Journal of Crohn's & colitis最新文献

{"title":"ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment.","authors":"Javier P Gisbert, María Chaparro, Bram Verstockt, Peter Kienle, Silvia Minozzi, Mariangela Allocca, Raja Atreya, Nicolas Avellaneda, Manuel Barreiro-de Acosta, Robert Battat, Dominik Bettenworth, Irina Blumenstein, Steven R Brown, John P Burke, Flavio Caprioli, María José Casanova, Niki Christou, Anthony de Buck van Overstraeten, Glen Doherty, Piotr Eder, Alaa El-Hussuna, Pierre Ellul, Massimo Claudio Fantini, Federica Furfaro, Thomas Greuter, Karl Hazel, Stefan Holubar, Christina Kapizioni, Uri Kopylov, Rupert W Leong, Sezai Leventoglu, Jimmy K Limdi, Nurulamin M Noor, Ioannis Papaconstantinou, Georgios Peros, Lieven Pouillon, Catherine Reenaers, Simone Saibeni, Carsten Schmidt, Paula Sousa, Laurents P S Stassen, Mathieu Uzzan, Sophie Vieujean, Eva Visser, Pär Myrelid, Michel Adamina, Torsten Kucharzik","doi":"10.1093/ecco-jcc/jjag066","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag066","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407638","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":"AI-based quantification of inflammatory extent for relapse prediction in ulcerative colitis: a prospective cohort study.","authors":"Yasuharu Maeda, Shin-Ei Kudo, Noriyuki Ogata, Kento Takenaka, Kaoru Takabayashi, Takanori Kuroki, Yurie Kawabata, Taishi Okumura, Tatsuya Sakurai, Yuta Kouyama, Katsuro Ichimasa, Takemasa Hayashi, Toshiyuki Baba, Haruhiko Ogata, Kazuo Ohtsuka, Yuichi Mori, Marietta Iacucci, Masashi Misawa","doi":"10.1093/ecco-jcc/jjag115","DOIUrl":"10.1093/ecco-jcc/jjag115","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic remission is a key therapeutic goal in ulcerative colitis (UC); however, conventional indices focus on peak severity without accounting for the spatial extent of inflammation. We developed a deep learning-based score, Quantitative Ulcerative Colitis Assessment using Deep Learning (QUAD), and evaluated whether incorporating inflammatory extent improves relapse prediction in patients with UC in clinical remission. To our knowledge, no studies have examined whether artificial intelligence (AI)-derived assessment of inflammatory extent predicts clinical relapse.</p><p><strong>Methods: </strong>This prospective cohort study evaluated relapse prediction over 24 months in patients with UC in clinical remission. The QUAD model assigns a score of 0-3 to each image quadrant, yielding a total score of 0-12. The model was trained on 84 743 images from 998 patients with UC across three centers. Still image-based validation and automated full-length video analysis were conducted to assess the impact of inflammatory extent on relapse prediction.</p><p><strong>Results: </strong>Clinical relapse occurred in 19.4% of patients with QUAD ≥ 4 compared with 5.2% of those with QUAD < 4 (P = .01), with an area under the curve (AUC) of 0.67 (95% confidence interval [CI]: 0.57-0.76). Notably, automated video-based analysis showed that distal inflammatory burden yielded the highest predictive performance, with analysis of the distal 10% segment achieving an AUC of 0.73 (95% CI: 0.62-0.85), compared with whole-colon assessment (AUC, 0.62; 95% CI: 0.48-0.76) and still image-based evaluation.</p><p><strong>Conclusion: </strong>AI-augmented assessment integrating inflammatory severity and extent may provide complementary prognostic information beyond severity-based evaluation.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632754","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":"Intestinal ultrasound for the detection of postoperative recurrence in Crohn's disease: a systematic review and meta-analysis.","authors":"Viviana Parra-Izquierdo, Juan Sebastian Frías Ordoñez, Elisabeth Eggermont, Bram Verstockt","doi":"10.1093/ecco-jcc/jjag094","DOIUrl":"10.1093/ecco-jcc/jjag094","url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative recurrence of Crohn's disease (CD) is common and may occur without symptoms. Ileocolonoscopy is the reference standard for detecting endoscopic recurrence, but its invasiveness limits repeated use. Intestinal ultrasound (IUS) is a non-invasive monitoring tool, although diagnostic criteria and ultrasound modalities vary across studies. We conducted a systematic review and diagnostic test accuracy meta-analysis to evaluate the performance of IUS for detecting postoperative recurrence.</p><p><strong>Methods: </strong>PubMed/MEDLINE, EMBASE, Scopus, and the Cochrane Library were searched from inception to April 2025. Eligible studies evaluated IUS for postoperative recurrence in CD using ileocolonoscopy as the reference standard. Data were extracted to reconstruct independent 2 × 2 diagnostic tables. The primary synthesis used hierarchical bivariate binomial random-effects models to jointly estimate summary sensitivity and specificity. Heterogeneity was explored through subgroup analyses by ultrasound modality, Doppler use, contrast route, bowel wall thickness threshold, diagnostic definition, data collection period, and recurrence severity.</p><p><strong>Results: </strong>Twelve studies were included in the systematic review and narrative synthesis; 11 provided reconstructable independent 2 × 2 data and were included in the bivariate meta-analysis. IUS showed high summary sensitivity of 87.6% (95% CI, 81.0%-92.1%; P < .001) and good summary specificity of 80.2% (95% CI, 60.6%-91.5%; P < .001). The false negative rate was 12.4% (95% CI, 7.9%-19.0%), the false positive rate was 19.8% (95% CI, 8.5%-39.4%), positive likelihood ratio was 4.436 (95% CI, 2.070-9.505), negative likelihood ratio was 0.154 (95% CI, 0.101-0.236), and diagnostic odds ratio was 28.8 (95% CI, 11.0-75.4). Diagnostic performance was generally consistent across studies, although differences in ultrasound protocols and bowel wall thickness thresholds, most commonly ≥3 or ≥5 mm, appeared to contribute to between-study variability.</p><p><strong>Conclusions: </strong>IUS shows high sensitivity and good specificity for postoperative recurrence surveillance in CD. Its interpretation should remain linked to ultrasound protocol, threshold, recurrence definition, and clinical context.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537930","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":"Dietary emulsifiers and host inflammation synergistically drive genomic evolution of Crohn's disease-associated Escherichia coli toward enhanced pathogenicity.","authors":"Héloïse Rytter, Caroline Chevarin, Lucas Martin, Emma Bruder, Jérémy Denizot, Olivier Tenaillon, Olivier Espéli, Aurélien Birer, Nicolas Barnich, Emilie Viennois, Benoit Chassaing","doi":"10.1093/ecco-jcc/jjag088","DOIUrl":"10.1093/ecco-jcc/jjag088","url":null,"abstract":"<p><strong>Background and aims: </strong>The rising incidence of Crohn's disease (CD) in Westernized countries has been linked to changes in diet and increased consumption of food additives, yet the mechanisms by which these factors fuel intestinal inflammation remain unclear. Adherent-invasive Escherichia coli (AIEC), a pathobiont involved in CD pathogenesis, lacks a clear genetic hallmark but exhibits intestinal colonization and virulence traits, raising questions about the evolutionary forces promoting its emergence among select individuals. Here, we investigated how chronic exposure to two common dietary emulsifiers, carboxymethylcellulose (CMC) and polysorbate 80 (P80), along with host inflammation, drives AIEC genomic evolution and pathogenic potential.</p><p><strong>Methods: </strong>Wild-type and Il10-deficient mice were monocolonized with AIEC and chronically exposed to CMC, P80, or water. Bacterial isolates were collected and analyzed for genomic diversification, mutations, and phenotype both in vitro and in vivo.</p><p><strong>Results: </strong>Emulsifiers accelerated AIEC genomic diversification and selected for mutations linked to increased motility, invasion, and pro-inflammatory activity. Moreover, dietary emulsifier-evolved strains displayed a marked fitness advantage in vivo, outcompeting their counterparts in murine hosts, with the greatest advantage observed when evolution occurred under inflammatory conditions. Notably, evolutionary pathways and phenotypic outcomes were shaped by both emulsifier and the host's inflammatory status, highlighting synergy between diet and host genetics in fostering pro-inflammatory pathobionts.</p><p><strong>Conclusion: </strong>These findings provide an evolutionary framework connecting modern dietary habits to the emergence of pathogenic AIEC strains, and underscore the importance of dietary interventions in individuals at risk for inflammatory bowel disease.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414490","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":"Third N-ECCO Consensus Statements on the Nursing Roles in Caring for Patients with Inflammatory Bowel Disease.","authors":"Susanna Jäghult, Michel Adamina, Dawn Farrell, Palle Bager, Wladyslawa Czuber-Dochan, Karen Kemp, Nynke Boontje, Ferdinando D'Amico, Goedele Dewitte, Ola Haj, Petra Hartmann, Daniel Lightowler, Regula Locher, Clarisse Maia, Francisca Murciano Gonzalo, Daniele Napolitano, Berna Nilgün Özgürsoy Uran, Katarina Pihl Lesnovska, Shellie Radford, Adriana Rivera Sequeiros, Chen Sarbagili-Shabat, Tanja Tiitta Inkeri Toivonen, Catherine Walsh, Debora Zaetta, Simona Radice","doi":"10.1093/ecco-jcc/jjag054","DOIUrl":"10.1093/ecco-jcc/jjag054","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407588","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":"Correction to: 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":"","doi":"10.1093/ecco-jcc/jjag090","DOIUrl":"10.1093/ecco-jcc/jjag090","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458147","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":"Methotrexate for inflammatory bowel disease: the MICI-METHO multicenter retrospective cohort study.","authors":"Bénédicte Caron, Julien Kirchgesner, Maria Nachury, Guillaume Bouguen, Mathieu Uzzan, Anthony Buisson, Guillaume Le Cosquer, Lucine Vuitton, Philippe Seksik, Séverine Petit, Pauline Wils, Stéphane Nancey, Romain Altwegg, Marianne Hupe, Mathurin Fumery, Xavier Roblin, David Laharie, Xavier Hebuterne, Cédric Baumann, Eric Vicaut, Laurent Peyrin-Biroulet","doi":"10.1093/ecco-jcc/jjag102","DOIUrl":"10.1093/ecco-jcc/jjag102","url":null,"abstract":"<p><strong>Background and aim: </strong>Methotrexate has demonstrated efficacy in Crohn's disease (CD) as monotherapy and is increasingly used in combination therapy. We investigated for the first time the use of methotrexate in a very large cohort of patients with inflammatory bowel disease (IBD) in a real-world setting.</p><p><strong>Methods: </strong>This was an observational, retrospective, multicenter study including consecutive adult IBD patients treated with methotrexate in monotherapy or combination therapy between January 2015 and December 2022 in 15 French centers.</p><p><strong>Results: </strong>Among the 1115 patients included, 77% had CD and 34.5% had at least one extra-intestinal manifestation (EIM). Regarding prior treatments, 44.0% of patients had been exposed to azathioprine and 75.1% to anti-tumor necrosis factor agents. The primary indication for methotrexate was IBD (81.5%), followed by EIM (rheumatological [11.9%] or dermatological [3.9%]). Methotrexate was prescribed in combination therapy in 90.6% of cases. The most frequent induction and maintenance dose was 15 mg/week (47.5% and 51.1% respectively). The persistence rate of methotrexate was 27.7 months in CD and 22.4 months in ulcerative colitis (UC). For CD, factors associated with persistence were female gender (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.05-1.51) and the presence of EIM (HR 0.71; 95% CI 0.58-0.86), and for UC, the presence of EIM (HR 0.63; 95% CI 0.42-0.94). Among the 344 (31.7%) patients who experienced an adverse event related to methotrexate, nine experienced a serious adverse event.</p><p><strong>Conclusion: </strong>The French multicenter MICI-METHO study is the first to provide a comprehensive overview of the real-world use, persistence, and safety of methotrexate in patients with IBD.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551745","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":"All-cause and cause-specific mortality in inflammatory bowel disease across the biologic era: a population-based matched cohort study.","authors":"Onuma Sattayalertyanyong, Zoann Nugent, Charles N Bernstein","doi":"10.1093/ecco-jcc/jjag105","DOIUrl":"10.1093/ecco-jcc/jjag105","url":null,"abstract":"<p><strong>Background & aims: </strong>Inflammatory bowel disease (IBD) is associated with increased mortality, but whether death rates and causes of death have changed across the biologic era is unclear. We aimed to assess all-cause and cause-specific mortality in Crohn's disease (CD) and ulcerative colitis (UC) across therapeutic eras.</p><p><strong>Methods: </strong>We conducted a retrospective, population-based matched cohort study (1984-2019). IBD cases were matched 1:10 to unaffected controls by age, sex, and geography. Follow-up was stratified into a pre-biologic era (1984-2000) and biologic era (2001-2019). All-cause mortality was assessed using Cox models and cause-specific mortality using competing-risk methods.</p><p><strong>Results: </strong>We identified 13 306 patients with IBD (5955 CD; 7351 UC) and 133 060 matched controls. During follow-up, 2156 patients with IBD (16.2%) and 19 095 controls (14.4%) died. CD was associated with higher all-cause mortality than controls (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.19-1.37). UC mortality did not differ from controls (HR 1.03, 95% CI 0.97-1.10). In era-stratified analyses, mortality was comparable in the pre-biologic era (IBD HR 1.04, 95% CI 0.93-1.15). In the biologic era, excess mortality was observed in CD (HR 1.34, 95% CI 1.24-1.45) but not in UC (HR 1.05, 95% CI 0.98-1.12). Compared with controls, CD had higher mortality from colorectal cancer (HR 2.28), renal disease (HR 2.79), non-Hodgkin lymphoma (HR 1.89), and sepsis (HR 2.12), while UC had higher mortality from colorectal cancer (HR 1.56) and cholangiocarcinoma (HR 3.21).</p><p><strong>Conclusions: </strong>All-cause mortality was modestly higher in CD, while UC mortality was similar to matched controls. The CD mortality gap appeared most evident with longer follow-up.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440543","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":"Methodological and respiratory concerns regarding JAK inhibitor safety in ulcerative colitis.","authors":"Shan Qingqing","doi":"10.1093/ecco-jcc/jjag109","DOIUrl":"10.1093/ecco-jcc/jjag109","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551737","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":"Off-label upadacitinib 60 mg daily in the rescue of refractory ulcerative colitis: an open-labeled cohort study.","authors":"Bonita Gu, Viraj Kariyawasam, Rupert W Leong","doi":"10.1093/ecco-jcc/jjag091","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag091","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 7","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414517","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}