Journal of Crohn's & colitis最新文献

{"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}

{"title":"Inflammatory bowel disease must be a policy priority after the 2025 United Nations declaration on non-communicable diseases and mental health.","authors":"Arshdeep Singh, Arshia Bhardwaj, Vandana Midha, Ajit Sood","doi":"10.1093/ecco-jcc/jjag048","DOIUrl":"10.1093/ecco-jcc/jjag048","url":null,"abstract":"<p><p>The 2025 United Nations Political Declaration on non-communicable diseases (NCDs) and mental health provides a critical opportunity to recognize inflammatory bowel disease (IBD) as part of the global NCD agenda. Once confined to the West, IBD now affects over 7 million people worldwide, with the steepest rise in South Asia, Latin America, and Africa. Its early onset, chronic relapsing course, psychosocial burden, and economic cost align it closely with major NCDs. Yet, policy recognition remains limited, particularly in low- and middle-income countries, where diagnostic delays, inequitable access to advanced therapies (biologics and small molecules), and catastrophic healthcare costs persist. Integrating IBD into national NCD frameworks, universal health coverage schemes, and essential drug lists would advance Sustainable Development Goals. The Declaration's emphasis on mental health is especially relevant, as anxiety and depression affect nearly 40% of IBD patients, influencing disease activity and outcomes. Embedding psychosocial care, primary care training, and research equity into IBD programs will foster patient-centered, resilient health systems. Recognizing IBD within the NCD continuum is both a moral and policy imperative, essential to achieving equitable, integrated, and sustainable chronic disease care in the 21st century.</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":"148274395","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":"Gastrointestinal symptom-specific anxiety is associated with disability in inflammatory bowel diseases independent of general anxiety and self-reported disease activity: evidence from a large cross-sectional patient study.","authors":"Sarah Van den Borren, Livia Guadagnoli, Anouk Teugels, Ilse van den Eijnden, Bep Keersmaekers, Marc Ferrante, Ilse Van Diest","doi":"10.1093/ecco-jcc/jjag079","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag079","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal symptom-specific anxiety (GSA) is increasingly recognized as an important construct in the disease experience of inflammatory bowel diseases (IBD). However, it remains unclear to what extent GSA overlaps with general anxiety in the IBD population, and whether it is associated with disability beyond general anxiety and other clinical and demographic variables.</p><p><strong>Aims: </strong>First, we examined how many patients with elevated GSA do or do not experience general anxiety, and vice versa. Second, we assessed the unique contribution of GSA to variance in IBD-related disability, keeping general anxiety, disease activity, and other variables constant.</p><p><strong>Methods: </strong>In a cross-sectional survey study, over 1000 IBD patients completed questionnaires on general anxiety (the anxiety subscale of the Hospital Anxiety and Depression Scale [HADS]), GSA (the Visceral Sensitivity Index [VSI]), IBD-related disability (the IBD Disk), and self-reported clinical disease activity (Patient-Reported Outcomes [PRO] and Manitoba IBD Index [MIBDI]) alongside a set of general demographic and clinical questions.</p><p><strong>Results: </strong>GSA and general anxiety frequently co-occurred, but 38.0% of patients reported GSA without general anxiety. Additionally, GSA was significantly associated with IBD-related disability (P < .001) even when general anxiety, disease activity, and other variables were controlled for. Although general anxiety showed the strongest association with disability (β = .27), the association for GSA (β = 0.22) was stronger than for clinical disease activity (β = .18) and other demographic and clinical variables.</p><p><strong>Conclusion: </strong>Overall, this highlights the clinical significance of GSA beyond general anxiety and disease activity in IBD.</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":"148285017","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":"Limited placental transfer and clearance of risankizumab by 6 months following in utero exposure.","authors":"Christina Balmer, Julie Korgaard, Charlotte Henneberg Holmboe, Signe Neldeborg, Mette Julsgaard","doi":"10.1093/ecco-jcc/jjag086","DOIUrl":"10.1093/ecco-jcc/jjag086","url":null,"abstract":"<p><strong>Background and aims: </strong>The recent Global Consensus supports the use of risankizumab during pregnancy. However, infant clearance following in utero exposure remains unknown, and data on placental transfer are scarce. We report on infant clearance following in utero exposure to risankizumab, and characterize placental transfer and infant outcomes.</p><p><strong>Methods: </strong>Two pregnant women with inflammatory bowel disease exposed to risankizumab during pregnancy were included. Maternal serum and umbilical cord blood were collected at delivery, and infant serum at 3 and 6 months postpartum. Infant development was assessed using the Ages and Stages Questionnaire®, and infections and vaccine tolerance were assessed by maternal questionnaire, telephone follow-up, and review of infant medical records.</p><p><strong>Results: </strong>One woman with ulcerative colitis initiated risankizumab during pregnancy following disease flare, whereas one woman with Crohn's disease continued intravenous maintenance therapy. Maternal concentrations exceeded cord blood concentrations in both pairs, with a median cord blood-to-maternal ratio of 0.19 (range, 0.14-0.23). At 3 months, the median infant concentration was 0.42 μg/mL (range, 0.37-0.47). At 6 months, the concentration was below the lower limit of quantification in one infant (sampling failed in the other). No adverse pregnancy or infant outcomes were observed.</p><p><strong>Conclusions: </strong>Risankizumab showed limited placental transfer, with cord blood concentrations substantially lower than maternal concentrations and clearance within the first 6 months of life. These early findings support the Global Consensus recommendations that risankizumab may be continued during pregnancy and that live BCG vaccine may be administered from 6 months of age, although larger prospective studies are needed.</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":"148335180","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":"Histological activity predicts relapse in pediatric ulcerative colitis despite mucosal healing: a multicenter study from the pediatric IBD Porto group of ESPGHAN.","authors":"Ivana Trivić Mažuranić, Marina Aloi, Matteo Bramuzzo, Claudia Chiantese, Giulia D'Arcangelo, Stefan Gattenlöhner, Laura Gianolio, Maya Granot, Hayriye Hızarcıoğlu Gülşen, Seamus Hussey, Ben Kang, Kaija-Leena Kolho, Jan de Laffolie, Sara Lega, Massimo Martinelli, Manar Matar, Chen Mayer, Erasmo Miele, Lorenzo Norsa, Iacopo Panarese, Firas Rinawi, Pejman Rohani, Claudio Romano, Naire Sansotta, Luca Scarallo, Dror S Shouval, Annamaria Staiano, Caterina Strisciuglio, Davor Tomas, Anat Yerushalmy-Feler, Reyhaneh Zojaji, Iva Hojsak","doi":"10.1093/ecco-jcc/jjag074","DOIUrl":"10.1093/ecco-jcc/jjag074","url":null,"abstract":"<p><strong>Background and aims: </strong>The STRIDE-II recommends mucosal healing as a treatment goal for patients with ulcerative colitis (UC), yet histological remission is increasingly recognized as a meaningful therapeutic target. This study aims to evaluate whether histological activity among patients with mucosal healing is associated with the risk of subsequent relapse.</p><p><strong>Methods: </strong>A multicenter, retrospective cohort study comprised of 19 IBD centers from 9 countries. The study included children diagnosed with UC from January 2012 to December 2022 who had a follow-up endoscopy demonstrating mucosal healing and for whom histology scores were available. Histological remission was defined as a Nancy index (NI) ≤ 1, a Geboes score (GS) ≤ 2, or a Robarts Histopathology Index (RHI) ≤ 3. Histological healing was defined as a histological score of 0.</p><p><strong>Results: </strong>We included 193 children (mean age at diagnosis 10.8 ± 4.3 years; 128 [66%] female). At endoscopy, 155 (80%) children were in histological remission, and 107 (55%) had histological healing. During a median follow-up of 2.4 (range 1-8.7) years, 65 (34%) children experienced a relapse. Patients with histological healing had lower relapse rates than those with residual histological activity (27% vs. 41%; P = .031). Cox regression analysis showed that the absence of histological remission was significantly associated with a higher risk of relapse during follow-up (hazard ratio [HR] 0.499, 95% confidence interval [CI] 0.289-0.863, P = .013), with an even stronger association in those without histological healing (HR 0.469, 95% CI 0.284-0.773, P = .003).</p><p><strong>Conclusion: </strong>Histological activity is a risk factor for relapse of UC in children with mucosal healing.</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":"148201787","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":"Deep learning layer-specific collagen quantification correlates with activity and is associated with outcomes in Crohn's disease.","authors":"Efthymios Tsounis, Roberta Forlano, Theodoros Voulgaris, Pinelopi Bosgana, Odysseas Tsakai, Nikolaos Giannakeas, Maria Kalafateli, Ioanna Aggeletopoulou, Ploutarchos Pastras, Georgia Diamantopoulou, Chrysostomos Tsolias, Gerassimos J Mantzaris, Maria Melachrinou, Konstantinos Thomopoulos, Georgios Theocharis, Alexandros Tzallas, Robert Goldin, Pinelopi Manousou, Christos Triantos","doi":"10.1093/ecco-jcc/jjag075","DOIUrl":"10.1093/ecco-jcc/jjag075","url":null,"abstract":"<p><strong>Background & aims: </strong>Intestinal fibrosis remains a major unmet need in inflammatory bowel disease (IBD). Although collagen deposition is the defining feature of this process, its quantification across intestinal layers has relied on semiquantitative, low-throughput methods that provide limited clinical insight. We developed and validated the first machine learning-based pipeline for layer-specific collagen quantification in intestinal biopsies and assessed its association with disease activity and clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective, single-center study, 1317 intestinal biopsies from 191 IBD patients (92 Crohn's disease [CD], 99 ulcerative colitis [UC]) and 74 controls were analyzed. Sirius Red-stained whole-slide images were segmented using a deep learning model trained on manual annotations to delineate mucosa, muscularis mucosa (MM), and submucosa. Collagen proportional area (CPA) was calculated within each layer using K-means clustering. Associations with clinical, endoscopic, and histological parameters were examined, and the prognostic value of collagen burden for IBD-related outcomes was explored.</p><p><strong>Results: </strong>Machine learning-based collagen quantification showed good reproducibility across layers (intraclass correlation coefficient [ICC] 0.72-0.75). MM and submucosal CPA were significantly higher in active CD than in remission or controls, correlating with disease activity indices and inflammation markers. Elevated baseline submucosal CPA was independently associated with IBD-related surgery (adjusted hazard ratio [aHR] = 1.024; P = .043), while MM CPA was independently associated with hospitalization during follow-up (adjusted odds ratio [aOR] = 1.044; P = .008). In UC, submucosal CPA was higher in remission versus controls. In paired biopsies, bio-experienced patients showed greater reductions in MM and submucosal CPA than bio-naive patients.</p><p><strong>Conclusions: </strong>Layer-specific collagen burden reflects disease activity and is associated with adverse outcomes in CD, supporting its potential as a biomarker for risk stratification and therapeutic monitoring.</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":"148201784","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":"Risk and outcome of interstitial lung disease in inflammatory bowel disease: evidence from a Danish nationwide population-based cohort study.","authors":"Jonas A Baekdal, Erik Sören Halvard Hansen, Howraman Meteran, Charlotte Suppli Ulrik, Flemming Bendtsen, Kjell Erik Julius Håkansson, Nicklas Brustad, Peter Ascanius Jacobsen, Johan Burisch, Elisabeth Bendstrup","doi":"10.1093/ecco-jcc/jjag096","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag096","url":null,"abstract":"<p><strong>Background: </strong>Extra-intestinal manifestations of inflammatory bowel disease (IBD) are well-recognized, but the long-term risk of developing interstitial lung disease (ILD) in IBD and its impact on mortality remain poorly understood. We aimed to assess the risk of ILD in patients with IBD and the subsequent effect on survival.</p><p><strong>Methods: </strong>This nationwide cohort study (1978-2022) utilized the Danish National Patient Registry, including 53 591 patients with IBD and 267 955 age- and sex-matched controls. Adjusted hazard ratios (aHRs) were estimated using Cox regression, adjusted for age, sex, education, and Charlson Comorbidity Index (CCI). Cumulative incidence was assessed via the Aalen-Johansen estimator. Mortality in patients with comorbid IBD-ILD was analyzed using Cox regression and Kaplan-Meier curves.</p><p><strong>Results: </strong>The 45-year cumulative incidence of ILD was 2.1% for IBD versus 0.9% for controls (P < .001), and aHR was 2.1 (95% CI, 1.8-2.4). Furthermore, the aHR was 3.0 (95% CI, 2.2-4.1) in patients with frequent IBD-related hospitalizations compared to matched controls. The 5-year mortality in concomitant IBD and ILD was 29.3% (95% CI, 23.3-35.3) compared to 11.9% (95% CI, 9.8-14.0) for matched patients with only IBD. Male sex and higher CCI were independent risk factors for both ILD and mortality (all P < .001).</p><p><strong>Conclusion: </strong>IBD is associated with a two-fold increase in ILD risk. Risk factors may include old age, longstanding disease, male sex, and comorbidity. Comorbid IBD-ILD increases mortality substantially compared to only IBD, highlighting the need for clinical awareness and early detection to improve outcomes.</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":"148364548","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":"Fatal abdominal compartment syndrome following mannitol bowel preparation in a patient with refractory Crohn's disease.","authors":"Bingqing Xia, Yanzhu Li, Weishan Ruan","doi":"10.1093/ecco-jcc/jjag083","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjag083","url":null,"abstract":"","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":"148274457","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 CONTEXT trial: Real world clinical use of GIQuant-a motility MRI based activity biomarker for small bowel Crohn's disease.","authors":"Alex Menys, Iyad Naim, Joy Barber, Kamal Patel, Nirav Patel, Attah Ocholi, Samantha Baillie, Nkem Onyeador, Victoria Jennings, Sudheer Vuyyuru, Christopher Clarke, Rahul Munyal, Gauraang Bhatnagar, Thomas Shepherd, Laurence Bourn, Sara Upponi, Juan De la Revilla Negro, Anish Kuzhiyanjal, Jimmi Limdi, Aung Win, Priyanka Ghodekar, Afaq Siddiqui, Damian Tolan, Heather Fitzke, William Weston, Paul Harrow, Jie Han Yeo, M Hameed, Stuart A Taylor, Gordon William Moran","doi":"10.1093/ecco-jcc/jjag037","DOIUrl":"10.1093/ecco-jcc/jjag037","url":null,"abstract":"<p><strong>Background: </strong>Motility MRI is a validated marker of small bowel Crohn's disease (CD) activity. Objective assessment of small bowel motility with GIQuant (Motilent, London, U.K.) may have a valuable role to play in personalised patient care. The aim of this study was to assess the impact of implementing GIQuant on clinical impressions around treatment response in small bowel CD.</p><p><strong>Methods: </strong>Patients with small bowel CD on or starting therapy underwent two MRE scans (∼1 year apart) including motility MRI (mMRI) imaging. Twelve gastroenterologists from six U.K. participating centres evaluated patient response based on standard of care tests, grading them on a 6-point scale (much/somewhat/slightly worse through to slightly/somewhat/much better). After initial assessment, GIQuant scores and percentage change were revealed to the gastroenterologist who then updated their response assessment with this information. GIQuant scores at baseline and follow up are reported along with magnitude of change in clinically categorised responders and non-responders.</p><p><strong>Results: </strong>Over the study period of 3.6 years a total of 253 patients (61% male), with ileal (52%) or ileocolonic (48%) CD underwent 506 MRE scans, with a median 10.4-month gap (range 2 to 36) between scans.In 120/253 (47%) patients, gastroenterologists reported a change in their impression of patient status (one step change or greater) after reviewing the GIQuant results with 55/253 (22%) reversing their overall assessment (between deterioration or improvement) across the two time points.In clinical responders, the GIQuant score increased from 123 to 163 (32% increase), P < .001 with non-responders showing a 2 point decrease in score (P = .9).</p><p><strong>Conclusion: </strong>GIQuant as a measure of motility MRI demonstrated robust utility to track the response of small bowel Crohn's activity to therapeutic intervention across time points.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221301","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}