Therapeutic Advances in Gastroenterology最新文献

{"title":"Increased failure of budesonide MMX for ulcerative colitis during the COVID-19 pandemic: a population-based study.","authors":"Stephanie Coward, Karen J B Martins, Scott Klarenbach, Lawrence P Richer, Christopher Ma, Remo Panaccione, Cynthia H Seow, Karen Kroeker, Frank Hoentjen, Laura E Targownik, Gilaad G Kaplan","doi":"10.1177/17562848261434442","DOIUrl":"10.1177/17562848261434442","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids induce remission in ulcerative colitis (UC) but are associated with adverse effects, including prednisone ⩾20 mg/day associated with serious COVID-19 outcomes.</p><p><strong>Objectives: </strong>To evaluate the risk of rescue prednisone use following budesonide multimatrix system (MMX) initiation in newly diagnosed individuals with UC before and during the COVID-19 pandemic.</p><p><strong>Design: </strong>Population-based cohort study.</p><p><strong>Methods: </strong>We conducted a population-based study in Alberta, Canada, identifying adults with incident UC (2018-2022). Courses of budesonide MMX were examined for treatment failure, defined as prednisone rescue or inflammatory bowel disease-specific hospitalization within 90 days. Outcomes were compared between prepandemic (before April 2020) and pandemic periods using Cox proportional hazards models.</p><p><strong>Results: </strong>Among 269 dispensings of budesonide MMX (38 with multiple courses), 30.5% required rescue prednisone and 6.7% resulted in hospitalization. Budesonide MMX dispensing declined during the pandemic wherein, the hazard of prednisone rescue increased (HR 1.64; 95% CI: 1.01-2.67).</p><p><strong>Conclusion: </strong>Budesonide MMX was prescribed less frequently during the COVID-19 pandemic, with increased treatment failure, underscoring pandemic-related disruptions in UC management.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261434442"},"PeriodicalIF":3.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595779","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":"Comparative study on the application of fully covered self-expanding metal stents in benign and malignant strictures of the distal bile duct.","authors":"Ziyan Wang, Fei Xu, Weigang Shu, Xinyan Zhu, Feng Zhu","doi":"10.1177/17562848261435331","DOIUrl":"10.1177/17562848261435331","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic placement of fully covered self-expanding metal stents (FCSEMS) is a treatment for distal biliary strictures (DBS). However, there remains a notable gap in the research regarding the efficacy and safety of FCSEMS in benign distal biliary stricture (BDBS) and malignant distal biliary stricture (MDBS).</p><p><strong>Objective: </strong>To compare the short-term efficacy and long-term safety of FCSEMS in benign versus malignant DBS.</p><p><strong>Design: </strong>A retrospective, single-center cohort study.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 123 patients with DBS who underwent FCSEMS placement via endoscopic retrograde cholangiopancreatography (ERCP) at Shanghai East Hospital Affiliated to Tongji University from January 2019 to December 2024. Patients were stratified into BDBS (<i>n</i> = 46) and MDBS (<i>n</i> = 77) based on comprehensive diagnostic criteria, including medical history (underlying diseases, prior surgeries, etc.), clinical manifestations, laboratory tests (hepatic function panel, tumor biomarkers, IgG4, autoimmune antibodies, etc.), and multimodality imaging (Computed Tomography, magnetic resonance cholangiopancreatography, endoscopic ultrasound, etc.). The primary endpoint was short-term stricture resolution rate; secondary endpoints included ERCP-related complication rates (short- and long-term).</p><p><strong>Results: </strong>Median follow-up durations were comparable between BDBS (6 (4,9) months) and MDBS (7 (4,12) months) groups (<i>p</i> > 0.05). Short-term stricture resolution rates were 97.8% (45/46) in the BDBS group and 92.2% (71/77) in the MDBS group (<i>p</i> > 0.05). Early ERCP complications (hyperamylasemia, bleeding, perforation, cholecystitis) did not differ significantly between groups (all <i>p</i> > 0.05). However, the incidence of post-ERCP pancreatitis (PEP) was markedly higher in BDBS (37.0%, 17/46) than in MDBS (7.8%, 6/77; <i>p</i> < 0.05). Long-term complications (stent migration, occlusion) showed no intergroup differences (all <i>p</i> > 0.05), but late biliary infections were more frequent in MDBS (41.7%, 10/24) versus BDBS (7.7%, 3/39; <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>FCSEMS effectively alleviates strictures in both benign and malignant DBS, with comparable short-term efficacy. Notably, BDBS patients had a higher risk of early PEP, whereas MDBS patients were more prone to late biliary infections. Long-term stricture resolution was not analyzed due to divergent disease trajectories (e.g., limited survival in MDBS).</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261435331"},"PeriodicalIF":3.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595700","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":"Competence network inflammatory bowel diseases in Germany: 25 years of interdisciplinary and cross-sectoral research and knowledge transfer across all levels of IBD care.","authors":"Bernd Bokemeyer, Sandra Plachta-Danielzik, Ulf Helwig, Patrick Beuchert, Stefan Schreiber","doi":"10.1177/17562848261431187","DOIUrl":"10.1177/17562848261431187","url":null,"abstract":"<p><p>The Competence Network Inflammatory Bowel Diseases (Kompetenznetz Darmerkrankungen) was established in Germany in 1999 through a 10-year funding programme by the German Ministry of Education and Research. It was created to address the growing gap between the rising prevalence and therapeutic complexity of inflammatory bowel disease (IBD) and the fragmented care structures and isolated academic initiatives of the time. The network's continuing mission is to improve care for patients with Crohn's disease and ulcerative colitis by more closely integrating clinical practice, translational science and patient involvement. This review summarises the history, governance, registries, biobanking, clinical trials, educational programmes and collaborations of the Competence Network IBD. Over the past 25 years, the Competence Network IBD has established prospective national registries (e.g. RUN-CD, RUN-UC, VEDO-IBD and FilgoColitis), developed pragmatic real-world cohorts (TARGET and GeCer) and contributed to the UMBRELLA-IBD data warehouse of the Competence Network IBD in Germany. The network played a central role in creating the German IBD DNA collection and supported the Kiel University biobank, both of which link biospecimens with longitudinal clinical data to support genetic and microbiome research. It also conducts and coordinates multicentre clinical trials and has supported the development of the German evidence- and consensus-based IBD guidelines. With more than 800 members from university centres, community practices, nursing and patient organisations, it now provides a robust platform for research and knowledge transfer across all levels of IBD care. The Competence Network IBD demonstrates how long-term interdisciplinary and cross-sectoral collaboration can improve the management of chronic inflammatory diseases. By integrating research infrastructures with education and patient involvement, the network serves as a scalable and sustainable model for national and international collaboration in IBD.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261431187"},"PeriodicalIF":3.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610262","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":"Persistence of advanced therapies in patients with ulcerative colitis: real-world data from the nationwide CREdIT registry.","authors":"Ondrej Hradsky, Dana Duricova, Milan Lukas, Lenka Nedbalová, Barbora Pipek, Pavel Drastich, Premysl Falt, Tomas Vanasek, Jana Svikova, Milan Siroky, Ludek Bouchner, Pavel Svoboda, Jiri Bronsky, Martin Bortlik","doi":"10.1177/17562848261436156","DOIUrl":"10.1177/17562848261436156","url":null,"abstract":"<p><strong>Background: </strong>The expanding therapeutic landscape of ulcerative colitis (UC) introduces uncertainty regarding the optimal positioning of new agents.</p><p><strong>Objectives: </strong>This study aimed to compare the real-world persistence of advanced therapies for UC.</p><p><strong>Design: </strong>This observational cohort study used a population-based national registry of biologic and small-molecule therapies for inflammatory bowel disease, CREdIT, to identify patients treated with advanced therapy for UC.</p><p><strong>Methods: </strong>The primary outcome was treatment persistence - defined as time from therapy initiation to discontinuation or last follow-up, whichever occurred first - and was analysed using mixed-effects Cox models and inverse probability weighting. Persistence was assessed overall, in first-line therapy, and in second-line therapy after adalimumab or infliximab exposure.</p><p><strong>Results: </strong>We included 3718 observations from 2525 patients with UC (48% female). Infliximab (40%), vedolizumab (27%) and adalimumab (17%) were most frequently used. At 5 years, 1852 of 3718 observations (49.8%) remained on the same therapy. The treatment line alone was not associated with treatment persistence after accounting for patient-level clustering using a mixed-effects model. Vedolizumab showed significantly greater persistence than infliximab or adalimumab, including in first-line use. In second-line settings post-anti-tumour necrosis factor (TNF) exposure, upadacitinib had the highest persistence compared to tofacitinib, vedolizumab and ustekinumab, whereas vedolizumab was more persistent than tofacitinib.</p><p><strong>Conclusion: </strong>Vedolizumab demonstrated longer persistence than infliximab or adalimumab, regardless of treatment line. Following anti-TNF failure, upadacitinib showed the highest persistence.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261436156"},"PeriodicalIF":3.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594669","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":"Efficacy and safety ranking of endoscopic resection techniques for colorectal polyps: a systematic review and network meta-analysis.","authors":"Shirui Li, Yue Lei, Yunfan Deng, Sheng Dai, Dehai Xiong, Qi Fan, Xiuyang Li","doi":"10.1177/17562848261436116","DOIUrl":"10.1177/17562848261436116","url":null,"abstract":"<p><strong>Background: </strong>The rapid evolution of endoscopic resection techniques for colorectal polyps has created a diverse but fragmented evidence base, making it challenging to determine the technique that optimally balances efficacy and safety.</p><p><strong>Objectives: </strong>To comprehensively compare the efficacy and safety of all mainstream colorectal polypectomy techniques.</p><p><strong>Design: </strong>A systematic review and Bayesian network meta-analysis (NMA), conducted in accordance with PRISMA-NMA guidelines.</p><p><strong>Data sources and methods: </strong>Databases searched included PubMed, Web of Science, Embase, Scopus, Cochrane Library, CNKI, Wanfang Database, and SinoMed. Model convergence was assured (Brooks-Gelman-Rubin diagnostic), and consistency was evaluated via node-splitting analysis. Treatment hierarchies for primary efficacy outcomes (R0 resection, En bloc resection, complete resection) and secondary safety outcomes (bleeding, perforation) were established using surface under the cumulative ranking curve (SUCRA) probabilities.</p><p><strong>Results: </strong>100 RCTs (24,786 patients; 34,244 polyps) comparing 13 techniques were included. Underwater endoscopic mucosal resection (U-EMR) and EMR ranked highest for R0 resection (SUCRA: U-EMR 49%, EMR 30%) and En bloc resection. For complete resection, endoscopic submucosal dissection (ESD) ranked highest (SUCRA: ESD 49%). Cold forceps polypectomy (CFP) and cold snare polypectomy with submucosal injection (CSP-SI) were consistently the least effective across efficacy outcomes. Hot snare EMR (HS-EMR) was associated with the highest risk of bleeding, while cold snare polypectomy (CSP)-based techniques were generally safer for perforation. ESD demonstrated a favorable safety profile for bleeding. The evidence certainty was generally low to moderate.</p><p><strong>Conclusion: </strong>This NMA provides a comprehensive hierarchy of polypectomy techniques. U-EMR and EMR are among the most effective for R0 and En bloc resection, while CSP-based techniques are among the safest. HS-EMR carries a higher bleeding risk. These findings provide crucial evidence to guide clinical decision-making and future guideline development, while also highlighting key evidence gaps requiring further research.</p><p><strong>Trial registration: </strong>PROSPERO (CRD420251139746).</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261436116"},"PeriodicalIF":3.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610297","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":"Corrigendum to \"Evaluating the role of ChatGPT in gastroenterology: a comprehensive systematic review of applications, benefits, and limitations\".","authors":"","doi":"10.1177/17562848261427266","DOIUrl":"10.1177/17562848261427266","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/17562848231218618.].</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261427266"},"PeriodicalIF":3.4,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595694","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":"Re-investigation rate following colon capsule endoscopy stratified by faecal haemoglobin concentration in a screening population.","authors":"Ulrik Deding, Benedicte Schelde-Olesen, Thomas Bjørsum-Meyer, Lasse Kaalby, Issam Al-Najami, Anastasios Koulaouzidis, Morten Kobaek-Larsen, Gunnar Baatrup","doi":"10.1177/17562848261434425","DOIUrl":"10.1177/17562848261434425","url":null,"abstract":"<p><strong>Background: </strong>Endoscopy units throughout the world have seen a substantial increase in colonoscopy activity. One way to keep patient waiting time acceptable could be to introduce alternative diagnostic modalities. Colon capsule endoscopy has been proven to have a high diagnostic accuracy, yet the re-investigation rates reported are too high. Faecal haemoglobin concentration may offer a valid measure for triaging patients between diagnostic modalities, due to its association with colonic pathology.</p><p><strong>Objective: </strong>To investigate the re-investigation rate and risk classification in complete colon capsule endoscopies in a screening population stratified by faecal haemoglobin concentration.</p><p><strong>Design: </strong>Cross-sectional analyses of a data set derived from the intervention arm of a large randomised controlled trial, CareForColon2015, conducted in the Region of Southern Denmark between August 2020 and December 2022.</p><p><strong>Methods: </strong>Complete colon capsule endoscopy investigations were identified, and the proportions of investigations leading to re-investigation by colonoscopy were calculated, stratified by faecal haemoglobin concentration. Further, the odds of re-investigation were estimated by logistic regression models and the odds of increased risk classification by ordinal regression models.</p><p><strong>Results: </strong>The re-investigation rate was 58.6% in 1413 complete colon capsule endoscopies out of 2030 procedures. There were no significant differences (<i>p</i> = 0.312) in re-investigation rates between faecal haemoglobin concentration subgroups with 58.2%, 61.1% and 62.7% in the groups of 100-249, 250-499 and >499 ng hb/mL buffer, respectively. The odds of referral for re-investigation did not differ significantly either. The odds of increased risk classification (i.e. higher than level one) was 1.17 (CI 95% 0.92; 1.49, <i>p</i> = 0.211) for concentrations between 250 and 499 ng hb/mL buffer, and 1.40 (CI 95% 1.12; 1.77, <i>p</i> = 0.003) for concentrations above 499 ng hb/mL buffer, compared to 100-249 ng hb/mL buffer.</p><p><strong>Conclusion: </strong>Faecal haemoglobin concentration did not prove to be a stand-alone selection parameter for diagnostic modality in a faecal immunochemical test-positive colorectal cancer screening population, although it was significantly associated with an increased risk classification.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261434425"},"PeriodicalIF":3.8,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594935","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":"Efficacy and health-related quality of life associated with second-line vedolizumab after first-line treatment with one anti-TNF in patients with ulcerative colitis: a meta-analysis of the GEMINI-1 and VISIBLE-1 trials.","authors":"Raja Atreya, Julien Kirchgesner, Zoe Cheah, Patricia Biedermann, Lytske Bakker, Marlies Meyer, Tim Raine","doi":"10.1177/17562848261431467","DOIUrl":"10.1177/17562848261431467","url":null,"abstract":"<p><strong>Background: </strong>Vedolizumab is a monoclonal antibody approved for adults with moderately to severely active ulcerative colitis and an inadequate response/intolerance to conventional, or anti-tumor necrosis factor (TNF) treatment. Additional efficacy data for second-line vedolizumab after first-line anti-TNF treatment are required to determine its optimal position in the treatment sequence.</p><p><strong>Objectives: </strong>To evaluate efficacy and health-related quality of life (HRQoL) associated with second-line vedolizumab after first-line anti-TNF in patients with ulcerative colitis.</p><p><strong>Design: </strong>Meta-analysis.</p><p><strong>Data sources and methods: </strong>Data from randomized, placebo-controlled phase III trials (GEMINI-1 (NCT00783718) and VISIBLE-1 (NCT02611830)) were used. Patients who received second-line vedolizumab after first-line anti-TNF treatment within 5 years before trial enrollment were included. The primary outcome was clinical remission with two definitions based on the adapted Mayo score. Secondary outcomes were corticosteroid (CS)-free remission, Mayo endoscopic score (MES) ⩽1, and HRQoL (Inflammatory Bowel Disease Questionnaire and EuroQoL-5 Dimension Visual Analog Scale). Outcomes were assessed at Week 52. Efficacy of vedolizumab versus placebo was compared using fixed-effects models. Regression analyses assessed treatment effects, adjusting for disease location/duration and previous CS use.</p><p><strong>Results: </strong>Overall, 137 patients from GEMINI-1/VISIBLE-1 were included. Patient characteristics were similar across cohorts, although mean disease duration ranged from 6.6 to 9.9 years. Second-line vedolizumab was associated with a higher likelihood of achieving both definitions of clinical remission and all secondary outcomes (CS-free remission, MES ⩽1, and HRQoL) versus placebo. Regression analysis showed that patients treated with vedolizumab were 7.13-11.35 times more likely to achieve clinical remission (both definitions) versus placebo.</p><p><strong>Conclusion: </strong>Second-line vedolizumab after first-line anti-TNF treatment significantly increased the likelihood of achieving clinical remission, MES ⩽1, and improved HRQoL at Week 52 versus placebo in patients with ulcerative colitis. The small sample size, associated limitations, and heterogeneity observed in some outcomes warrant further research to strengthen these findings.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261431467"},"PeriodicalIF":3.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516251","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":"Examining attitudes to intestinal ultrasound in inflammatory bowel disease: a national survey of Australian gastroenterologists.","authors":"Lynna Chen, Leonie Ruddick-Collins, Yoon-Kyo An, Brandon Baraty, Jakob Begun, Ray K Boyapati, Robert V Bryant, Rebecca L Smith, Ashish R Srinivasan","doi":"10.1177/17562848261432538","DOIUrl":"10.1177/17562848261432538","url":null,"abstract":"<p><strong>Introduction: </strong>Intestinal ultrasound (IUS) is a non-invasive, accurate, and increasingly utilized tool for the assessment and monitoring of inflammatory bowel disease (IBD).</p><p><strong>Objectives: </strong>This Australian survey, endorsed by the Gastroenterology Network of Intestinal Ultrasound (GENIUS), aimed to evaluate clinician attitudes toward IUS and identify barriers to its broader national implementation.</p><p><strong>Design: </strong>National cross-sectional observational study.</p><p><strong>Methods: </strong>An online survey was distributed to adult and pediatric gastroenterologists and trainees across Australia, with data collected between September and December 2024.</p><p><strong>Results: </strong>One hundred twenty-two respondents participated, comprising adult (52%), pediatric (25%), and trainee (23%) gastroenterologists, with two-thirds reporting a subspecialty interest in IBD. Nearly all agreed that IUS has clinical utility in Crohn's disease (99%) and ulcerative colitis (96%), with 96% considering IUS standard of care in IBD. Clinical confidence in IUS was high (84%), particularly among IBD specialists (95% vs 73%; <i>p</i> < 0.01), though lower than for colonoscopy (98%) and magnetic resonance enterography (MRE; 97%). IUS was also perceived as more resource-efficient than colonoscopy (96%) and MRE (88%). While 82% of respondents had access to IUS, mainly in an outpatient capacity, availability was lower in non-metropolitan locations. Among clinicians without access, almost all agreed that IUS access would improve IBD care; with scarcity of IUS funding and trained personnel cited as barriers. Almost half of the respondents had completed or were undertaking IUS training, with 40% of remaining respondents interested in future training.</p><p><strong>Conclusion: </strong>Australian gastroenterologists widely support IUS in IBD care. Expanding access to IUS requires renewed focus on service development and training initiatives, particularly in underserved areas, and cost-effectiveness studies to support these efforts.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261432538"},"PeriodicalIF":3.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516244","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":"Quantification of visceral adipose tissue volume predicts both short-term and long-term transmural healing in patients with Crohn's disease receiving Ustekinumab.","authors":"Xiaomin Wu, Cien Fan, Xiaoyu Duan, Zhiyin Feng, Xuehua Li, Minhu Chen, Yu Wang, Qingzhu Zheng, Ren Mao","doi":"10.1177/17562848261424142","DOIUrl":"10.1177/17562848261424142","url":null,"abstract":"<p><strong>Background: </strong>Transmural healing (TH) is an emerging therapeutic target in Crohn's disease (CD). Visceral adipose tissue (VAT) is associated with the prognosis of CD, but few studies investigate the ability of VAT in predicting TH.</p><p><strong>Objectives: </strong>We aimed to quantitatively assess VAT by magnetic resonance enterography (MRE) and evaluate the prediction of baseline VAT volume for TH in CD patients with Ustekinumab (UST) treatment.</p><p><strong>Design: </strong>This is an observational study.</p><p><strong>Methods: </strong>We retrospectively included CD patients receiving UST treatment, with bowel wall thickness (BWT) >3 mm assessed by MRE at baseline. Clinical characteristics, laboratory, endoscopic, and MRE indicators were evaluated at baseline, week 26 (W26), and week 78 (W78) of the therapy. Quantification of VAT volume was assessed by MRE at baseline, and adjusted by body mass index (BMI). The TH was defined as BWT ⩽3 mm without any signs of inflammation at W26 and W78.</p><p><strong>Results: </strong>Sixty-two patients were included in our study. After UST treatment for W26 and W78, 8 (13.1%) and 13 (21.0%) patients achieved TH. Compared with baseline, laboratory indicators such as C-reactive protein and erythrocyte sedimentation rate, simple endoscopic score for CD, and BWT were significantly improved at W26 and W78. We divided patients into the TH and non-TH groups at both W26 and W78, and found that adjusted VAT volume at baseline was significantly lower in the W26-TH and W78-TH groups. Adjusted VAT volume was then categorized into four scores by quartiles, and multivariable analysis showed that baseline VAT score could negatively predict W26-TH (odds ratio (OR) = 0.296, <i>p</i> = 0.018) and W78-TH (OR = 0.419, <i>p</i> = 0.012).</p><p><strong>Conclusion: </strong>Our study demonstrated that baseline VAT was an independent risk factor for predicting both short- and long-term TH in CD patients receiving UST. Patients with lower VAT volume at baseline were more likely to achieve TH after UST treatment.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261424142"},"PeriodicalIF":3.8,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516241","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}