Journal of Crohn's & colitis最新文献

{"title":"Impact Of Hladqa1*05 And Hladqa1*03 On Safety And Loss Of Response To Anti-Tnf In Patients With Inflammatory Bowel Disease.","authors":"Julia López De-La-Cruz, Fernando Gomollón, Javier Louro, Juan López Pérez, María Mercedes Lourdes Nocito-Colon, Beatriz Gallego Llera, Sandra García-Mateo, Samuel J Martínez-Domínguez, María Concepción Aso Gonzalvo, Carla J Gargallo-Puyuelo","doi":"10.1093/ecco-jcc/jjae178","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae178","url":null,"abstract":"<p><strong>Background: </strong>HLADQA1*05 is recently associated with heightened immunogenicity to anti-TNF. Our aims were to determine whether HLADQ1*05 is a risk factor for primary non-response, loss of response (LOR) or adverse events (AE) to first-line anti-TNFα in patients with inflammatory bowel disease.</p><p><strong>Methods: </strong>We performed a retrospective observational study enrolling biologic naïve patients with Crohn´s disease and ulcerative colitis who initiated adalimumab or infliximab from 2000 to 2021. HLA-DQA1 genotype was determined in all patients and immunogenicity in 98 patients.</p><p><strong>Results: </strong>We enrolled 408 patients who started first-line infliximab (n=211) and adalimumab (n=197), with a mean follow-up of 7.6 years. Primary response at week 24 occurred in 347 (85.0%), LOR in 133 (38.3%) and AE in 93 (22.8%). The HLADQA1*05 was identified in 185 (43.3%) patients. In multivariate analyses, no risk factors were identified for primary response. HLADQA1*05 was an independent risk factor for LOR (aHR=1.80, 95%CI=1.21-2.67) and immunogenicity (aOR=3.44, 95% CI=1.12-11.92). HLADQA1*03 was a protective factor against LOR (aHR=0.42, 95%CI=0.20-0.88). Stratified analysis by anti-TNF type showed that HLADQA1*05 increased the risk of LOR to infliximab but not to adalimumab and HLADQA1*03 decreased the risk of LOR to adalimumab but not to infliximab. Female sex, infliximab and the co-presentation of at least one allele of the HLADQA1*03 and HLADQA1*05 were risk factors for AE.</p><p><strong>Conclusions: </strong>HLADQA1*05 is associated with a higher risk of LOR and immunogenicity, particularly to infliximab. HLADQA1*03 seems to play a protective role against LOR, particularly to adalimumab. Female sex and infliximab are risk factors for AE.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial Enteral Nutrition in the Management of Crohn's Disease: A Systematic Review and Meta-Analysis.","authors":"Aleksandra Jatkowska, Bernadette White, Konstantinos Gkikas, John Paul Seenan, Jonathan MacDonald, Konstantinos Gerasimidis","doi":"10.1093/ecco-jcc/jjae177","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae177","url":null,"abstract":"<p><strong>Background: </strong>Exclusive enteral nutrition is an established treatment for active Crohn's disease (CD) but the role of partial enteral nutrition (PEN) in the broader management of the disease is less clear. This systematic review and meta-analysis reviewed the literature on the role of PEN in CD management.</p><p><strong>Methods: </strong>This review was conducted following Cochrane recommendations. The protocol was registered on PROSPERO. Findings were reported following the PRISMA guidelines.</p><p><strong>Results: </strong>Sixty-four articles were identified, of which 11 reported data from randomised control trials. Good quality evidence suggests that PEN may be used as a maintenance and induction therapy, particularly at high dosages and/or alongside exclusion diets. A higher dosage of PEN is associated with a lower risk of subsequent disease relapse, with benefits observed at intakes above 35% of energy requirements (35-50% PEN: OR [95% CI]: 0.42 [0.27-0.65]; >50% PEN: OR [95% CI]: 0.27 [0.08-0.88]). Low quality evidence suggests that post-operative use of PEN may prevent disease recurrence or enhance treatment outcomes when used as adjunct therapy to biologics. PEN can improve nutritional parameters, showing efficacy comparable to EEN in paediatric patients (weight: OR [95% CI]: -0.04 [-0.32, 0.25]). The effect of PEN on improving patients' quality of life is comparable to that of EEN and anti-TNFα therapies.</p><p><strong>Conclusion: </strong>Partial enteral nutrition may help in various aspects of CD management but much of the current evidence is of low quality. Well-designed RCTs are required to confirm findings from current literature and before clinical recommendations can be made.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684000","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":"Incidence, disease burden and clinical presentation of patients newly diagnosed with inflammatory bowel disease in a population-based inception cohort.","authors":"Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Jakob Benedict Seidelin, Johan Burisch","doi":"10.1093/ecco-jcc/jjae176","DOIUrl":"10.1093/ecco-jcc/jjae176","url":null,"abstract":"<p><strong>Background and aims: </strong>Emerging data indicate a stabilizing incidence of inflammatory bowel diseases (IBD), including ulcerative colitis (UC), Crohn's disease (CD), and IBD unclassified (IBDU) in Western countries. We aimed to investigate the incidence of IBD, its initial clinical presentation, and patient-reported burden.</p><p><strong>Methods: </strong>Copenhagen IBD Inception Cohort is a prospective, population-based cohort of patients with newly diagnosed IBD according to the ECCO guidelines in the period between May 2021 and May 2023, within a catchment area covering 20% of the Danish population.</p><p><strong>Results: </strong>Based on 554 patients (UC: 308, CD: 201, and IBDU: 18), the incidence rates per 100,000 person-years were: IBD: 23.4 (95% confidence interval, 21.5-25.4), UC: 14.0 (12.6-15.6), CD: 8.6 (7.4-9.8), and IBDU: 0.8 (0.5-1.3). The median diagnostic delay was significantly shorter for UC (2.5 months (interquartile range [IQR] 1-6)) than for CD (5 months (IQR 1.5-11), p<0.01). Moderate-to-severe disability was reported by 34% of CD patients and 22% of UC patients (p=0.01), severe fatigue by 30% and 26% (p=0.43), and severely impaired health-related quality of life (HRQoL) by 43% and 30% of patients, respectively (p=0.01). Hospitalization rates (UC: 20%, CD: 34%, p<0.01), and need for immunomodulators, biologics, or surgery within three months of diagnosis, were high in both UC (3%, 7%, and 37%, respectively) and CD (31%, 18%, and 10%, respectively).</p><p><strong>Conclusions: </strong>We found a high incidence of IBD in Copenhagen with a substantial disease burden characterized by early and high requirement for advanced therapies and high rates of fatigue, disability and impaired HRQoL at diagnosis.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677674","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":"Association of the HLA DQA1*05 allelic gene variants with immunogenicity to anti-TNF therapeutics - important differences between infliximab and adalimumab.","authors":"Nicola Ternette, Hanqing Liao, Jack Satsangi","doi":"10.1093/ecco-jcc/jjae172","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae172","url":null,"abstract":"","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645290","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":"Use of MM-SES-CD Endoscopic Improvement Thresholds Enhances Effect Size Differentiation between Adalimumab vs. Placebo: A Post-hoc Analysis of the EXTEND Trial.","authors":"Emily C L Wong, Parambir S Dulai, John K Marshall, Stephen Laroux, Vipul Jairath, Walter Reinisch, Neeraj Narula","doi":"10.1093/ecco-jcc/jjae171","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae171","url":null,"abstract":"<p><strong>Introduction: </strong>The Modified Multiplier of the SES-CD (MM-SES-CD) refines the assessment of endoscopic Crohn's Disease (CD) severity by differentially weighting parameters in the original SES-CD. A threshold of <22.5 for MM-SES-CD suggests endoscopic remission and correlates with a low risk of long-term disease progression. This study examines whether MM-SES-CD-defined endoscopic remission (ER) and response criteria are more sensitive to treatment effects compared to conventional SES-CD definitions.</p><p><strong>Methods: </strong>This post-hoc analysis of the EXTEND trial compared various SES-CD and MM-SES-CD definitions of ER and endoscopic response in CD patients treated with adalimumab or placebo. The study included participants with moderate-severe CD and a baseline MM-SES-CD score ≥22.5. The primary outcome of ER, defined as MM-SES-CD <22.5, was evaluated at weeks 12 and 52. AUC analyses compared thresholds for predicting week 52 ER.</p><p><strong>Results: </strong>Of the 100 participants (77.5% of the EXTEND population), 51 received adalimumab and 49 placebo. At week 12, 62% achieved MM-SES-CD ≥20% reduction from baseline, compared to 39% with SES-CD ≥50% reduction. At week 52, 56.9% of adalimumab-treated participants achieved MM-SES-CD <22.5, compared to 10.2% in the placebo group. MM-SES-CD ≥20% reduction at week 12 better predicted week 52 ER than SES-CD ≥50% reduction (AUC: 0.73 vs. 0.62, p=0.002).</p><p><strong>Conclusion: </strong>MM-SES-CD definitions improved discrimination between treatment and placebo and offered superior predictive accuracy for week 52 ER. Its use may enhance trial efficiency and better predict long-term disease outcomes.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635157","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":"Fatigue in patients with inflammatory bowel disease in remission one year after diagnosis (the IBSEN III study).","authors":"Kristina A Holten, Tomm Bernklev, Randi Opheim, Bjørn C Olsen, Trond Espen Detlie, Vibeke Strande, Petr Ricanek, Raziye Boyar, May-Bente Bengtson, Tone B Aabrekk, Øyvind Asak, Svein Oskar Frigstad, Vendel A Kristensen, Milada Hagen, Magne Henriksen, Gert Huppertz-Hauss, Marte Lie Høivik, Lars-Petter Jelsness-Jørgensen","doi":"10.1093/ecco-jcc/jjae170","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae170","url":null,"abstract":"<p><strong>Background and aims: </strong>Fatigue is commonly observed in Crohn's disease (CD) and ulcerative colitis (UC), but its association to achieving remission is not clearly established. In this study we describe the odds for fatigue in patients with CD/UC one year after diagnosis based on different definitions of remission and identified factors associated with chronic fatigue (CF) among patients in endoscopic/radiological remission.</p><p><strong>Methods: </strong>Patients ≥18 years with CD/UC were recruited from the IBSEN III cohort. Using the Fatigue Questionnaire, and dichotomizing the score, CF was defined as the presence of substantial fatigue (SF) for ≥6 months. Remission was divided into symptomatic (CD: HBI score<5/UC: SCCAI score<3), biochemical (faecal calprotectin ≤250µg/g), endoscopic/radiological (CD: normal intestinal MRI/CT combined with normal endoscopy/UC: Mayo endoscopic score 0) and histological (normal mucosal biopsies). Both the likelihood of SF/CF, depending on the definition of remission, and associations between CF and selected factors for CD/UC in endoscopic/radiological remission, were evaluated using binary logistic regression analysis.</p><p><strong>Results: </strong>In total, 711/1416 patients were included. For both CD and UC, symptomatic remission significantly reduced the odds for SF and CF. Additionally, the odds for SF were significantly reduced for UC in biochemical remission. Among those in endoscopic/radiological remission (n=181), CF was independently associated with sleep disturbances (OR=10.40, 95%CI [3.28;32.99], p<0.001) and current treatment with infliximab (OR=4.31, 95%CI [1.15;16.17], p=0.03).</p><p><strong>Conclusions: </strong>Stricter definitions of disease remission were not associated with a decreased likelihood of fatigue. For patients in endoscopic/radiological remission, CF was independently associated with sleep disturbances and current treatment with infliximab.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635147","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":"Labour market participation and income in patients with IBD onset before young adulthood - the role of disease severity and mental health.","authors":"Julie Rasmussen, Bente Mertz Nørgård, Henrik Bøggild, Niels Qvist, Åsa H Everhov, Petter Malmborg, Rasmus Gaardskær Nielsen, René Børge Korsgaard Brund, Kirsten Fonager","doi":"10.1093/ecco-jcc/jjae165","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjae165","url":null,"abstract":"<p><strong>Background and aim: </strong>Only few studies have examined the socioeconomic consequences of being diagnosed with inflammatory bowel disease (IBD) in childhood or youth. Disease severity has been linked to lower earnings, but little attention has been paid to comorbid mental health conditions. The aim is to examine labour market participation (LMP) and income in patients with IBD-onset in childhood or youth and examine how disease severity and mental health conditions affects LMP.</p><p><strong>Methods: </strong>In this register-based cohort study, we included patients with IBD-onset before 25 years of age and matched comparators. We estimated the relative risk (RR) of having low LMP and the median yearly income from ages 26 to 30. RR of low LMP was also assessed in subgroups of patients based on disease severity (severe/non-severe) and mental health conditions (yes/no).</p><p><strong>Results: </strong>A total of 3,398 patients with IBD and 28,207 comparators were included. Overall, patients with IBD more often had low LMP (16.4% vs 14.4% in comparators), but slightly higher income (median yearly income difference at age 30: 1,141 Euro [95% CI: 483-1,798]). In subgroup analyses, only patients with severe IBD had higher risk of low LMP (RR 1.46 [95% CI 1.23-1.72]), not patients with non-severe IBD. Among patients with severe disease and mental health conditions 46% had low LMP (RR 5.03 [95% CI 4.38-5.78]).</p><p><strong>Conclusion: </strong>Patients with IBD more often had low LMP, but their income was not affected. The subgroup of patients with severe disease and mental health conditions had the highest risk of low LMP.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577103","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 Prior Biologic or Janus Kinase Inhibitor Therapy on Efficacy and Safety of Etrasimod in the ELEVATE UC 52 and ELEVATE UC 12 Trials.","authors":"Séverine Vermeire, Bruce E Sands, Laurent Peyrin-Biroulet, Geert R D'Haens, Julian Panés, Andres J Yarur, Douglas C Wolf, Timothy Ritter, Stefan Schreiber, John C Woolcott, Irene Modesto, Michael Keating, Kevin Shan, Joseph Wu, Michael V Chiorean, Filip Baert, Marla C Dubinsky, Martina Goetsch, Silvio Danese, Brian G Feagan","doi":"10.1093/ecco-jcc/jjae079","DOIUrl":"10.1093/ecco-jcc/jjae079","url":null,"abstract":"<p><strong>Background and aims: </strong>Etrasimod is an oral, once daily, selective, sphingosine 1-phosphate [S1P]1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis [UC]. This subgroup analysis evaluated the efficacy and safety of etrasimod 2 mg once daily vs placebo by prior biologic/Janus kinase inhibitor [bio/JAKi] exposure in ELEVATE UC 52 and ELEVATE UC 12.</p><p><strong>Methods: </strong>Pre-defined efficacy endpoints were assessed at Weeks 12 and 52 in ELEVATE UC 52 and Week 12 in ELEVATE UC 12 in bio/JAKi-naïve and -experienced patients, and at Week 12 [pooled] based on prior advanced therapy exposure mechanism.</p><p><strong>Results: </strong>In the ELEVATE UC 52 and ELEVATE UC 12 analysis populations, 80/274 [29.2%] and 74/222 [33.3%] patients receiving etrasimod and 42/135 [31.1%] and 38/112 [33.9%] patients receiving placebo, respectively, were bio/JAKi-experienced. In both bio/JAKi-naïve and -experienced patients, a significantly greater proportion receiving etrasimod vs placebo achieved clinical remission [p < 0.05] in ELEVATE UC 52 at Weeks 12 [naïve: 30.9% vs 9.7%; experienced: 17.5% vs 2.4%] and 52 [naïve: 36.6% vs 7.5%; experienced: 21.3% vs 4.8%]; in ELEVATE UC 12, this was observed only for bio/JAKi-naïve patients [naïve: 27.7% vs 16.2%, p = 0.033; experienced: 18.9% vs 13.2%, p = 0.349]. Similar patterns were observed for most efficacy endpoints. Among patients with prior anti-integrin exposure [N = 90], a significantly greater proportion achieved clinical response [54.1% vs 27.6%, p = 0.030], but not clinical remission [9.8% vs 3.4%, p = 0.248], with etrasimod vs placebo.</p><p><strong>Conclusions: </strong>Bio/JAKi-naïve and -experienced patients had clinically meaningful induction and maintenance treatment benefits with etrasimod vs placebo.</p><p><strong>Clinicaltrials.gov: </strong>NCT03945188; NCT03996369.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":"1780-1794"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328251","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":"Serum Metabolites Relate to Mucosal and Transmural Inflammation in Paediatric Crohn Disease.","authors":"Ricardo G Suarez, Namitha Guruprasad, Ganesh Tata, Zhengxiao Zhang, Gili Focht, Daniel McClement, Víctor Manuel Navas-López, Sibylle Koletzko, Anne M Griffiths, Oren Ledder, Lissy de Ridder, David Wishart, Ben Nichols, Konstantinos Gerasimidis, Dan Turner, Eytan Wine","doi":"10.1093/ecco-jcc/jjae085","DOIUrl":"10.1093/ecco-jcc/jjae085","url":null,"abstract":"<p><strong>Background and aims: </strong>We aimed to identify serum metabolites associated with mucosal and transmural inflammation in paediatric Crohn disease [pCD].</p><p><strong>Methods: </strong>In all, 56 pCD patients were included through a pre-planned sub-study of the multicentre, prospective, ImageKids cohort, designed to develop the Paediatric Inflammatory Crohn magnetic resonance enterography [MRE] Index [PICMI]. Children were included throughout their disease course when undergoing ileocolonoscopy and MRE and were followed for 18 months, when MRE was repeated. Serum metabolites were identified using liquid chromatography/mass spectroscopy. Outcomes included: PICMI, the simple endoscopic score [SES], faecal calprotectin [FCP], and C-reactive protein [CRP], to assess transmural, mucosal, and systemic inflammation, respectively. Random forest models were built by outcome. Maximum relevance minimum redundancy [mRMR] feature selection with a j-fold cross-validation scheme identified the best subset of features and hyperparameter settings.</p><p><strong>Results: </strong>Tryptophan and glutarylcarnitine were the top common mRMR metabolites linked to pCD inflammation. Random forest models established that amino acids and amines were among the most influential metabolites for predicting transmural and mucosal inflammation. Predictive models performed well, each with an area under the curve [AUC] > 70%. In addition, serum metabolites linked with pCD inflammation mainly related to perturbations in the citrate cycle [TCA cycle], aminoacyl-tRNA biosynthesis, tryptophan metabolism, butanoate metabolism, and tyrosine metabolism.</p><p><strong>Conclusions: </strong>We extend on recent studies, observing differences in serum metabolites between healthy controls and Crohn disease patients, and suggest various associations of serum metabolites with transmural and mucosal inflammation. These metabolites could improve the understanding of pCD pathogenesis and assessment of disease severity.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":"1832-1844"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262226","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":"Seeing Beyond the Surface: Superior Performance of Ultrasound Elastography over Milan Ultrasound Criteria in Distinguishing Fibrosis of Ulcerative Colitis.","authors":"Feng Zhu, Xin Chen, Xueni Qiu, Wenwen Guo, Xuesong Wang, Junying Cao, Jianfeng Gong","doi":"10.1093/ecco-jcc/jjae081","DOIUrl":"10.1093/ecco-jcc/jjae081","url":null,"abstract":"<p><strong>Background: </strong>Colonic fibrosis has important clinical implications in ulcerative colitis [UC]. Ultrasound imaging has emerged as a convenient and reliable tool in diagnosis of inflammatory bowel disease. We aimed to explore the potential use of ultrasound to evaluate UC fibrosis.</p><p><strong>Methods: </strong>Consecutive UC patients who had proctocolectomy from July 2022 to September 2023 were enrolled in the study. Patients underwent bowel ultrasound examination and ultrasound elastography imaging prior to surgery. Milan ultrasound criteria [MUC] were calculated and bowel wall stiffness was determined using two mean strain ratios [MSRs]. Degree of colonic fibrosis and inflammation was measured upon histological analysis. Receiver operating characteristic [ROC] analysis was used to evaluate the performance of ultrasound-derived parameters to predict fibrosis.</p><p><strong>Results: </strong>In all, 56 patients were enrolled with 112 segments included in analysis. The median fibrosis score was 2 [0-4] and the median Geboes score was 5 [0-13] and these two scores were significantly correlated [p < 0.001]. The muscularis mucosa thickness was significantly higher in moderate-severe fibrosis than none-mild fibrosis [p = 0.003] but bowel wall thickness was not [p = 0.082]. The strain ratios [p < 0.001] and MUC [p = 0.010] were significantly higher in involved than non-involved segments. The strain ratios were correlated with fibrosis score [p < 0.001] but not MUC [p = 0.387]. At ROC analysis, mean strain ratio 1 [MSR1] had an area under the curve [AUC] of 0.828 [cutoff value 3.07, 95% CI 0.746-0.893, p < 0.001] to predict moderate-severe fibrosis.</p><p><strong>Conclusion: </strong>Ultrasound elastography imaging could predict the degree of colonic fibrosis in UC. Application of this technique could help disease monitoring and decision making in UC patients.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":"1795-1803"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201659","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}