Journal of Crohn's & colitis最新文献

{"title":"Independent Predictors of 90-Day Readmission in Patients with Inflammatory Bowel Disease: A Nationwide Retrospective Study.","authors":"Bryce Kunkle, Harjit Singh, Danielle Abraham, Nikiya Asamoah, Jasmine Barrow, Mark Mattar","doi":"10.1093/ecco-jcc/jjaf034","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf034","url":null,"abstract":"<p><strong>Background and aims: </strong>There is a paucity of literature that comprehensively investigates risk factors for inflammatory bowel disease (IBD) readmissions on a national scale. In this study, we look to identify independent risk factors for readmission, including psychosocial factors, in patients admitted with a primary diagnosis of Ulcerative colitis (UC) or Crohn's disease (CD).</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from the Nationwide Readmissions Database (NRD). We identified cohorts of adult patients (n=28,473) who required inpatient admission for UC or CD in the US in the year 2020. Multivariate logistic regression models controlling for confounding variables were used to identify independent predictors of 90-day readmission.</p><p><strong>Results: </strong>Patients were identified who required hospitalization for UC (n=11,476) and CD (n=16,997). In patients with UC, younger age, male sex, and transfusion requirement during index hospitalization were all independently predictive of increased 90-day readmission (all p < .05). Psychosocial factors predictive of readmission include alcohol use disorder, drug abuse, and poverty (all p < .05). In patients with CD, younger age and chronic pain were both predictive of increased readmissions (all p < .05). Psychosocial factors predictive of readmission include lower income quartile, uninsured status, depression, drug abuse, nicotine dependence, and opioid use disorder (all p < .05).</p><p><strong>Conclusions: </strong>This study identifies several risk factors for readmission in patients with IBD, many of which are potentially modifiable psychosocial factors. Closer follow-up, possibly via virtual modalities, as well as alternative treatment strategies, should be considered in patients with IBD at higher risk of readmission.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560492","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":"Intestinal Ultrasound as a Prognostic Tool in New-Onset Ulcerative Colitis - A Copenhagen IBD Cohort Study.","authors":"Gorm Roager Madsen, Rune Wilkens, Mohamed Attauabi, Johan F K F Ilvemark, Klaus Theede, Jacob Tveiten Bjerrum, Flemming Bendtsen, Jakob Benedict Seidelin, Trine Boysen, Johan Burisch","doi":"10.1093/ecco-jcc/jjaf033","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf033","url":null,"abstract":"<p><strong>Background and aims: </strong>This study assesses the prognostic role of intestinal ultrasound (IUS) in determining the disease course of ulcerative colitis (UC) in the first year after diagnosis.</p><p><strong>Methods: </strong>A prospective, multicenter population-based inception-cohort study was conducted on patients newly diagnosed with UC. Patients with left-sided or extensive UC underwent IUS assessments at diagnosis, three months, and 12 months, alongside symptomatic, biochemical, and endoscopic evaluations. Transmural remission was defined as bowel wall thickness ≤ 3 mm without color Doppler signal in all segments.</p><p><strong>Results: </strong>From May 2021 to April 2023, 193 patients with left-sided or extensive UC were included. Inflammatory findings on IUS at diagnosis were associated with symptomatic, biochemical, and endoscopic markers of inflammation, but not with diagnostic delay. IUS-detected inflammation at diagnosis was an independent predictor for colectomy within the first three months, with bowel wall thickness > 6 mm as the optimal cut-off (OR 38, 95% CI 8-270, p<0.0001). Three months after diagnosis, 59% of patients achieved transmural remission, which was associated with higher rates of steroid-free clinical remission in all subsequent follow-ups, as well as a reduced need for steroids during follow-up (6% vs. 19%, p=0.036). Furthermore, transmural remission at three months increased the likelihood of steroid-free clinical remission, as well as transmural and complete remission, at 12 months.</p><p><strong>Conclusions: </strong>Findings by intestinal ultrasound at the time of diagnosis predict early colectomy risk in UC. Our results underscore that transmural remission is a feasible treatment target in early UC, and significantly impacts the disease course.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558437","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":"Uncovering the therapeutic potential of anti-tuberculoid agent Isoniazid in a model of microbial-driven Crohn's Disease.","authors":"Matthew Stephens, Keith Keane, Simon Roizes, Manon Defaye, Christophe Altier, Pierre-Yves von der Weid","doi":"10.1093/ecco-jcc/jjaf032","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf032","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;TNFα has long stood as a hallmark feature of both inflammatory bowel disease (IBD) and arthritis with its therapeutic potential demonstrated in neutralizing monoclonal antibody treatments such as Infliximab. Due to the high global burden of latent Mycobacterium tuberculosis (TB) infections, prior to receiving anti-TNF therapy, patients testing positive for latent TB are given prophylactic treatment with anti-tuberculoid medications including the first described TB-selective antibiotic, Isoniazid. While this is common clinical practice to prevent the emergence of TB, little is known about whether Isoniazid modifies intestinal inflammation alone. The aim of this study therefore, was to determine whether Isoniazid presents a novel TB-independent therapeutic option for the treatment of CD-like ileitis and uncover new mechanisms predisposing the host to intestinal inflammation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The transgenic TNFΔARE mouse model of Crohn's-like terminal ileitis was used. The impact of Isoniazid administration (10mg/kg/day dosed in drinking water) on disease development was monitored between 8 and 12 weeks of age using a variety of behavioural and serological assays. Behavioural and motor functions were assessed using the LABORAS automated monitoring system while systemic and local tissue inflammation were determined at experimental termination using multiplex cytokine analysis. Whole mount tissue immunofluorescence and fluorescent in situ hybridization (FISH) was used to qualify changes within the host as well as the microbial compartment of the ileum and associated mesentery. Proposed cellular mechanisms of altered cytokine decay were performed on isolated primary splenocytes in vitro using selective pharmacological agents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to age-matched WT littermates, TNFΔARE mice display prominent progressive sickness behaviours from 8 through 12 weeks of age indicated by reduced movement, climbing, and rearing. Prophylactic administration of Isoniazid (10mg/kg/day) is effectively able to protect TNFΔARE mice from this loss of function during the same period. Analysis revealed that Isoniazid was able to significantly reduce both systemic and intestinal inflammation compared to untreated vehicle controls impacting the epithelial colonization of known pathobiont segmented filamentous bacteria (SFB). Reduction in terminal ileal inflammation was also associated to the diminished formation of precursor-tertiary lymphoid organs within the associated ileal mesentery which were found to be associated with endospores derived SFB itself. Finally, we reveal that due to their genetic manipulation, TNFΔARE mice display accelerated post-transcriptional decay of IL-22 mRNA resulting in diminished IL-22 protein production and associated downstream antimicrobial peptide production.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Isoniazid protects against the development of intestinal and systemic inflammation ","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477174","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":"The ulcerative colitis risk gene adenylyl cyclase 7 restrains the T helper 2 phenotype and Class II antigen presentation.","authors":"Christopher J Cardinale, Yichuan Liu, Aayush Kevadia, Alanna Strong, Val J Watts, Hakon Hakonarson","doi":"10.1093/ecco-jcc/jjaf030","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf030","url":null,"abstract":"<p><strong>Background and aims: </strong>Genome-wide association studies have shown that the most risk-conferring genetic polymorphism for ulcerative colitis outside the human leukocyte antigen locus is the amino acid substitution p.Asp439Glu in the adenylyl cyclase 7 gene (ADCY7). ADCY7 is the main isoform in the hematopoietic system and produces the second messenger cyclic AMP (cAMP) downstream of G protein-coupled receptor signaling. Our aim was to determine the contribution of this polymorphism to UC risk by analyzing its effect on ADCY7 function in cell-based assays.</p><p><strong>Methods: </strong>We characterized the p.Asp439Glu variant in cell lines using western blots, immunofluorescence, cAMP assay, and luciferase assay. We modeled this variant using siRNA knock-down in human primary CD4+ T cells and characterized them by RNA-seq, viability assay, flow cytometry, cAMP assay, and ELISA.</p><p><strong>Results: </strong>The p.Asp439Glu variant is deficient in protein expression but retains membrane localization. This results in a 40% reduction in cAMP synthesis and luciferase reporter expression. Knock-down of ADCY7 in T cells reduces the expression of ribosomal proteins and cAMP signaling proteins, while skewing cytokine production towards a T helper 2 pattern and upregulating antigen presentation accompanied by increased surface expression of MHC Class II and CD86.</p><p><strong>Conclusions: </strong>The ulcerative colitis risk-conferring variant, p.Asp439Glu, in ADCY7 reduces cyclic AMP signaling, leading to modifications in cytokine profile and antigen presentation. Medications that enhance cyclic AMP by direct activation of ADCY7 or by phosphodiesterase inhibition may be beneficial in this disease.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434658","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":"Differences in the Adverse Event Burden of Corticosteroid Use in Inflammatory Bowel Disease as Reported Between Adverse Event Reporting Systems and a Patient Questionnaire.","authors":"Eman Al Sulais, Edouard Louis, Bernd Bokemeyer, Krisztina B Gecse, Gareth C Parkes, Miles Parkes, Christian Selinger, Melvin Munsaka, Meng Liu, James Crooks, Tricia Finney-Hayward, Tim Raine","doi":"10.1093/ecco-jcc/jjae138","DOIUrl":"10.1093/ecco-jcc/jjae138","url":null,"abstract":"<p><strong>Background and aims: </strong>Corticosteroids are widely used in managing inflammatory bowel disease (IBD). While adverse events (AEs) of corticosteroids are well recognized, current understanding of corticosteroid-related AE burden in IBD remains incomplete.</p><p><strong>Methods: </strong>AE reports for prednisone/prednisolone and budesonide were extracted from the Food and Drug Administration Adverse Event Reporting System (FAERS) and VigiBase databases. Total and frequently reported AEs were tabulated, and AEs of special interest were compared with reports for all drugs using proportional reporting ratio criteria. Database reports were compared with AEs reported in a patient survey capturing corticosteroid exposure and AE recall.</p><p><strong>Results: </strong>In FAERS and VigiBase, 344 140 and 42 836 AEs were reported, respectively, in patients with IBD; among these, 10 157 (3.0%) and 11 391 (26.6%), respectively, were related to prednisone/prednisolone or budesonide. AEs associated with corticosteroid use in IBD increased over time. Adrenal insufficiency, Cushingoid complications, osteonecrosis, osteoporosis, diabetes, and pancreatitis were disproportionately reported for corticosteroids. Among 9229 patients who responded to the survey, 6434 (69.7%) reported corticosteroid exposure. AEs were more frequently recalled by patients exposed to prednisone (61.9%) vs budesonide (27.4%; p = 0.0001). The most commonly recalled AEs differed from those reported in the pharmacovigilance databases and included weight gain, sleep problems, mood disturbance, and skin changes. Younger patients and those with mental health disorders were more likely to recall suicidal thoughts/attempts.</p><p><strong>Conclusions: </strong>Adverse events associated with IBD-related corticosteroid use were frequent. Patients reported AEs affecting quality of life, while clinicians disproportionately reported AEs based on objective diagnostic criteria.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147096","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":"Dynamics of Gut Microbiota After Fecal Microbiota Transplantation in Ulcerative Colitis: Success Linked to Control of Prevotellaceae.","authors":"Susanne Pinto, Dominika Šajbenová, Elisa Benincà, Sam Nooij, Elisabeth M Terveer, Josbert J Keller, Andrea E van der Meulen-de Jong, Johannes A Bogaards, Ewout W Steyerberg","doi":"10.1093/ecco-jcc/jjae137","DOIUrl":"10.1093/ecco-jcc/jjae137","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota transplantation (FMT) is an experimental treatment for ulcerative colitis (UC). We aimed to study microbial families associated with FMT treatment success.</p><p><strong>Methods: </strong>We analyzed stools from 24 UC patients treated with 4 FMTs weekly after randomization for pretreatment during 3 weeks with budesonide (n = 12) or placebo (n = 12). Stool samples were collected 9 times pre-, during, and post-FMT. Clinical and endoscopic response was assessed 14 weeks after initiation of the study using the full Mayo score. Early withdrawal due to worsening of UC symptoms was classified as non-response.</p><p><strong>Results: </strong>Nine patients (38%) reached remission at week 14, and 15 patients had a partial response or non-response at or before week 14. With a Dirichlet multinomial mixture model, we identified 5 distinct clusters based on the microbiota composition of 180 longitudinally collected patient samples and 27 donor samples. A Prevotellaceae-dominant cluster was associated with poor response to FMT treatment. Conversely, the families Ruminococcaceae and Lachnospiraceae were associated with a successful clinical response. These associations were already visible at the start of the treatment for a subgroup of patients and were retained in repeated measures analyses of family-specific abundance over time. Responders were also characterized by a significantly lower Simpson dominance compared to non-responders.</p><p><strong>Conclusions: </strong>The success of FMT treatment of UC patients appears to be associated with specific gut microbiota families, such as control of Prevotellaceae. Monitoring the dynamics of these microbial families could potentially be used to inform treatment success early during FMT.</p><p><strong>Clinical trial registration number: </strong>The study was registered in the Netherlands Trial Register, with reference number NL9858.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121355","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":"Machine learning and metabolomics identify biomarkers associated with the disease extent of ulcerative colitis.","authors":"Changchang Ge, Yi Lu, Zhaofeng Shen, Yizhou Lu, Xiaojuan Liu, Mengyuan Zhang, Yijing Liu, Hong Shen, Lei Zhu","doi":"10.1093/ecco-jcc/jjaf020","DOIUrl":"10.1093/ecco-jcc/jjaf020","url":null,"abstract":"<p><strong>Background and aims: </strong>Ulcerative colitis (UC) is a metabolism-related chronic intestinal inflammatory disease. Disease extent is a key parameter of UC. Using serum metabolic profiling to identify noninvasive biomarkers of disease extent may inform therapeutic decisions and risk stratification.</p><p><strong>Methods: </strong>The orthogonal partial least squares-discriminant analysis (OPLS-DA) was performed to identify the metabolites. Least absolute shrinkage and selection operator regression, random forest-recursive feature elimination, and support vector machine-recursive feature elimination algorithms were used to screen metabolites. Five machine learning algorithms (eXtreme Gradient Boosting, K-NearestNeighbor, Naive Bayes, random forest [RF], and SVM) were used to construct the prediction model.</p><p><strong>Results: </strong>A total of 220 differential metabolites between the patients with UC and healthy controls (HCs) were confirmed by the OPLS-DA model. Machine learning screened 8 essential metabolites for distinguishing patients with UC from HCs. A total of 23, 6, and 6 differential metabolites were obtained through machine learning between groups E1 and E2, E1 and E3, and E2 and E3. The RF model had a prediction accuracy of up to 100% in all 3 training sets. The serum levels of tridecanoic acid were significantly lower, and pelargonic acid was significantly higher in patients with extensive colitis than in the other groups. The serum level of asparaginyl valine in patients with rectal UC was significantly lower than that in the E2 and E3 groups.</p><p><strong>Conclusions: </strong>Our findings revealed the metabolic landscape of UC and identified biomarkers for different disease extents, confirming the value of metabolites in predicting the occurrence and progression of UC.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191560","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":"Open Label Vancomycin in Primary Sclerosing Cholangitis-Inflammatory Bowel Disease: Improved Colonic Disease Activity and Associations With Changes in Host-Microbiome-Metabolomic Signatures.","authors":"Mohammed Nabil Quraishi, Jonathan Cheesbrough, Peter Rimmer, Benjamin H Mullish, Naveen Sharma, Elena Efstathiou, Animesh Acharjee, Georgios Gkoutus, Arzoo Patel, Julian R Marchesi, Stephane Camuzeaux, Katie Chappell, Maria A Valdivia-Garcia, James Ferguson, Matthew J Brookes, Martine Walmsley, Amanda E Rossiter, Willem van Schaik, Ross S McInnes, Rachel Cooney, Michael Trauner, Andrew D Beggs, Tariq H Iqbal, Palak J Trivedi","doi":"10.1093/ecco-jcc/jjae189","DOIUrl":"10.1093/ecco-jcc/jjae189","url":null,"abstract":"<p><strong>Background: </strong>We conducted a single-arm interventional study, to explore mucosal changes associated with clinical remission under oral vancomycin (OV) treatment, in primary sclerosing cholangitis-associated inflammatory bowel disease (PSC-IBD); NCT05376228.</p><p><strong>Methods: </strong>Fifteen patients with PSC and active colitis (median fecal calprotectin 459 µg/g; median total Mayo score 5) were treated with OV (125 mg QID) for 4 weeks and followed-up for a further 4 weeks of treatment withdrawal (8 weeks, end-of-study). Colonic biopsies were obtained at baseline and Week 4. Clinical assessments, and serum and stool samples (metagenomics, metatranscriptomics, and metabolomics) were collected at Weeks 0, 2, 4, and 8. The primary efficacy outcome measure was the induction of clinical remission.</p><p><strong>Results: </strong>Oral vancomycin resulted in clinical remission in 12/15 patients and significant reductions in fecal calprotectin. Oral vancomycin was associated with reduced abundances of Lachnospiraceae, genera Blautia and Bacteroides; and enrichment of Enterobacteriaceae, and genera Veillonella, Akkermansia, and Escherichia. Oral vancomycin treatment was associated with the downregulation of multiple metatranscriptomic pathways (including short-chain fatty acid [SCFA] metabolism and bile acid [BA] biotransformation), along with host genes and multiple pathways involved in inflammatory responses and antimicrobial defence; and an upregulation of genes associated with extracellular matrix repair. Oral vancomycin use resulted in the loss of specific fecal SCFAs and secondary BAs, including lithocholic acid derivatives. Colitis activity relapsed following OV withdrawal, with host mucosal and microbial changes trending toward baseline.</p><p><strong>Conclusions: </strong>Four weeks of OV induces remission in PSC-IBD activity, associated with a reduction in gut bacterial diversity and compositional changes relating to BA and SCFA homeostasis.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824982","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":"Peripheral Blood Eosinophilia at Diagnosis of Inflammatory Bowel Disease Is Associated With Severe Disease Course: A Nationwide Study From the epi-IIRN Cohort.","authors":"Anat Yerushalmy-Feler, Rona Lujan, Yiska Loewenberg Weisband, Shira Greenfeld, Amir Ben-Tov, Natan Ledderman, Eran Matz, Iris Dotan, Raffi Lev-Tzion, Idan Goren, Dan Turner, Shlomi Cohen","doi":"10.1093/ecco-jcc/jjae130","DOIUrl":"10.1093/ecco-jcc/jjae130","url":null,"abstract":"<p><strong>Background and aims: </strong>We conducted this nationwide study to evaluate the association between peripheral blood eosinophilia (PBE) and long-term outcomes in children and adults with inflammatory bowel diseases (IBDs).</p><p><strong>Methods: </strong>Data from the Epidemiology Group of the Israeli IBD Research Nucleus (epi-IIRN) cohort, a validated population-based IBD database, included patients diagnosed between 2005 and 2020, who had an eosinophil count recorded at diagnosis, and non-IBD controls. PBE was defined as an eosinophil count of >0.5 × 109/L. Severe disease course was defined as corticosteroid dependency, use of ≥2 biologics from different classes, or surgery. Time-to-outcomes, including severe disease course, was determined by Cox proportional hazard models.</p><p><strong>Results: </strong>This study included 28 133 patients (15 943 Crohn's disease [CD] and 12 190 ulcerative colitis [UC]) and 28 724 non-IBD controls. The prevalence of PBE was 13% in the IBD group and 5% in the control group (p < 0.001). PBE was more prevalent in UC (16.1%) compared to CD (10.6%, odds ratio [OR] = 1.52, 95% confidence interval [CI], 1.42-1.63; p < 0.001) and in pediatric-onset (23.5%) compared to adult-onset (11%) IBD (OR = 2.14, 95% CI, 1.97-2.31; p < 0.001). In a multivariate analysis, PBE was a predictor of severe disease course in IBD (hazard ratio [HR] = 1.49, 95% CI, 1.38-1.62, p < 0.001). PBE also predicted time-to-hospitalization (HR = 1.24, 95% CI, 1.19-1.30), use of corticosteroids (HR = 1.32, 95% CI, 1.28-1.36), corticosteroid dependency (HR = 1.37, 95% CI, 1.31-1.43), and need for biologics (HR = 1.27, 95% CI, 1.21-1.33).</p><p><strong>Conclusions: </strong>In this largest nationwide study, PBE predicted severe IBD course. These findings support the use of PBE as a marker of adverse outcomes of IBD and as a potential target for future therapies.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038096","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":"Childhood-onset inflammatory bowel disease and chronic non-bacterial osteomyelitis: a Swedish nationwide cohort study 2002-2022.","authors":"Marianne Malmquist, Siri Voghera, Stefan Berg, Robert Saalman, Ola Olén","doi":"10.1093/ecco-jcc/jjaf007","DOIUrl":"10.1093/ecco-jcc/jjaf007","url":null,"abstract":"<p><strong>Background and aims: </strong>Nationwide, population-based studies of chronic non-bacterial osteomyelitis (CNO) in patients with childhood-onset inflammatory bowel disease (IBD) are lacking.</p><p><strong>Methods: </strong>We used nationwide registers to identify all children in Sweden diagnosed with IBD during 2002-2022 and the occurrence of CNO in this IBD cohort and general population non-IBD comparators. To estimate the temporal associations between IBD and CNO we used Cox regression. We compared clinical data for IBD patients with CNO (IBD+CNO) and the IBD patients without CNO.</p><p><strong>Results: </strong>We identified 8244 children with IBD and 82 400 non-IBD comparators. At IBD diagnosis, CNO had been diagnosed in 0.13% (11/8244) of the IBD cohort and 0.03% (26/82 400) of the non-IBD comparators. During follow-up, 13 additional CNO cases occurred in the IBD cohort and 22 in the non-IBD comparators (adjusted hazard ratio = 5.87 [95% CI 2.95-11.66]). The prevalence of CNO among all prevalent children with IBD and prevalent matched non-IBD comparators December 31, 2022 was 0.48% (9/1885) and 0.02% (4/18 567), respectively. Median age at IBD diagnosis was lower in IBD + CNO compared to IBD without CNO (11 vs 14 years [-3 years, 95% CI -5 to -1]). Extraintestinal manifestations (except CNO) were more frequent in IBD + CNO (62% vs 21%, P < .0001). Treatment with biologics was more common in the IBD + CNO group (78% vs 44%, P = .004), prescribed for IBD and/or CNO.</p><p><strong>Conclusions: </strong>We found a 6-fold increased risk of CNO in childhood-onset IBD compared to non-IBD comparators. Patients with IBD + CNO are characterized by younger age at IBD onset, more frequent extraintestinal manifestations, and higher usage of biologics.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981085","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}