Therapeutic Advances in Gastroenterology最新文献

{"title":"Utilizing large language models for gastroenterology research: a conceptual framework.","authors":"Parul Berry, Rohan Raju Dhanakshirur, Sahil Khanna","doi":"10.1177/17562848251328577","DOIUrl":"10.1177/17562848251328577","url":null,"abstract":"<p><p>Large language models (LLMs) transform healthcare by assisting clinicians with decision-making, research, and patient management. In gastroenterology, LLMs have shown potential in clinical decision support, data extraction, and patient education. However, challenges such as bias, hallucinations, integration with clinical workflows, and regulatory compliance must be addressed for safe and effective implementation. This manuscript presents a structured framework for integrating LLMs into gastroenterology, using Hepatitis C treatment as a real-world application. The framework outlines key steps to ensure accuracy, safety, and clinical relevance while mitigating risks associated with artificial intelligence (AI)-driven healthcare tools. The framework includes defining clinical goals, assembling a multidisciplinary team, data collection and preparation, model selection, fine-tuning, calibration, hallucination mitigation, user interface development, integration with electronic health records, real-world validation, and continuous improvement. Retrieval-augmented generation and fine-tuning approaches are evaluated for optimizing model adaptability. Bias detection, reinforcement learning from human feedback, and structured prompt engineering are incorporated to enhance reliability. Ethical and regulatory considerations, including the Health Insurance Portability and Accountability Act, General Data Protection Regulation, and AI-specific guidelines (DECIDE-AI, SPIRIT-AI, CONSORT-AI), are addressed to ensure responsible AI deployment. LLMs have the potential to enhance decision-making, research efficiency, and patient care in gastroenterology, but responsible deployment requires bias mitigation, transparency, and ongoing validation. Future research should focus on multi-institutional validation and AI-assisted clinical trials to establish LLMs as reliable tools in gastroenterology.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251328577"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765477","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":"Standardized approach to removal of lumen apposing metal stents following endoscopic necrosectomy: one size does not fit all.","authors":"Robert Dorrell, Alexa Cecil, Swati Pawa, Gregory Russell, Rishi Pawa","doi":"10.1177/17562848251320739","DOIUrl":"10.1177/17562848251320739","url":null,"abstract":"<p><strong>Background: </strong>Walled-off necrosis (WON) is a sequela of acute necrotizing pancreatitis preferentially managed with lumen apposing metal stents (LAMS). Adverse events including buried stent syndrome and bleeding have been associated with a longer duration of LAMS placement.</p><p><strong>Objectives: </strong>We attempt to examine our outcomes of a standardized approach to LAMS dwell time and hypothesize that LAMS removal based on imaging characteristics and patient symptoms improves outcomes.</p><p><strong>Design: </strong>From November 2015 to May 2022, a prospectively maintained database on patients with symptomatic WON undergoing endoscopic drainage with LAMS was retrospectively reviewed and analyzed.</p><p><strong>Methods: </strong>Patient characteristics, procedure details, and outcomes were recorded. Imaging was performed at 1, 3, and 6 weeks after LAMS placement and 1 week after each necrosectomy. Imaging findings and patient symptoms were used to determine the need for repeat necrosectomy. The timing of LAMS removal was guided by adequate endoscopic necrosectomy and resolution of the patient's symptoms. Subgroups were identified based on the duration of LAMS placement (less than 4 weeks and more than 4 weeks). Independent <i>t</i>-tests (continuous variables) and Fisher's exact tests (categorical outcomes) were used to analyze the two groups.</p><p><strong>Results: </strong>In all, 104 patients underwent endoscopic necrosectomy during the study period. Of the two subgroups identified based on LAMS dwell time, 70 patients had a LAMS duration greater than 4 weeks and 34 patients had a LAMS duration less than 4 weeks. Collections with >50% necrosis were more commonly seen in patients with longer LAMS dwell time (<4 weeks (12%) vs >4 weeks (33%), <i>p</i> = 0.031). The median number of necrosectomies was fewer in the early LAMS removal group compared to the late LAMS removal cohort (<i>p</i> = 0.03). Clinical outcomes including technical success, clinical success, delayed adverse events, and 6-month mortality were similar in both groups.</p><p><strong>Conclusion: </strong>A patient-specific customized approach to endoscopic drainage of WON improves outcomes. Patients with extensive necrosis may require a longer LAMS dwell time to achieve adequate debridement and clinical resolution. An increased risk of bleeding or adverse events related to prolonged duration of LAMS placement was not observed in our study. Future larger prospective studies are needed to confirm these conclusions.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251320739"},"PeriodicalIF":3.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755040","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":"Transanal endoscopic local resection versus radical excision in the treatment of massive rectal gastrointestinal stromal tumors: striving for therapeutic advantages.","authors":"Taixuan Wan, Jingkun Xiao, Xingwei Zhang, Yunxing Shi, Hao Xie, Fujin Ye, Haoqi Zheng, Yihang Zhou, Zhanzheng Liu, Liang Kang, Liang Huang","doi":"10.1177/17562848251328860","DOIUrl":"10.1177/17562848251328860","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the therapeutic advantages of transanal endoscopic local resection (taLR) and transabdominal radical resection (tbRR) in the treatment of massive gastrointestinal stromal tumors (GIST).</p><p><strong>Design: </strong>Single-center retrospective study.</p><p><strong>Methods: </strong>From October 2012 to October 2022, the clinical, surgical, pathological, and prognostic data of patients with rectal GIST who underwent surgery were retrospectively collected. The patients were divided into the taLR group and the tbRR group according to the surgical methods, and the research indicators were compared.</p><p><strong>Results: </strong>Thirty-five patients with rectal GIST larger than 5 cm were enrolled, including 17 cases in the taLR group and 18 cases in the tbRR group. The taLR group showed shorter intraoperative time (<i>p</i> = 0.006), shorter postoperative hospital days (<i>p</i> = 0.035), earlier postoperative drainage tube removal (<i>p</i> = 0.007), and a higher anus preservation rate (<i>p</i> = 0.011). There was no significant survival difference in the 5-year disease-free survival between the taLR group and the tbRR group (94.1% vs 100%, <i>p</i> = 0.405).</p><p><strong>Conclusion: </strong>In conclusion, there were no significant differences in survival between taLR and laparoscopic radical resection for massive rectal GIST. Moreover, compared with transabdominal radical excision technique, the transanal endoscopy surgery provides a new method of anal preservation, thereby improving the patient's quality of life.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251328860"},"PeriodicalIF":3.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765476","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":"Sequential rescue therapy with JAK inhibitors in corticosteroid and infliximab-refractory acute severe ulcerative colitis: a case series.","authors":"Amirah Etchegaray, George Tambakis, Rina Kumar, Anthony Croft, Graham Radford-Smith, Gareth J Walker","doi":"10.1177/17562848251323511","DOIUrl":"10.1177/17562848251323511","url":null,"abstract":"<p><p>Acute severe ulcerative colitis (ASUC) is a life-threatening medical emergency affecting over 20% of patients with ulcerative colitis (UC). Up to 40% of patients are refractory to intravenous corticosteroids (IVCS) and require rescue medical therapy or immediate colectomy. The potent Janus kinase (JAK) inhibitors, upadacitinib and tofacitinib, have proven efficacy in a randomised control trial setting for moderate-to-severe UC, but not ASUC. We describe a case series of sequential rescue therapy with JAK inhibitors following the failure of dose-intensified infliximab in corticosteroid-refractory ASUC. Six adult (>16 years old) patients received sequential rescue therapy with a JAK inhibitor (upadacitinib <i>n</i> = 5, tofacitinib <i>n</i> = 1) following failure of IVCS and dose-intensified infliximab at the Royal Brisbane and Women's Hospital (QLD, Australia) between October 2023 and April 2024. All patients met the Truelove and Witts criteria for ASUC on admission. Data were captured during admission and at 90-days post-discharge. Co-primary outcomes were 90-day colectomy-free survival and inpatient clinical response (<4 non-bloody stools per day) 72 h after JAK-inhibitor initiation. Secondary outcomes included 90-day clinical (PRO-2 score < 1) and biochemical (faecal calprotectin (FCP) < 150 µg/g and C-reactive protein (CRP) < 5 mg/L) corticosteroid-free remission and adverse events. Median CRP on admission was 100 mg/L (interquartile range (IQR) 58-105), median FCP 3400 µg/g (IQR 910-4950) and median Mayo Endoscopic Score 3. Four out of six patients had a clinical response within 72 h of sequential JAK-inhibitor rescue therapy. Two patients underwent emergent inpatient colectomy for refractory disease - one of whom developed post-operative sepsis. Among the four JAK-responders at 90 days, all achieved corticosteroid-free clinical remission and three achieved biochemical remission. No other adverse events were recorded. There is a promising role for JAK inhibitors as sequential rescue therapy following the failure of dose-intensified infliximab in select patients with corticosteroid-refractory ASUC.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251323511"},"PeriodicalIF":3.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754911","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":"Unmet needs in adult patients with ulcerative colitis in Spain: a real-world Adelphi Disease Specific Programme study.","authors":"Ignacio Marín-Jiménez, Itxaso Aguirregabiria, Silvia Díaz-Cerezo, Sebastián Moyano, Hugo Gabilondo, Hannah Knight, Niamh Harvey, Theresa Hunter Gibble, Pilar Nos","doi":"10.1177/17562848251325190","DOIUrl":"10.1177/17562848251325190","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) characterized by chronic inflammation of the colonic mucosal lining.</p><p><strong>Objectives: </strong>This study aimed to examine unmet needs among patients with UC in Spain.</p><p><strong>Design: </strong>Data were analyzed from the Adelphi Real World IBD Disease Specific Programme™, a cross-sectional survey of physicians and patients with IBD in Spain between October 2020 and March 2021.</p><p><strong>Methods: </strong>Physicians reported patient clinical characteristics, disease severity, treatment patterns and satisfaction, symptoms, and flare and remission status. Patients were then invited to voluntarily self-complete a form reporting health-related quality of life (HRQoL) and work productivity/activity impairment. Analyses were descriptive.</p><p><strong>Results: </strong>Overall, 57 physicians reported data for 410 patients with UC presenting a high disease severity profile. The mean (standard deviation) patient age was 45 (15) years, with 88% presenting with moderate-to-severe UC at diagnosis. In the survey, 75% and 63% of patients were treated with conventional therapy and biologics, respectively. After treatment initiation, patients had lower disease severity, but 29% of patients had moderate-to-severe disease despite receiving biologics or Janus kinase inhibitors. Overall, 81% of patients and 86% of physicians were satisfied with treatment. Among patients classified as having moderate-to-severe UC, commonly reported symptoms included abdominal pain (41%), bowel urgency (37%), and bloody diarrhea (37%). The mean number of flares experienced in the past year was 1.7, lasting on average >30 days. Consequently, the HRQoL of these patients was impaired.</p><p><strong>Conclusion: </strong>While disease severity appeared to be lower after the initiation of current treatment, and despite the high prevalence of treatment satisfaction, almost a third of patients remained classified as moderate-to-severe, experiencing symptoms, flares, and impaired HRQoL. Therefore, there is a need for new therapeutic alternatives to target patient unmet needs.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251325190"},"PeriodicalIF":3.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755112","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":"Authors' comment on: effectiveness and safety of oral vancomycin for the treatment of inflammatory bowel disease associated with primary sclerosing cholangitis: a systematic review and pooled analysis.","authors":"Badr Al-Bawardy, Mohammed Nabil Quraishi","doi":"10.1177/17562848251328606","DOIUrl":"10.1177/17562848251328606","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251328606"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722099","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":"Comment on: Randomized clinical trial: the effects of mirtazapine in functional dyspepsia patients.","authors":"Motij Kumar Dalai, Yogesh Bairwa, Sanjay Chandnani","doi":"10.1177/17562848251329433","DOIUrl":"10.1177/17562848251329433","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251329433"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722101","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":"Switching from intravenous to subcutaneous infliximab is safe and feasible in patients with perianal Crohn's disease.","authors":"Pauline Wils, Mathurin Fumery, Maria Nachury, Clara Yzet, Dilek Coban, Anthony Buisson","doi":"10.1177/17562848251326471","DOIUrl":"10.1177/17562848251326471","url":null,"abstract":"<p><strong>Background and objectives: </strong>We assessed the evolution of perianal lesions after switching intravenous (IV) to subcutaneous (SC) infliximab in patients with Crohn's disease (CD).</p><p><strong>Design: </strong>Subgroup analysis of REMSWITCH studies.</p><p><strong>Methods: </strong>We described the clinical and MRI outcomes of patients with a prior or current CD perianal lesions after the switch.</p><p><strong>Results: </strong>In REMSWITCH, 40 CD patients had a prior history of perianal lesions. No patient experienced a new perianal lesion (median follow-up = 18 months). Among the three patients (3/40, 7.5%) with clinically active perianal lesions at baseline, two patients had no more perianal lesions at month 18 while the last patient experienced lesions worsening. Another one with active perianal lesions on MRI but no symptom at baseline did not have any relapse within 18 months. Only one patient (1/40, 2.5%) had a perianal relapse (at month 25) with remission recapture after SC infliximab intensification.</p><p><strong>Conclusion: </strong>Switching from IV to SC infliximab in CD with perianal lesions is safe and feasible.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251326471"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732615","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":"Association of early therapeutic drug monitoring of adalimumab with biologic remission and drug survival in Crohn's Disease.","authors":"José Luis Rueda García, Cristina Suárez-Ferrer, Clara Amiama Roig, Laura García Ramírez, Cristina García Rojas, Eduardo Martín-Arranz, Joaquín Poza Cordón, María Sánchez Azofra, Jesús Noci, Cristina Cubillo García, María Dolores Martín-Arranz","doi":"10.1177/17562848251324226","DOIUrl":"10.1177/17562848251324226","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic drug monitoring of adalimumab (ADA) is still controversial.</p><p><strong>Objectives: </strong>To study the association between ADA trough levels in the early stages of treatment with biological remission (BR) and drug survival in Crohn's disease (CD).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Patients treated with ADA with available trough levels at weeks 2 and 6 (after the first induction and maintenance dose, respectively) were included. Fecal calprotectin (Fcal) and C-reactive protein (CRP) were registered at baseline, week 24, and week 52. BR was defined as Fcal <200 µg/g and CRP <5 mg/dl. Treatment survival and the need for dose escalation were assessed at week 52. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic accuracy of ADA cutoff levels for BR. Quartile-specific comparisons were performed to evaluate differences in the proportion of patients achieving BR at weeks 24 and 52, drug survival, and dose escalation.</p><p><strong>Results: </strong>In all, 112 patients were included. ADA trough levels at week 6 were higher in patients achieving BR at week 24 (12.32 μg/ml vs 10.3 μg/ml, <i>p</i> = 0.0008), week 52 (12.3 μg/ml vs 10.8 μg/ml, <i>p</i> = 0.035), and in patients with 1-year treatment persistence (12.17 μg/ml vs 9.7 μg/ml, <i>p</i> = 0.03), but lower in patients requiring maintenance intensification (9.7 μg/ml vs 12.2 µg/ml, <i>p</i> < 0.0001). ADA week 6 trough levels >12.27 μg/ml predicted BR at week 24 with 79.7% specificity and 79.5% positive predictive value. Patients in the third quartile (Q3) and fourth quartile (Q4) of ADA levels at week 6 exhibited higher rates of BR at week 24, BR at week 52, 1-year drug survival, and less need for dose escalation (all <i>p</i>-values <0.05). In logistic regression, Q3 and Q4 of week 6 levels were significantly associated with BR at week 24 (<i>p</i> = 0.02 and <i>p</i> = 0.001); and week 6 Q4 with BR at week 52 (<i>p</i> = 0.02), treatment persistence (<i>p</i> = 0.03), and lower dose escalation (<i>p</i> = 0.004). ADA trough levels at week 2 did not show similar associations.</p><p><strong>Conclusion: </strong>ADA trough levels at week 6 are associated with BR at weeks 24 and 52, drug survival, and need for dose escalation in CD. However, ADA concentrations at week 2 failed to yield similar results.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251324226"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665225","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":"Quality of life and burden of disease in a Mexican population with inflammatory bowel disease: an analysis of the RISE-MX trial.","authors":"Rosa M Miranda-Cordero, Francisco J Bosques-Padilla, Manuel Alejandro Martínez-Vázquez, Cristian Barajas-Maldonado, Mauricio M Rodriguez-Mendoza, Jesús K Yamamoto-Furusho","doi":"10.1177/17562848251318032","DOIUrl":"10.1177/17562848251318032","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that have a negative impact on patient quality of life (QOL).</p><p><strong>Objective: </strong>To evaluate QOL, work productivity, use of healthcare resources, and medical costs in patients with IBD from the RISE-MX trial.</p><p><strong>Design: </strong>RISE-MX was a non-interventional, multicentric, cross-sectional, retrospective study conducted in a Mexican population with IBD.</p><p><strong>Methods: </strong>The 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ) were used to assess QOL. The burden of disease was analyzed using the Work Productivity and Activity Impairment Questionnaire (WPAI), healthcare resources use, and medical costs.</p><p><strong>Results: </strong>Of 326 subjects, 95 (29.1%) had CD, and 231 (70.8%) had UC. In patients with CD, 43 patients (45.3%) showed moderate-to-severe activity, and 42 (18.1%) had moderate-to-severe disease activity in patients with UC. In all SF-36 dimensions, a significant difference between moderate-to-severe and mild activity/in remission groups was observed in patients with UC, while in patients with CD, the difference between activity groups was significant only for physical functioning and social functioning dimensions. In patients with CD, a higher but non-significant IBDQ score difference between activity groups was observed while a statistical difference between activity groups was observed for all dimensions in UC patients. In WPAI, the total percentage for work impairment (absenteeism plus presenteeism) and the percentage of regular daily activity impairment were statistically significant between activity groups only for UC. The annual total costs (direct and indirect) per patient in CD were USD 19,757 (moderate-to-severe activity group) and USD 12,587 (mild activity/in remission group), while in patients with UC were USD 11,702 and USD 9144, respectively.</p><p><strong>Conclusion: </strong>Moderate-to-severe activity of disease was associated with a substantial impact on QOL, work productivity, and medical costs in Mexican patients with IBD. Total costs were higher for patients with CD than for patients with UC.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251318032"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663979","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}