Journal of Crohn's & colitis最新文献

{"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":"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}

{"title":"Region-specific immune regulation determines differential response to JAK1 inhibition in Crohn's disease ex vivo.","authors":"Klaudia Maria Grieger, Susann Dehmel, Valerie Schröder, Kevin Schmidt, Victoria Neufeldt, Laura Bock, Dirk Schaudien, Ulf Kulik, Alexander Wagner, Benjamin Gundert, Heiko Aselmann, Vanessa Neuhaus, Armin Braun, Katherina Sewald","doi":"10.1093/ecco-jcc/jjag101","DOIUrl":"10.1093/ecco-jcc/jjag101","url":null,"abstract":"<p><p>Crohn's disease (CD) remains a significant therapeutic challenge, with limited treatment options and heterogeneous clinical responses. The selective JAK1 inhibitor filgotinib has shown great potential in treating ulcerative colitis but failed to demonstrate consistent efficacy in CD, for reasons that remain unclear. Here, we address this gap using an immunocompetent ex vivo model of precision-cut intestinal slices (PCIS) from CD patients, allowing region-specific analysis of ileal and colonic responses. We reveal that colonic PCIS display strong T cell activation and are highly sensitive to filgotinib, with suppression of Th1/Th17 cytokines, oxidative stress, and STAT signaling ex vivo. In contrast, ileal PCIS exhibited predominantly innate and Th17-driven inflammation, and were less sensitive to JAK1 inhibition. These data provide a potential mechanistic explanation for the limited efficacy of filgotinib in CD clinical trials and established PCIS as a human-relevant ex vivo model for region-specific drug responses, underscoring the importance of developing therapies tailored to different segments of the gut in 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/PMC13423239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632757","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":"Henoch-Schönlein purpura following adalimumab treatment optimization for Crohn's disease: a letter to the editor.","authors":"Rukaia Barà, Alessandro Barruscotti, Matteo Gianferrari, Mariangela Allocca, Chiara Livia Lanzani, Ferdinando D'Amico","doi":"10.1093/ecco-jcc/jjag098","DOIUrl":"10.1093/ecco-jcc/jjag098","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":"148427769","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":"ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease.","authors":"Henit Yanai, Pierre Ellul, Bram Verstockt, Thomas Greuter, Uri Kopylov, María José Casanova, Gabriele Dragoni, Piotr Eder, Maria Manuela Estevinho, Candida Abreu, Federica Furfaro, Christina Kapizioni, Konstantinos Karmiris, Konstantinos Katsanos, Julien Kirchgesner, Eyal Leshem, Nurulamin M Noor, Gianluca Pellino, Daniela Pugliese, Murat Toruner, Nathalie Viget, Yamile Zabana, Edyta Sylwia Zagorowicz, Javier P Gisbert","doi":"10.1093/ecco-jcc/jjag071","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag071","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":"148407635","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":"Corticosteroid-sparing effects of risankizumab versus ustekinumab in patients with moderately to severely active Crohn's disease: post hoc results from the phase 3b SEQUENCE trial.","authors":"Tim Raine, Silvio Danese, Stefan Schreiber, Xiang Gao, Stephen Hanauer, Joana Torres, Colla Cunneen, Kristina Kligys, Xiu Huang, Andrew Garrison, Ezequiel Neimark, Toni Anschutz, Jameson Crowley, Raymond K Cross","doi":"10.1093/ecco-jcc/jjag104","DOIUrl":"10.1093/ecco-jcc/jjag104","url":null,"abstract":"<p><strong>Background: </strong>This post hoc analysis evaluated the corticosteroid-sparing effects of risankizumab (RZB) versus ustekinumab (UST) in patients with moderate to severe Crohn's disease (CD) with prior inadequate response or intolerance to ≥ 1 anti-tumor necrosis factor (TNF) therapy.</p><p><strong>Methods: </strong>SEQUENCE (NCT04524611) was an open-label, multicenter, randomized, efficacy assessment-blinded study. Patients were randomized 1:1 to receive RZB (intravenous [IV] 600 mg induction dose at weeks 0, 4, and 8, then a subcutaneous [SC] 360 mg maintenance dose every 8 weeks [Q8w] starting at week 12) or UST (single weight-based IV induction dose, then a SC 90 mg maintenance dose Q8w starting at week 8) up to week 48. Patients tapered corticosteroids beginning at week 2. Achievement of clinical, endoscopic, and quality of life outcomes without concomitant use of steroids (\"corticosteroid-free\") and safety were assessed.</p><p><strong>Results: </strong>In patients taking corticosteroids at baseline, response rate differences by the week 24 and 48 timepoints with RZB versus UST were 10.5% and 25.4% (P ≤ .01) for corticosteroid-free clinical remission per CD activity index and 20.4% (P ≤ .001) and 29.2% (P ≤ .01) per stool frequency/abdominal pain score, and 23.0% and 20.2% (both P ≤ .01) for corticosteroid-free endoscopic remission. Similar results were also observed for additional corticosteroid-free endpoints, including endoscopic, composite (clinical + endoscopic), and quality of life outcomes. Numerically higher exposure-adjusted event rates of serious infections and hypersensitivity with RZB and UST were observed with corticosteroid use.</p><p><strong>Conclusion: </strong>In patients with CD refractory to anti-TNF therapy, higher rates of corticosteroid-free clinical, endoscopic, and quality of life outcomes were achieved with RZB versus UST. Both treatments were well-tolerated.</p><p><strong>Clinical trial registration number: </strong>NCT04524611.</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/PMC13387155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551807","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":"Retention of the ileocolic pedicle correlates with higher postoperative endoscopic recurrence risk in Crohn's disease ileocolic resection.","authors":"Chunjie Zhang, Ganglei Liu, Jun Bi, Jiajun Fu, Qianwen Tu, Changsheng Zhou, Ming Duan, Lei Cao, Lingling Peng, Zhao Ding, Yi Li","doi":"10.1093/ecco-jcc/jjag116","DOIUrl":"10.1093/ecco-jcc/jjag116","url":null,"abstract":"<p><strong>Background and aims: </strong>The role of residual mesentery after ileocolic resection in Crohn's disease (CD) remains controversial. We conducted a multicenter retrospective study to evaluate the association between postoperative residual ileocolic artery length (RIAL), a surrogate marker of residual mesenteric burden, and endoscopic recurrence (ER) in CD.</p><p><strong>Methods: </strong>This multicenter retrospective study involved patients with CD who underwent ileocolic resection between January 2019 and December 2024. RIAL was measured using postoperative contrast-enhanced computed tomography. The primary outcome was ER at the first endoscopic assessment. Least absolute shrinkage and selection operator (LASSO) logistic regression was used to identify predictors of ER and to construct a nomogram. Kaplan-Meier and Cox regression analyses were applied to evaluate ER outcome within 36 months after surgery.</p><p><strong>Results: </strong>Among 270 patients, 90 (33.3%) developed ER at the first postoperative endoscopy. LASSO logistic regression and the derived nomogram identified that a longer RIAL was associated with an increased risk of ER. ROC curve analysis identified 32.8 mm as the optimal cutoff of RIAL for predicting ER. Kaplan-Meier curve showed that patients with a RIAL < 32.8 mm had significantly longer ER-free survival (log-rank P < .001). Cox analysis identified an RIAL < 32.8 mm and the postoperative use of biologics were independent protective factors for ER-free survival.</p><p><strong>Conclusions: </strong>Postoperative ER risk was positively correlated with RIAL in CD. Though these correlative data reveal at a statistical association between ileocolic pedicle division and reduced ER risk, our observational analysis does not prove a causal protective effect of pedicle resection.</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":"148595314","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: P0562 Comparative Efficacy and Safety of Upadacitinib Versus Oral Prednisolone for the Induction of Remission in Ulcerative Colitis: A Prospective, Multicenter, Open-label, Randomized Controlled Trial (PREDUPA Trial) Protocol and P0563 Mirikizumab Demonstrated Sustained and Durable Long-Term Efficacy and Favorable Safety in Week 52 Endoscopic Responders with Crohn's disease: 3-year VIVID-2 Open-Label Extension Interim Results.","authors":"","doi":"10.1093/ecco-jcc/jjag010","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag010","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":"148427736","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":"Stability of infliximab serum concentrations during long-term frozen storage: a paired biobank study.","authors":"Suzanne I Anjie, Sarah van Zon, Karien Bloem, Theo Rispens, Geert R D'Haens","doi":"10.1093/ecco-jcc/jjag113","DOIUrl":"10.1093/ecco-jcc/jjag113","url":null,"abstract":"<p><strong>Background: </strong>Pharmacokinetic research of infliximab often relies on prospectively collected, long-term frozen serum samples. Although the effect of storage conditions on infliximab stability has been researched extensively, the influence of long-term storage on the reliability of infliximab concentration measurements remains unknown.</p><p><strong>Methods: </strong>In this proof-of-concept study, infliximab serum concentrations measured after 2, 5, and 8 years of standardized frozen storage at -70 °C were compared with paired samples analyzed directly after collection. Equivalence was assessed using a two one-sided tests framework with predefined margins of 80%-125%, in line with FDA equivalence guidance.</p><p><strong>Results: </strong>Equivalence was demonstrated at all three storage durations. Geometric mean ratios were 87.0% (90% CI, 80.9%-93.6%), 103.2% (90% CI, 90.3%-117.9%), and 99.3% (90% CI, 92.5%-106.6%) at 2, 5, and 8 years, respectively, all within predefined equivalence margins. A statistically significant reduction was observed in the 2-year group (P = .010), though within equivalence bounds. No concentration-dependent bias was detected (P = .926), and Spearman correlation between fresh and frozen concentrations was high (ρ = 0.908, P < .001).</p><p><strong>Conclusion: </strong>Infliximab serum concentrations remain stable after long-term frozen storage of up to 8 years under standardized conditions, supporting the validity of deferred concentration analyses in prospectively stored serum samples.</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/PMC13425999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632688","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":"Risk of symptomatic leishmaniasis in patients with inflammatory bowel disease receiving biologic therapy in an endemic Mediterranean region: a population-based case-control study.","authors":"Leticia Gimeno-Pitarch, Marisa Iborra, Ana Crespo, Laura Sanchis, María Rosario Antón, Miguel Pastor, Lidia Martí, Belén Herreros, Cristina Peña, Lucía Ruíz, Amparo Almudena Pérez, Francia Carolina Díaz, Nuria Maroto, Raquel Laveda, Lucía Madero, Lidia Buendía, Pilar Nos","doi":"10.1093/ecco-jcc/jjag067","DOIUrl":"10.1093/ecco-jcc/jjag067","url":null,"abstract":"<p><strong>Background and aims: </strong>Leishmaniasis is an emerging opportunistic infection in patients with inflammatory bowel disease (IBD) living in Mediterranean endemic areas. However, the magnitude of the risk and treatment-related determinants remain unknown, and no controlled population-based studies have addressed this issue. We aimed to estimate the incidence of symptomatic Leishmania infection in IBD population and to identify associated clinical and therapeutic risk factors, particularly immunosuppressive treatments.</p><p><strong>Methods: </strong>An observational study was conducted in the Valencian Community (Spain) between 2015 and 2022, involving 16 hospitals. The study comprised 3 components: (1) a population-based retrospective cohort to estimate incidence of leishmaniasis in IBD patients; (2) a multicenter case series, to characterize clinical presentation, diagnosis, and outcomes; and (3) a matched 1:2 case-control study, to identify factors associated with the infection. Cases were adults with Crohn's disease or ulcerative colitis and confirmed symptomatic Leishmania (polymerase chain reaction [PCR], histology or culture). Controls were matched by sex, IBD subtype, and year of birth (±10 years). Immunosuppressive exposure at the index date was recorded. Conditional logistic regression was used to identify independent predictors of infection, with covariate selection guided by a directed acyclic graph.</p><p><strong>Results: </strong>Eighty-two cases were identified: 80.5% cutaneous, 14.6% visceral, and 4.9% mucocutaneous leishmaniasis. The mean annual incidence was 0.464 per 1000 IBD patients, 13.2-fold higher than in the general population (0.0035 per 1000; P < .001). Comorbidities were more frequent among cases. Diagnosis often requires PCR, with ≥ 2 biopsies needed in 26.2% of patients. At infection, 90.1% of cases vs 44.5% of controls were receiving biologic therapy (P < .001). Anti-TNF exposure, combination therapy (biologic plus immunomodulator), and escalated biologic regimens were more frequent among cases (P < .001). Overall, 90.7% of patients achieved cure with first-line therapy; been systemic treatment reserved for refractory cutaneous disease. Differences were observed between continuation or withdrawal of immunosuppressive therapy along first-line treatment (P-value = .036). In multivariable analysis, biologic therapy (adjusted odds ratio [OR] 16.1; 95% CI, 4.56-57.1) and presence of comorbidities (adjusted OR 6.47; 95% CI, 1.66-25.2) were independently associated with infection.</p><p><strong>Conclusions: </strong>In the Mediterranean endemic areas, patients with IBD have a markedly increased risk of developing symptomatic leishmaniasis. Biologic therapy represents the principal driver of infection risk, underscoring the need for heightened clinical awareness and update guidance on opportunistic infections in endemic regions.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":"20 6","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201829","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}