Journal of Crohn's & colitis最新文献

{"title":"Corrigendum to: Discordant Effects of Janus Kinase Inhibition Ex Vivo on Inflammatory Responses in Colonic Compared to Ileal Mucosa.","authors":"","doi":"10.1093/ecco-jcc/jjaf004","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf004","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974107","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":"Artificial intelligence-enabled histology exhibits comparable accuracy to pathologists in assessing histological remission in ulcerative colitis: a systematic review, meta-analysis, and meta-regression.","authors":"Miguel Puga-Tejada, Snehali Majumder, Yasuharu Maeda, Irene Zammarchi, Ilaria Ditonno, Giovanni Santacroce, Ivan Capobianco, Carlos Robles-Medranda, Subrata Ghosh, Marietta Iacucci","doi":"10.1093/ecco-jcc/jjae198","DOIUrl":"10.1093/ecco-jcc/jjae198","url":null,"abstract":"<p><strong>Background and aims: </strong>Achieving histological remission is a desirable emerging treatment target in ulcerative colitis (UC), yet its assessment is challenging due to high inter- and intraobserver variability, reliance on experts, and lack of standardization. Artificial intelligence (AI) holds promise in addressing these issues. This systematic review, meta-analysis, and meta-regression evaluated the AI's performance in assessing histological remission and compared it with that of pathologists.</p><p><strong>Methods: </strong>We searched Medline/PubMed and Scopus databases from inception to September 2024. We included studies on AI models assessing histological activity in UC, with or without comparison to pathologists. Pooled performance metrics were calculated: sensitivity, specificity, positive and negative predictive value (PPV and NPV), observed agreement, and F1 score. A pairwise meta-analysis compared AI and pathologists, while sub-meta-analysis and meta-regression evaluated heterogeneity and factors influencing AI performance.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria. AI models exhibited strong performance with a pooled sensitivity of 0.84 (95% CI, 0.80-0.88), specificity 0.87 (0.84-0.91), PPV 0.90 (0.87-0.92), NPV 0.80 (0.71-0.88), observed agreement 0.85 (0.82-0.89), and F1 score 0.85 (0.82-0.89). AI models demonstrated no significant differences with pathologists for specificity, observed agreement, and F1 score, while they were outperformed by pathologists for sensitivity and NPV. AI models for the adult population were linked to reduced heterogeneity and enhanced AI performance at meta-regression.</p><p><strong>Conclusions: </strong>AI shows significant potential for assessing histological remission in UC and performs comparably to pathologists. Future research should focus on standardized, large-scale studies to minimize heterogeneity and support widespread AI implementation in clinical practice.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916524","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":"Assessment and reporting of extraintestinal manifestations and fatigue in phase 3 inflammatory bowel disease clinical trials.","authors":"Tarun Chhibba, Karan Sachdeva, Ashwin N Ananthakrishnan","doi":"10.1093/ecco-jcc/jjaf009","DOIUrl":"10.1093/ecco-jcc/jjaf009","url":null,"abstract":"<p><strong>Background: </strong>Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are frequently experienced by patients and may lead to severe symptoms and fatigue. However, the reporting patterns of these outcomes in IBD randomized controlled trials (RCTs) are not clear.</p><p><strong>Methods: </strong>We searched placebo-controlled phase 3 RCTs of advanced therapies in IBD and assessed the frequency and means of reporting EIM and fatigue data in these studies.</p><p><strong>Results: </strong>Thirty-three phase 3 RCTs for Crohn's disease (CD) (n = 16) or ulcerative colitis (UC) (n = 16) were identified between 2002 and 2023. While all trials (16/16) in CD collected some EIM data, we could only ascertain 6/16 (38%) collected EIM data in UC trials. Fewer than one-third (9/32, 28%) reported EIM prevalence at baseline; fewer reported the improvement with active treatment (9%). Fatigue was measured in 20/32 trials (63%).</p><p><strong>Conclusions: </strong>EIM and fatigue data are inconsistently collected in RCTs of IBD. Standardizing collection methods across RCTs would provide greater insight on these agents and their efficacy in treating these manifestations of disease.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019026","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 Natural History of Crohn's Disease Leading to Intestinal Failure: A Longitudinal Cohort Study from 1973 to 2018.","authors":"Tian Hong Wu, Christopher Filtenborg Brandt, Thomas Scheike, Johan Burisch, Palle Bekker Jeppesen","doi":"10.1093/ecco-jcc/jjae114","DOIUrl":"10.1093/ecco-jcc/jjae114","url":null,"abstract":"<p><strong>Background and aims: </strong>The natural history of Crohn's disease leading to intestinal failure is not well characterised. This study aims to describe the clinical course of Crohn's disease preceding intestinal failure and to compare disease course and burden between Crohn's disease patients with and without intestinal failure.</p><p><strong>Methods: </strong>Patients with Crohn's disease complicated by intestinal failure from Rigshospitalet, Copenhagen [n = 182] and a nationwide Danish Crohn's disease cohort without intestinal failure [n = 22,845] were included. Using nationwide registries in Denmark, disease course was determined from hospitalisations, surgeries, and outpatient medications, and disease burden was determined from employment and mortality data.</p><p><strong>Results: </strong>The 10-year cumulative incidence of intestinal failure following Crohn's disease diagnosis declined from 2.7% prior to 1980 to 0.2% after 2000. Compared with Crohn's disease patients without intestinal failure, those with intestinal failure experienced significantly longer duration of severe disease [50 vs 19 years per 100 patient-years, p < 0.01], secondary to greater corticosteroid use [71% vs 60%, p = 0.02], inpatient contacts [98% vs 55%, p < 0.01], and abdominal surgeries [99% vs 48%, p < 0.01]. However, exposure to biologics was not different between the two groups [20.4% vs 21%, p = 0.95], and duration on biologics was shorter in Crohn's disease patients with intestinal failure [2068 vs 4126 days per 100 patient-years, p = 0.02]. Standard mortality ratio in Crohn's disease patients with intestinal failure was 3.66 (97.5% confidence interval [CI] 2.79, 4.72].</p><p><strong>Conclusion: </strong>Patients with Crohn's disease complicated by intestinal failure experienced a more persistently severe preceding course of Crohn's disease but were not more likely to be treated with biological therapy.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750116","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":"Deconditioning in quiescent Crohn's disease patients with heightened fatigue perception.","authors":"Jordan J McGing, Sébastien Serres, Rosemary Nicholas, Ayushman Gupta, Shellie J Radford, Aline V Nixon, Joanne Mallinson, Christopher Bradley, Stephen Bawden, Susan T Francis, Paul L Greenhaff, Gordon W Moran","doi":"10.1093/ecco-jcc/jjae194","DOIUrl":"10.1093/ecco-jcc/jjae194","url":null,"abstract":"<p><strong>Background and objective: </strong>Inflammatory bowel disease (IBD) fatigue aetiology is poorly understood. This study quantified body composition and physical function alongside proton magnetic resonance imaging (1H MRI) and spectroscopy (31P MRS) measures of organ structure and function in quiescent Crohn's disease patients (CD) and healthy volunteers (HVs), to identify a physiological basis for IBD fatigue.</p><p><strong>Methods: </strong>Body composition was determined using dual-energy X-ray absorptiometry and 1H MRI. Knee extensor isometric strength and isokinetic fatigue were measured using dynamometry. 1H MRI was used to quantify cardiac output, cerebral blood flow (gmCBF), and brain oxygen extraction fraction (OEF) at rest, and during supine, steady-state exercise, and recovery. 31P MRS was used to quantify post-exercise muscle phosphocreatine (PCr) resynthesis.</p><p><strong>Results: </strong>Sixteen CD and 12 HV (age, sex, and BMI matched) were recruited. Fatigue perception was greater (13.9 ± 1 vs 8.3 ± 0.9, P = .001), and daily step count was less (5482 ± 684 vs 8168 ± 1123, P = .04) in CD. During steady-state exercise, gmCBF was less in CD (653 ± 30 vs 823 ± 40 mL/min, P = .003). Cardiac output and brain OEF were no different. Post-exercise PCr resynthesis was less in CD (17.2 ± 2.0 vs 25.3 ± 2.4 mM·min-1, P = .02). Body composition, isometric strength, and isokinetic fatigability were no different.</p><p><strong>Conclusions: </strong>CD self-reported increased fatigue perception and exhibited a slower rate of post-exercise PCr resynthesis compared to HV. This occurred independently of changes in body composition, muscle strength, and fatigability. IBD fatigue may be linked to peripheral muscle deconditioning and lower gmCBF during submaximal exercise.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960678","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":"Diagnosing Crohn's disease in presumed cryptoglandular perianal fistulas: an expert Delphi consensus on early identification of patients at risk of Crohn's disease in perianal fistulas (PREFAB).","authors":"Liesbeth J Munster, Luke N Hanna, Ailsa L Hart, Phil J Tozer, Christianne J Buskens, Jarmila D W van der Bilt","doi":"10.1093/ecco-jcc/jjaf002","DOIUrl":"10.1093/ecco-jcc/jjaf002","url":null,"abstract":"<p><strong>Background: </strong>The aim of this Delphi study was to reach consensus on a new clinical decision tool to help identify or exclude Crohn's disease (CD) in patients with perianal fistula(s) (PAF).</p><p><strong>Methods: </strong>A panel of international experts in the field of proctology/inflammatory bowel disease was invited to participate. In the first round (electronic survey), participants were asked to anonymously provide their opinion probing (1) the relevance and use of clinical characteristics suggestive of underlying CD, (2) the use of fecal calprotectin (FCP) for screening for CD, and (3) on the diagnostic work-up for CD in PAF patients with raised clinical suspicion. In the second/third round (virtual consensus meetings), statements were paired/revised and presented in final sets of statements. Consensus was predefined as ≥70% (dis)agreement.</p><p><strong>Results: </strong>Final consensus was reached on 12 statements, including screening of all PAF patients (regardless of the complexity, biological behavior, and co-existent perianal symptoms) and referral of PAF patients for a colonoscopy in case of elevated FCP levels (≥150 mcg/g) and/or in case of one clinical major criterion (defined as: unintentional weight loss, unexplained diarrhea, PSC, UC, >1 internal fistula openings, fistula involving other organs (vagina/bladder), recurrent fistulation (after initial healing), proctitis, and anal stenosis). Also, clinical (fistula-)characteristics that warrant raised suspicion for CD and an algorithm on the diagnostic work-/follow-up of patients with raised suspicion were defined.</p><p><strong>Conclusion: </strong>International consensus was reached on a new, clinical decision tool, including a practical and relevant algorithm for finding/excluding CD in PAF patients.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960681","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":"Combination of white-light imaging-based and narrow-band imaging-based artificial intelligence models during colonoscopy in patients with ulcerative colitis.","authors":"Takanori Kuroki, Yasuharu Maeda, Shin-Ei Kudo, Noriyuki Ogata, Kaoru Takabayashi, Kento Takenaka, Jiro Kawashima, Yurie Kawabata, Shunto Iwasaki, Osamu Shiina, Yuriko Morita, Yuta Kouyama, Tatsuya Sakurai, Yushi Ogawa, Toshiyuki Baba, Yuichi Mori, Marietta Iacucci, Haruhiko Ogata, Kazuo Ohtsuka, Masashi Misawa","doi":"10.1093/ecco-jcc/jjaf014","DOIUrl":"10.1093/ecco-jcc/jjaf014","url":null,"abstract":"<p><strong>Background and aims: </strong>The long-term treat-to-target (T2T) approach in ulcerative colitis (UC) aims for endoscopic remission, but variability among endoscopists and a lack of precision in relapse prediction both limit its clinical usefulness. A recently reported white-light imaging (WLI) artificial intelligence (AI) model helps standardize diagnosis, although challenges remain. Therefore, we attempted to combine a narrow-band imaging (NBI) AI model with the WLI AI model to determine whether these challenges can be overcome.</p><p><strong>Methods: </strong>This post hoc analysis of a prospective study evaluated the efficacy of combining AI-assisted WLI and NBI models in predicting clinical relapse in patients with UC over a 12-month follow-up period. A total of 102 patients with UC in clinical remission were included, and the combined AI models were used during colonoscopy to assess relapse risk.</p><p><strong>Results: </strong>The study found that within the same AI-based Mayo endoscopic subscore category, patients with vascular activity were more likely to experience clinical relapse than those with vascular healing. Compared with the WLI model alone, the specificity of the combined method significantly increased from 42.2% (95% confidence interval [CI]: 32.1%-52.9%) to 61.5% (95% CI: 50.7%-71.2%) (P = .013) with its sensitivity being maintained.</p><p><strong>Conclusions: </strong>The sequential use of WLI and NBI AI models can provide better stratification of relapse risk compared with using either model alone, offering a more accurate and personalized approach to treatment intensification. This dual-model AI approach aligns with the T2T approach in UC management.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071304","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":"Risankizumab efficacy and safety based on prior inadequate response or intolerance to advanced therapy: post hoc analysis of the INSPIRE and COMMAND phase 3 studies.","authors":"Remo Panaccione, Edouard Louis, Jean-Frederic Colombel, Geert D'Haens, Laurent Peyrin-Biroulet, Marla Dubinsky, Ken Takeuchi, David T Rubin, Jasmina Kalabic, Karen B Chien, Su Chen, Ling Cheng, Yafei Zhang, W Rachel Duan, Ramona Vladea, Patrick M Hecht, Pierre Morisset, Stefan Schreiber, Marc Ferrante","doi":"10.1093/ecco-jcc/jjaf005","DOIUrl":"10.1093/ecco-jcc/jjaf005","url":null,"abstract":"<p><strong>Background and aims: </strong>Treating ulcerative colitis (UC) in patients with prior advanced therapy (AT) exposure may be challenging. We report the efficacy and safety of risankizumab, a monoclonal interleukin 23p19 antibody, in patients with UC and prior inadequate response or intolerance to AT (AT-IR).</p><p><strong>Methods: </strong>In the 12-week phase 3 INSPIRE induction study, patients were randomized to intravenous risankizumab 1200 mg or placebo. Clinical responders were randomized to subcutaneous risankizumab 180 mg, risankizumab 360 mg, or placebo (risankizumab withdrawal) in the 52-week phase 3 COMMAND maintenance study. This post hoc analysis assessed outcomes by AT-IR status, number, and mechanism of action. AT included biologics, Janus kinase inhibitors, and sphingosine-1-phosphate receptor modulators.</p><p><strong>Results: </strong>Efficacy analyses included 472 non-AT-IR and 503 AT-IR patients (induction), and 137 non-AT-IR and 411 AT-IR patients (maintenance). More patients achieved clinical remission per Adapted Mayo score with risankizumab 1200 mg versus placebo at induction week 12 (non-AT-IR, 29.7% versus 8.4%, nominal P < .0001; AT-IR, 11.4% versus 4.3%, nominal P = .0083); consistent with risankizumab 180 mg or risankizumab 360 mg versus placebo (withdrawal) at maintenance week 52 (non-AT-IR, 50.9% or 61.7% versus 31.1%, nominal P = .057 or P = .0033, respectively; AT-IR, 36.6% or 29.5% versus 23.2%, nominal P = .0159 or P = .2334, respectively). Risankizumab had increased efficacy over placebo, regardless of AT-IR number or mechanism of action, with higher efficacy rates for non-AT-IR compared to AT-IR. Safety results in non-AT-IR and AT-IR patients were generally comparable in both induction and maintenance.</p><p><strong>Conclusions: </strong>Risankizumab was effective and well tolerated, regardless of prior AT-IR status.</p><p><strong>Clinical trial registration numbers: </strong>INSPIRE [NCT03398148], COMMAND [NCT03398135].</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974105","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":"Disruption of Epithelial Barrier Integrity via Altered GILZ/c-Rel/RACK1 Signaling in Inflammatory Bowel Disease.","authors":"Erica Buoso, Mirco Masi, Roberta Valeria Limosani, Francesca Fagiani, Chiara Oliviero, Giorgia Colombo, Luigi Cari, Marco Gentili, Eleonora Lusenti, Lucrezia Rosati, Federica Pisati, Alessandra Pasini, Marco Vincenzo Lenti, Antonio Di Sabatino, Claire Louise Mobbs, Stefan Przyborski, Simona Ronchetti, Cristina Travelli, Marco Racchi","doi":"10.1093/ecco-jcc/jjae191","DOIUrl":"10.1093/ecco-jcc/jjae191","url":null,"abstract":"<p><strong>Background and aims: </strong>Given the role of Receptor for Activated C Kinase 1 (RACK1) in both immune cell activation and in the maintenance of the intestinal epithelial barrier integrity, we investigated whether it was involved in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>RACK1 expression was analyzed in intestinal mucosal samples of healthy and IBD patients, in mice with chemically induced colitis, and in diseased in vitro 2D and 3D coculture models by luciferase assay, reverse transcription-quantitative PCR, Western blotting, immunofluorescence, and immunohistochemistry. Based on our finding that glucocorticoid-induced leucine zipper (GILZ or tsc22d3) positively correlates with RACK1 expression in IBD patients, GILZ knockout mice and cell silencing experiments were performed.</p><p><strong>Results: </strong>RACK1 was significantly decreased in IBD, especially in ulcerative colitis. This was associated with an NF-κB/c-Rel-related mechanism, correlating with decreased GILZ protein expression. GILZ depletion confirmed a decrease in RACK1 expression, which favored SRC activation and led to a significant reduction in E-cadherin, resulting in impaired epithelial barrier integrity. Finally, our data highlighted that this novel mechanism could be considered to develop new therapies since dexamethasone, the first line of treatment in IBD, restored RACK1 expression through the glucocorticoid receptor in a c-Rel/GILZ-independent manner.</p><p><strong>Conclusions: </strong>We provide the first evidence that an alteration of RACK1/SRC/E-cadherin regulatory mechanism, correlating with decreased GILZ protein expression, is involved in epithelial barrier disruption. The clinical relevance is based on the fact that this mechanism involving GILZ/c-Rel-related RACK1 expression could be considered to improve IBD therapies, particularly in patients with low or no response to glucocorticoid treatment.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857340","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":"Histologic and Endoscopic Findings Are Highly Correlated in a Prospective Cohort of Patients With Inflammatory Bowel Diseases.","authors":"Federica Di Vincenzo, Maria A Quintero, Joao M Serigado, Tulay Koru-Sengul, Rose Marie Killian, Julio Poveda, Jonathan England, Oriana Damas, David Kerman, Amar Deshpande, Maria T Abreu","doi":"10.1093/ecco-jcc/jjae141","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae141","url":null,"abstract":"<p><strong>Background and aims: </strong>The advantages of endoscopic vs histologic assessments of inflammation in inflammatory bowel disease remain unclear. We compared endoscopic and histologic inflammation in a prospective cohort. Furthermore, in patients with discordant findings, we compared the ability of endoscopy vs histology to predict disease course.</p><p><strong>Methods: </strong>Ulcerative colitis (UC) or Crohn's disease (CD) patients underwent routine colonoscopies with intestinal biopsies, which included ratings of inflammation severity. Tetrachoric correlation analysis between the endoscopic and histologic inflammation ratings was performed. In postsurgical CD patients, major adverse outcomes (MAOs) were recorded.</p><p><strong>Results: </strong>The analysis included 749 patients (60.2% CD patients), with 2807 biopsied segments. We found high concordance between endoscopist and pathologist inflammation ratings (0.84, 95% confidence interval, 0.81-0.87, p < 0.0001). Only 12.5% of biopsied segments exhibited microscopic inflammation without endoscopic inflammation. Neo-terminal ileum (neo-TI) biopsies exhibited the highest discordance; UC colonic biopsies had the highest concordance. Postsurgical CD patients who completed the 48-month follow-up (n = 138) were included in the survival analysis. The probability of MAO-free survival was significantly higher in patients with a Rutgeerts score of i0 at baseline than in those with higher scores. Microscopic inflammation in the neo-TI did not predict a higher risk of MAOs (p = 1.00).</p><p><strong>Conclusions: </strong>In a real-world setting, endoscopic inflammation predicted histologic inflammation with high accuracy. In patients with a Rutgeerts score of i0, microscopic inflammation in neo-TI biopsies did not predict more aggressive disease behavior over the next 4 years. These results have implications for the design of clinical trials, suggesting the use of endoscopic healing as an endpoint.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911163","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}