in 2016-2017 to 51.0% in 2020. The step-up group was significantly younger, more likely to have perianal lesions, and received more intensive treatments than the SCS group. In terms of SCS use, the step-up group was more likely to have shorter time-to-SCS initiation, and a higher initial SCS dose, than the SCS group.</p><p><strong>Conclusions: </strong>Escalation from SCS to biologics in Japanese patients with newly diagnosed CD increased between 2016 and 2020, particularly in patients with younger onset CD or perianal complications.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"532-541"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596551","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":"Current burden and health care utilization of inflammatory bowel disease in the United States, 2023-2024.","authors":"Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Sidhartha R Sinha, Aijaz Ahmed","doi":"10.5217/ir.2026.00046","DOIUrl":"https://doi.org/10.5217/ir.2026.00046","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between remnant cholesterol and advanced colorectal adenoma in individuals under 50 years of age.","authors":"Kwangmin Joo, Jong Yoon Lee, Jong Hoon Lee","doi":"10.5217/ir.2026.00093","DOIUrl":"https://doi.org/10.5217/ir.2026.00093","url":null,"abstract":"<p><strong>Background/aims: </strong>The incidence of early-onset colorectal cancer is rising globally. While metabolic dysregulation is a known risk, the specific contribution of lipid profiles to colorectal carcinogenesis in young adults remains unclear. Remnant cholesterol (RC) has emerged as a significant cardiovascular risk factor, but its association with young-onset colorectal neoplasia is not fully elucidated.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional study of 4,100 asymptomatic individuals under 50 years of age undergoing screening colonoscopy. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. We used multivariate logistic regression to assess the independent association between RC levels and the presence of young-onset adenoma (YOA) and advanced YOA.</p><p><strong>Results: </strong>Patients with YOA had significantly higher RC levels than controls (17.65 ± 14.52 mg/dL vs. 14.69 ± 11.14 mg/dL; P< 0.001). In adjusted multivariate analysis, RC was independently associated with YOA risk (odds ratio [OR], 1.011; 95% confidence interval [CI], 1.003-1.019; P= 0.005). Notably, for advanced YOA, RC remained the only lipid parameter that retained statistical significance in the multivariable model (OR, 1.021; 95% CI, 1.004-1.038; P= 0.015), whereas traditional lipid markers were not significant.</p><p><strong>Conclusions: </strong>Higher RC levels were independently associated with YOA and advanced YOA in this cohort of asymptomatic individuals under 50 years of age. Among the lipid parameters examined, RC remained statistically significant in the multivariable model for advanced YOA.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid diagnosis and therapeutic mitigation in inflammatory bowel disease: utilizing the window of opportunity-findings from the UAE Epi-IBD study.","authors":"Thaer Khaleel Swaid, Layth Raafat Hamzeh, Laurette L Bukasa, Tine Jess, Mohammed Nabil Quraishi","doi":"10.5217/ir.2026.00032","DOIUrl":"https://doi.org/10.5217/ir.2026.00032","url":null,"abstract":"<p><strong>Background/aims: </strong>To determine time to diagnosis (TTD) and its impact on surgery and advanced therapy (AT) burden in inflammatory bowel disease (IBD) in a multi-ethnic United Arab Emirates (UAE) cohort, a region in the acceleration phase of IBD incidence.</p><p><strong>Methods: </strong>Retrospective analysis of the UAE Epi-IBD registry. TTD was calculated from patient-reported symptom onset to diagnosis. Logistic, Poisson regression and Cox proportional hazards models were used. Sensitivity analyses using 6- and 18-month thresholds and TTD quartiles were performed.</p><p><strong>Results: </strong>Among 243 patients (148 Crohn's disease [CD], 95 ulcerative colitis [UC]), median TTD was 4.0 months (interquartile range [IQR], 1.5-9.0 months) for CD and 3.0 months (IQR, 1.0-7.0 months) for UC (P= 0.111, Wilcoxon; log-rank P= 0.054), shorter than pooled estimates from high-income countries. UC TTD accelerated significantly post-2021 (2.0 months vs. 5.5 months; P= 0.006), while CD remained stable (P= 0.646). Diagnostic speed was identical between tertiary and non-tertiary settings (P= 0.943). Diagnostic delay did not predict AT exposure (P= 0.986) or surgical risk (P= 0.586); instead, penetrating CD phenotype drove therapy burden (P= 0.019). Time to first AT was rapid (median 4.5 months for CD, 14.0 months for UC). Era-stratified analysis showed a trend toward higher AT use in 2021 to 2025 (incidence rate ratio, 1.36; 95% CI, 0.98-1.89; P= 0.071), consistent with expanding therapeutic availability, though null association between delay and outcomes persisted after adjustment.</p><p><strong>Conclusions: </strong>TTD in this cohort is shorter than global benchmarks and comparable to recent Asian data. Diagnostic delay did not predict adverse outcomes, though limited surgical events and short follow-up preclude definitive conclusions. Multiple factors beyond healthcare system architecture may contribute, and larger multicenter studies are needed.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing intestinal ultrasound to assess treatment response in ulcerative colitis.","authors":"Shintaro Sagami, Taku Kobayashi","doi":"10.5217/ir.2026.00006","DOIUrl":"https://doi.org/10.5217/ir.2026.00006","url":null,"abstract":"<p><p>Intestinal ultrasound (IUS) enables frequent, noninvasive assessment of inflammatory activity in ulcerative colitis and can support treat-to-target decisions without bowel preparation. Evidence from prospective cohorts indicates that early IUS changes within 1 to 2 weeks-particularly reductions in bowel wall thickness and color Doppler vascularity-are associated with shortterm response and can guide timely treatment optimization during induction. Follow-up assessments at 6 to 12 weeks further improve risk stratification by reassessing bowel wall thickness and Doppler vascularity, including composite indices such as the Milan Ultrasound Criteria, which correlate with endoscopic outcomes and subsequent medium- to long-term clinical events (e.g., relapse and colectomy). This review synthesizes the most reproducible IUS parameters and proposes a practical, time-windowed monitoring approach integrating IUS with symptoms, biomarkers, and endoscopy, whereby assessments within 1-2 weeks and again at 6-12 weeks provide actionable information to accelerate induction optimization and anticipate later outcomes in ulcerative colitis.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guselkumab efficacy and safety in East Asian participants with moderately to severely active Crohn's disease: subgroup analysis of the phase 3 GALAXI 2 and GALAXI 3 trials.","authors":"Hiroshi Nakase, Baili Chen, Qian Cao, Katsuyoshi Matsuoka, Tadakazu Hisamatsu, Dong Il Park, Keira Herr, Bryan Wahking, Wai Chun Yiu, Jianmin Zhuo, Minhu Chen","doi":"10.5217/ir.2025.00150","DOIUrl":"https://doi.org/10.5217/ir.2025.00150","url":null,"abstract":"<p><strong>Background/aims: </strong>Guselkumab, a dual-acting interleukin-23p19 subunit inhibitor, demonstrated efficacy and safety in participants with moderately to severely active Crohn's disease in the global phase 3 GALAXI 2 and 3 trials. We report a subgroup analysis in East Asian participants.</p><p><strong>Methods: </strong>GALAXI 2 and 3 (NCT03466411) are identical, 48-week treat-through trials. Participants were randomized 2:2:2:1 to guselkumab 200 mg IV every 4 weeks (q4w; ×3), followed by 100 mg SC every 8 weeks (q8w) or 200 mg SC q4w; ustekinumab; or placebo. Placebo participants not in clinical response at week (W)12 received ustekinumab. Co-primary endpoints were the composite of clinical response at W12 and clinical remission at W48, and the composite of clinical response at W12 and endoscopic response at W48. This subgroup analysis included participants from China, Japan, South Korea, and Taiwan.</p><p><strong>Results: </strong>The East Asian subgroup included 192 participants. Rates of clinical response at W12 and clinical remission at W48 with guselkumab were 55.6% (100 mg SC q8w) and 51.0% (200 mg SC q4w) versus 3.1% with placebo. Rates of clinical response at W12 and endoscopic response at W48 with guselkumab were 44.4% (100 mg SC q8w) and 39.2% (200 mg SC q4w), versus 0% for placebo. Numerically higher proportions of guselkumab participants achieved clinical and endoscopic outcomes at W48 relative to ustekinumab. Adverse event rates were consistent with the global population.</p><p><strong>Conclusions: </strong>Efficacy of guselkumab in East Asian participants was consistent with that observed in the global GALAXI 2 and 3 population. The safety profile was favorable and consistent with previous reports.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Factors affecting 1-year persistence with vedolizumab for ulcerative colitis: a multicenter, retrospective real-world study\".","authors":"Joaquín Borrás-Blasco, Alejandro Valcuende-Rosique, Silvia Cornejo-Uixeda","doi":"10.5217/ir.2026.00062","DOIUrl":"https://doi.org/10.5217/ir.2026.00062","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world use and perceptions of advanced combined therapies in treating inflammatory bowel disease.","authors":"Hsin-Yun Wu, Zhi-Che Chen, Meng-Tzu Weng, Agnes Hiu Yan Ho, Joyce Wing Yan Mak, Rupert W Leong, Siew-Chien Ng, Uma Mahadevan, Fernando Magro, Deng-Chyang Wu, Shu-Chen Wei","doi":"10.5217/ir.2025.00325","DOIUrl":"https://doi.org/10.5217/ir.2025.00325","url":null,"abstract":"<p><strong>Background/aims: </strong>Combining therapies targeting distinct pathways shows promise in breaking the therapeutic ceiling for inflammatory bowel disease. The study explored real-world experiences and gaps between current evidence and clinical practice regarding advanced combined therapies.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted via QR code during meetings or email invitation. The survey covered participant demographics, experiences with advanced combined therapies for ulcerative colitis, Crohn's disease, and knowledge of these therapies.</p><p><strong>Results: </strong>Between March and October of 2024, 234 participants from 20 countries replied and 51.7% had adopted advanced combined therapies (86.0% had treated ulcerative colitis, 66.9% Crohn's disease, and 52.9% both). Among the 48.3% who had no experience, 76.1% would try if indicated. Refractory diseases were the most common indications. For combined therapies duration, 52.8% were time-oriented, favoring limited use within 6 months. Physicians reported no adverse events in 59.5% of cases. Of the events, infections (69.8%) were most common. Add-on strategy was the most commonly adopted, particularly the Janus kinase inhibitor added on anti-integrin for ulcerative colitis and anti-tumor necrosis factor alpha added on anti-interleukin 12/23 for Crohn's disease. Concomitant strategy followed, while sequential strategy was the least used. More non-Asian experts were experienced (82.4%) compared to Asian participants (46.5%). Both inexperienced and non-Asian physicians preferred add-on strategy, but prioritized goal-oriented use, targeting clinical and endoscopic remission.</p><p><strong>Conclusions: </strong>In real-world practice, advanced combined therapies were primarily used for refractory inflammatory bowel disease with limited duration. Add-on use was the most adopted. Differences in treatment approaches reflect varying levels of physician experience and geographical locations.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Efficacy and safety of mirikizumab in maintenance therapy for ulcerative colitis in difficultto- treat inflammatory bowel disease: a single-center retrospective study in Japan\".","authors":"Chenchen Xu, Hailing Li","doi":"10.5217/ir.2026.00071","DOIUrl":"https://doi.org/10.5217/ir.2026.00071","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}