Intestinal Research

Most-cited are based on citations from 2022 ~ 2024.

Reviews

IBD

Use of thiopurines in inflammatory bowel disease: an update: Arshdeep Singh, Ramit Mahajan, Saurabh Kedia, Amit Kumar Dutta, Abhinav Anand, Charles N. Bernstein, Devendra Desai, C. Ganesh Pai, Govind Makharia, Harsh Vardhan Tevethia, Joyce WY Mak, Kirandeep Kaur, Kiran Peddi, Mukesh Kumar Ranjan, Perttu Arkkila, Rakesh Kochhar, Rupa Banerjee, Saroj Kant Sinha, Siew Chien Ng, Stephen Hanauer, Suhang Verma, Usha Dutta, Vandana Midha, Varun Mehta, Vineet Ahuja, Ajit Sood; Intest Res 2022;20(1):11-30. Published online April 15, 2021; DOI: https://doi.org/10.5217/ir.2020.00155

Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.

Citations

Citations to this article as recorded by

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IBD

Update on the epidemiology of inflammatory bowel disease in Asia: where are we now?: Sang Hyoung Park; Intest Res 2022;20(2):159-164. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2021.00115

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD) has become a global disease. As IBD is a chronic disease that can result in remarkable morbidity and disability, estimation and understanding the disease burden of IBD is imperative to prepare adequate health care systems. However, variations in IBD incidence or prevalence may reflect differences in the distribution, and there are regional disparities in Asia with a large population of approximately 4.6 billion in 2020, which is equivalent to 60% of the total world population. Although comprehensive understanding of the epidemiology of IBD in Asian countries is difficult, this review includes updated data regarding the incidence and prevalence of IBD and the estimated disease burden in Asia.

Citations

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IBD

Natural history of inflammatory bowel disease: a comparison between the East and the West: Eun Mi Song, Suk-Kyun Yang; Intest Res 2022;20(4):418-430. Published online December 2, 2021; DOI: https://doi.org/10.5217/ir.2021.00104

Abstract PDF PubReader ePub

Over the past decades, there has been a rapid increase in the incidence and prevalence of inflammatory bowel disease (IBD) in Asia. The natural history of IBD in Asian patients could be different from that in Western patients due to variations in disease phenotypes and genotypes as well as the healthcare environment between the 2 populations. To adequately cope with this disease, it is important to fully understand the potential differences in its natural history among different populations. In this review, we evaluated the differences in the clinical course of IBD between Asian and Western patients with regards to phenotypic progression, hospitalization, major surgery, risk of colorectal cancer, and mortality, mainly based on the results of population-based studies. The findings of our narrative review suggest that the clinical course of Asian patients with IBD, especially ulcerative colitis, is better than that of Western patients, as indicated by the lower rates of major surgery and hospitalization. In addition, similar to Western patients, the clinical course of Asian patients with IBD has been improving as evidenced by the decreasing rates of disease behavior progression (in Crohn’s disease), hospitalization, and major surgery.

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IBD

Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis: Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):61-87. Published online May 31, 2022; DOI: https://doi.org/10.5217/ir.2022.00007

Abstract PDF Supplementary Material PubReader ePub

Ulcerative colitis (UC), a relapsing-remitting chronic inflammatory bowel disease (IBD), has a variable natural course but potentially severe disease course. Since the development of anti-tumor necrosis factor (TNF) agents has changed the natural disease course of moderate-to-severe UC, therapeutic options for patients who failed conventional treatments are expanding rapidly. IBD clinical trials have demonstrated the potential efficacy and safety of novel biologics such as anti-integrin α4β7 and anti-interleukin-12/23 monoclonal antibodies and small molecules such as a Janus kinase inhibitor. Anti-TNF biosimilars also have been approved and are widely used in IBD patients. Wise drug choices should be made considering evidence-based efficacy and safety. However, the best position of these drugs remains several questions, with limited data from direct comparative trials. In addition, there are still concerns to be elucidated on the effect of therapeutic drug monitoring and combination therapy with immunomodulators. The appropriate treatment regimens in acute severe UC and the risk of perioperative use of biologics are unclear. As novel biologics and small molecules have been approved in Korea, we present the Korean guidelines for medical management of adult outpatients with moderate-to-severe UC and adult hospitalized patients with acute severe UC, focusing on biologics and small molecules.

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Microbiota

The role of microbiome in colorectal carcinogenesis and its clinical potential as a target for cancer treatment: Sang Hoon Kim, Yun Jeong Lim; Intest Res 2022;20(1):31-42. Published online May 21, 2021; DOI: https://doi.org/10.5217/ir.2021.00034

Abstract PDF PubReader ePub

The role of gut microbiome-intestinal immune complex in the development of colorectal cancer and its progression is well recognized. Accordingly, certain microbial strains tend to colonize or vanish in patients with colorectal cancer. Probiotics, prebiotics, and synbiotics are expected to exhibit both anti-tumor effects and chemopreventive effects during cancer treatment through mechanisms such as xenometabolism, immune interactions, and altered eco-community. Microbial modulation can also be safely used to prevent complications during peri-operational periods of colorectal surgery. A deeper understanding of the role of intestinal microbiota as a target for colorectal cancer treatment will lead the way to a better prognosis for colorectal cancer patients.

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IBD

Korean clinical practice guidelines on biologics for moderate to severe Crohn’s disease: Seong-Joon Koh, Sung Noh Hong, Soo-Kyung Park, Byong Duk Ye, Kyeong Ok Kim, Jeong Eun Shin, Yong Sik Yoon, Hong Sub Lee, Sung Hoon Jung, Miyoung Choi, Soo-Young Na, Chang Hwan Choi, Joo Sung Kim, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):43-60. Published online October 18, 2022; DOI: https://doi.org/10.5217/ir.2022.00029

Abstract PDF PubReader ePub

Crohn’s disease (CD) is a relapsing and progressive condition characterized by diarrhea, abdominal pain, weight loss, and hematochezia that results in serious complications such as perforations, fistulas, and abscesses. Various medications, interventions, and surgical treatments have been used to treat CD. The Korean guidelines for CD management were distributed in 2012 and revised in 2017 by the Inflammatory Bowel Disease (IBD) Research Group of the Korean Association for the Study of Intestinal Diseases. Substantial progress in mucosal immunologic research has elucidated the pathophysiology of IBD, leading to development of biological agents for treatment of CD. The first developed biologic agent, tumor necrosis factor-α agents, were shown to be efficacious in CD, heralding a new era in management of CD. Subsequently, vedolizumab, a monoclonal antibody against integrin α4β7, and ustekinumab, a human monoclonal antibody that inhibits the common p40 subunit of interleukin-12 and interleukin-23, were both approved for clinical use and are efficacious and safe for both induction and maintenance of remission in moderate-to-severe CD patients. Moreover, a recent study showed the non-inferiority of CT-P13, an infliximab biosimilar, compared with infliximab in CD patients. The third Korean guidelines for CD management provide updated information regarding treatment of moderate-to-severe CD patients with biologic agents.

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Original Article

IBD

Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy: Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan; Intest Res 2022;20(1):101-113. Published online March 12, 2021; DOI: https://doi.org/10.5217/ir.2020.00146

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The residual risk of colectomy after infliximab salvage in steroid-refractory acute severe ulcerative colitis (ASUC) is required to inform the need for subsequent maintenance biologic therapy. The aim of this study was to determine the dynamic response of common serum biomarkers to infliximab salvage and assess their utility in predicting subsequent colectomy.
Methods
A retrospective single-center cohort study was conducted on all patients who received infliximab salvage for steroid-refractory ASUC between January 1, 2010, and July 31, 2019. Biomarkers were assessed on admission and days 1 and 3 post infliximab, and included C-reactive protein (CRP)-albumin-ratio (CAR), CRP-lymphocyte-ratio (CLR), platelet-lymphocyte-ratio (PLR) and neutrophil-lymphocyte-ratio (NLR).
Results
Of 94 patients (median age, 35 years; 67% of male), 20% required colectomy at 12 months. Biomarkers on day 3 post-infliximab best differentiated nonresponders, who had higher CRP, lower albumin and lower lymphocyte count (each P< 0.05). Day 3 predictive performance (area under the curve) for 12-month colectomy was best for CAR (0.871) and CLR (0.874), which were similar to Lindgren (0.829; P> 0.05) but superior to Mayo (0.726), partial Mayo (0.719), PLR (0.719), Ho index (0.714), NLR (0.675), Travis score (0.657) and endoscopic Mayo (0.609) (each P< 0.05). A day 3 CAR cutoff of 0.47 mg/g had 79% sensitivity, 80% specificity, 94% negative predictive value (NPV) to predict colectomy; while a day 3 CLR cutoff of 6.0 mg/10⁹ had 84% sensitivity, 84% specificity, 96% NPV.
Conclusions
CAR and CLR measured on day 3 post infliximab salvage for steroid-refractory ASUC represent simple and routinely performed biomarkers that appear to be strong predictors of colectomy. Prospective studies are required to confirm the utility of these predictive scores.

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Reviews

Cancer

Endoscopic diagnosis and treatment of early colorectal cancer: Seung Wook Hong, Jeong-Sik Byeon; Intest Res 2022;20(3):281-290. Published online July 26, 2022; DOI: https://doi.org/10.5217/ir.2021.00169

Abstract PDF PubReader ePub

Early colorectal cancer refers to cancer in the colorectum that is confined to the mucosa or submucosa and does not invade the muscularis propria, irrespective of lymph node or distant metastasis. As the number of persons undergoing screening colonoscopy increases, the proportion of patients diagnosed with precancerous colorectal lesions and early colorectal cancer also increases. In the last decade, innovative optical technologies for endoscopic diagnosis have been introduced and endoscopic treatment techniques such as endoscopic submucosal dissection have provided major breakthroughs in the management of early colorectal cancer. With these remarkable developments, endoscopic treatment has established itself as an alternative to surgical resection in the treatment of early colorectal cancer. This review will discuss the endoscopic diagnosis and treatment of early colorectal cancer. Furthermore, the unmet needs in this field and the latest research addressing those issues will be summarized.

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IBD

Management of inflammatory bowel disease in the COVID-19 era: Kyeong Ok Kim, Byung Ik Jang; Intest Res 2022;20(1):3-10. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00156

Abstract PDF PubReader ePub

During the coronavirus disease 2019 (COVID-19) pandemic, many unpredictable changes have occurred in the medical field. Risk of COVID-19 does not seem to increase in patients with inflammatory bowel disease (IBD) considering based on current reports. Current medications for IBD do not increase this risk; on the contrary, some of these might be used as therapeutics against COVID-19 and are under clinical trial. Unless the patients have confirmed COVID-19 and severe pneumonia or a high oxygen demand, medical treatment should be continued during the pandemic, except for the use of high-dose corticosteroids. Adherence to general recommendations such as social distancing, wearing facial masks, and vaccination, especially for pneumococcal infections and influenza, is also required. Patients with COVID-19 need to be withhold immunomodulators or biologics for at least 2 weeks and treated based on both IBD and COVID-19 severity. Prevention of IBD relapse caused by sudden medication interruption is important because negative outcomes associated with disease flare up, such as corticosteroid use or hospitalization, are much riskier than medications. The outpatient clinic and infusion center for biologics need to be reserved safe spaces, and endoscopy or surgery should be considered in urgent cases only.

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Ana M. Espino, Albersy Armina-Rodriguez, Laura Alvarez, Carlimar Ocasio-Malavé, Riseilly Ramos-Nieves, Esteban I. Rodriguez Martinó, Paola López-Marte, Esther A. Torres, Carlos A. Sariol
Viruses.2024; 16(2): 187. CrossRef
Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn’s disease
Yoo Jin Lee, Sang Gyu Kwak, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Yun Jin Chung, Byung Ik Jang, Kyeong Ok Kim, Jeongseok Kim, Hyeong Ho Jo, Eun Young Kim
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Ilenia Rosa, Chiara Conti, Luigia Zito, Konstantinos Efthymakis, Matteo Neri, Piero Porcelli
International Journal of Environmental Research and Public Health.2023; 20(2): 1103. CrossRef
Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?
Shailesh Perdalkar, Pooja Basthi Mohan, Balaji Musunuri, Siddheesh Rajpurohit, Shiran Shetty, Krishnamurthy Bhat, Cannanore Ganesh Pai
International Immunopharmacology.2023; 116: 109597. CrossRef
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Parniyan Sadeghi, Parmida Sadat Pezeshki, Nima Rezaei
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Perceptions and Behaviors of Patients with Inflammatory Bowel Disease during the COVID-19 Crisis
Yoo Jin Lee, Kyeong Ok Kim, Min Cheol Kim, Kwang Bum Cho, Kyung Sik Park, Byeong Ik Jang
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Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence
Susanna Esposito, Caterina Caminiti, Rosanna Giordano, Alberto Argentiero, Greta Ramundo, Nicola Principi
Frontiers in Immunology.2022;[Epub] CrossRef
Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
Intestinal Research.2022; 20(3): 386. CrossRef
Inflammatory Bowel Disease Management during the COVID-19 Pandemic: A Literature Review
Ahmad Hormati, Alireza Arezoumand, Hadi Dokhanchi, Mehdi Pezeshgi Modarres, Sajjad Ahmadpour
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Paola López-Marte, Alondra Soto-González, Lizzie Ramos-Tollinchi, Stephan Torres-Jorge, Mariana Ferre, Esteban Rodríguez-Martinó, Esther A. Torres, Carlos A. Sariol
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Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
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The Korean Journal of Gastroenterology.2021; 78(2): 117. CrossRef
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The Korean Journal of Gastroenterology.2021; 78(2): 105. CrossRef
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IBD

Animal models of inflammatory bowel disease: novel experiments for revealing pathogenesis of colitis, fibrosis, and colitis-associated colon cancer: Chan Hyung Lee, Seong-Joon Koh, Zaher A Radi, Aida Habtezion; Intest Res 2023;21(3):295-305. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2023.00029

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a lifelong disease that manifests with chronic intestinal inflammation, sequential fibrosis, and an increased risk of colitis-associated colon cancer (CAC). The combined effects of genetic, immunological, environmental, and microbial factors render it difficult to determine the specific mechanism underlying the induction and perpetuation of IBD. Various animal models of IBD have contributed enormously to the understanding of IBD pathogenesis in terms of genomics, transcriptomics, proteomics, microbiome, and drug development of novel therapeutics. Although comprehensive research on IBD has been enabled by advanced technologies, such as genetically engineered models, there is a great need to develop relevant in vivo models of colitis and fibrosis. Here, we review 4 categories of animal models of acute and chronic intestinal inflammation, fibrosis, and CAC: chemically induced, genetically engineered, T cell transfer, and spontaneous gene mutation models.

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Original Articles

IBD

The dietary practices and beliefs of British South Asian people living with inflammatory bowel disease: a multicenter study from the United Kingdom: Benjamin Crooks, Ravi Misra, Naila Arebi, Klaartje Kok, Matthew J. Brookes, John McLaughlin, Jimmy K. Limdi; Intest Res 2022;20(1):53-63. Published online January 6, 2021; DOI: https://doi.org/10.5217/ir.2020.00079

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Epidemiological associations have implicated factors associated with Westernization, including the Western diet, in the development of inflammatory bowel disease (IBD). The role of diet in IBD etiopathogenesis, disease control and symptom management remains incompletely understood. Few studies have collected data on the dietary habits of immigrant populations living with IBD. Our aim was to describe the dietary practices and beliefs of British South Asians with IBD.
Methods
A 30-item questionnaire was developed and consecutively administered to 255 British South Asians with IBD attending gastroenterology clinics in the United Kingdom.
Results
Fifty-one percent of participants believed diet was the initiating factor for their IBD and 63% felt diet had previously triggered disease relapse. Eighty-nine percent avoided certain dietary items in the belief that this would prevent relapse. The most commonly avoided foods and drinks were spicy and fatty foods, carbonated drinks, milk products, alcohol, coffee, and red meat. A third of patients had tried a whole food exclusion diet, most commonly lactose- or gluten-free, and this was most frequently reported amongst those with clinically active IBD (P= 0.02). Almost 60% of participants avoided eating the same menu as their family, or eating out, at least sometimes, to prevent IBD relapse.
Conclusions
British South Asians with IBD demonstrate significant dietary beliefs and food avoidance behaviors with increased frequency compared to those reported in Caucasian IBD populations. Studies in immigrant populations may offer valuable insights into the interaction between diet, Westernization and cultural drift in IBD pathogenesis and symptomatology.

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‘Eating is like experiencing a gamble’: A qualitative study exploring the dietary decision‐making process in adults with inflammatory bowel disease
Yin Ting‐Ting, Tu Wen‐Jing, Li Yi‐Ting, Xu Wen‐Jing, Xu Gui‐Hua
Health Expectations.2024;[Epub] CrossRef
The Role of the Trace Element Selenium in Inflammatory Bowel Disease
Ruifang Hu, Jinliang Xiao, Lijuan Fan
Biological Trace Element Research.2024; 202(11): 4923. CrossRef
Dietary therapies for adult and pediatric inflammatory bowel disease
Jessica Deas, Neha D. Shah, Gauree G. Konijeti, Abigail Lundin, Olivia Lanser, Pooja Magavi, Sabina Ali
Nutrition in Clinical Practice.2024; 39(3): 530. CrossRef
Experience of diet in patients with inflammatory bowel disease: A thematic synthesis of qualitative studies
Huan Xiong, Xu Zhang, Huiling Zeng, Shanshan Xie, Shuanglian Yi
Journal of Clinical Nursing.2024; 33(8): 3283. CrossRef
Calcium deficiency is associated with malnutrition risk in patients with inflammatory bowel disease
Zihan Yu, Wenxuan Song, Xiangfeng Ren, Jihua Chen, Qinyan Yao, Hang Liu, Xiaoxuan Wang, Jinjie Zhou, Bangmao Wang, Xin Chen
Postgraduate Medicine.2024; 136(4): 456. CrossRef
The role of selenium in the pathogenesis and therapy of inflammatory bowel diseases
Tatyana A. Glazunova, Riana M. Mameeva, Sofia N. Samsonova, Aleksander O. Ryzhov, Aleksey V. Nedilko, Sergey A. Shpenev, Julia E. Khaiminova, Ekaterina S. Ilina, Vasiliy A. Evtushenko-Sigaev, Linara Yu. Ilyasova, Milana Sh. Eloeva, Markha Kh. Ayubova, Kha
HERALD of North-Western State Medical University named after I.I. Mechnikov.2024; 16(2): 27. CrossRef
Effects of Milk and Dairy on the Risk and Course of Inflammatory Bowel Disease versus Patients’ Dietary Beliefs and Practices: A Systematic Review
Radoslaw Kempinski, Damian Arabasz, Katarzyna Neubauer
Nutrients.2024; 16(15): 2555. CrossRef
Impact of Coffee Consumption on Subjective Perception and Inflammatory Markers in Patients with Inflammatory Bowel Diseases
Lidia Neamți, Simona R. Gheorghe, Amalia Ventuneac, Tudor Drugan, Cristina Drugan, Ciprian N. Silaghi, Lidia Ciobanu, Alexandra M. Crăciun
Biomedicines.2024; 12(8): 1733. CrossRef
Dietary behaviour, attitude and food perceptions of patients with ulcerative colitis – An observational study
Nancy Sahni, Urvashi Rana, Sindhuja Rajan, Anuraag Jena, Anupam K Singh, Usha Dutta, Vishal Sharma
Journal of the Royal College of Physicians of Edinburgh.2024;[Epub] CrossRef
Association of Waist Circumference with the Risk of Inflammatory Bowel Disease: a Nationwide Cohort Study of 10 Million Individuals in Korea
Yeonjin Je, Kyungdo Han, Jaeyoung Chun, Yuna Kim, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park, Jong Pil Im, Joo Sung Kim
Journal of Crohn's and Colitis.2023; 17(5): 681. CrossRef
The Bidirectional Link between Nutritional Factors and Inflammatory Bowel Diseases: Dietary Deficits, Habits, and Recommended Interventions—A Narrative Review
Ilaria Saracino, Enzo Spisni, Veronica Imbesi, Chiara Ricci, Nikolas Dussias, Patrizia Alvisi, Paolo Gionchetti, Fernando Rizzello, Maria Valerii
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Journal of Pediatric Gastroenterology & Nutrition.2023; 76(6): 749. CrossRef
Selected Aspects of Nutrition in the Prevention and Treatment of Inflammatory Bowel Disease
Paulina Panufnik, Martyna Więcek, Magdalena Kaniewska, Konrad Lewandowski, Paulina Szwarc, Grażyna Rydzewska
Nutrients.2022; 14(23): 4965. CrossRef
Experiences of ethnic minority patients who are living with a primary chronic bowel condition: a systematic scoping review with narrative synthesis
Salina Ahmed, Paul D. Newton, Omorogieva Ojo, Lesley Dibley
BMC Gastroenterology.2021;[Epub] CrossRef
Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse
Paweł Kuźnicki, Katarzyna Neubauer
Journal of Clinical Medicine.2021; 10(19): 4623. CrossRef
The dietary practices and beliefs of people living with older-onset inflammatory bowel disease
Benjamin Crooks, Ravi Misra, Naila Arebi, Klaartje Kok, Matthew J. Brookes, John McLaughlin, Jimmy K. Limdi
European Journal of Gastroenterology & Hepatology.2021; 33(1S): e442. CrossRef

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367 Download
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16 Crossref

IBD

Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study: Seung Yong Shin, Soo Jung Park, Young Kim, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-Ho Kim, Do Hyun Kim, Dennis Teng, Jong-Hwa Kim, Wonyong Kim, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):350-360. Published online July 23, 2021; DOI: https://doi.org/10.5217/ir.2021.00049

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC).
Methods
A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score.
Results
A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients.
Conclusions
ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

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Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
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Seok-Young Kim, Seung Yong Shin, Soo Jung Park, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-
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Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
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Sophie Vieujean, Edouard Louis
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Real-world effectiveness and safety of adalimumab in Korean patients with intestinal Behcet’s disease: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter study
Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
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The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
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Seok-Young Kim, Seung Yong Shin, Maham Saeed, Ji Eun Ryu, Jung-Seop Kim, Junyoung Ahn, Youngmi Jung, Jung Min Moon, Chang Hwan Choi, Hyung-Kyoon Choi
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Association of C-reactive Protein and Partial Mayo Score With Response to Tofacitinib Induction Therapy: Results From the Ulcerative Colitis Clinical Program
Marla C Dubinsky, Fernando Magro, Flavio Steinwurz, David P Hudesman, Jami A Kinnucan, Ryan C Ungaro, Markus F Neurath, Nicole Kulisek, Jerome Paulissen, Chinyu Su, Dario Ponce de Leon, Miguel Regueiro
Inflammatory Bowel Diseases.2022;[Epub] CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef
Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef

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IBD

Vedolizumab for perianal fistulizing Crohn’s disease: systematic review and meta-analysis: Fares Ayoub, Matthew Odenwald, Dejan Micic, Sushila R. Dalal, Joel Pekow, Russell D. Cohen, David T. Rubin, Atsushi Sakuraba; Intest Res 2022;20(2):240-250. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00091

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Perianal fistulas are a debilitating manifestation of Crohn’s disease (CD). Despite the advent of anti-tumor necrosis factor (anti-TNF) therapy, the medical management of fistulizing CD continues to be challenged by unmet needs. We conducted a systematic review and meta-analysis of the effectiveness of vedolizumab for the management of perianal fistulizing CD.
Methods
A search of PubMed, EMBASE and the Cochrane Library was performed from inception to June 2020 for studies reporting rates of perianal fistula healing in CD patients treated with vedolizumab. The primary outcome of interest was complete healing of perianal fistulas and the secondary outcome was partial healing. The pooled fistula healing rates with 95% confidence intervals (CI) were calculated utilizing a random effects model.
Results
A total of 74 studies were initially identified, 4 of which met the inclusion criteria. A total of 198 patients with active perianal fistulas were included, 87% of whom had failed previous anti-TNF therapy. The pooled complete healing rate was 27.6% (95% CI, 18.9%–37.3%) with moderate heterogeneity (I2=49.4%) and the pooled partial healing rate was 34.9% (95% CI, 23.2%–47.7%) with high heterogeneity (I2=67.1%).
Conclusions
In a meta-analysis of 4 studies that included 198 patients with perianal fistulizing CD, the majority of whom had failed previous anti-TNF therapy, vedolizumab treatment led to healing of perianal fistulas in nearly one-third of the patients. The lack of high-quality data and significant study heterogeneity underscores the need for future prospective studies of fistula healing in patients receiving anti-integrin therapy.

Citations

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Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
Inflammatory Bowel Diseases.2024; 30(9): 1579. CrossRef
Choosing Therapy for Moderate to Severe Crohn’s Disease
Malcolm Irani, Bincy Abraham
Journal of the Canadian Association of Gastroenterology.2024; 7(1): 1. CrossRef
Perianal fistulizing Crohn’s disease: Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies
Jalpa Devi, David H. Ballard, Tina Aswani-Omprakash, Alyssa M. Parian, Parakkal Deepak
Indian Journal of Gastroenterology.2024; 43(1): 48. CrossRef
Clinical use of biologics for Crohn’s disease in adults: lessons learned from real-world studies
Antonio Tursi, Giammarco Mocci, Angelo Del Gaudio, Alfredo Papa
Expert Opinion on Biological Therapy.2024; 24(3): 171. CrossRef
Biologics, Small Molecules and More in Inflammatory Bowel Disease: The Present and the Future
Manish Manrai, Atul Abhishek Jha, Saurabh Dawra, Aditya Vikram Pachisia
Future Pharmacology.2024; 4(1): 279. CrossRef
How to Approach the Difficult Perineum in Crohn's Disease
Emily Rinebold, Alex L. Huang, Sue J. Hahn
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
Ten missteps in the management of inflammatory bowel disease in Asia: An expert report by the Asian Pacific Association of Gastroenterology Working Group on Inflammatory Bowel Disease
Vineet Ahuja, Ida Hilmi, Byong Duk Ye, Khoon Lin Ling, Siew C. Ng, Rupert W. Leong, Peeyush Kumar, Xin Hui Khoo, Govind K. Makharia, Jose Sollano, Pises Pisespongsa, Nazri Mustaffa, Rupa Banerjee, Alex Hwong‐Ruey Leow, Raja Affendi Raja Ali, Sai Wei Chuah
Journal of Gastroenterology and Hepatology.2024; 39(8): 1500. CrossRef
The potential for medical therapies to address fistulizing Crohn’s disease: a state-of-the-art review
Mohammad Shehab, Davide De Marco, Peter L. Lakatos, Talat Bessissow
Expert Opinion on Biological Therapy.2024; 24(8): 733. CrossRef
A Crohn-betegég terápiás stratégiája
Klaudia Farkas, Hajnal Székely, Péter Bacsur, Balázs Bánky, Zsuzsa Bianka Élthes, László Harsányi, Katalin Edit Müllner, Ágnes Milassin, Károly Palatka, Patrícia Sarlós, Tamás Szamosi, Tamás Molnár, Pál Miheller
Orvosi Hetilap.2024; 165(Supplement): 1. CrossRef
Terápiás kihívások nehezen kezelhető, penetráló Crohn-betegségben – multidiszciplináris megoldás
Bernadett Farkas, Péter Bacsur, Emese Ivány, Anita Bálint, Mariann Rutka, Klaudia Farkas, Tamás Molnár
Orvosi Hetilap.2024; 165(32): 1252. CrossRef
Is There a Best First Line Biological/Small Molecule in IBD: Are We Ready for Sequencing?
Gustavo Drügg Hahn, Petra Anna Golovics, Panu Wetwittayakhlang, Alex Al Khoury, Talat Bessissow, Peter Laszlo Lakatos
Biomedicines.2022; 10(4): 749. CrossRef
The Optimal Management of Fistulizing Crohn’s Disease: Evidence beyond Randomized Clinical Trials
Panu Wetwittayakhlang, Alex Al Khoury, Gustavo Drügg Hahn, Peter Laszlo Lakatos
Journal of Clinical Medicine.2022; 11(11): 3045. CrossRef
Management of Non-response and Loss of Response to Anti-tumor Necrosis Factor Therapy in Inflammatory Bowel Disease
Jan Marsal, Manuel Barreiro-de Acosta, Irina Blumenstein, Maria Cappello, Thomas Bazin, Shaji Sebastian
Frontiers in Medicine.2022;[Epub] CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef

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IBD

Clinical presentation of COVID-19 in patients with inflammatory bowel disease: a systematic review and meta-analysis: Anupam K. Singh, Anuraag Jena, Praveen Kumar-M, Daya Krishna Jha, Vishal Sharma; Intest Res 2022;20(1):134-143. Published online January 18, 2021; DOI: https://doi.org/10.5217/ir.2020.00108

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Coronavirus disease 2019 (COVID-19) is recognized to have variable clinical manifestations. The clinical presentation of patients with inflammatory bowel disease (IBD) having COVID-19 is unclear.
Methods
We identified articles reporting about the clinical presentation of COVID-19 in those with underlying IBD from PubMed and Embase. The studies, irrespective of design or language, were included. The overall pooled frequency of various symptoms was estimated. Joanna Briggs Institute Critical appraisal checklist was used to assess the quality of studies.
Results
Eleven studies, including 1,325 patients, were included in the pooled analysis. The pooled estimates for clinical presentation were; fever: 67.53% (95% confidence interval [CI], 45.38–83.88), cough: 59.58% (95% CI, 45.01–72.63), diarrhea: 27.26% (95% CI, 19.51–36.69), running nose: 27% (95% CI, 15.26–43.19) and dyspnea: 25.29% (95% CI, 18.52–33.52). The pooled prevalence rates for abdominal pain, nausea and vomiting were 13.08% (95% CI, 9.24–18.19), 10.08% (95% CI, 5.84–16.85) and 8.80% (95% CI, 4.43–16.70) per 100 population, respectively.
Conclusions
The clinical presentation of COVID-19 in IBD patients is similar to the general population.

Citations

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Small Bowel Diverticulosis and COVID-19: Awareness Is the Key: A Case Series and Review of the Literature
Petros Bangeas, Nikolaos Konstantinidis, Tania Chrisopoulou, Despoina Karatzia, Alexandros Giakoustidis, Vasileios Papadopoulos
Medicina.2024; 60(2): 229. CrossRef
Exacerbated gastrointestinal symptoms and long COVID in IBD patients with SARS-CoV-2 infection: A multi-center study from taiwan
Tsung-Yu Tsai, Jia-Feng Wu, Meng-Tzu Weng, Chiao-Hsiung Chuang, Tien-Yu Huang, Wei-Chen Tai, Chi-Ming Tai, Chen-Shuan Chung, Chih-Cheng Chen, Ching-Pin Lin, Yuan-Yao Tsai, Shu-Chen Wei
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COVID-19 IN INFLAMMATORY BOWEL DISEASE: SHOULD WE BE MORE CAREFUL WITH THE USE OF SALICYLATES?
Mariana Rolim Fernandes MACEDO, Carlos Arthur Fernandes SOBREIRA, Carola Braz de LAVOR, Camila Ribeiro RÔLA, Ticiana Maria de Lavor ROLIM, Francisco Sérgio Rangel de Paula PESSOA, Milena Santana GIRÃO, Caio César Furtado FREIRE, Ranna Caroline Bezerra SIE
Arquivos de Gastroenterologia.2024;[Epub] CrossRef
Diarrhea and Coronavirus Disease 2019 Infection
David M. Friedel, Mitchell S. Cappell
Gastroenterology Clinics of North America.2023; 52(1): 59. CrossRef
Managing IBD in the COVID-19 era
Nicholas Scalzo, Ryan C. Ungaro
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients
Alfredo Papa, Marcello Covino, Sara Sofia De Lucia, Angelo Del Gaudio, Marcello Fiorani, Giorgia Polito, Carlo Romano Settanni, Andrea Piccioni, Francesco Franceschi, Antonio Gasbarrini
World Journal of Gastroenterology.2023; 29(26): 4099. CrossRef
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Giulia Concas, Michele Barone, Ruggiero Francavilla, Fernanda Cristofori, Vanessa Nadia Dargenio, Rossella Giorgio, Costantino Dargenio, Vassilios Fanos, Maria Antonietta Marcialis
Digestive Diseases and Sciences.2022; 67(7): 2771. CrossRef
Perceptions and Behaviors of Patients with Inflammatory Bowel Disease during the COVID-19 Crisis
Yoo Jin Lee, Kyeong Ok Kim, Min Cheol Kim, Kwang Bum Cho, Kyung Sik Park, Byeong Ik Jang
Gut and Liver.2022; 16(1): 81. CrossRef
Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic
Simeng Lin, Louis HS Lau, Neil Chanchlani, Nicholas A Kennedy, Siew C Ng
Gut.2022; 71(7): 1426. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
Intestinal Research.2022; 20(4): 431. CrossRef
Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis
Ho Min Yong, Sung-Jo Park, Seong Ran Jeon, Heesu Park, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Hyeon Jeong Goong, Suyeon Park
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Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 105. CrossRef
The natural history of COVID-19 in patients with inflammatory bowel disease: a nationwide study by the Hellenic Society for the study of IBD
Giorgos Bamias, Georgios Kokkotis, Angeliki Christidou, Dimitrios K. Christodoulou, Vasileios Delis, Georgia Diamantopoulou, Smaragdi Fessatou, Anthia Gatopoulou, Olga Giouleme, Panagiota Kafritsa, Chrisostomos Kalantzis, Andreas Kapsoritakis, Pantelis Ka
European Journal of Gastroenterology & Hepatology.2021; 33(1S): e810. CrossRef

6,688 View
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IBD

Vedolizumab does not increase perioperative surgical complications in patients with inflammatory bowel disease, cohort study: Vitaliy Y. Poylin, Jose Cataneo Serrato, Jonathan Pastrana Del Valle, Joseph D. Feuerstein; Intest Res 2022;20(1):72-77. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00117

Abstract PDF PubReader ePub

Background/Aims
Biologics are increasingly used to manage ulcerative colitis (UC) and Crohn’s disease (CD). However, even with earlier usage of biologic therapy, a significant proportion of patients will require surgery. Vedolizumab is an anti-integrin antibody that is increasingly used given that it is more gut selective and associated with fewer side effects. The aim of this study is to assess the effect of vedolizumab compared to anti-tumor necrosis factor (anti-TNF) therapy on the perioperative complications in patients undergoing surgery for inflammatory bowel disease (IBD).
Methods
Retrospective review of patients treated for IBD at a tertiary care center between 2013 and 2017. Rates of 30- and 90-day complications for patients on vedolizumab were compared to patients on anti-TNF regimens.
Results
One hundred and ninety-nine patients met inclusion criteria with 87 (43%) patients undergoing surgery for CD, 111 (55.8%) for UC and 1 (0.5%) for indeterminate colitis. Thirty-eight patients received preoperative vedolizumab and 94 received anti-TNF. There were more males and lower body mass index in the anti-TNF group. There was no significant difference in overall rate of complications at 30 or 90 days. There was a trend for lower leak rate vedolizumab group (0% for vedolizumab vs. 2.1% for anti-TNF at 30 days, P= 1.00; 0% for vedolizumab vs. 1.1% for anti-TNF at 90 days, P= 1.00). Multivariate analysis showed low albumin ( < 3.6 g/dL) at the time of surgery to be a significant risk factor for overall and infectious complications at 90 days (odds ratio, 3.24; 95% confidence interval, 1.12–8.79; P= 0.021).
Conclusions
Perioperative vedolizumab does not increase rates of perioperative complications in IBD surgery when compared to anti-TNF medications.

Citations

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Shubha Bhat, Benjamin Click, Miguel Regueiro
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Ye Rin Koh, Kenneth C. Cummings
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Peri-Operative Optimization of Patients with Crohn’s Disease
Hareem Syed, Ahmed Nadeem, David Gardinier, Kendra Weekley, Dovid Ribakow, Stephen Lupe, Shubha Bhat, Stefan Holubar, Benjamin L. Cohen
Current Gastroenterology Reports.2024; 26(5): 125. CrossRef
Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
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Gabriele Dragoni, Tommaso Innocenti, Aurelién Amiot, Fabiana Castiglione, Laura Melotti, Stefano Festa, Edoardo Vincenzo Savarino, Marie Truyens, Konstantinos Argyriou, Daniele Noviello, Tamas Molnar, Vincent Bouillon, Cristina Bezzio, Piotr Eder, Samuel
American Journal of Gastroenterology.2024;[Epub] CrossRef
Newer Immunosuppressants for Rheumatologic Disease
Ye Rin Koh, Kenneth C. Cummings
Rheumatic Disease Clinics of North America.2024; 50(3): 545. CrossRef
Full Guidelines—From the Medical Board of the National Psoriasis Foundation: Perioperative management of systemic immunomodulatory agents in patients with psoriasis and psoriatic arthritis
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Brad Pasternak, Ashish Patel, Paul Tran, Lisa McMahon
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William J. Kane, Puja Shah Berry
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Which biologic agents increase perioperative complications in patients with inflammatory bowel disease?
Jihye Park
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Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef
Anti -TNFα agents in preventing the postoperative recurrence of Crohn’s disease: Do they still play a role in the biological era?
Caiguang Liu, Na Li, Shukai Zhan, Zhenyi Tian, Dongxuan Wu, Tong Li, Zhirong Zeng, Xiaojun Zhuang
Expert Opinion on Biological Therapy.2021; : 1. CrossRef

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Microbiota

Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease: Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):148-160. Published online June 14, 2022; DOI: https://doi.org/10.5217/ir.2021.00168

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The fecal microbiota of Korean patients with inflammatory bowel disease (IBD) was investigated with respect to disease phenotypes and taxonomic biomarkers for diagnosis and prognosis of IBD.
Methods
Fecal samples from 70 ulcerative colitis (UC) patients, 39 Crohn’s disease (CD) patients, and 100 healthy control individuals (HC) were collected. The fecal samples were amplified via polymerase chain reaction and sequenced using Illumina MiSeq. The relationships between fecal bacteria and clinical phenotypes were analyzed using the EzBioCloud database and 16S microbiome pipeline.
Results
The alpha-diversity of fecal bacteria was significantly lower in UC and CD (P<0.05) compared to that in HC. Bacterial community compositions in UC and CD were significantly different from that of HC according to Bray-Curtis dissimilarities, and there was also a difference between community composition in UC and CD (P=0.01). In UC, alpha-diversity was further decreased when the disease was more severe and the extent of disease was greater, and community composition significantly differed depending on the extent of the disease. We identified 9 biomarkers of severity and 6 biomarkers of the extent of UC. We also identified 5 biomarkers of active disease and 3 biomarkers of ileocolonic involvement in CD. Lachnospiraceae and Ruminococcus gnavus were biomarkers for better prognosis in CD.
Conclusions
The fecal microbiota profiles of IBD patients were different from those of HC, and several bacterial taxa may be used as biomarkers to determine disease phenotypes and prognosis. These data may also help discover new therapeutic targets for IBD.

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Aditya Bajaj, Manasvini Markandey, Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2024; 43(1): 103. CrossRef
An Update on the Role and Potential Molecules in Relation to Ruminococcus gnavus in Inflammatory Bowel Disease, Obesity and Diabetes Mellitus
Jinni Hong, Tingting Fu, Weizhen Liu, Yu Du, Junmin Bu, Guojian Wei, Miao Yu, Yanshan Lin, Cunyun Min, Datao Lin
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 1235. CrossRef
Research advancements and perspectives of inflammatory bowel disease: A comprehensive review
Junyi Bai, Ying Wang, Fuhao Li, Yueyao Wu, Jun Chen, Meng Li, Xi Wang, Bin Lv
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Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
International Journal of Molecular Sciences.2024; 25(12): 6697. CrossRef
Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
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Min Heo, Young Soo Park, Hyuk Yoon, Nam-Eun Kim, Kangjin Kim, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
Gut and Liver.2023; 17(1): 108. CrossRef
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Emmanuelle H Crost, Erika Coletto, Andrew Bell, Nathalie Juge
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Yu Kyung Jun, Da-Ae Yu, Yoo Min Han, Soo Ran Lee, Seong-Joon Koh, Hyunsun Park
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Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
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Hyuk Yoon, Sunghyouk Park, Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
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IBD

Efficacy and safety of filgotinib as induction and maintenance therapy for Japanese patients with moderately to severely active ulcerative colitis: a post-hoc analysis of the phase 2b/3 SELECTION trial: Toshifumi Hibi, Satoshi Motoya, Tadakazu Hisamatsu, Fumihito Hirai, Kenji Watanabe, Katsuyoshi Matsuoka, Masayuki Saruta, Taku Kobayashi, Brian G Feagan, Chantal Tasset, Robin Besuyen, Chohee Yun, Gerald Crans, Jie Zhang, Akira Kondo, Mamoru Watanabe; Intest Res 2023;21(1):110-125. Published online March 11, 2022; DOI: https://doi.org/10.5217/ir.2021.00143

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The safety and efficacy of filgotinib, a once-daily oral Janus kinase 1 preferential inhibitor, were evaluated in Japanese patients with ulcerative colitis (UC) in the phase 2b/3 SELECTION trial.
Methods
SELECTION (NCT02914522) was a randomized, placebo-controlled trial comprising 2 induction studies and a maintenance study. Adults with moderately to severely active UC were randomized in induction study A (biologic-naïve) or B (biologic-experienced) to receive filgotinib 200 mg, 100 mg, or placebo once daily for 11 weeks. Patients in clinical remission or Mayo Clinic score response at week 10 entered the 47-week maintenance study. Efficacy and safety outcomes were assessed in Japanese patients enrolled in Japan.
Results
Overall, 37 and 72 Japanese patients were enrolled in Japan in induction studies A and B, respectively, and 54 entered the maintenance study. Numerically higher proportions of filgotinib 200 mg-treated than placebo-treated patients achieved clinical remission in induction study A (4/15 [26.7%] vs. 0/6 [0%]) and the maintenance study (5/20 [25.0%] vs. 0/9 [0%]), but not induction study B (1/29 [3.4%] vs. 1/14 [7.1%]). Both doses were well tolerated, and no new safety signals were noted. Herpes zoster was reported in 1 filgotinib 200 mg-treated patient in each of induction study A (2.3%, 1/44) and the maintenance study (5.0%, 1/20).
Conclusions
These data, alongside those of the overall SELECTION population, suggest the potential of filgotinib 200 mg as a viable treatment option for Japanese patients with UC. Owing to small patient numbers, data should be interpreted cautiously.

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Efficacy and safety of filgotinib for ulcerative colitis: A real‐world multicenter retrospective study in Japan
Shintaro Akiyama, Kaoru Yokoyama, Soichi Yagi, Shinichiro Shinzaki, Kozo Tsuruta, Shinichiro Yoshioka, Minako Sako, Hiromichi Shimizu, Mariko Kobayashi, Toshiyuki Sakurai, Kei Nomura, Tomoyoshi Shibuya, Masahiro Takahara, Sakiko Hiraoka, Kyohei Sugai, Shu
Alimentary Pharmacology & Therapeutics.2024; 59(11): 1413. CrossRef
Real-World Data on the Effectiveness and Safety of Filgotinib for Ulcerative Colitis in Japanese Patients: A Single-Center Experience
Takahito Toba, Ryo Karashima, Kodai Fujii, Keiichi Inoue, Nanako Inoue, Yurie Ogawa, Aya Hojo, Ai Fujimoto, Takahisa Matsuda
Cureus.2024;[Epub] CrossRef
Safety and effectiveness of tofacitinib in Korean adult patients with ulcerative colitis: post-marketing surveillance study
Hyuk Yoon, Byong Duk Ye, Sang-Bum Kang, Kang-Moon Lee, Chang Hwan Choi, Joo-young Jo, Juwon Woo, Jae Hee Cheon
BMC Gastroenterology.2024;[Epub] CrossRef
Patients’ Preference on Advanced Therapy and Follow-Up Procedure for Inflammatory Bowel Disease in Japan: A Web-Based 3A Survey
Toshifumi Morishita, Shunichi Yanai, Yosuke Toya, Takayuki Matsumoto
Inflammatory Intestinal Diseases.2024; 9(1): 174. CrossRef
The role and prospect of tofacitinib in patients with ulcerative colitis
Jun Lee
Intestinal Research.2023; 21(1): 168. CrossRef
Advances in pharmacotherapy for ulcerative colitis: a focus on JAK1 inhibitors
Alexander Goetsch, Ferdinando D’Amico, Mariangela Allocca, Gionata Fiorino, Federica Furfaro, Alessandra Zilli, Tommaso Lorenzo Parigi, Simona Radice, Laurent Peyrin-Biroulet, Silvio Danese
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Hiroshi Nakase
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Olga Maria Nardone, Irene Zammarchi, Giovanni Santacroce, Subrata Ghosh, Marietta Iacucci
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Alessandro Massano, Luisa Bertin, Fabiana Zingone, Andrea Buda, Pierfrancesco Visaggi, Lorenzo Bertani, Nicola de Bortoli, Matteo Fassan, Marco Scarpa, Cesare Ruffolo, Imerio Angriman, Cristina Bezzio, Valentina Casini, Davide Giuseppe Ribaldone, Edoardo
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Zhimin Wu, Tao Zhang, Xiaofei Ma, Shuai Guo, Qingqing Zhou, Arshad Zahoor, Ganzhen Deng
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Filgotinib for moderately to severely active ulcerative colitis
Alessandro Mannucci, Ferdinando D’Amico, Ahmad El Saadi, Laurent Peyrin-Biroulet, Silvio Danese
Expert Review of Gastroenterology & Hepatology.2022; 16(10): 927. CrossRef

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Microbiota

Relationship between the gut microbiota and bile acid composition in the ileal mucosa of Crohn’s disease: Shigeki Bamba, Osamu Inatomi, Atsushi Nishida, Masashi Ohno, Takayuki Imai, Kenichiro Takahashi, Yuji Naito, Junichi Iwamoto, Akira Honda, Naohiro Inohara, Akira Andoh; Intest Res 2022;20(3):370-380. Published online May 14, 2021; DOI: https://doi.org/10.5217/ir.2021.00054

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Background/Aims
Crosstalk between the gut microbiota and bile acid plays an important role in the pathogenesis of gastrointestinal disorders. We investigated the relationship between microbial structure and bile acid metabolism in the ileal mucosa of Crohn’s disease (CD).
Methods
Twelve non-CD controls and 38 CD patients in clinical remission were enrolled. Samples were collected from the distal ileum under balloon-assisted enteroscopy. Bile acid composition was analyzed by liquid chromatography-mass spectrometry. The gut microbiota was analyzed by 16S rRNA gene sequencing.
Results
The Shannon evenness index was significantly lower in endoscopically active lesions than in non-CD controls. β-Diversity, evaluated by the UniFrac metric, revealed a significant difference between the active lesions and non-CD controls (P=0.039). The relative abundance of Escherichia was significantly higher and that of Faecalibacterium and Roseburia was significantly lower in CD samples than in non-CD controls. The increased abundance of Escherichia was more prominent in active lesions than in inactive lesions. The proportion of conjugated bile acids was significantly higher in CD patients than in non-CD controls, but there was no difference in the proportion of primary or secondary bile acids. The genera Escherichia and Lactobacillus were positively correlated with the proportion of conjugated bile acids. On the other hand, Roseburia, Intestinibacter, and Faecalibacterium were negatively correlated with the proportion of conjugated bile acids.
Conclusions
Mucosa-associated dysbiosis and the alteration of bile acid composition were identified in the ileum of CD patients. These may play a role in the pathophysiology of ileal lesions in CD patients.

Citations

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A critical review on inflammatory bowel diseases risk factors, dietary nutrients regulation and protective pathways based on gut microbiota during recent 5 years
Pengkui Xia, Tao Hou, Hong Jin, Yaqi Meng, Jing Li, Fuchao Zhan, Fang Geng, Bin Li
Critical Reviews in Food Science and Nutrition.2024; 64(24): 8805. CrossRef
Gut microbiota disparities between active Crohn's disease and healthy controls: A global systematic review
Rupa Tharu, Geetika Malik Ahlawat, Savitesh Kushwaha, Poonam Khanna
Clinical Epidemiology and Global Health.2024; 25: 101497. CrossRef
Gut microbes improve prognosis of Klebsiella pneumoniae pulmonary infection through the lung-gut axis
Yuxiu Tang, Liquan Chen, Jin Yang, Suqing Zhang, Jun Jin, Yao Wei
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
International Journal of Molecular Sciences.2024; 25(12): 6697. CrossRef
Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi
Intestinal Research.2023; 21(1): 148. CrossRef
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Oluwamayowa S. Akinsuyi, Luiz F. W. Roesch, Olubukola Oluranti Babalola
Microbiology Spectrum.2023;[Epub] CrossRef
Crohn’s disease: Why the ileum?
Nicolas Richard, Guillaume Savoye, Mathilde Leboutte, Asma Amamou, Subrata Ghosh, Rachel Marion-Letellier
World Journal of Gastroenterology.2023; 29(21): 3222. CrossRef
The Emerging Role of Raman Spectroscopy as an Omics Approach for Metabolic Profiling and Biomarker Detection toward Precision Medicine
Gabriel Cutshaw, Saji Uthaman, Nora Hassan, Siddhant Kothadiya, Xiaona Wen, Rizia Bardhan
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Yizhe Tie, Yongle Huang, Rirong Chen, Li Li, Minhu Chen, Shenghong Zhang
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Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
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Evaluation of gut dysbiosis using serum and fecal bile acid profiles
Tadakuni Monma, Junichi Iwamoto, Hajime Ueda, Makoto Tamamushi, Fumio Kakizaki, Naoki Konishi, Shoichiro Yara, Teruo Miyazaki, Takeshi Hirayama, Tadashi Ikegami, Akira Honda
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Jongwook Yu, Jae Hee Cheon
Immune Network.2022;[Epub] CrossRef

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Review

IBD

An integrative review of physical activity in adults with inflammatory bowel disease: Suja P Davis, Patricia B. Crane, Linda P. Bolin, Lee Ann Johnson; Intest Res 2022;20(1):43-52. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00049

Abstract PDF Supplementary Material PubReader ePub

Adults with inflammatory bowel disease (IBD) search for self-management strategies to manage their symptoms and improve their quality of life (QOL). Physical activity (PA) is one of the self-management strategies widely adopted by adults with IBD. This integrative review aimed to synthesize the evidence on health outcomes of PA in adults with IBD as well as to identify the barriers to engaging in PA. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), published literature was searched to identify the articles that addressed PA in adults with IBD. Twenty-eight articles met the inclusion criteria. Many of the reviewed studies used the terms of PA and exercise interchangeably. Walking was the most common PA reported in the studies. The findings from the majority of the reviewed studies supported the benefits of moderate-intensity exercise/PA among adults with IBD. The reviewed studies noted the following positive health outcomes of PA: improvement in QOL, mental health, sleep quality, gastrointestinal symptoms, fatigue and cardiorespiratory fitness. More importantly, participation in PA reduced the risk for development of IBD and the risk for future active disease. The findings from the reviewed studies highlighted the following barriers to engage in PA: fatigue, joint pain, abdominal pain, bowel urgency, active disease and depression.

Citations

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S. V. Kostyukevich, I. G. Bakulin
Koloproktologia.2024; 23(1): 152. CrossRef
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Remus Stafie, Ana-Maria Singeap, Adrian Rotaru, Carol Stanciu, Anca Trifan
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Progress in research of exercise intervention in inflammatory bowel disease
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The impact of physical exercise on health-related quality of life in inflammatory bowel disease
Ayokunle T Abegunde, Daniela Goyes, Umer Farooq, Amy H Luke, Elizabeth Huggins, Richard S Cooper, Lara R Dugas
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Patients’ perspectives on, experience with and concerns about crohn's disease: insights from Chinese social media
Shaopeng Sun, Yunhong Hu, Heng Li, Jiajia Chen, Yijie Lou, Chunyan Weng, Lixia Chen, Bin Lv
BMC Gastroenterology.2023;[Epub] CrossRef
Fecal Calprotectin in Gastrointestinal Disease
Jennifer Murray, Klaartje B Kok, Ruth M Ayling
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Alicja E. Ratajczak‐Pawłowska, Michał Michalak, Aleksandra Szymczak‐Tomczak, Anna Maria Rychter, Agnieszka Zawada, Kinga Skoracka, Agnieszka Dobrowolska, Iwona Krela‐Kaźmierczak
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Lee Hill, Noushin Roofigari, Maria Faraz, Jelena Popov, Michal Moshkovich, Melanie Figueiredo, Emily Hartung, Meryem Talbo, Marie-Laure Lalanne-Mistrih, Mary Sherlock, Mary Zachos, Brian W. Timmons, Joyce Obeid, Nikhil Pai
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Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The “BE-FIT-IBD” study
Antonietta Gerarda Gravina, Raffaele Pellegrino, Tommaso Durante, Giovanna Palladino, Rossella D’Onofrio, Simone Mammone, Giusi Arboretto, Salvatore Auletta, Giuseppe Imperio, Andrea Ventura, Mario Romeo, Alessandro Federico
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E. Wilke, W. Reindl, P.A. Thomann, M.P. Ebert, T. Wuestenberg, A.K. Thomann
Complementary Therapies in Clinical Practice.2021; 45: 101465. CrossRef
Physical Activity in Patients With Inflammatory Bowel Disease: A Narrative Review
Maitreyi Raman, Vidya Rajagopalan, Sandeep Kaur, Raylene A Reimer, Christopher Ma, Subrata Ghosh, Jeff Vallance
Inflammatory Bowel Diseases.2021;[Epub] CrossRef

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Original Articles

IBD

Incidence comparison of adverse events in patients with inflammatory bowel disease receiving different biologic agents: retrospective long-term evaluation: Brigida Barberio, Edoardo Vincenzo Savarino, Timothy Card, Cristina Canova, Francesco Baldisser, Alessandro Gubbiotti, Davide Massimi, Matteo Ghisa, Fabiana Zingone; Intest Res 2022;20(1):114-123. Published online August 4, 2021; DOI: https://doi.org/10.5217/ir.2021.00037

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Current literature is lacking in studies comparing the incidence of adverse events (AEs) in patients with inflammatory bowel diseases (IBD) treated with adalimumab (ADA) or vedolizumab (VDZ) in a real-life scenario. Therefore, our primary aim was to compare the AEs occurring in patients taking ADA to those of patients taking VDZ.
Methods
In this single center study, data on AEs from IBD patients who underwent treatment with ADA and VDZ were retrospectively collected. AE rates per 100 person-years were calculated. A Cox regression model was used to estimate the hazard ratios of the AEs between the 2 drugs.
Results
A total of 16 ADA patients (17.2%) and 11 VDZ patients (7.6%) had AEs causing drug interruption during the study period (P=0.02). Most of the AEs were noninfectious extraintestinal events (50% in ADA and 54.5% in VDZ) while infections accounted for 31.2% of the AEs in patients treated with ADA and 27.3% in those treated with VDZ. The incidence rate of AEs causing withdrawal of therapy was 13.2 per 100 person-years for ADA and 5.3 per 100 person-years for VDZ, corresponding to a 76% lower risk in patients in VDZ. Considering the first year of treatment, we observed 34 subjects treated with ADA (36.5%) having at least 1 AEs and 57 (39.3%) among those taking VDZ (P=0.67).
Conclusions
VDZ has a lower incidence rate of AEs causing withdrawal of treatment compared to ADA but a similar risk of AEs not causing drug interruption. Real-life head-to-head studies are still necessary to further explore the safety profile of these drugs.

Citations

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Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Comparative Risk of Serious Infection With Vedolizumab vs Anti-Tumor Necrosis Factor in Inflammatory Bowel Disease: Results From Nationwide Swedish Registers
Sara Karlqvist, Michael C. Sachs, Carl Eriksson, Yang Cao, Scott Montgomery, Jonas F. Ludvigsson, Ola Olén, Jonas Halfvarson
American Journal of Gastroenterology.2024;[Epub] CrossRef
The effect of medical cannabis in inflammatory bowel disease: analysis from the UK Medical Cannabis Registry
Nishaanth Dalavaye, Simon Erridge, Martha Nicholas, Manaswini Pillai, Lara Bapir, Carl Holvey, Ross Coomber, James J Rucker, Jonathan Hoare, Mikael H Sodergren
Expert Review of Gastroenterology & Hepatology.2023; 17(1): 85. CrossRef
Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
Intestinal Research.2023; 21(3): 353. CrossRef
Beyond the survey, to the ideal therapy for Asian
Ki Jae Jo, Jong Pil Im
Intestinal Research.2023; 21(3): 280. CrossRef
Which biologic agents increase perioperative complications in patients with inflammatory bowel disease?
Jihye Park
Intestinal Research.2022; 20(1): 1. CrossRef
Feasibility of a Clinical Decision Support Tool for Ustekinumab to Predict Clinical Remission and Relapse in Patients With Crohn’s Disease: A Multicenter Observational Study
Jihye Park, Jaeyoung Chun, Hyuk Yoon, Jae Hee Cheon
Inflammatory Bowel Diseases.2022;[Epub] CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Real-World Evidence of the Effectiveness and Safety of Ustekinumab for the Treatment of Crohn’s Disease: Systematic Review and Meta-Analysis of Observational Studies
Cristina Rubín de Célix, María Chaparro, Javier P. Gisbert
Journal of Clinical Medicine.2022; 11(14): 4202. CrossRef
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Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef
Vedolizumab Is Safe and Efficacious for the Treatment of Pediatric-Onset Inflammatory Bowel Disease Patients Who Fail a Primary Biologic Agent
Sujin Choi, Eun Sil Kim, Yiyoung Kwon, Mi Jin Kim, Yon Ho Choe, Byung-Ho Choe, Ben Kang
Journal of Korean Medical Science.2022;[Epub] CrossRef

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IBD

Factors associated with anti-tumor necrosis factor effectiveness to prevent postoperative recurrence in Crohn’s disease: Anthony Buisson, Lisa Cannon, Konstantin Umanskiy, Roger D. Hurst, Neil H. Hyman, Atsushi Sakuraba, Joel Pekow, Sushila Dalal, Russell D. Cohen, Bruno Pereira, David T. Rubin; Intest Res 2022;20(3):303-312. Published online August 4, 2021; DOI: https://doi.org/10.5217/ir.2021.00018

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We assessed the effectiveness of anti-TNF agents and its associated factors to prevent endoscopic and clinical postoperative recurrence (POR) in Crohn’s disease (CD).
Methods
From a prospectively-maintained database, we retrieved 316 CD patients who underwent intestinal resection (2011–2017). Endoscopic (Rutgeerts index ≥ i2 at 6 months) and clinical (recurrence of symptoms leading to hospitalization or therapeutic escalation) POR were assessed.
Results
In 117 anti-TNF-naïve patients, anti-TNF therapy was more effective than immunosuppressive agents (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.8–43.9; P= 0.008) and no medication/5-aminosalicylates (OR, 5.2; 95% CI, 1.0–27.9; P= 0.05) to prevent endoscopic POR. In 199 patients exposed to anti-TNF prior to the surgery, combination with anti-TNF and immunosuppressive agents was more effective than anti-TNF monotherapy (OR, 2.32; 95% CI, 1.02–5.31; P= 0.046) to prevent endoscopic POR. Primary failure to anti-TNF agent prior to surgery was predictive of anti-TNF failure to prevent endoscopic POR (OR, 2.41; 95% CI, 1.10–5.32; P= 0.03). When endoscopic POR despite anti-TNF prophylactic medication (n = 55), optimizing anti-TNF and adding an immunosuppressive drug was the most effective option to prevent clinical POR (hazard ratio, 7.38; 95% CI, 1.54–35.30; P= 0.012). Anti-TNF therapy was the best option to prevent clinical POR (hazard ratio, 3.10; 95% CI, 1.09–8.83; P= 0.034) in patients with endoscopic POR who did not receive any biologic to prevent endoscopic POR (n = 55).
Conclusions
Anti-TNF was the most effective medication to prevent endoscopic and clinical POR. Combination with anti-TNF and immunosuppressive agents should be considered in patients previously exposed to anti-TNF.

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Chak Lam Ip, Ray Boyapati, Rahul Kalla
Current Opinion in Gastroenterology.2024; 40(3): 209. CrossRef
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Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis
Eline M. L. van der Does de Willebois, Vittoria Bellato, Marjolijn Duijvestein, Susan van Dieren, Silvio Danese, Pierpaolo Sileri, Christianne J. Buskens, Andrea Vignali, Willem A. Bemelman
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Systematic review: Patient‐related, microbial, surgical, and histopathological risk factors for endoscopic post‐operative recurrence in patients with Crohn's disease
Michiel T. J. Bak, Karlijn Demers, Nassim Hammoudi, Matthieu Allez, Mark S. Silverberg, Gwenny M. Fuhler, Kaushal Parikh, Marieke J. Pierik, Laurents P. S. Stassen, C. Janneke van der Woude, Michail Doukas, Oddeke van Ruler, Annemarie C. de Vries
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Javier P. Gisbert, María Chaparro
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Jiri Bronsky, Kristyna Zarubova, Michal Kubat, Vojtech Dotlacil
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Javier P. Gisbert, María Chaparro
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Jung-Bin Park, Sang Hyoung Park
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Kai Xia, Ren-Yuan Gao, Xiao-Cai Wu, Lu Yin, Chun-Qiu Chen
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Reviews

IBD

Artificial intelligence in inflammatory bowel disease: implications for clinical practice and future directions: Harris A. Ahmad, James E. East, Remo Panaccione, Simon Travis, James B. Canavan, Keith Usiskin, Michael F. Byrne; Intest Res 2023;21(3):283-294. Published online April 20, 2023; DOI: https://doi.org/10.5217/ir.2023.00020

Abstract PDF PubReader ePub

Inflammatory bowel disease encompasses Crohn’s disease and ulcerative colitis and is characterized by uncontrolled, relapsing, and remitting course of inflammation in the gastrointestinal tract. Artificial intelligence represents a new era within the field of gastroenterology, and the amount of research surrounding artificial intelligence in patients with inflammatory bowel disease is on the rise. As clinical trial outcomes and treatment targets evolve in inflammatory bowel disease, artificial intelligence may prove as a valuable tool for providing accurate, consistent, and reproducible evaluations of endoscopic appearance and histologic activity, thereby optimizing the diagnosis process and identifying disease severity. Furthermore, as the applications of artificial intelligence for inflammatory bowel disease continue to expand, they may present an ideal opportunity for improving disease management by predicting treatment response to biologic therapies and for refining the standard of care by setting the basis for future treatment personalization and cost reduction. The purpose of this review is to provide an overview of the unmet needs in the management of inflammatory bowel disease in clinical practice and how artificial intelligence tools can address these gaps to transform patient care.

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Cancer

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):20-42. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00096

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Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
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Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
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Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
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Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol with Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis
Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Intestinal Research.2023; 21(4): 510. CrossRef
Summary and comparison of recently updated post-polypectomy surveillance guidelines
Yoon Suk Jung
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Original Articles

IBD

Maintaining infliximab induced clinical remission with azathioprine and 5-aminosalicylates in acute severe steroid-refractory ulcerative colitis has lower cost and high efficacy (MIRACLE): a multicenter study: Ramit Mahajan, Arshdeep Singh, Saurabh Kedia, Kirandeep Kaur, Vandana Midha, Pabitra Sahu, Varun Mehta, Dharmatma Singh, Namita Bansal, Khushdeep Dharni, Sandeep Kaushal, Vineet Ahuja, Ajit Sood; Intest Res 2022;20(1):64-71. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00100

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Background/Aims
Infliximab (IFX) has been used to induce and maintain remission in patients with severe steroid-refractory ulcerative colitis (UC). Long-term use of biologics in developing countries is limited by high cost and frequent side effects. An optimal maintenance strategy in these patients needs to be established.
Methods
A retrospective analysis of maintenance of clinical remission with combination of azathioprine (AZA) and 5-aminosalicylates (5-ASA) in patients with severe steroidrefractory UC where IFX (5 mg/kg intravenously at weeks 0, 2, 6) had been used only as an induction therapy was done at 2 centers in India. Primary outcome was the proportion of patients maintaining corticosteroid-free sustained clinical remission (SCR) at the end of study period. Rates of relapse and cost of therapy were also analyzed.
Results
Of the 137 patients who received rescue IFX induction therapy, 77 (56.2%) achieved clinical remission (mean age 34.81 ± 13.32 years, 68.83% males, median follow-up 4 years, range 3 months to 6 years) and were included. Cumulative corticosteroid-free SCR was maintained in 68%, 59%, 42%, and 35% patients at 1, 2, 4, and 6 years respectively. Sixty-seven relapses were observed in 33 patients. Majority of the relapses (45/67, 67.16%) occurred within first 2 years of follow-up. Two relapses were managed with re-induction with IFX, one required colectomy, whereas all other responded to repeat course(s) of corticosteroids. Annual per capita maintenance therapy with 5-ASA and AZA was cheaper by US$ 4,526 compared to maintaining remission with IFX.
Conclusions
Clinical remission achieved with IFX induction therapy in severe steroid-refractory UC can be sustained over long time with a combination of AZA and 5-ASA.

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Effect of Ornithine α-Ketoglutarate on Intestinal Microbiota and Serum Inflammatory Cytokines in Dextran Sulfate Sodium Induced Colitis
Tao Wang, Junquan Tian, Wenxuan Su, Fan Yang, Jie Yin, Qian Jiang, Yuying Li, Kang Yao, Tiejun Li, Yulong Yin
Nutrients.2023; 15(11): 2476. CrossRef
Management of Ulcerative Colitis: A Review of Indian Literature
Santhosh Rajendran, Ratnakar Kini, K. Muthukumaran, I. Shubha, A. Chezhian, R. Murali
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 127. CrossRef
Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
Soo-Young Na
The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef
Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo
Alexander Keith Turbayne, Miles Patrick Sparrow
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Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
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Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
Intestinal Research.2022; 20(4): 452. CrossRef
Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
Clinical Gastroenterology and Hepatology.2022; 20(11): 2421. CrossRef
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Ji Young Chang, Jae Hee Cheon
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Functional bowel disorder

An evaluation of dietary adequacy among patients with constipation-predominant irritable bowel syndrome in Malaysia: Nor Hamizah Shafiee, Nurul Huda Razalli, Norfilza M. Mokhtar, Eunice Tan, Raja Affendi Raja Ali; Intest Res 2022;20(1):124-133. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00050

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Background/Aims
Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls.
Methods
A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls.
Results
A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B₁, B₂, B₆, folate, B₁₂, E, K, and potassium) among IBS-C patients did not meet the standard RNI.
Conclusions
Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

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Junfeng Cai, Danqing Li, Ruijun Xie, Xiaoling Yu, Yuning Wu, Feng Sun, Chenxiong Zhang
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Systematic review and meta-analysis of habitual intake of fermentable oligo-, di-, mono- saccharides and polyols in the general population and revisiting the low FODMAP diet concept
Yoghatama Cindya Zanzer, Stephan Theis
Journal of Functional Foods.2024; 112: 105914. CrossRef
A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome
Marlynna Sarkawi, Raja Affendi Raja Ali, Norhazlina Abdul Wahab, Norshafila Diana Abdul Rathi, Norfilza Mohd Mokhtar
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Scientific Reports.2023;[Epub] CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
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Mahsa Rezazadegan, Maryam Soheilipour, Mohammad Javad Tarrahi, Reza Amani
Digestive Diseases and Sciences.2022; 67(8): 3632. CrossRef

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IBD

One-year clinical efficacy and safety of indigo naturalis for active ulcerative colitis: a real-world prospective study: Yuichi Matsuno, Takehiro Torisu, Junji Umeno, Hiroki Shibata, Atsushi Hirano, Yuta Fuyuno, Yasuharu Okamoto, Shin Fujioka, Keisuke Kawasaki, Tomohiko Moriyama, Tomohiro Nagasue, Keizo Zeze, Yoichiro Hirakawa, Shinichiro Kawatoko, Yutaka Koga, Yoshinao Oda, Motohiro Esaki, Takanari Kitazono; Intest Res 2022;20(2):260-268. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2021.00124

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Background/Aims
Recent studies suggested a favorable effect of indigo naturalis (IN) in inducing remission for refractory ulcerative colitis (UC), however, the maintenance effect of IN for patients with UC remains unknown. Therefore, we conducted a prospective uncontrolled open-label study to analyze the efficacy and safety of IN for patients with UC.
Methods
Patients with moderate to severe active UC (clinical activity index [CAI] ≥ 8) took 2 g/day of IN for 52 weeks. CAI at weeks 0, 4, 8, and 52 and Mayo endoscopic subscore (MES) and Geboes score (GS) at weeks 0, 4, and 52 were assessed. Clinical remission (CAI ≤ 4), mucosal healing (MES ≤ 1), and histological healing (GS ≤ 1) rates at each assessment were evaluated. Overall adverse events (AEs) during study period were also evaluated. The impact of IN on mucosal microbial composition was assessed using 16S ribosomal RNA gene sequences.
Results
Thirty-three patients were enrolled. The rates of clinical remission at weeks 4, 8, and 52 were 67%, 76%, and 73%, respectively. The rates of mucosal healing at weeks 4 and 52 were 48% and 70%, respectively. AEs occurred in 17 patients (51.5%) during follow-up. Four patients (12.1%) showed severe AEs, among whom 3 manifested acute colitis. No significant alteration in the mucosal microbial composition was observed with IN treatment.
Conclusions
One-year treatment of moderate to severe UC with IN was effective. IN might be a promising therapeutic option for maintaining remission in UC, although the relatively high rate of AEs should be considered.

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Indigo naturalis (Qing dai) for inflammatory bowel disease: A systematic review and meta-analysis
Rinkalben Kakdiya, Daya Krishna Jha, Arup Choudhury, Anuraag Jena, Vishal Sharma
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Reply to “Ferroptosis in the colon epithelial cells as a therapeutic target for ulcerative colitis”
Akihito Yokote, Noriyuki Imazu, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Tomohiko Moriyama, Kohta Miyawaki, Koichi Akashi, Takanari Kitazono, Takehiro Torisu
Journal of Gastroenterology.2024; 59(1): 77. CrossRef
Risk of Infection in Patients With Inflammatory Bowel Disease Treated With Interleukin-Targeting Agents: A Systematic Review and Meta-Analysis
Konstantinos Ouranos, Hira Saleem, Stephanos Vassilopoulos, Athanasios Vassilopoulos, Evangelia K Mylona, Fadi Shehadeh, Markos Kalligeros, Bincy P Abraham, Eleftherios Mylonakis
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis
Preetha Iyengar, Gala Godoy-Brewer, Isha Maniyar, Jacob White, Laura Maas, Alyssa M. Parian, Berkeley Limketkai
Nutrients.2024; 16(7): 934. CrossRef
Clinical Efficacy and Future Application of Indigo Naturalis in the Treatment of Ulcerative colitis
Dianzhen Wu, Qi Huang, Yingbi Xu, Ruiyi Cao, Ming Yang, Jin Xie, Dingkun Zhang
Journal of Ethnopharmacology.2024; : 118782. CrossRef
Ferroptosis in the colon epithelial cells as a therapeutic target for ulcerative colitis
Akihito Yokote, Noriyuki Imazu, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Tomohiko Moriyama, Kohta Miyawaki, Koichi Akashi, Takanari Kitazono, Takehiro Torisu
Journal of Gastroenterology.2023; 58(9): 868. CrossRef
Hyaluronic acid/inulin-based nanocrystals with an optimized ratio of indigo and indirubin for combined ulcerative colitis therapy via immune and intestinal flora regulation
Jin Xie, Qi Huang, Huijuan Xie, Jun Liu, Shimin Tian, Ruiyi Cao, Ming Yang, Junzhi Lin, Li Han, Dingkun Zhang
International Journal of Biological Macromolecules.2023; 252: 126502. CrossRef
High-Quality Indigo Naturalis Obtained with Automatic Foam Separation
Xin Yang, Jun Tang, Juan Su, Xin Yang, Ming Yang, Xiangbo Yang, Qisen Ji, Yanan He, Li Han, Dingkun Zhang
ACS Applied Materials & Interfaces.2023; 15(37): 43272. CrossRef

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IBD

Intestinal ultrasonography and fecal calprotectin for monitoring inflammation of ileal Crohn’s disease: two complementary tests: José María Paredes, Tomás Ripollés, Ángela Algarra, Rafael Diaz, Nadia Moreno, Patricia Latorre, María Jesús Martínez, Pilar Llopis, Antonio López, Eduardo Moreno-Osset; Intest Res 2022;20(3):361-369. Published online March 15, 2022; DOI: https://doi.org/10.5217/ir.2021.00126

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Background/Aims
Tight control of inflammation and adjustment of treatment if activity persists is the current strategy for the management of Crohn’s disease (CD). The usefulness of fecal calprotectin (FC) in isolated involvement of the small intestine in CD is controversial. To assess the usefulness of FC to determine the inflammatory activity detected by intestinal ultrasonography (IUS) in ileal CD.
Methods
Patients with exclusively ileal involvement CD who underwent IUS and an FC were prospectively included. Simple ultrasound index was used to determine inflammatory activity. The usual statistical tests for comparison of diagnostic techniques were used.
Results
One hundred and five patients were included, IUS showed inflammatory activity in 59% of patients and complications in 18.1%. FC showed a significant correlation with IUS in the weak range (Spearman coefficient r=0.502; P<0.001); the area under the receiver operating characteristic curve was 0.79 (95% confidence interval, 0.70–0.88; P<0.001). The FC value that best reflected the activity in IUS was 100 μg/g with sensitivity, specificity, and positive and negative predictive values of 73.0%, 71.4%, 79.3% and 63.8%, respectively. There were no differences in FC concentration between patients with or without transmural complications. The addition of serum C-reactive protein to FC did not improve the ability to assess IUS activity.
Conclusions
FC has a significant correlation with IUS to monitor ileal CD activity. This correlation is weak and it does not allow assessing the presence of CD complications. Both tests should be used in conjunction for tight control of ileal CD. More studies on noninvasive tests in this location are needed.

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Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review
Vasile-Claudiu Mihai, Liliana Gheorghe, Ioana-Irina Rezuș, Alina Ecaterina Jucan, Mihaela-Cristiana Andronic, Otilia Gavrilescu, Mihaela Dranga, Andrei-Mihai Andronic, Cristina Cijevschi Prelipcean, Ciprian Rezuș, Cătălina Mihai
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The intestinal ultrasound role in inflammatory bowel disease in clinical practice and a critical appraisal of the current guidelines (mini-review)
Sarah El-Nakeep
The Egyptian Journal of Internal Medicine.2024;[Epub] CrossRef
Intestinal Ultrasonography as an Alternative to Fecal Calprotectin to Monitor Patients with Crohn’s Disease: Experience from a Novice Sonographer
Kelly Mathieu, Jérémy Junda, Régine Minet-Quinard, Dilek Coban, Marie Dodel, Bruno Pereira, Anthony Buisson
Digestive Diseases and Sciences.2024; 69(9): 3402. CrossRef
Intestinal ultrasound for follow-up after 24 weeks of biological therapy in inflammatory bowel disease patients: an Egyptian center experience during the COVID-19 pandemic
Sarah El-Nakeep, Ehab Nashaat, Fatma Alsherif, Mohamed Magdy Salama
Egyptian Journal of Radiology and Nuclear Medicine.2024;[Epub] CrossRef
Assessing Active Bowel Inflammation in Crohn's Disease Using Intestinal Ultrasound
Myung‐won You, Sung Kyoung Moon, Yong Dae Lee, Shin Ju Oh, Seong Jin Park, Chang Kyun Lee
Journal of Ultrasound in Medicine.2023; 42(12): 2791. CrossRef
Standardizing Endoscopic Reporting in Patients with IBD: JEDII™ to the Rescue?
Sara Massironi, Alice Laffusa, Tommaso Lorenzo Parigi, Silvio Danese
Digestive Diseases and Sciences.2023; 68(12): 4287. CrossRef
Application of transabdominal ultrasound in Crohn’s disease
Wei-Jie Chen, Lei-Lei Luo, Zhi-Xing Dong, Jing Wu, Xing-Xing Gu, Zhao-Lian Bian
World Chinese Journal of Digestology.2022; 30(8): 364. CrossRef
Is radiological healing alone enough? ‘Can’t take my eyes off’ the mucosa
Su Hyun Park, Sang Hyoung Park
The Korean Journal of Internal Medicine.2022; 37(3): 551. CrossRef

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Review

IBD

Artificial intelligence for endoscopy in inflammatory bowel disease: Kento Takenaka, Ami Kawamoto, Ryuichi Okamoto, Mamoru Watanabe, Kazuo Ohtsuka; Intest Res 2022;20(2):165-170. Published online January 7, 2022; DOI: https://doi.org/10.5217/ir.2021.00079

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), with its 2 subtypes, Crohn’s disease and ulcerative colitis, is a complex chronic condition. A precise definition of disease activity and appropriate drug management greatly improve the clinical course while minimizing the risk or cost. Artificial intelligence (AI) has been used in several medical diseases or situations. Herein, we provide an overview of AI for endoscopy in IBD. We discuss how AI can improve clinical practice and how some components have already begun to shape our knowledge. There may be a time when we can use AI in clinical practice. As AI systems contribute to the exact diagnosis and treatment of human disease, we should continue to learn best practices in health care in the field of IBD.

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Could histologic healing be a new treatment target in patients with ulcerative colitis?
Soyoung Kim, Sang Hyoung Park
The Korean Journal of Internal Medicine.2024; 39(1): 2. CrossRef
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Joana Mota, Maria João Almeida, Francisco Mendes, Miguel Martins, Tiago Ribeiro, João Afonso, Pedro Cardoso, Helder Cardoso, Patrícia Andrade, João Ferreira, Miguel Mascarenhas, Guilherme Macedo
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The Role of Artificial Intelligence in the Diagnosis and Treatment of Ulcerative Colitis
Petar Uchikov, Usman Khalid, Nikola Vankov, Maria Kraeva, Krasimir Kraev, Bozhidar Hristov, Milena Sandeva, Snezhanka Dragusheva, Dzhevdet Chakarov, Petko Petrov, Bistra Dobreva-Yatseva, Ivan Novakov
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Deep learning and minimally invasive inflammatory activity assessment: a proof-of-concept study for development and score correlation of a panendoscopy convolutional network
Pedro Cardoso, Miguel Mascarenhas, João Afonso, Tiago Ribeiro, Francisco Mendes, Miguel Martins, Patrícia Andrade, Hélder Cardoso, Miguel Mascarenhas Saraiva, João P.S. Ferreira, Guilherme Macedo
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
Deep Learning Model Using Stool Pictures for Predicting Endoscopic Mucosal Inflammation in Patients With Ulcerative Colitis
Jung Won Lee, Dongwon Woo, Kyeong Ok Kim, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Ben Kang, Yoo Jin Lee, Jeongseok Kim, Byung Ik Jang, Eun Young Kim, Hyeong Ho Jo, Yun Jin Chung, Hanjun Ryu, Soo-Kyung Park, Dong-Il Park, Hosang Yu, Sungmoon Jeong
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Joaquim Carreras
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Radu-Alexandru Vulpoi, Mihaela Luca, Adrian Ciobanu, Andrei Olteanu, Oana-Bogdana Barboi, Vasile Liviu Drug
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Stefania Chetcuti Zammit, Reena Sidhu
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Original Articles

IBD

Long-term efficacy and tolerability of dose-adjusted thiopurine treatment in maintaining remission in inflammatory bowel disease patients with NUDT15 heterozygosity: Takato Maeda, Hirotake Sakuraba, Hiroto Hiraga, Shukuko Yoshida, Yoichi Kakuta, Hidezumi Kikuchi, Shogo Kawaguchi, Keisuke Hasui, Tetsuya Tatsuta, Daisuke Chinda, Tatsuya Mikami, Shinsaku Fukuda; Intest Res 2022;20(1):90-100. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00133

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Thiopurines are key drugs for inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Recently, NUDT15 polymorphism (R139C, c.415C > T) has been shown to be associated with thiopurineinduced adverse events in Asian populations. In patients with the C/T genotype, low-dose thiopurine treatment is recommended, but its long-term efficacy and tolerability remain unclear. This study aimed to uncover the long-term efficacy and appropriate dosage of thiopurine for IBD patients with the C/T genotype.
Methods
A total of 210 patients with IBD (103 UC and 107 CD) determined to have NUDT15 R139C variants were enrolled. Clinical data were retrospectively reviewed from medical records.
Results
Of 46 patients (21.9%) with the C/T genotype, 30 patients (65.2%) were treated with thiopurines. Three of whom (10.0%) discontinued thiopurine treatment due to adverse events and 27 of whom continued. The median maintenance dosage of 6-mercaptopurine was 0.25 mg/kg/day (range, 0.19–0.36 mg/kg/day), and 6-thioguanine nucleotides level was 230 (104–298) pmol/8 × 10⁸ red blood cells. Cumulative thiopurine continuation rates for 120 months for patients with the C/C and C/T genotypes were not significantly different (P= 0.895). Cumulative non-relapse rates in the patients with UC treated with thiopurine monotherapy and surgery-free rates in CD patients treated with combination therapy (thiopurines and anti-tumor necrosis factor-α agents) for maintenance remission were not significantly different at 60 months (C/C vs. C/T, P= 0.339 and P= 0.422, respectively).
Conclusions
Low-dose thiopurine treatment is an effective and acceptable treatment for patients with C/T genotype.

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Effectiveness and Tolerability of Methotrexate Combined with Biologics in Patients with Crohn’s Disease: A Multicenter Observational Study
Jihye Park, Jaeyoung Chun, Soo Jung Park, Jae Jun Park, Tae Il Kim, Hyuk Yoon, Jae Hee Cheon
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IBD

Effectiveness of administering zinc acetate hydrate to patients with inflammatory bowel disease and zinc deficiency: a retrospective observational two-center study: Kensuke Sakurai, Shigeru Furukawa, Takehiko Katsurada, Shinsuke Otagiri, Kana Yamanashi, Kazunori Nagashima, Reizo Onishi, Keiji Yagisawa, Haruto Nishimura, Takahiro Ito, Atsuo Maemoto, Naoya Sakamoto; Intest Res 2022;20(1):78-89. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00124

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Inflammatory bowel disease (IBD) patients frequently have zinc deficiency. IBD patients with zinc deficiency have higher risks of IBD-related hospitalization, complications, and requiring surgery. This study aimed to examine the effectiveness of zinc acetate hydrate (ZAH; Nobelzin) in IBD patients with zinc deficiency.
Methods
IBD patients with zinc deficiency who received ZAH from March 2017 to April 2020 were registered in this 2-center, retrospective, observational study. Changes in serum zinc levels and disease activity (Crohn’s Disease Activity Index [CDAI]) before and after ZAH administration were analyzed.
Results
Fifty-one patients with Crohn’s disease (CD, n = 40) or ulcerative colitis (UC, n = 11) were registered. Median serum zinc level and median CDAI scores significantly improved (55.5–91.0 μg/dL, P< 0.001; 171.5–129, P< 0.001, respectively) in CD patients 4 weeks after starting ZAH administration. Similarly, median serum zinc levels and CDAI scores significantly improved (57.0–81.0 μg/dL, P< 0.001; 177–148, P= 0.012, respectively) 20 weeks after starting ZAH administration. Similar investigations were conducted in groups where no treatment change, other than ZAH administration, was implemented; significant improvements were observed in both serum zinc level and CDAI scores. Median serum zinc levels in UC patients 4 weeks after starting ZAH administration significantly improved from 63.0 to 94.0 μg/dL (P= 0.002), but no significant changes in disease activity were observed. One patient experienced side effects of abdominal discomfort and nausea.
Conclusions
ZAH administration is effective in improving zinc deficiency and may contribute to improving disease activity in IBD.

Citations

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