Intestinal Research

Original Articles

IBD

Serum albumin is the strongest predictor of anti-tumor necrosis factor nonresponse in inflammatory bowel disease in resource-constrained regions lacking therapeutic drug monitoring: Peeyush Kumar, Sudheer K. Vuyyuru, Prasenjit Das, Bhaskar Kante, Mukesh Kumar Ranjan, David Mathew Thomas, Sandeep Mundhra, Pabitra Sahu, Pratap Mouli Venigalla, Saransh Jain, Sandeep Goyal, Rithvik Golla, Shubi Virmani, Mukesh K. Singh, Karan Sachdeva, Raju Sharma, Nihar Ranjan Dash, Govind Makharia, Saurabh Kedia, Vineet Ahuja; Intest Res 2023;21(4):460-470. Published online March 17, 2023; DOI: https://doi.org/10.5217/ir.2022.00128

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn’s disease (CD).
Methods
Inflammatory bowel disease patients treated with anti-TNF agents (January 2005–October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies.
Results
One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1±13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28–100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P<0.001), postoperative recurrence (P=0.001) and high IL-7R expression (P<0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03–0.28; P<0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15–0.62; P=0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P<0.001), and high C-reactive protein (P<0.001), OSM (P<0.04) and OSM-R (P=0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03–0.39; P=0.001) on multivariate analysis respectively.
Conclusions
Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients.

Citations

Citations to this article as recorded by

Does surgical approach affect Hirschsprung-associated enterocolitis risk? A comparison between transanal Swenson-like and endorectal pull-throughs
Azzahra Fatinnuha Azmi Prayogi Putri, Dwiki Afandy, Ahmad Zakiy Habibiy, Setiani Silvy Nurhidayah, Khanza Adzkia Vujira, Pramana Adhityo, Gilang Vigorous Akbar Eka Candy, Kristy Iskandar, Eko Purnomo, Gunadi, Kota V. Ramana
PLOS One.2026; 21(1): e0340813. CrossRef
HLA-DQB1*03:01 and HLA-DQA1*05:05 as key genetic determinants of infliximab response and immunogenicity in Japanese patients with inflammatory bowel disease
Ryuya Osaka, Takeo Naito, Seik-Soon Khor, Yoichi Kakuta, Yosuke Kawai, Masao Nagasaki, Hiroshi Meguro, Hideya Iwaki, Daisuke Okamoto, Hiroshi Nagai, Yusuke Shimoyama, Rintaro Moroi, Hisashi Shiga, Yoshitaka Kinouchi, Atsushi Masamune
Journal of Gastroenterology.2026;[Epub] CrossRef
Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study
Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim
Gut and Liver.2025; 19(3): 376. CrossRef
The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn’s disease: a cohort study
Chen Huang, Chao Chen, Hao Wu, Hanyu Yin, Weixiang Yao, Susu Bai, Baixue Zhuo, Xiaoli Wu
Frontiers in Nutrition.2025;[Epub] CrossRef
Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef
Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
Sayan Malakar, Srikanth Kothalkar, Umair Shamsul Hoda, Uday C Ghoshal
Cureus.2023;[Epub] CrossRef

9,604 View
486 Download
7 Web of Science
6 Crossref

Infection

Interferon-gamma release assay has poor diagnostic accuracy in differentiating intestinal tuberculosis from Crohn’s disease in tuberculosis endemic areas: Karan Sachdeva, Peeyush Kumar, Bhaskar Kante, Sudheer K. Vuyyuru, Srikant Mohta, Mukesh K. Ranjan, Mukesh K. Singh, Mahak Verma, Govind Makharia, Saurabh Kedia, Vineet Ahuja; Intest Res 2023;21(2):226-234. Published online June 13, 2022; DOI: https://doi.org/10.5217/ir.2022.00010

Abstract PDF PubReader ePub

Background/Aims
Intestinal tuberculosis (ITB) and Crohn’s disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the same.
Methods
Patients with definitive diagnosis of ITB (n=59) or CD (n=49) who underwent IGRA testing (n=307) were retrospectively included at All India Institute of Medical Sciences, New Delhi (July 2014 to September 2021). CD or ITB was diagnosed as per standard criteria. IGRA was considered positive at >0.35 IU/mL. Relevant data was collected and IGRA results were compared between ITB and CD to determine its accuracy.
Results
Among 59 ITB patients (mean age, 32.6±13.1 years; median disease duration, 1 year; male, 59.3%), 24 were positive and 35 tested negative for IGRA. Among 49 CD patients (mean age, 37.8±14.0; median disease duration, 4 years; male, 61.2%), 12 were positive and 37 tested negative for IGRA. Hence, for diagnosing ITB, IGRA showed a sensitivity, specificity, positive and negative predictive values of 40.68%, 75.51%, 66.67%, and 51.39%, respectively. The area under the curve of IGRA for ITB diagnosis was 0.66 (95% confidence interval, 0.55–0.75). In a subset (n=64), tuberculin skin test (TST) showed sensitivity, specificity, positive and negative predictive values of 64.7%, 73.3%, 73.3%, and 64.71%, respectively. IGRA and TST were concordant in 38 (59.4%) patients with κ=0.17.
Conclusions
In a tuberculosis endemic region, IGRA had poor diagnostic accuracy for differentiating ITB from CD, suggesting a limited value of IGRA in this setting.

Citations

Citations to this article as recorded by

ECCO consensus on management of inflammatory bowel disease in low- and middle-income countries
Alaa El-Hussuna, Almuthe Christina Hauer, Tarkan Karakan, Valerie Pittet, Henit Yanai, Jalpa Devi, Jesus K Yamamoto-Furusho, Ali Reza Sima, Hailemichael Desalegn, Mutaz Idrees Sultan, Vishal Sharma, Hany Shehab, Lamya Mrabti, Natalia Queiroz, Anuraag Jena
Journal of Crohn’s and Colitis.2026;[Epub] CrossRef
Mistakes to avoid in the management of abdominal tuberculosis
Abhirup Chatterjee, Daya Krishna Jha, Aravind Sekar, Vishal Sharma
Expert Review of Anti-infective Therapy.2025; 23(2-4): 197. CrossRef
Interferon-Gamma Release Assays Versus Tuberculin Skin Test for Active Tuberculosis Diagnosis: A Systematic Review and Diagnostic Meta-Analysis
Muhammad Abubaker Tobaiqi, Musleh Naser Alshamrani, Shyamkumar Sriram, Ahmad Bakur Mahmoud, Hammad Ali Fadlalmola, Muayad Albadrani
Diagnostics.2025; 15(18): 2343. CrossRef
An Updated Review on Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis
Ravi K Sharma, Alpa Singh, Saurabh Dawra
Journal of Postgraduate Medicine, Education and Research.2025; 60(1): 18. CrossRef
New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef
Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis
Tsvetelina Velikova, Anita Aleksandrova
World Journal of Clinical Cases.2024; 12(27): 6015. CrossRef
Diagnostic yield and technical performance of the novel motorized spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a prospective study (with video)
Partha Pal, Piyush Vishwakarma, Aniruddha Pratap Singh, Palle Manohar Reddy, Mohan Ramchandani, Rupa Banerjee, Anuradha Sekaran, Polina Vijayalaxmi, Hardik Rughwani, Pradev Inavolu, Santosh Darishetty, Pradeep Rebala, Guduru Venkat Rao, Manu Tandan, D. Na
Gastrointestinal Endoscopy.2023; 97(3): 493. CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn’s disease: a randomised controlled, open-label study (the MOTOR-CD trial)
Partha Pal, Mohan Ramchandani, Rupa Banerjee, Piyush Viswakarma, Aniruddha Pratap Singh, Manohar Reddy, Hardik Rughwani, Rajendra Patel, Anuradha Sekaran, Swathi Kanaganti, Santosh Darisetty, Zaheer Nabi, Jagadish Singh, Rajesh Gupta, Sundeep Lakhtakia, R
Gut.2023; 72(10): 1866. CrossRef

8,250 View
579 Download
7 Web of Science
9 Crossref

Brief Communication

IBD

Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis: Nagesh Kamat, Sudheer K Vuyyuru, Saurabh Kedia, Pabitra Sahu, Bhaskar Kante, Peeyush Kumar, Mukesh Kumar Ranjan, Mukesh Kumar Singh, Sambuddha Kumar, Vikas Sachdev, Govind Makharia, Vineet Ahuja; Intest Res 2022;20(2):269-273. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00064

PDF Supplementary Material PubReader ePub

Citations

Citations to this article as recorded by

Clinical Insights on “Tolerability and Effectiveness of Glucagon‑Like Peptide‑1 Receptor Agonists in Patients with Inflammatory Bowel Disease”
XiRui Yang, FengJie Xie
Digestive Diseases and Sciences.2026; 71(2): 743. CrossRef
A patient-reported outcome measure comprising the stool frequency and abdominal pain items from the Crohn’s Disease Activity Index: psychometric evaluation in adults with Crohn’s disease
James D. Lewis, Aisha Vadhariya, Sylvia Su, Xian Zhou, Frederick Durand, Ariane K. Kawata, Larissa Stassek, Claudine Clucas, Stefan Schreiber
Journal of Patient-Reported Outcomes.2025;[Epub] CrossRef
Predictive accuracy of fecal calprotectin in assessing clinical activity and disease severity in patients with Ulcerative Colitis and Crohn’s disease
Ankit V. Jain, Sandeep Gopal, Anurag J. Shetty, Suresh Shenoy, B. V. Tantry, B. Unnikrishnan, Ramesh Holla, Rishit Anand
BMC Gastroenterology.2025;[Epub] CrossRef
Clinical outcome assessment may be a more useful tool for supporting inflammatory bowel disease clinical practice than just patient-reported outcome measures
Nagesh Kamat, Gaurav Patil, Ankit Dalal, Amit Maydeo
Current Medical Research and Opinion.2025; 41(6): 1041. CrossRef
Patient-reported outcome measures poorly correlate with objective inflammatory bowel disease activity measures: a systematic review
Xavier Calvet, Maria Giovanna Ferrario, Vanessa Marfil, Santos Armenteros, Manuel Barreiro-de Acosta
Journal of Crohn’s and Colitis.2025;[Epub] CrossRef
AI-Guided Multi-Omic Microbiome Modulation Improves Clinical and Inflammatory Outcomes in Refractory IBD: A Real-World Study
Raluca Lupusoru, Lavinia Cristina Moleriu, Ruxandra Mare, Ioan Sporea, Alina Popescu, Roxana Sirli, Adrian Goldis, Camelia Nica, Tudor Voicu Moga, Bogdan Miutescu, Iulia Ratiu, Oana Belei, Laura Olariu, Victor Dumitrascu, Radu Dumitru Dragomir
International Journal of Molecular Sciences.2025; 27(1): 201. CrossRef
Depression and active disease are the major risk factors for fatigue and sleep disturbance in inflammatory bowel disease with consequent poor quality of life: Analysis of the interplay between psychosocial factors from the developing world
Partha Pal, Rupa Banerjee, Polina Vijayalaxmi, D. Nageshwar Reddy, Manu Tandan
Indian Journal of Gastroenterology.2024; 43(1): 226. CrossRef
Research Progress in the Study of Biomarkers for Diagnosing Ulcerative Colitis or Assessing Its Activity
琳杨
Advances in Clinical Medicine.2024; 14(01): 1167. CrossRef
A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef
The prevalence and burden of Rome IV faecal incontinence in ulcerative colitis: A cross‐sectional study
Dipesh H. Vasant, Gaurav B. Nigam, Sebastian Bate, Shaheen Hamdy, Jimmy K. Limdi
Alimentary Pharmacology & Therapeutics.2023; 58(1): 26. CrossRef
Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef

7,672 View
297 Download
10 Web of Science
11 Crossref

First
Prev
Page of 1
Next
Last

Search