Journal of Crohn's & colitis最新文献

{"title":"Deucravacitinib in patients with inflammatory bowel disease: 12-week efficacy and safety results from 3 randomized phase 2 studies in Crohn's disease and ulcerative colitis.","authors":"Geert D'Haens, Silvio Danese, Remo Panaccione, David T Rubin, Laurent Peyrin-Biroulet, Katsuyoshi Matsuoka, Edward V Loftus, Taku Kobayashi, Walid Elsharkawi, Rosa Miceli, Samia Ahmed, Yi Luo, Andrew Napoli, John Vaile, Quentin Dornic, Aditya Patel, Stefan Schreiber","doi":"10.1093/ecco-jcc/jjaf080","DOIUrl":"10.1093/ecco-jcc/jjaf080","url":null,"abstract":"<p><strong>Background and aims: </strong>Tyrosine kinase 2 is a downstream intracellular mediator of interleukin-23 signaling, which has a key role in the pathogenesis of inflammatory bowel disease. Deucravacitinib is a novel, oral, selective, allosteric tyrosine kinase 2 inhibitor currently approved for the treatment of adults with moderate to severe plaque psoriasis.</p><p><strong>Methods: </strong>Here we describe 3 randomized, double-blind, placebo-controlled phase 2 studies of deucravacitinib in patients with moderately to severely active Crohn's disease (LATTICE-CD [NCT03599622]) or ulcerative colitis (LATTICE-UC [NCT03934216] and IM011-127 [NCT04613518]). Patients were randomized to receive placebo or twice-daily deucravacitinib 3 or 6 mg (LATTICE-CD), 6 mg (LATTICE-UC), or 12 mg (IM011-127) for 12 weeks. Coprimary endpoints for LATTICE-CD were clinical remission and endoscopic response at week 12. The primary endpoint was clinical remission (per modified Mayo score) at week 12 for LATTICE-UC and clinical response (per modified Mayo score) at week 12 for IM011-127.</p><p><strong>Results: </strong>A total of 239 (LATTICE-CD), 131 (LATTICE-UC), and 38 (IM011-127) patients were randomized. The primary endpoints were not met for all 3 studies, which resulted in early study termination for LATTICE-CD and IM011-127. High efficacy rates were observed in placebo groups throughout the studies. In all studies, the safety profile of deucravacitinib was consistent with the known safety profile observed in patients with psoriasis, and no new safety signals were observed.</p><p><strong>Conclusions: </strong>Deucravacitinib at multiple doses did not demonstrate significant clinical benefit vs placebo in moderately to severely active Crohn's disease or ulcerative colitis. Deucravacitinib was safe and well tolerated.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046755","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":"Metabolism and response to stress gene signatures reveal ulcerative colitis heterogeneity and identify patients with increased response to therapy.","authors":"Bryan Linggi, Melissa Filice, Bruno Sangiorgi, Michelle I Smith, Wendy Teft, Vipul Jairath, Christopher Ma, Niels Vande Casteele","doi":"10.1093/ecco-jcc/jjaf092","DOIUrl":"10.1093/ecco-jcc/jjaf092","url":null,"abstract":"<p><strong>Background and aims: </strong>Ulcerative colitis (UC) therapies lead to variable remission and response rates in patients participating in clinical trials, likely due to interindividual target variability, differences in active biological pathways, feedback, and/or resistance mechanisms. Here, we stratified patients into subtypes by characterizing heterogeneity using mucosal biopsy transcriptomics data.</p><p><strong>Methods: </strong>Transcriptomics data from an andecaliximab phase 2/3 study in patients with UC were scored for gene signature enrichment. Eleven Reactome gene sets, moderately correlated with histological disease activity using Robarts Histopathology Index with low correlation to each other, were selected and evaluated in baseline gene expression data of ustekinumab, infliximab, and adalimumab clinical trials in patients with UC.</p><p><strong>Results: </strong>Of 11 gene sets, referred to as \"Metabolism and Response to Stress\" (MARS) signatures, 5 correlated with \"non-disease\" mucosa and 6 with \"disease-related\" mucosa. Clustering baseline andecaliximab samples scored with MARS revealed 3 clusters with low non-disease/high disease-related, high non-disease/low disease-related, or a mixture. Importantly, these clusters did not correlate with patient demographics, clinical characteristics, or disease activity metrics. Clustering baseline data from other clinical trials (anti-interleukin-12/23 and anti-tumor necrosis factor) in patients with UC scored with MARS showed that patients in low non-disease/high disease-related baseline score clusters less likely to achieve treatment response.</p><p><strong>Conclusions: </strong>We identified and evaluated a novel, multi-dimensional signature gene set to characterize previously undefined heterogeneity in patients with UC and identify patients less likely to respond to therapy. This approach offers potential utility to define clinical trial populations, enrich for clinical responders, and identify difficult-to-treat populations for therapeutic development.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251609","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":"ECCO Topical Review on Predictive Models on Inflammatory Bowel Disease Disease Course and Treatment Response.","authors":"Julien Kirchgesner, Bram Verstockt, Michel Adamina, Kristine H Allin, Mariangela Allocca, Arno R Bourgonje, Johan Burisch, Glen Doherty, Parambir S Dulai, Alaa El-Hussuna, Ravi Misra, Nurulamin Noor, Valérie Pittet, Nick Powell, Iago Rodríguez-Lago, Sophie Restellini","doi":"10.1093/ecco-jcc/jjaf073","DOIUrl":"10.1093/ecco-jcc/jjaf073","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) poses a clinical challenge due to its variable progression and treatment response. Despite the development of predictive models, their clinical application remains limited due to validation and methodological inconsistencies. The current topical review examines existing predictive models, assesses their relevance, and discusses the barriers to their clinical implementation.</p><p><strong>Methods: </strong>An expert panel formed by European Crohn's and Colitis Organisation, including gastroenterologists, surgeons, and clinical epidemiologists, reviewed predictive models on IBD disease course and treatment response. Delphi methodology was applied to develop practice position statements. A practice position was set when at least 80% of participants reached agreement on a recommendation.</p><p><strong>Results: </strong>Fourteen practice positions and 2 perspective points were developed, highlighting factors included in models predicting IBD disease course and treatment response identified in the literature and barriers to clinical implementation. The appropriate methodological approaches for model development and validation have been defined, while methodological barriers to tackle have been identified. Perspectives on the inclusion of relevant biomarkers, and flexible study design have been outlined.</p><p><strong>Conclusions: </strong>This topical review offers practice recommendations and guidance for future predictive models on IBD disease course and treatment response including their implementation in clinical practice.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000933","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":"Serum biomarkers of collagen remodeling are associated with intestinal fibrosis and differentiate stenotic from luminal Crohn's disease patients: a pre- and post-resection longitudinal study.","authors":"Anja Poulsen, Marta Sorokina Alexdóttir, Lene Buhl Riis, Pernille Dige Ovesen, Julie Rasmussen, Mads Damsgaard Wewer, Viviane Lin, Ronja M B Lagström, Marwah Al-Sheikh, Emilie Dahl, Annedorte Ries, Martin Pehrsson, Thomai Tsapanou-Katranara, Peter-Martin Krarup, Ismail Gögenur, Florian Rieder, Johan Burisch, Joachim Høg Mortensen, Jakob Benedict Seidelin","doi":"10.1093/ecco-jcc/jjaf085","DOIUrl":"10.1093/ecco-jcc/jjaf085","url":null,"abstract":"<p><strong>Background and aims: </strong>Crohn's disease (CD) is characterized by progressive intestinal transmural damage, including fibrosis and strictures, which impair quality of life and require surgical intervention. No anti-stricture therapies are available, and no accurate biomarkers have been validated allowing prediction of strictures. Collagen fragments synthesis and remodeling show potential as markers of transmural disease activity. This study aimed to evaluate serum collagen markers for their accuracy in differentiating between stenosing and luminal CD and assessing their correlation with histopathology.</p><p><strong>Methods: </strong>Sixty-two patients undergoing resection for stricturing CD and 49 with luminal CD were prospectively included. Extracellular matrix (ECM) markers were quantified using ELISA, and histological assessments of fibrosis and inflammation were performed on full-thickness tissue samples. Clinical outcomes, biomarkers, and histology were analyzed over a 12-month follow-up.</p><p><strong>Results: </strong>Extracellular matrix markers, including PRO-C6, PRO-C3, PRO-C5, C4M, and PRO-C4, distinguished stenosing from luminal CD with and the combination of PRO-C6, PRO-C3, and PRO-C5 achieved the highest discriminative power of (AUC 0.91). Significant changes in levels of the collagen biomarker were observed post-resection. Histological analysis revealed extensive intestinal fibrosis in the submucosa of the stenotic segments, which correlated with PRO-C6 levels. C4M and PRO-C4 positively correlated with neutrophils in the lamina propria. CTX-III correlated negatively with the D'Haens score and neutrophils and mononuclear cells in the lamina propria and in the epithelium.</p><p><strong>Conclusions: </strong>Collagen markers distinguished stenosing from luminal CD, and they correlated with histological fibrosis and chronic inflammation, promising for understanding ECM remodeling. This study highlights the need for extended follow-up to assess long-term stenosis-related outcomes.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113149","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":"Subcutaneous infliximab (CT-P13 SC) as maintenance therapy for Crohn's disease and ulcerative colitis: 2-year results from open-label extensions of two randomized controlled trials (LIBERTY).","authors":"Jean-Frederic Colombel, William J Sandborn, Stefan Schreiber, Silvio Danese, Maria Kłopocka, Jarosław Kierkuś, Roman Kulynych, Maciej Gonciarz, Artur Sołtysiak, Patryk Smoliński, Slobodan Srećković, Ekaterina Valuyskikh, Adi Lahat, Marek Horyński, Antonio Gasbarrini, Marina Osipenko, Vladimir Borzan, Maciej Kowalski, Daria Saenko, Ruslan Sardinov, Sang Joon Lee, Sunghyun Kim, Yunju Bae, Sunhee Lee, Seulgi Lee, Joon Ho Lee, Jong Min Kim, Gahee Park, Jimin Lee, Juhyun Lee, Jae Yeoul Ryu, Bruce E Sands, Stephen B Hanauer","doi":"10.1093/ecco-jcc/jjaf060","DOIUrl":"10.1093/ecco-jcc/jjaf060","url":null,"abstract":"<p><strong>Background and aims: </strong>In the LIBERTY phase 3 studies in Crohn's disease (CD) or ulcerative colitis (UC), maintenance CT-P13 subcutaneous (SC) 120 mg was more effective than placebo after 1 year. Here we report 2-year data from the LIBERTY open-label extensions.</p><p><strong>Methods: </strong>Two randomized, placebo-controlled, double-blind studies evaluated the efficacy and safety of CT-P13 SC maintenance in moderate-to-severe CD or UC. Responders to CT-P13 intravenous induction were randomized at week (W) 10 to CT-P13 SC 120 mg or placebo biweekly, until W54. From W22, dose adjustment to CT-P13 SC 240 mg was permitted for loss of response. At W56, patients could enter an open-label extension, receiving CT-P13 SC 120 mg (or 240 mg if dose-adjusted), biweekly, until W102.</p><p><strong>Results: </strong>The extension comprised 278/343 (81.0%) and 348/438 (79.5%) patients in the CD and UC studies, respectively. In those continuing on-study, efficacy (non-responder imputation) was well maintained in the CT-P13 SC group at W102: 63.5% (as-observed: 70.5%) and 49.0% (as-observed: 58.8%) of CD patients (N = 192) achieved clinical remission and endoscopic response, respectively; 45.1% (as-observed: 60.1%) and 41.4% (as-observed: 52.4%) of UC patients (N = 237) achieved clinical remission and endoscopic-histologic mucosal improvement, respectively. No new safety signals were identified from longer-term CT-P13 SC treatment or starting CT-P13 SC 120 mg after placebo, with similar adverse event rates for patients undergoing dose adjustment to CT-P13 SC 240 mg from CT-P13 SC 120 mg or placebo.</p><p><strong>Conclusion: </strong>CT-P13 SC is an effective and well-tolerated long-term maintenance treatment in moderate-to-severe CD and UC.</p><p><strong>Clinicaltrials.gov identifiers: </strong>NCT03945019 (CD) and NCT04205643 (UC).</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061265","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":"The angiotensin receptor blocker, losartan, reduces inflammation and fibrosis, and prevents relapse of fibrosis after steroid-induced remission, in mice prone to Crohn's disease-like ileitis.","authors":"Serena Artone, Shuvra Ray, Joseph J Williams, Kenan Akbulut, Paul Cordero, Ana M Gómez-Úriz, Hannah R Friedman, Anna V Saline, Isabel M Hart, Elakia Vadivelan, Tommaso L Parigi, Davide Pietropaoli, Giovanni Latella, Jeremy D Sanderson, Carlo De Salvo, Jude A Oben, Theresa T Pizarro, Stefania De Santis","doi":"10.1093/ecco-jcc/jjaf083","DOIUrl":"10.1093/ecco-jcc/jjaf083","url":null,"abstract":"<p><strong>Background and aims: </strong>The renin-angiotensin system (RAS) is known to modulate fibrosis, which is a common complication of ileal Crohn's disease. We tested the efficacy of losartan, an angiotensin receptor blocker, to treat intestinal fibrosis in relevant preclinical models of Crohn's-like disease.</p><p><strong>Methods: </strong>Effector molecules of the RAS were mined in a large publicly available RNA-Seq dataset of intestinal biopsies from Crohn's patients and healthy individuals, and the presence of associated proteins was confirmed by immunohistochemistry in full-thickness intestinal tissues. Losartan's efficacy in altering mediators of the RAS and of fibrosis was tested in vitro using activated CCD-18Co fibroblasts, while its in vivo effects were investigated by administering losartan to SAMP1/YitFc (SAMP) mice, a well-described model of Crohn's-like disease that progressively develops both ileal-specific inflammation and fibrosis, using either therapeutic or maintenance of remission (treatment after dexamethasone) approaches.</p><p><strong>Results: </strong>Angiotensinogen, an upstream regulator of the RAS, and the downstream effector, angiotensin II receptor type 1, expressed on target cells, are both increased in involved vs non-involved gut mucosa from Crohn's patients compared to healthy controls. In vitro, losartan suppresses the expression of molecules related to fibrosis, fibroblast-to-myofibroblast differentiation, collagen deposition, and cytoskeletal alterations. In vivo, losartan decreases both inflammation and fibrosis in SAMP mice with established disease, and prevents the reoccurrence of fibrosis following a novel relapse protocol.</p><p><strong>Conclusions: </strong>Losartan, and other drugs targeting the RAS, may serve as an effective treatment to successfully dampen intestinal fibrosis during active inflammation, as well as prevent its progression after corticosteroid-induced remission in Crohn's patients.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102006","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":"Therapeutic potential of Janus kinase inhibitors for the management of fibrosis in inflammatory bowel disease.","authors":"Jie Su, Dalia A Lartey, Gaia Zanella, Lukas J A C Hawinkels, Gianluca Matteoli, Mark Löwenberg, Marieke C Barnhoorn","doi":"10.1093/ecco-jcc/jjaf087","DOIUrl":"10.1093/ecco-jcc/jjaf087","url":null,"abstract":"<p><p>Intestinal fibrosis in inflammatory bowel disease (IBD) is caused by uncontrolled accumulation of extracellular matrix deposited by fibroblasts. This may result in stricture formation, especially in Crohn's disease. Since there are no anti-fibrotic drugs available, endoscopic or surgical interventions are the only options to treat intestinal strictures. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway plays a crucial role in intestinal homeostasis and inflammation. JAK inhibition represents a relatively novel therapeutic strategy in IBD by simultaneously blocking multiple cytokines across various inflammatory pathways. Interestingly, JAK inhibitors extend their benefits beyond anti-inflammatory effects, as they have been shown to interfere with fibrotic processes in various diseases, including IBD. We here summarize the current understanding of the role of the JAK-STAT pathway in the pathogenesis of intestinal fibrosis and the application of JAK inhibitors for IBD. In addition, we discuss the use of JAK inhibitors in other fibrotic-related diseases to postulate how these agents might be applied for future treatment of intestinal fibrosis.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136581","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":"A multicenter study of the real-world effectiveness and safety of risankizumab in Crohn's disease.","authors":"Amanda M Johnson, Manar Askar, Seema Belani, Abdul Khan, Anthony A Xu, Blake Kassmeyer, Hyder Said, Michael Santiago-Castro, Jalpa Devi, Katherine Huang, Fnu Jaiprada, Nickhil Seth, David Dulaney, Edward V Loftus, Marc Fenster, Anish Patel, Shrinivas Bishu, Ryan C Ungaro, Richa Shukla, Andres J Yarur, Parakkal Deepak","doi":"10.1093/ecco-jcc/jjaf070","DOIUrl":"10.1093/ecco-jcc/jjaf070","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the effectiveness and safety of risankizumab (RZB) for Crohn's disease (CD) in routine clinical practice.</p><p><strong>Methods: </strong>We performed a retrospective review of a multicenter consortium of CD patients treated with RZB. Co-primary outcomes were week 12 clinical remission (Harvey Bradshaw Index [HBI] score of ≤4 or physician global assessment in those without HBI or with ileostomy) and 6-month endoscopic remission (Simplified Endoscopic Mucosal Assessment for Crohn's Disease of 0-1 or absence of ulcers). Secondary outcomes included steroid-free clinical remission, clinical response, radiographic response, cumulative clinical and endoscopic remission rates at 6 and 12 months, and adverse events.</p><p><strong>Results: </strong>A total of 309 patients were included (median disease duration 14 years [IQR, 6-24]; median follow-up 7.1 months [IQR, 4.1-10.3]). Most patients (85.8%) were advanced therapy (AT)-exposed, and 169 (54.7%) had prior ustekinumab (UST) exposure. Week 12 clinical remission rates were 49.7% (98/197) overall, and 44.2% (50/113) vs 57.1% (48/84) in UST-exposed vs naïve patients (P = .073). Among those with active disease on baseline endoscopy (n = 122) who had an available follow-up at 6 months, 52.4% (22/42) achieved endoscopic remission. Cumulative rates of clinical and endoscopic remission at 12 months were 65.0% and 49.5%, respectively. Cumulative 12-month endoscopic remission was 33.9% (19/56) in UST-exposed and 68.1% (32/47) in UST-naïve patients (P < .001). Risankizumab was well-tolerated with no new safety signals identified.</p><p><strong>Conclusions: </strong>In this large multicenter cohort of patients with CD, RZB was well-tolerated and effective in achieving favorable clinical and endoscopic outcomes in both AT-exposed and naïve populations, including those with exposure to UST.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012173","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":"Clinical Outcomes After First-Line Anti- Tumor-Necrosis-Factor Treatment of Patients With Inflammatory Bowel Disease-A Prospective Multicenter Cohort Study.","authors":"Mirabella Zhao, Lone Larsen, Anders Dige, Anja Poulsen, Bobby Lo, Mohamed Attauabi, Pernille Dige Ovesen, Mads Damsgaard Wewer, Dagmar Christiansen, Christian Lodberg Hvas, Andreas Munk Petersen, Flemming Bendtsen, Jakob Seidelin, Johan Burisch","doi":"10.1093/ecco-jcc/jjae192","DOIUrl":"10.1093/ecco-jcc/jjae192","url":null,"abstract":"<p><strong>Background and aims: </strong>Existing findings on outcomes of anti-tumor-necrosis-factor (TNF) therapy in patients with inflammatory bowel diseases (IBD) are largely based on retrospective studies. We aimed to investigate real-world outcomes of anti-TNF therapy and predictors thereof in a prospective IBD cohort.</p><p><strong>Methods: </strong>In a Danish multicenter cohort of adult bio-naïve patients with IBD treated with anti-TNF, we assessed clinical response and remission to induction therapy using clinical disease activity scoring indices at Week 14. In patients who continued treatment beyond the induction period, we also assessed loss of response (LOR), drug withdrawal, and major IBD surgery during maintenance therapy.</p><p><strong>Results: </strong>This study included 774 patients (706 infliximab, 68 adalimumab) followed for a median duration of 125 weeks Clinical response was achieved in 209/331 (67.4%) of ulcerative colitis (UC) and 125/197 (74.0%) of Crohn's disease (CD) patients, while 143/331 (46.1%) UC and 81/197 (47.9%) CD patients achieved clinical remission. In 294 UC and 309 CD patients received maintenance therapy, while 86/294 (29.3%) UC and 78/309 (25.2%) CD patients experienced LOR. Active smoking and less severe disease activity predicted favorable outcomes in UC, while short disease duration, colonic disease, nonstricturing behavior, and concomitant immunomodulator therapy predicted favorable outcomes in CD.</p><p><strong>Conclusions: </strong>Clinical response was achieved in 2 in 3 UC and 3 in 4 CD patients, meanwhile, one-third of UC and one-fourth of CD patients experienced LOR despite the short disease duration in this study. Several clinical features were associated with outcomes and may be useful predictors of anti-TNF treatment response.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866280","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":"Partial Enteral Nutrition in the Management of Crohn's Disease: A Systematic Review and Meta-Analysis.","authors":"Aleksandra Jatkowska, Bernadette White, Konstantinos Gkikas, John Paul Seenan, Jonathan MacDonald, Konstantinos Gerasimidis","doi":"10.1093/ecco-jcc/jjae177","DOIUrl":"10.1093/ecco-jcc/jjae177","url":null,"abstract":"<p><strong>Background: </strong>Exclusive enteral nutrition is an established treatment for active Crohn's disease but the role of partial enteral nutrition (PEN) in the broader management of the disease is less clear. This systematic review and meta-analysis reviewed the literature on the role of PEN in Crohn's disease management.</p><p><strong>Methods: </strong>This review was conducted following Cochrane recommendations. The protocol was registered on PROSPERO. Findings were reported following the PRISMA guidelines.</p><p><strong>Results: </strong>Sixty-four articles were identified, of which 11 reported data from randomized control trials. Good quality evidence suggests that PEN may be used as a maintenance and induction therapy, particularly at high dosages and/or alongside exclusion diets. A higher dosage of PEN is associated with a lower risk of subsequent disease relapse, with benefits observed at intakes above 35% of energy requirements (35%-50% PEN: OR [95% confidence intervals (CI)]: 0.42 [0.27-0.65]; > 50% PEN: OR [95% CI]: 0.27 [0.08-0.88]). Low-quality evidence suggests that postoperative use of PEN may prevent disease recurrence or enhance treatment outcomes when used as adjunct therapy to biologics. PEN can improve nutritional parameters, showing efficacy comparable to EEN in pediatric patients (weight: OR [95% CI]: -0.04 [-0.32, 0.25]). The effect of PEN on improving patients' quality of life is comparable to that of EEN and anti-tumor necrosis factor alpha therapies.</p><p><strong>Conclusions: </strong>Partial enteral nutrition may help in various aspects of Crohn's disease management but much of the current evidence is of low quality. Well-designed randomized control trials are required to confirm findings from current literature and before clinical recommendations can be made.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684000","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}