Journal of Crohn's & colitis最新文献

{"title":"Correction to: Fidaxomicin for Clostridioides difficile infection in patients with inflammatory bowel disease: a multicenter retrospective cohort study.","authors":"","doi":"10.1093/ecco-jcc/jjaf123","DOIUrl":"10.1093/ecco-jcc/jjaf123","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"19 8","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093336","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":"Repurposing losartan for fibrostenosing Crohn's disease: a compelling preclinical rationale.","authors":"Luca Massimino, Virginia Solitano, Federica Ungaro","doi":"10.1093/ecco-jcc/jjaf147","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf147","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"19 8","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133196","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":"Impact of concomitant corticosteroid use on adverse events in ulcerative colitis clinical trials.","authors":"Hasan Hamam, Parambir S Dulai, John K Marshall, Christopher Ma, Vipul Jairath, Walter Reinisch, Neeraj Narula","doi":"10.1093/ecco-jcc/jjaf145","DOIUrl":"10.1093/ecco-jcc/jjaf145","url":null,"abstract":"<p><strong>Background and aims: </strong>Adverse events (AEs) are frequently reported in clinical trials of advanced therapies for ulcerative colitis (UC). It remains uncertain whether patients receiving concomitant corticosteroids experience higher AE rates. This study aimed to determine whether corticosteroid use is associated with increased AEs in UC trials.</p><p><strong>Methods: </strong>This post-hoc analysis used participant-level data from several placebo-controlled trials (GEMINI-1, ULTRA-2, VARSITY, ACT-1, OCTAVE, and PURSUIT). The primary population included induction responders with or without baseline corticosteroid use. The primary outcome assessed the association between corticosteroid use and total AEs. Secondary outcomes included AE rates among those who achieved corticosteroid-free remission versus those who did not, and whether specific AEs were more common in corticosteroid users.</p><p><strong>Results: </strong>Among 2339 patients who achieved clinical response after induction, 1159 (49.5%) used corticosteroids at baseline. By 1 year, AE incidence was higher among corticosteroid users than non-users (75.2% vs. 67.6%, P < .001). Patients who achieved corticosteroid-free remission had fewer AEs than those who did not (67.4% vs. 77.5%, P < .001). Moderate AEs were more frequent among corticosteroid users. Common AEs included infections (in both groups) and liver abnormalities (more in corticosteroid users). Multivariable logistic regression confirmed baseline corticosteroid use as an independent AE risk factor [odds ratio (OR) 1.5, 95% CI 1.3-1.8, P = .002]. Ongoing corticosteroid use at 1 year was associated with even higher AE risk (OR 4.6, 95% CI 2.1-6.8, P < .001).</p><p><strong>Conclusion: </strong>Corticosteroid use is independently associated with increased AEs in UC clinical trials. Continued monitoring and strategies for corticosteroid tapering may reduce AE burden.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839463","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":"Early reduction in rectal wall thickness on transperineal ultrasound predicts mucosal healing in ulcerative colitis.","authors":"Shintaro Sagami, Kazuhiro Odajima, Kunio Asonoma, Yusuke Miyatani, Masaru Nakano, Ichiro Maeda, Toshifumi Hibi, Taku Kobayashi","doi":"10.1093/ecco-jcc/jjaf141","DOIUrl":"10.1093/ecco-jcc/jjaf141","url":null,"abstract":"<p><strong>Background: </strong>Intestinal ultrasound (IUS) is a valuable tool for assessing short-term responses to treatment of ulcerative colitis (UC). Nevertheless, no prior reports on IUS use, earlier than weeks 6-14, are known for predicting long-term endoscopic responses. This study evaluated whether IUS (transabdominal and transperineal) at week 1 can predict long-term clinical-endoscopic remission (CER) and histo-endoscopic mucosal improvement (HEMI) following advanced therapies.</p><p><strong>Methods: </strong>This was a post-hoc analysis of a prospective study examining the predictive value of IUS at baseline and weeks 1 and 8 after the initiation of advanced therapy in patients with active UC. CER and HEMI were defined based on the Mayo endoscopic subscore and Geboes score assessed from colonoscopy after >14 weeks. The predictive values of the IUS for CER and HEMI were assessed using a receiver operating characteristic analysis.</p><p><strong>Results: </strong>Of the 69 patients, 15 (21%) achieved CER and 11 (16%) achieved HEMI. At week 1, reduction in rectal bowel wall thickness (Δrectal BWT) was significantly greater in the CER and HEMI groups than those without these improvements (CER: 1.1 ± 0.7 vs -0.1 ± 1.4, P < .01; HEMI: 1.2 ± 0.7 vs 0.0 ± 1.4, P < .01). However, Δrectal BWT at week 8 did not differ between the groups. ΔRectal BWT at week 1 accurately predicted both CER [area under the curve (AUC) 0.75; 95% CI 0.60-0.86; P = .02] and HEMI (AUC 0.79; 95% CI 0.65-0.88; P = .02) with high accuracy.</p><p><strong>Conclusion: </strong>Assessing rectal wall thickness at week 1 is valuable for predicting advanced therapy-induced CER and HEMI in patients with UC.</p><p><strong>Clinical trials registry number: </strong>UMIN000032422 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000036970).</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839462","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":"Magnetic resonance cell size imaging reveals intestinal fibrosis to predict intestinal disease progression in patients with Crohn's disease.","authors":"Xinyue Wang, Li Huang, Shaochun Lin, Xiaodi Shen, Qingzhu Zheng, Ruonan Zhang, Yangdi Wang, Luyao Wu, Yaoqi Ke, Xiaomin Wu, Zhoulei Li, Zhenpeng Peng, Canhui Sun, Ren Mao, Shi-Ting Feng, Xuehua Li","doi":"10.1093/ecco-jcc/jjaf119","DOIUrl":"10.1093/ecco-jcc/jjaf119","url":null,"abstract":"<p><strong>Background: </strong>Intestinal fibrosis in Crohn's disease (CD) is driven by mesenchymal cell activation, resulting in adverse outcomes. We aimed to evaluate the efficacy of time-dependent diffusion magnetic resonance imaging (TD-dMRI) in characterizing fibrosis-associated cellular properties and predicting disease progression in CD.</p><p><strong>Methods: </strong>This prospective study enrolled 145 CD patients undergoing TD-dMRI to map fibrotic cellular characteristics (eg, cell diameter [d]). The performance of TD-dMRI was evaluated in surgical cohort 1 (31 patients, 63 specimens) based on myofibroblast/fibroblast area ratio from immunohistochemical staining, and further validated in surgical cohort 2 (21 patients, 25 specimens) using vimentin+ cell diameter from immunofluorescent staining. A follow-up cohort of 93 patients with different baseline mesenchymal cell phenotypes characterized by TD-dMRI was monitored for disease progression.</p><p><strong>Results: </strong>TD-dMRI-derived d correlated strongly with myofibroblast/fibroblast area ratio in surgical cohort 1 (r = 0.58; P < .001) and with vimentin+ cell diameter (r = 0.70; P < .001) in surgical cohort 2. Cell diameter d was the most discriminative parameter for distinguishing diseased and normal samples (AUC = 0.86; P < .001), with d  ≥  11 μm indicating profibrotic mesenchymal cell activation state. In all cohorts, d correlated positively with wall thickness and negatively with the narrowest lumen diameter and stenosis index (|r|=0.43-0.51, all P < .001). CD patients with d  ≥  11 μm exhibited higher disease progression rate (33% vs. 7%; P = .008) and shorter disease-progression-free survival (P = .003) than those with d  <  11 μm. Moreover, d was the most prominent predictor for disease progression (HR: 1.3; P < .001).</p><p><strong>Conclusions: </strong>TD-dMRI-derived d serves as a noninvasive microstructural biomarker for intestinal fibrosis in CD, which significantly enhances the accuracy in predicting disease progression risk.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585899","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":"Practical considerations for the use of IL-23p19 inhibitors in inflammatory bowel disease: how to choose between them and why it matters?","authors":"Cecilia Lina Pugliano, Raymond Fueng-Hin Liang, Andrea Ruffa, Marietta Iacucci, Subrata Ghosh","doi":"10.1093/ecco-jcc/jjaf144","DOIUrl":"10.1093/ecco-jcc/jjaf144","url":null,"abstract":"<p><p>A wide range of advanced therapies has become available in recent years for the treatment of moderate-to-severe inflammatory bowel disease (IBD). Among these, monoclonal antibodies targeting the interleukin 23 p19 subunit (anti-IL23p19) have emerged as a promising therapeutic class. Pivotal Phase 3 trials have demonstrated their favorable clinical efficacy and safety in both Crohn's disease (CD) and ulcerative colitis (UC). Three such agents, Risankizumab, Mirikizumab, and Guselkumab, have now been approved in CD and UC. For gastroenterologists, the ability to rationally select among these options to personalize treatment and maximize patient benefit is critical. Key factors to consider when selecting an anti-IL23p19 agent include patient preference regarding mode of administration, IBD phenotype, presence of coexisting extra-intestinal manifestations, concomitant immune-mediated diseases, and previous advanced-therapy exposure. Our review summarizes the current clinical evidence on anti-IL23p19 therapies and provides practical guidance on their use in IBD clinical management, including dosing strategies, choice of dose in CD and UC, and clinical positioning across patients. Finally, anti-IL23p19 inhibition may represent a future first-line therapy option for moderate-to-severe IBD, particularly in patients with concomitant IL-23 driven comorbidities such as psoriasis. Its use in combination with other advanced therapies in selected patients is being explored to enhance therapeutic efficacy and improve long-term outcomes. Further real-world studies are needed to assess its effectiveness and benefits in complex disease phenotypes, including perianal fistulizing Crohn's disease.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765898","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":"Efficacy and safety of upadacitinib maintenance therapy in patients with moderately to severely active Crohn's disease: 2-year results from the U-ENDURE Long-Term Extension study.","authors":"Edward V Loftus, Geert D'Haens, Edouard Louis, Miguel Regueiro, Vipul Jairath, Fernando Magro, Hiroshi Nakase, Elena Dubcenco, Ana Paula Lacerda, Sharanya Ford, Tian Feng, Benjamin Duncan, Irina Fish, Colla Cunneen, Samuel I Anyanwu, Fernando Aponte, Jenny Griffith, Irina Blumenstein","doi":"10.1093/ecco-jcc/jjaf138","DOIUrl":"10.1093/ecco-jcc/jjaf138","url":null,"abstract":"<p><strong>Background and aims: </strong>The long-term efficacy and safety of upadacitinib in patients with moderate to severe Crohn's disease (CD) were evaluated in the U-ENDURE Long-Term Extension (LTE) study. Here we report the results after 2 years of total maintenance treatment.</p><p><strong>Methods: </strong>U-ENDURE is an ongoing 240-week LTE study conducted at 243 sites across 43 countries (first patient enrolled in LTE 21 March 2019). Patients who completed the 52-week maintenance study continued their previously assigned treatment, once-daily upadacitinib 15 mg or upadacitinib 30 mg. Efficacy was analyzed at week 48 of the LTE; safety was analyzed in the cumulative study population (combined 52 week maintenance and 48 week LTE) and the LTE study population only (cutoff date: 19 December 2023).</p><p><strong>Results: </strong>From LTE week 0 to week 48, as-observed efficacy rates for clinical remission (per stool frequency/abdominal pain score, upadacitinib 15 mg: 78.3% to 82.9%; upadacitinib 30 mg: 84.7% to 76.6%; per CD Activity Index, upadacitinib 15 mg: 81.3% to 83.1%; upadacitinib 30 mg: 86.1% to 86.8%), endoscopic response (upadacitinib 15 mg: 59.6% to 67.1%; upadacitinib 30 mg: 71.2% to 69.6%), inflammatory biomarkers, and quality-of-life outcomes remained stable. The safety profile of the cumulative maintenance population observed through LTE week 48 was consistent with previous trials in the upadacitinib CD program. Treatment-emergent adverse event rates for the cumulative maintenance population were 283.1 and 273.4 events/100 patient-years for upadacitinib 15 mg and upadacitinib 30 mg, respectively. Event rates of serious treatment--emergent adverse events were 16.0 events/100 patient-years for upadacitinib 15 mg and 14.6 events/100 patient-years for upadacitinib 30 mg. The most common adverse events of special interest (≥ 5.0 events/100 patient-years) were hepatic disorder, lymphopenia, creatine phosphokinase elevation, herpes zoster, and anemia. There was 1 treatment-emergent adverse event of suicide leading to death.</p><p><strong>Conclusion: </strong>Sustained clinical, endoscopic, quality-of-life, and biomarker outcomes were observed in patients who were initial responders to upadacitinib and completed 2 years of maintenance therapy, with no new safety signals identified.</p><p><strong>Clinical trial identifier: </strong>U-ENDURE; ClinicalTrials.gov number, NCT03345823.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700775","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":"Spatiotemporal analysis of Crohn's disease reveals PECAM2 signaling at the basis of the inflammation-to-fibrosis transition.","authors":"Luca Massimino, Tommaso Lorenzo Parigi, Matteo Riva, Sabrina Nicolò, Carmela Errico, Salvatore Spanò, Sara Mino, Mattia Bugatti, Alice Frontali, Federico Scarfò, Andrea Vignali, Andrea Municchi, Vincenzo Villanacci, Luca Albarello, Maurilio Ponzoni, Virginia Solitano, Alberto Malesci, Vipul Jairath, Laurent Peyrin-Biroulet, Pierpaolo Sileri, Silvio Danese, Federica Ungaro","doi":"10.1093/ecco-jcc/jjaf130","DOIUrl":"10.1093/ecco-jcc/jjaf130","url":null,"abstract":"<p><strong>Background and aims: </strong>Crohn's disease (CD) is a chronic inflammatory disease of the bowel, often complicated by fibrotic strictures, for which medical treatment is lacking, and surgery is commonly required. The mechanisms underlying the progression from chronic inflammation to fibrosis are not yet defined. We aim to unravel CD pathogenesis using a cutting-edge computational pipeline combining several available tools.</p><p><strong>Methods: </strong>Spatial transcriptomics was performed on 13 surgical specimens, including inflamed and fibrotic CD tissues and healthy controls. The resulting spatial data were integrated with single-cell RNA sequencing to trace the cellular and molecular transitions from healthy intestine to fibrotic tissue. Ligand-receptor interaction and pseudotime analyses were employed to infer dynamic cell-cell communication networks and lineage trajectories. Key computational findings were validated through immunostaining in an independent cohort of CD patients. Finally, the therapeutic relevance of the identified target was evaluated in a TNBS-induced chronic colitis mouse model upon CD38 inhibitor administration.</p><p><strong>Results: </strong>We demonstrated that intestinal cytoarchitecture was rearranged while chronic inflammation progressed. CD-associated fibrosis evolved within the mesenchymal compartment, driven by PECAM2 signaling through the PECAM1-CD38 interaction. In parallel, ApoA signaling, particularly the APOA1-ABCA interaction, emerged as relevant for maintaining epithelial and stromal homeostasis, while its downregulation was associated with fibrosis development. Moreover, inhibition of CD38 signaling effectively reduced colitis symptoms and colon thickening in the experimental TNBS-induced model of chronic inflammation.</p><p><strong>Conclusions: </strong>Our results provide insights into CD38-driven fibrosis and indicate that blockade of PECAM2 signaling could reduce the development of strictures in patients with CD, potentially offering a new treatment target.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664134","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":"Catching fibrosis in motion: time-dependent diffusion MRI-derived cell diameter reveals the transitional state of intestinal scarring in Crohn's disease.","authors":"Ilaria Faggiani, Sarah Bencardino, Laurent Peyrin-Biroulet","doi":"10.1093/ecco-jcc/jjaf146","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf146","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"19 8","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133162","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 Outcome After Entero-Enteric Anastomosis for Crohn's Disease: A Case-Control Study.","authors":"Benedetto Neri, Sara Concetta Schiavone, Roberto Mancone, Mariasofia Fiorillo, Antonio Fonsi, Emma Calabrese, Lorenzo Perugini, Gaspare Piccione, Francesco Maria Di Matteo, Irene Marafini, Elisabetta Lolli, Giuseppe Sigismondo Sica, Giovanni Monteleone, Livia Biancone","doi":"10.1093/ecco-jcc/jjaf163","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf163","url":null,"abstract":"<p><strong>Background and aims: </strong>The outcome of Crohn's Disease (CD) patients with entero-enteric anastomosis (EEA) after small bowel resection is undefined. The primary aim of the present case-control study was to compare the clinical recurrence rate within the first 5 years after surgery in CD patients with small bowel EEA (Cases) versus age-matched patients with ileo-colonic anastomosis (ICA, Controls).</p><p><strong>Methods: </strong>All CD patients with EEA were matched for age at diagnosis (±5years) and smoking habits with 2 Controls with ICA. Inclusion criteria: 1)age ≥ 18; 2)EEA or ICA for CD; 3)≥5-years follow-up after surgery. Exclusion criteria: 1) missing data; 2)ostomy; 3)stricturoplasty.</p><p><strong>Results: </strong>The study population included 51CD patients with EEA and 102 matched Controls with ICA. During the first 5 years after surgery, clinical recurrence and CD-related hospitalizations were more frequent in Cases (34 [66.7%] vs. 43 [42.2%], p = 0.007; 25 [49%] vs. 23 [22.5%], p = 0.001). During the same period, corticosteroids, immunosuppressors and biologics use were also more frequent in Cases (26 [50.9%] vs. 18 [17.6%], p < 0.0001; 21 [41.2%] vs. 24 [23.5%], p = 0.03; 23 [45.1%] vs. 15 [14.7%], p = 0.03). Survival time from clinical recurrence and hospitalization was shorter in Cases (2.36 [1.29-4.35], p = 0.003; 1.71 [1.06-2.77], p = 0.02).EEA and immunosuppressors use before surgery were risk factors for clinical recurrence and CD-related hospitalization at 5 years (2.68 [1.11-6.45], p = 0.02; 2.61 [1.21-5.6], p = 0.01; 2.53 [1.05-6.09], p = 0.03; 2.44 [1.18-5], p = 0.01).</p><p><strong>Conclusions: </strong>The clinical outcome is more severe in CD patients with EEA than in those with ICA, being associated with a higher rate of clinical recurrence and hospitalization after surgery.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002226","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}