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Original Articles
Week 2 remission with vedolizumab as a predictor of long-term remission in patients with ulcerative colitis: a multicenter, retrospective, observational study
Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Mary Cavaliere, Kaori Ishiguro, Jovelle L Fernandez, Toshifumi Hibi
Received April 9, 2024  Accepted April 6, 2025  Published online July 14, 2025  
DOI: https://doi.org/10.5217/ir.2025.00047    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Vedolizumab (VDZ), a gut-selective monoclonal antibody for ulcerative colitis (UC) treatment, has no established biomarkers or clinical features that predict long-term remission. Week 2 remission, a potential predictor of long-term remission, could inform maintenance treatment strategy.
Methods
This retrospective, observational chart review included patients with UC in Japan who initiated VDZ between December 2018 and February 2020. Outcome measures included 14- and 54-week remission rates in patients with week 2 and non-week 2 remission (remission by week 14), 54-week remission rates in patients with week 14 remission and primary nonresponse, and predictive factors of week 2 and week 54 remission (logistic regression).
Results
Overall, 332 patients with UC (176 biologic-naïve and 156 biologic-non-naïve) were included. Significantly more biologic-naïve than biologic-non-naïve patients achieved week 2 remission (36.9% vs. 28.2%; odds ratio [OR], 1.43; 95% confidence interval [CI], 1.05–1.94; P= 0.0224). Week 54 remission rates were significantly different between week 14 remission and primary nonresponse (both groups: P< 0.0001), and between week 2 and non-week 2 remission (all patients: OR, 2.41; 95% CI, 1.30–4.48; P= 0.0052; biologic-naïve patients: OR, 2.40; 95% CI, 1.10–5.24; P= 0.0280). Week 2 remission predictors were male sex, no anti-tumor necrosis factor alpha exposure, and normal/mild endoscopic findings. Week 54 remission was significantly associated with week 2 remission and no tacrolimus use.
Conclusions
Week 2 remission with VDZ is a predictor of week 54 remission in patients with UC. Week 2 may be used as an evaluation point for UC treatment decisions. (Japanese Registry of Clinical Trials: jRCT-1080225363)

Citations

Citations to this article as recorded by  
  • Interpreting vedolizumab persistence: lessons from real-world trajectories in ulcerative colitis
    Jung Min Moon
    Intestinal Research.2026; 24(1): 3.     CrossRef
  • 5,127 View
  • 623 Download
  • 1 Crossref
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The duration of prior anti-tumor necrosis factor agents is associated with the effectiveness of vedolizumab in patients with ulcerative colitis: a real-world multicenter retrospective study
Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Minoru Matsuura, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Mary Cavaliere, Kaori Ishiguro, Jovelle L Fernandez, Toshifumi Hibi
Received August 9, 2024  Accepted March 20, 2025  Published online June 4, 2025  
DOI: https://doi.org/10.5217/ir.2024.00126    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Previous literature suggests that the response of patients with ulcerative colitis to vedolizumab may be affected by previous biologic therapy exposure. This real-world study evaluated vedolizumab treatment effectiveness in biologicnon-naïve patients.
Methods
This was a multicenter, retrospective, observational chart review of records from 16 hospitals in Japan (December 1, 2018, to February 29, 2020). Included patients who had ulcerative colitis, were aged ≥ 20 years, and received at least 1 dose of vedolizumab. Outcomes included clinical remission rates from weeks 2 to 54 according to prior biologic exposure status and factors associated with clinical remission up to week 54.
Results
A total of 370 eligible patients were included. Clinical remission rates were significantly higher in biologic-naïve (n=197) than in biologic-non-naïve (n=173) patients for weeks 2 to 54 of vedolizumab treatment. Higher clinical remission rates up to week 54 were significantly associated with lower disease severity (partial Mayo score ≤ 4, P= 0.001; albumin ≥ 3.0, P= 0.019) and the duration of prior anti-tumor necrosis factor α (anti-TNFα) therapy (P= 0.026). Patients with anti-TNFα therapy durations of < 3 months, 3 to < 12 months, and ≥ 12 months had clinical remission rates of 28.1%, 32.7%, and 60.0%, respectively (P= 0.001 across groups).
Conclusions
The effectiveness of vedolizumab in biologic-non-naïve patients was significantly influenced by duration of prior anti-TNFα therapy. (Japanese Registry of Clinical Trials: jRCT-1080225363)

Citations

Citations to this article as recorded by  
  • Interpreting vedolizumab persistence: lessons from real-world trajectories in ulcerative colitis
    Jung Min Moon
    Intestinal Research.2026; 24(1): 3.     CrossRef
  • Long-Term Outcomes and Prognostic Factors for Vedolizumab-Treated Japanese Patients with Ulcerative Colitis
    Shinya Fukushima, Takehiko Katsurada, Takahiro Ito, Atsuo Maemoto, Fumika Orii, Toshifumi Ashida, Masanao Nasuno, Hiroki Tanaka, Katsuyoshi Ando, Mikihiro Fujiya, Yoshihiro Yokoyama, Satoshi Motoya, Hiroshi Nakase
    Inflammatory Intestinal Diseases.2025; 11(1): 1.     CrossRef
  • 4,634 View
  • 740 Download
  • 1 Web of Science
  • 2 Crossref
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IBD
Factors affecting 1-year persistence with vedolizumab for ulcerative colitis: a multicenter, retrospective real-world study
Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Jovelle L. Fernandez, Kaori Ishiguro, Mary Cavaliere, Hisato Deguchi, Toshifumi Hibi
Intest Res 2026;24(1):64-75.   Published online January 16, 2025
DOI: https://doi.org/10.5217/ir.2024.00063
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The objectives of this real-world study were to determine 1-year persistence with vedolizumab in patients with ulcerative colitis and to evaluate factors contributing to loss of response.
Methods
In this multicenter, retrospective, observational chart review, patients with moderately to severely active ulcerative colitis who received ≥ 1 dose of vedolizumab in clinical practice at 16 tertiary hospitals in Japan (from December 2018 through February 2020) were enrolled.
Results
Persistence with vedolizumab was 64.5% (n = 370); the median follow-up time was 53.2 weeks. Discontinuation due to loss of response among initial clinical remitters was reported in 12.5% (35/281) of patients. Multivariate analysis showed that concomitant use of tacrolimus (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.00–7.62; P= 0.050) and shorter disease duration (OR for median duration ≥ 7.8 years vs. < 7.8 years, 0.33; 95% CI, 0.13–0.82; P= 0.017) were associated with discontinuation due to loss of response. Loss of response was not associated with prior use of anti-tumor necrosis factor alpha therapy, age at the time of treatment, disease severity, or concomitant corticosteroids or immunomodulators. Of the 25 patients with disease duration < 1 year, 32.0% discontinued due to loss of response.
Conclusions
Persistence with vedolizumab was consistent with previous reports. Use of tacrolimus and shorter disease duration were the main predictors of decreased persistence.

Citations

Citations to this article as recorded by  
  • Interpreting vedolizumab persistence: lessons from real-world trajectories in ulcerative colitis
    Jung Min Moon
    Intestinal Research.2026; 24(1): 3.     CrossRef
  • Real‐World Effectiveness and Safety of Vedolizumab in Patients ≥ 70 Versus < 70 Years With Ulcerative Colitis: Multicenter Retrospective Study
    Tadakazu Hisamatsu, Taku Kobayashi, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Sakiko Hiraoka, Ken Takeuchi, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Ma
    Journal of Gastroenterology and Hepatology.2025; 40(6): 1435.     CrossRef
  • Increasing age at diagnosis raises malignancy risk and aminosalicylate intolerance influences therapeutic strategies in ulcerative colitis: a multicenter I‑BRITE cohort study
    Shintaro Akiyama, Yuka Ito, Mamiko Shiroyama, Satoshi Suzuki, Masanori Ochi, Toshiro Kamoshida, Hiroshi Kashimura, Junichi Iwamoto, Rie Saito, Tsuyoshi Kaneko, Kazuto Ikezawa, Yoshinori Hiroshima, Junji Hattori, Takashi Mamiya, Satoshi Fukuda, Kazuho Iked
    Journal of Gastroenterology.2025; 60(10): 1259.     CrossRef
  • Mayo Endoscopic Subscore at Week 24 Is a Predictor of Future Loss of Response to Vedolizumab in Patients with Ulcerative Colitis in Clinical Remission
    Daisuke Saito, Minoru Matsuura, Hiromu Morikubo, Noritaka Hibi, Haruka Komatsu, Noriaki Oguri, Takeshi Fujima, Haruka Wada, Ryota Ogihara, Tatsuya Mitsui, Mari Hayashida, Jun Miyoshi, Teppei Omori, Tadakazu Hisamatsu
    Inflammatory Intestinal Diseases.2025; 10(1): 387.     CrossRef
  • 10,156 View
  • 959 Download
  • 2 Web of Science
  • 4 Crossref
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Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood
Intest Res 2025;23(2):144-156.   Published online November 11, 2024
DOI: https://doi.org/10.5217/ir.2024.00068
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC.
Methods
Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed.
Results
We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples.
Conclusions
FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission.

Citations

Citations to this article as recorded by  
  • KASID and Intestinal Research journal: a central academic hub for research of intestinal diseases in the Asia-Pacific region
    Jae Hee Cheon, Hye Kyung Hyun, You Sun Kim, Dong Il Park, Tae Il Kim, Dong Soo Han
    Intestinal Research.2026; 24(1): 6.     CrossRef
  • Beyond mucosal healing: fecal calprotectin and the path toward histologic remission in ulcerative colitis
    Yehyun Park
    Intestinal Research.2025; 23(2): 115.     CrossRef
  • Azathioprine or Tofacitinib as Maintenance Therapy in Corticosteroid‐Responsive Acute Severe Ulcerative Colitis
    Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Dharmatma Singh, Devanshi Jain, Namita Bansal, Gursimran Singh Kochhar, Vandana Midha, Ajit Sood
    Alimentary Pharmacology & Therapeutics.2025; 62(7): 722.     CrossRef
  • Endo-histologic outcomes in patients with ulcerative colitis responding to tofacitinib
    Arshdeep Singh, Arshia Bhardwaj, Devanshi Jain, Riya Sharma, Dharmatma Singh, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Manavjot Singh, Pritish Gupta, Tanisha Sehgal, Vandana Midha, Ajit Sood
    Indian Journal of Gastroenterology.2025;[Epub]     CrossRef
  • Crosstalk between neutrophil extracellular traps and gut microbiota in ulcerative colitis: traditional Chinese medicine strategies
    Yiyi Feng, Yuchen Liu, Xiuxiu Qiu, Jianfang Jiang, Jianling Mo, Yichuan Xv
    Frontiers in Cellular and Infection Microbiology.2025;[Epub]     CrossRef
  • Non-Invasive vs. Invasive Markers in Ulcerative Colitis: A Systematic Review of Intestinal Ultrasound, Biopsy, and Faecal Calprotectin
    Viviana Parra-Izquierdo, Juliette De Avila, Oscar Gómez, Nelson Barrero, Miguel Duarte, Consuelo Romero-Sánchez
    International Journal of Molecular Sciences.2025; 26(17): 8129.     CrossRef
  • 11,851 View
  • 232 Download
  • 5 Web of Science
  • 6 Crossref
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IBD
Early resolution of bowel urgency by budesonide foam enema results in improved quality of life in patients with ulcerative colitis: a multicenter prospective observational study
Taku Kobayashi, Kei Moriya, Toshimitsu Fujii, Shigeki Bamba, Shinichiro Shinzaki, Akihiro Yamada, Takashi Hisabe, Shintaro Sagami, Shuji Hibiya, Takahiro Amano, Noritaka Takatsu, Katsutoshi Inagaki, Ken-ichi Iwayama, Toshifumi Hibi
Intest Res 2025;23(2):157-169.   Published online July 15, 2024
DOI: https://doi.org/10.5217/ir.2024.00005
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Bowel urgency is an important symptom for quality of life determination in patients with ulcerative colitis (UC). Few clinical studies have focused on bowel urgency as an efficacy endpoint. Budesonide foam enema has shown efficacy for clinical and endoscopic improvement in mild-to-moderate UC. We evaluated the improvement of clinical symptoms (bowel urgency), safety, and treatment impact of twice-daily budesonide foam enema on the quality of life in patients with UC.
Methods
This open-label, multicenter, prospective observational study comprised a 4-week observation period assessing the effectiveness and safety of twice-daily budesonide foam enema. Mild-to-moderate UC patients who had bowel urgency were included. Patients collected data daily in an electronic patient-reported outcome system or logbooks. The primary endpoint was the rate of resolution of bowel urgency at the end of the 4-week observation period. The rate of bowel incontinence was also assessed.
Results
Sixty-one patients were enrolled. Of patients with a final evaluation, the rate of resolution of bowel urgency was 58.5% (31/53; 95% confidence interval, 44.1%–71.9%). Bowel urgency decreased over time, with a significant difference observed on day 7 versus day 0. Bowel incontinence showed a decreasing trend from day 5, with a significant difference confirmed on day 12 versus day 0. The clinical remission rate was 64.4% (38/59; 95% confidence interval, 50.9%–76.4%). One adverse event not related to budesonide rectal foam occurred.
Conclusions
The findings suggest that bowel urgency can be improved early with twice-daily budesonide foam enema. No new safety signals were observed.

Citations

Citations to this article as recorded by  
  • The choice of treatment approach for mild and moderate ulcerative colitis: A review
    Oleg V. Golovenko, Irina D. Loranskaia, Alexey M. Osadchuk
    Consilium Medicum.2025; 27(12): 744.     CrossRef
  • 8,968 View
  • 330 Download
  • 2 Web of Science
  • 1 Crossref
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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 9,549 View
  • 486 Download
  • 7 Web of Science
  • 6 Crossref
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IBD
Prevalence of hepatitis B virus and hepatitis C virus infection in patients with inflammatory bowel disease: a systematic review and meta-analysis
Suprabhat Giri, Dhiraj Agrawal, Shivaraj Afzalpurkar, Sunil Kasturi, Amrit Gopan, Sridhar Sundaram, Aditya Kale
Intest Res 2023;21(3):392-405.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00094
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The data on the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with inflammatory bowel disease (IBD) are conflicting. The present systematic review was thus conducted to study the prevalence of HBV and HCV markers in patients with IBD.
Methods
A comprehensive literature search of 3 databases was conducted from 2000 to April 2022 for studies evaluating the prevalence of HBV or HCV in patients with IBD. Pooled prevalence rates across studies were expressed with summative statistics.
Results
A total of 34 studies were included in the final analysis. The pooled prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B core antibodies were 3.3% and 14.2%, respectively. In HBsAg positive IBD patients, hepatitis B e antigen positivity and detectable HBV DNA were seen in 15.3% and 61.0% of patients, respectively. Only 35.6% of the IBD patients had effective HBV vaccination. The pooled prevalence of anti-HCV and detectable HCV RNA were 1.8% and 0.8%, respectively. The pooled prevalence of markers of HBV infection was higher in Asian studies, while the prevalence of markers of HCV infection was higher in European studies. The prevalence of viral hepatitis markers was similar between IBD patients and the general population and that between ulcerative colitis and Crohn’s disease.
Conclusions
The prevalence of markers of viral hepatitis remains same as the general population with significant regional variations, although the quality of evidence remains low due to publication bias. Only a small proportion of IBD patients had an effective HBV vaccination, requiring improvement in screening and vaccination practices.

Citations

Citations to this article as recorded by  
  • Prevalence of Comorbidities in Inflammatory Bowel Disease: An Umbrella Review of 18 Systematic Reviews
    Lupita Ana Maria Valladolid-Sandoval, Jhosmer Ballena-Caicedo, Fiorella E. Zuzunaga-Montoya, Darwin A. León-Figueroa, Percy Ordemar Vásquez, Mario J. Valladares-Garrido, Víctor Juan Vera-Ponce
    Journal of Clinical Medicine.2026; 15(5): 1739.     CrossRef
  • 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
  • Prevalence of viral hepatitis A and C in patients with inflammatory bowel disease: a nationwide population-based study in South Korea
    Jin Hwa Park, Sang Hyoung Park, Sang Pyo Lee, Kang Nyeong Lee, Hang Lak Lee, Oh Young Lee, Soorack Ryu, Junwon Go
    The Korean Journal of Internal Medicine.2026; 41(1): 95.     CrossRef
  • Hepatobiliary and pancreatic manifestations in inflammatory bowel disease: an umbrella review of meta-analyses
    Runsheng Hong, Zhixue Li, Meng Li, Yun Dai
    Therapeutic Advances in Gastroenterology.2025;[Epub]     CrossRef
  • Serological Assessment of Hepatitis in Patients with Inflammatory Bowel Disease in Taiwan: A Retrospective Cohort Analysis
    Yueh-An Lee, Hsu-Heng Yen, Yang-Yuan Chen
    Life.2025; 15(6): 893.     CrossRef
  • British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025
    Gordon W Moran, Morris Gordon, Vassiliki Sinopoulou, Shellie J Radford, Ana-Maria Darie, Sudheer Kumar Vuyyuru, Laith Alrubaiy, Naila Arebi, Jonathan Blackwell, Thomas D Butler, Thean Chew, Michael Colwill, Rachel Cooney, Gabriele De Marco, Said Din, Shah
    Gut.2025; 74(Suppl 2): s1.     CrossRef
  • Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
    Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin
    Intestinal Research.2024; 22(3): 213.     CrossRef
  • Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
    Ping Han, Chaohui Wang, Yan Qiu
    Critical Public Health.2024; 34(1): 1.     CrossRef
  • Associations between chronic hepatitis B infection and inflammatory bowel diseases in East Asian populations
    Haiyan Ye, Deqin Wei, Yike Huang
    Future Virology.2024; 19(16-18): 563.     CrossRef
  • Protective role of flavonoids quercetin and silymarin in the viral-associated inflammatory bowel disease: an updated review
    Elham Zarenezhad, Hussein T. Abdulabbas, Ahmed Shayaa Kareem, Seyed Amin Kouhpayeh, Silvia Barbaresi, Sohrab Najafipour, Abdulbaset Mazarzaei, Mitra Sotoudeh, Abdolmajid Ghasemian
    Archives of Microbiology.2023;[Epub]     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
  • Ulcerative colitis coexisting with hepatitis C: A rare occurrence
    Xiaoqiang Liu, Yisen Huan, Yubin Wang, Yingxuan Huang
    Medicine.2023; 102(50): e36629.     CrossRef
  • 8,415 View
  • 401 Download
  • 11 Web of Science
  • 12 Crossref
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IBD
Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Intest Res 2023;21(2):252-265.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00092
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients.
Methods
We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated.
Results
Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age.
Conclusions
In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.

Citations

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  • Association between statin use and the risk of colorectal cancer in patients with inflammatory bowel disease: a systematic review and meta-analysis
    Meng Ding, Yang Liu, Ying Zhang, Yunfeng Qiu
    Frontiers in Immunology.2026;[Epub]     CrossRef
  • Prevalence of viral hepatitis A and C in patients with inflammatory bowel disease: a nationwide population-based study in South Korea
    Jin Hwa Park, Sang Hyoung Park, Sang Pyo Lee, Kang Nyeong Lee, Hang Lak Lee, Oh Young Lee, Soorack Ryu, Junwon Go
    The Korean Journal of Internal Medicine.2026; 41(1): 95.     CrossRef
  • Colitis-associated colorectal neoplasia in ulcerative colitis with primary sclerosing cholangitis: a nationwide study
    Koichi Komatsu, Takahide Shinagawa, Motoi Uchino, Hiroki Ikeuchi, Koji Okabayashi, Shiro Oka, Kitaro Futami, Michio Itabashi, Kazuhiro Watanabe, Masatsune Shibutani, Yoshiki Okita, Toshifumi Wakai, Yusuke Mizuuchi, Kinya Okamoto, Kazutaka Yamada, Yu Sato,
    Intestinal Research.2026;[Epub]     CrossRef
  • Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis
    Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
    Intestinal Research.2025; 23(4): 455.     CrossRef
  • Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis
    Mengdan Shen, Shan Lu, Zihao Xu, Feifei Zhou, Li-Ting Sheng, Qiang Yu
    Frontiers in Pharmacology.2025;[Epub]     CrossRef
  • Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Intestinal Research.2023; 21(4): 420.     CrossRef
  • Are the risks of colorectal cancer and biliary cancer really increased if patients with ulcerative colitis have primary sclerosing cholangitis?
    Jung Wook Lee, Won Moon
    Intestinal Research.2023; 21(2): 171.     CrossRef
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IBD
Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India
Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja, Ajit Sood
Intest Res 2023;21(4):452-459.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00087
AbstractAbstract PDFPubReaderePub
Background/Aims
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
Methods
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
Results
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
Conclusions
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Citations

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  • Frequency, spectrum and outcome of patients with primary sclerosing cholangitis among patients presenting with cholestatic jaundice
    Srikanth Kothalkar, Sayan Malakar, Piyush Mishra, Akash Mathur, Uday C. Ghoshal
    Indian Journal of Gastroenterology.2025; 44(4): 553.     CrossRef
  • Incidence of Hepatobiliary Malignancies in Primary Sclerosing Cholangitis: Systematic Review and Meta-analysis
    Matheus Souza, Luan C.V. Lima, Lubna Al-Sharif, Daniel Q. Huang
    Clinical Gastroenterology and Hepatology.2025; 23(10): 1695.     CrossRef
  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
  • Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
    Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
    Gastroenterología y Hepatología.2025; 48(8): 502346.     CrossRef
  • Phenotypic Differences and Clinical Outcomes of South Asian Children With IBD: A Singapore–Malaysia Study From the Asian PIBD Registry Network
    James Guoxian Huang, Kee Seang Chew, Veena Logarajah, Way Seah Lee, Marion Margaret Aw
    Journal of Gastroenterology and Hepatology.2025; 40(8): 1933.     CrossRef
  • Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
    Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
    Gastroenterología y Hepatología (English Edition).2025; 48(8): 502346.     CrossRef
  • Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis
    Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
    Intestinal Research.2025; 23(4): 455.     CrossRef
  • Prevalence and Outcomes of Primary Sclerosing Cholangitis in Inflammatory Bowel Disease: A Multinational Study Across Asia
    Shintaro Akiyama, Sang Hyoung Park, Ji Eun Baek, Sachiko Kanai, Naminatsu Takahara, Ryosuke Kasuga, Nobuhiro Nakamoto, Yasuhiro Takagi, Shinichiro Shinzaki, Meng-Tzu Weng, Shu-Chen Wei, Toshio Fujisawa, Hiroyuki Isayama, Sidharth Harindranath, Devendra De
    Clinical Gastroenterology and Hepatology.2025;[Epub]     CrossRef
  • Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
    Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
    Cureus.2024;[Epub]     CrossRef
  • Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD): a condition exemplifying the crosstalk of the gut–liver axis
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Experimental & Molecular Medicine.2023; 55(7): 1380.     CrossRef
  • Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Intestinal Research.2023; 21(4): 420.     CrossRef
  • Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
    Kwang Woo Kim, Hyoun Woo Kang
    Intestinal Research.2023; 21(4): 413.     CrossRef
  • 10,147 View
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IBD
Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China
Zerong Cai, Xiaosheng He, Jianfeng Gong, Peng Du, Wenjian Meng, Wei Zhou, Jinbo Jiang, Bin Wu, Weitang Yuan, Qi Xue, Lianwen Yuan, Jinhai Wang, Jiandong Tai, Jie Liang, Weiming Zhu, Ping Lan, Xiaojian Wu
Intest Res 2023;21(2):235-243.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00012
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes.
Methods
Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis.
Results
A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery.
Conclusions
Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Citations

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  • Surgical trend including minimally invasive surgeries for ulcerative colitis in the COSUC study: the largest multicenter cohort study in Japan
    Koya Hida, Yoshiki Okita, Yusuke Fujii, Toru Miyake, Yoshiaki Kuriu, Yu Hidaka, Tomohiro Arita, Kiyotaka Kawaguchi, Shingo Ochi, Yusuke Fujita, Kazutaka Obama, Takeshi Naitoh, Nobuhisa Matsuhashi, Yudai Fukui, Shintaro Kohama, Manabu Takata, Shin Takesue,
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  • Surgical Options for Appropriate Length of J-Pouch Construction for Better Outcomes and Long-term Quality of Life in Patients with Ulcerative Colitis after Ileal Pouch-Anal Anastomosis
    Weimin Xu, Wenbo Tang, Wenjun Ding, Zhebin Hua, Yaosheng Wang, Xiaolong Ge, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Peng Du
    Gut and Liver.2024; 18(1): 85.     CrossRef
  • Time trend in surgical indications and outcomes in ulcerative colitis—A two decades in-depth retrospective analysis
    Guillaume Le Cosquer, Lena Capirchio, Pauline Rivière, Marie Armelle Denis, Florian Poullenot, Christophe Remue, Frank Zerbib, Daniel Leonard, Bertrand Célérier, Alex Kartheuser, David Laharie, Olivier Dewit
    Digestive and Liver Disease.2023; 55(10): 1338.     CrossRef
  • Surgical Treatment in Ulcerative Colitis, Still Topical: A Narrative Review
    Eduard Slonovschi, Pratyusha Kodela, Monalisa Okeke, Sandeep Guntuku, Shanmukh Sai Pavan Lingamsetty
    Cureus.2023;[Epub]     CrossRef
  • Surgical outcomes and stoma-related complications in inflammatory bowel disease in Saudi Arabia: a retrospective study
    Thamer A. Bin Traiki, Sulaiman A. Alshammari, Mansoor A. Abdulla, Fayez G. Aldarsouni, Noura S. Alhassan, Maha-Hamdien Abdullah, Awadh Alqahtani, Khayal A. Alkhayal
    Annals of Saudi Medicine.2023; 43(6): 386.     CrossRef
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IBD
Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim, on behalf of Seoul National University Inflammatory Bowel Disease Research Network (SIRN)
Intest Res 2023;21(2):244-251.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2022.00057
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with inflammatory bowel disease (IBD) are diagnosed with ankylosing spondylitis (AS) often. However, the disease course of patients with both IBD and AS is not well understood. This study aims to evaluate the effect of concomitant AS on IBD outcomes.
Methods
Among the 4,722 patients with IBD who were treated in 3 academic hospitals from 2004 to 2021, 55 were also diagnosed with AS (IBD-AS group). Based on patients’ electronic medical records, the outcomes of IBD in IBD-AS group and IBD group without AS (IBD-only group) were appraised.
Results
The proportion of patients treated with biologics or small molecule therapies was significantly higher in IBD-AS group than the proportion in IBD-only group (27.3% vs. 12.7%, P= 0.036). Patients with both ulcerative colitis and AS had a significantly higher risk of biologics or small molecule therapies than patients with only ulcerative colitis (P< 0.001). For univariable logistic regression, biologics or small molecule therapies were associated with concomitant AS (odds ratio, 4.099; 95% confidence interval, 1.863–9.021; P< 0.001) and Crohn’s disease (odds ratio, 3.552; 95% confidence interval, 1.590–7.934; P= 0.002).
Conclusions
Concomitant AS is associated with the high possibility of biologics or small molecule therapies for IBD. IBD patients who also had AS may need more careful examination and active treatment to alleviate the severity of IBD.

Citations

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  • Author's Reply: “Association of early antibiotic use with risk of ulcerative colitis”
    Junseok Park, Sungjin Woo, Seong-Joon Koh
    Digestive and Liver Disease.2025; 57(3): 795.     CrossRef
  • Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
    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
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • 9,224 View
  • 466 Download
  • 3 Web of Science
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IBD
Abdominal aortic calcification in patients with inflammatory bowel disease: does anti-tumor necrosis factor α use protect from chronic inflammation-induced atherosclerosis?
Aikaterini Mantaka, Nikolaos Galanakis, Dimitrios Tsetis, Ioannis E. Koutroubakis
Intest Res 2022;20(4):495-505.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2022.00017
AbstractAbstract PDFPubReaderePub
Background/Aims
Abdominal aortic calcium (AAC) deposition has been suggested as a marker of early atherosclerosis. There is no published data on the evaluation of AAC in inflammatory bowel disease (IBD).
Methods
AAC was quantified by computed tomography or enterography scans performed in 98 IBD patients and 1:1 age and sex matched controls. AAC deposition was correlated with IBD characteristics, disease activity or severity parameters, laboratory tests and cardiovascular disease (CVD) risk factors.
Results
Moderate-severe grade of AAC was found in 35.7% of IBD patients compared to 30.6% of controls (P= 0.544). IBD with CVD and ulcerative colitis patients had significantly higher rates of more severe atherosclerotic lesions (P= 0.001 and P= 0.01, respectively). AAC deposition was similarly distributed in age groups ( < 45, 45–64, and ≥ 65 years) among patients and controls. Multivariate analysis after excluding CVD risk confounders for non-CVD patients found extensive disease (P= 0.019) and lifetime steroids (P= 0.04) as independent risk factors for AAC. Anti-tumor necrosis factor α (TNF-α) use was negatively associated with AAC deposition in non-CVD IBD patients (odds ratio, 0.023; 95% confidence interval, 0.001–0.594; P= 0.023).
Conclusions
More than one-third of IBD patients have moderate to severe AAC. Better control of inflammation with anti-TNF-α agents seems to protect IBD patients from ACC deposition and subsequent atherosclerosis.

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  • Neutrophils at the Crossroads of Inflammatory Bowel Disease and Atherosclerosis: A State-of-the-Art Review
    Vadim Genkel, Yana Zaripova, Alla Kuznetsova, Alena Sluchanko, Anna Minasova, Maria Zotova, Anna Saenko, Albina Savochkina, Anastasiya Dolgushina
    Cells.2025; 14(10): 738.     CrossRef
  • Bridging the gut and the heart-Exploring pathophysiology, risk factors, and therapeutic implications of cardiovascular disease in inflammatory bowel disease
    Diana Othon-Martínez, Sylvia Valeria Peña-Muñoz, Margarita Riojas-Barrett, Genesis Vidales-López, Josué Moisés Sánchez Guzmán, Lukasz Kwapisz
    Journal of Investigative Medicine.2025; 73(8): 593.     CrossRef
  • Inhibition of long interspersed nuclear element-1 by nucleoside reverse transcriptase inhibitors attenuates vascular calcification
    Jianshuai Ma, Dayu He, Mingxuan Zhang, Ziting Zhou, Jinkun Cheng, Aoran Huang, Yaxin Lian, Yuncong Shi, Changming Xie, Zhengyan Guan, Zhengzhipeng Zhang, Chen Xie, Tingting Zhang, Hui Huang
    Signal Transduction and Targeted Therapy.2025;[Epub]     CrossRef
  • Abdominal aortic calcification among gastroenterological and transplant surgery
    Yuki Imaoka, Masahiro Ohira, Miho Akabane, Kazunari Sasaki, Hideki Ohdan
    Annals of Gastroenterological Surgery.2024; 8(6): 987.     CrossRef
  • A Potential New Link Between Inflammation and Vascular Calcification
    Xinjiang Cai, Yin Tintut, Linda L. Demer
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Associations between systemic immune-inflammation index and abdominal aortic calcification: Results of a nationwide survey
    Ruijie Xie, Xiaozhu Liu, Haiyang Wu, Mingjiang Liu, Ya Zhang
    Nutrition, Metabolism and Cardiovascular Diseases.2023; 33(7): 1437.     CrossRef
  • Cardiovascular manifestations of inflammatory bowel diseases and the underlying pathogenic mechanisms
    Ying Xiao, Don W. Powell, Xiaowei Liu, Qingjie Li
    American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.2023; 325(2): R193.     CrossRef
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IBD
Clinical spectrum of elderly-onset inflammatory bowel disease in India
Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood
Intest Res 2023;21(2):216-225.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2021.00177
AbstractAbstract PDFPubReaderePub
Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

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  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
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    Hye Kyung Hyun, Jae Hee Cheon
    Gut and Liver.2025; 19(3): 307.     CrossRef
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    Jiyoung Yoon, Daein Kim, You Sun Kim
    Intestinal Research.2025; 23(4): 430.     CrossRef
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    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
  • Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
    Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
    European Journal of Gastroenterology & Hepatology.2024; 36(4): 445.     CrossRef
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    Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
  • A prospective study of inflammatory bowel disease phenotypes in extremes of age and comparison with adults
    Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
    Indian Journal of Gastroenterology.2023; 42(3): 404.     CrossRef
  • Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
    Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
    Journal of Clinical Medicine.2023; 12(15): 5142.     CrossRef
  • 8,166 View
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Review
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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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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    Ki-Uk Kim, Jung Min Moon, Eunsu Lim, Kang-Bin Dan, Jeongkuk Seo, Kyuwon Kim, Seung Yong Shin, Hyeyoung Min, Chang Hwan Choi
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  • Deep Learning Model Using Stool Pictures for Predicting Endoscopic Mucosal Inflammation in Patients With Ulcerative Colitis
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  • Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
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Original Articles
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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • 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.2025; 31(1): 37.     CrossRef
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    Monica Dzwonkowski, Janak Bahirwani, Samantha Rollins, Alicia Muratore, Vikram Christian, Yecheskel Schneider
    Current Gastroenterology Reports.2025;[Epub]     CrossRef
  • Indigo naturalis‑associated ischemic injury of colorectal mucosa: A case series study
    Yiheng Ke, Liang Xu, Qi Tang, Zheyu Ruan, Junjie Liu, Shuiliang Ruan
    Experimental and Therapeutic Medicine.2025;[Epub]     CrossRef
  • Safety and Effectiveness of QingDai (Indigo naturalis) in Children With Mild-to-Moderate Ulcerative Colitis: A Short-Term 6-Week Open-Label Trial
    Dotan Yogev, Yael Weintraub, Oren Ledder, Manar Matar, Alex Krauthammer, Zivia Shavit-Brunschwig, Amichay Rotstein, Max E Godfrey, Amit Assa, Raanan Shamir, Dan Turner, Nir Salomon, Esther Orlanski-Meyer, Dror S Shouval
    Inflammatory Bowel Diseases.2025; 31(10): 2917.     CrossRef
  • Macrophage‐Mediated Transport of Insoluble Indirubin Induces Hepatic Injury During Intestinal Inflammation
    Yiqi Xu, Jingchun Shi, Heung‐Lam Mok, Cheng Lyu, Junbang Chen, Chunhua Huang, Hongyan Qin, Chengyuan Lin, Hor‐Yue Tan, Zhaoxiang Bian
    Advanced Science.2025;[Epub]     CrossRef
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    Jie Hu, Mengen Zhou, Li Huang, Xiutian Guo, Pingping Mei, Peng Li, Yiting Wang, Yan Chen
    Frontiers in Pharmacology.2025;[Epub]     CrossRef
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    Kelsey Ryan, Asha Cunningham, Joseph Runde
    Pediatric Annals.2025;[Epub]     CrossRef
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    Jie Liu, Chengjian Liu, Haitao Xiao, Zhiping Xu
    BIO Integration.2025;[Epub]     CrossRef
  • 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
    Clinics and Research in Hepatology and Gastroenterology.2024; 48(1): 102250.     CrossRef
  • 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
  • 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
Incidence rates for hospitalized infections, herpes zoster, and malignancies in patients with ulcerative colitis in Japan: an administrative health claims database analysis
Katsuyoshi Matsuoka, Kanae Togo, Noritoshi Yoshii, Masato Hoshi, Shoko Arai
Intest Res 2023;21(1):88-99.   Published online March 11, 2022
DOI: https://doi.org/10.5217/ir.2021.00154
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with ulcerative colitis (UC) are at an increased risk of certain infections and malignancies compared with the general population. Incidence rates (IRs) of hospitalized infections, herpes zoster (HZ), and malignancies in patients with UC, stratified by treatment, in Japan were estimated.
Methods
This retrospective study identified patients with UC treated with corticosteroids, immunosuppressants, or tumor necrosis factor inhibitors (TNFi) from 2 administrative databases (Japan Medical Data Center [JMDC] and Medical Data Vision [MDV]). IRs (unique patients with events per 100 patient‐years) were estimated for hospitalized infections, HZ, and malignancies, between June 2010 and May 2018.
Results
Among 6,033 MDV patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: hospitalized infections, 1.73 (1.52–1.93); HZ, 1.00 (0.85–1.16), and malignancies, 1.48 (1.29–1.66). Among 958 JMDC patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: HZ, 1.82 (1.27–2.37) and malignancies, 1.35 (0.87–1.82). In both cohorts, IRs of malignancies were generally similar among patients receiving immunosuppressants, TNFi, or combination therapy (immunosuppressants and TNFi); this was also true for IRs of hospitalized infections and HZ in the MDV cohort. IRs of hospitalized infections, HZ, and malignancies were higher in patients receiving calcineurin inhibitors compared with immunosuppressants or TNFi, in both cohorts.
Conclusions
IRs of hospitalized infections, HZ, and malignancies among patients with UC were generally similar regardless of UC treatment, except for calcineurin inhibitors.

Citations

Citations to this article as recorded by  
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    Shunsuke Omotaka, Hiroki Den, Takenori Yamauchi, Ryota Tokunaga, Suguru Ogihara, Masayuki Isozaki, Takahiro Hobo, Noboru Yokoyama, Haruhiro Inoue, Akatsuki Kokaze
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    Waki Imoto, Takumi Imai, Ryota Kawai, Yasutaka Ihara, Yuta Nonomiya, Hiroki Namikawa, Koichi Yamada, Hisako Yoshida, Yukihiro Kaneko, Ayumi Shintani, Hiroshi Kakeya
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    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
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    Ryota Hase, Daisuke Suzuki, Cynthia de Luise, Haoqian Chen, Edward Nonnenmacher, Takakazu Higuchi, Kayoko Katayama, Mitsuyo Kinjo, Sadao Jinno, Toshitaka Morishima, Naonobu Sugiyama, Yoshiya Tanaka, Soko Setoguchi
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    Yoo Jin Lee, Eun Soo Kim
    The Korean Journal of Internal Medicine.2022; 37(5): 920.     CrossRef
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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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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  • Quercus infectoria galls mitigates colitis in mice through alleviating mucosal barrier impairment and suppressing inflammatory factors
    Yan Ding, Jiao-Jiao Bai, Sabahat Ablimit, Muyassar Yasen, Arfidin Anwar, Kudelaidi Kuerban, Mubarak Iminjan, Guo-Qiang Zhang
    Journal of Ethnopharmacology.2025; 343: 119487.     CrossRef
  • Post-marketing surveillance of tofacitinib in patients with ulcerative colitis in Japan: a final report of safety and effectiveness data
    Katsuyoshi Matsuoka, Satoshi Motoya, Takayuki Yamamoto, Minoru Matsuura, Toshimitsu Fujii, Shinichiro Shinzaki, Yohei Mikami, Shoko Arai, Junichi Oshima, Yutaka Endo, Hirotoshi Yuasa, Masato Hoshi, Keiko Sato, Tadakazu Hisamatsu
    Journal of Gastroenterology.2025; 60(8): 979.     CrossRef
  • 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
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    Hyuk Yoon, Byong Duk Ye, Sang-Bum Kang, Kang-Moon Lee, Chang Hwan Choi, Joo-young Jo, Juwon Woo, Jae Hee Cheon
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    Toshifumi Morishita, Shunichi Yanai, Yosuke Toya, Takayuki Matsumoto
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    Jun Lee
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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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  • Integrated safety analysis of filgotinib for ulcerative colitis: Results from SELECTION and SELECTIONLTE
    Stefan Schreiber, Gerhard Rogler, Mamoru Watanabe, Séverine Vermeire, Christian Maaser, Silvio Danese, Margaux Faes, Paul Van Hoek, Jeremy Hsieh, Ulrik Moerch, Yan Zhou, Angela de Haas, Christine Rudolph, Alessandra Oortwijn, Edward V. Loftus
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    Alessandro Mannucci, Ferdinando D’Amico, Ahmad El Saadi, Laurent Peyrin-Biroulet, Silvio Danese
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IBD
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
Intest Res 2022;20(4):452-463.   Published online March 11, 2022
DOI: https://doi.org/10.5217/ir.2021.00125
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Epidemiological data on steroid use in South Korean patients with inflammatory bowel disease (IBD) are limited. We documented the steroid use patterns in these patients, and whether physician education on appropriate steroid use affected these patterns.
Methods
ACTION was an observational cohort study conducted in adults (≥19 years) with IBD. A retrospective chart review was performed at baseline (cohort 1) and 1 year after physician training (cohort 2). Eligible cases with excessive or inappropriate steroid use were identified, along with any associated risk factors.
Results
Data were collected during May 2018-July 2019 from patients with Crohn’s disease (CD) and ulcerative colitis (UC) in cohort 1 (n=1,685) and cohort 2 (n=1,649). At baseline, 155 patients (9.2%) had received steroids within the previous 12 months, 46 (29.7%) of whom had used steroids excessively, 16 (34.8%) of these having inappropriately used excessive steroids. Although steroid exposure was similar in cohort 1 (9.2%) and cohort 2 (9.7%), the latter comprised fewer excessive steroid users (20.0% vs. 29.7%). Severe disease was associated with excessive steroid use in cases with UC, but not with CD.
Conclusions
Although, overall steroid use was relatively low in South Korean patients with IBD, one-third of steroid users used them excessively, and one-third among these used excessive steroids inappropriately. High disease activity was the main risk factor for excessive steroid use which may potentially be reduced by physician education, especially in cases with UC. Active screening to minimize excessive and inappropriate steroid use through physician education should be considered.

Citations

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  • Corticosteroid Use in Randomized Clinical Trials of Biologics and Small Molecules in Inflammatory Bowel Disease: A Systematic Review
    Bruno César da Silva, Sam Papasotiriou, Stephen B Hanauer
    Inflammatory Bowel Diseases.2025; 31(5): 1430.     CrossRef
  • The Reliability and Quality of Short Videos as a Source of Dietary Guidance for Inflammatory Bowel Disease: Cross-sectional Study
    Zixuan He, Zhijie Wang, Yihang Song, Yilong Liu, Le Kang, Xue Fang, Tongchang Wang, Xuanming Fan, Zhaoshen Li, Shuling Wang, Yu Bai
    Journal of Medical Internet Research.2023; 25: e41518.     CrossRef
  • Corticosteroid, a double-edged sword in inflammatory bowel disease management: possibility of reducing corticosteroid use through physician education
    Seulji Kim, Seong-Joon Koh
    Intestinal Research.2022; 20(4): 389.     CrossRef
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  • 3 Web of Science
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IBD
Efficacy of hepatitis B vaccination in patients with ulcerative colitis: a prospective cohort study
Anurag Mishra, Amarender Singh Puri, Sanjeev Sachdeva, Ashok Dalal
Intest Res 2022;20(4):445-451.   Published online February 8, 2022
DOI: https://doi.org/10.5217/ir.2021.00106
AbstractAbstract PDFPubReaderePub
Background/Aims
Response to vaccine in patients with inflammatory bowel disease is lower than in the general population. We aimed to evaluate the efficacy of hepatitis B virus (HBV) vaccination in patients with ulcerative colitis (UC) versus controls.
Methods
We prospectively compared antibody response to HBV vaccination in 100 patients with UC versus controls. HBV vaccination was given to all the cases and controls at 0, 1 and 6 months. Anti-hepatitis B surface (anti-HBs) titers were then measured 4 weeks after the first and the third dose. Adequate immune response (AIR) was considered if the anti-HBs titer was >10 IU/L and effective immune response (EIR) if the anti-HBs titer was >100 IU/L.
Results
Median anti-HBs titer was lower in patients with UC than controls (67 IU/L vs. 105 IU/L, P<0.01). AIR and EIR were significantly lower in patients than in controls (82% vs. 96%, P=0.001; 41% vs. 66%, P<0.001, respectively). Univariate analysis showed that age <30 years, mild to moderate severity of disease, disease duration <5 years, male sex, post first dose anti-HBs titer >2 IU/L and non-exposure to corticosteroids, azathioprine and biologicals were predictors of AIR in patients with UC (P<0.05). Multivariate analysis revealed that only non-exposure to corticosteroids, azathioprine and biologicals, male sex, and disease duration <5 years were independent predictors of AIR.
Conclusions
Response rate to the HBV vaccination in patients with UC was significantly lower as compared to the controls. Male sex, shorter disease duration, and non-exposure to immunomodulators were independent predictors of AIR.

Citations

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  • 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
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    Mohammad Shehab, Fatema Alrashed, Munerah Alyaseen, Zainab Safar, Tunrayo Adekunle, Ahmad Alfadhli, Talat Bessissow
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    Ki Jae Jo, Jong Pil Im
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Perspective
IBD
Endoscopy for assessment of mucosal healing in ulcerative colitis: time bound or response guided?
Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta
Intest Res 2022;20(3):297-302.   Published online February 8, 2022
DOI: https://doi.org/10.5217/ir.2021.00099
AbstractAbstract PDFPubReaderePub
The timing of colonoscopy in patients with active ulcerative colitis (UC) lacks coherence. The published guidelines and recommendations advocate time-bound colonoscopy in patients with active UC to assess for mucosal healing. However, the practice of performing colonoscopies at fixed time frames lacks reasoning. The time to achieve mucosal healing in UC is not uniform across the patient populations and is influenced by the disease severity and efficacy and time to therapeutic response of the drugs being used. Additionally, with the availability of sensitive noninvasive inflammatory biomarkers such as fecal calprotectin, that parallel the disease activity and correlate with mucosal healing, the notion of performing colonoscopy at fixed intervals sounds unjustifiable. The authors express their view that a response-guided colonoscopy (driven by normalization of clinical symptoms and inflammatory biomarkers), rather than a time-bound colonoscopy, would be more logical, apart from being cost-effective and patient-friendly.

Citations

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    Vedran Tomašić, Petra Ćaćić, Neven Baršić, Alen Bišćanin
    World Journal of Gastrointestinal Endoscopy.2026;[Epub]     CrossRef
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    Scandinavian Journal of Gastroenterology.2025; 60(4): 336.     CrossRef
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    Vedran Tomašić
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Original Article
IBD
Fecal microbiota transplantation for induction of remission, maintenance and rescue in patients with corticosteroid-dependent ulcerative colitis: a long-term follow-up real-world cohort study
Avnish Kumar Seth, Priti Jain
Intest Res 2022;20(2):251-259.   Published online February 8, 2022
DOI: https://doi.org/10.5217/ir.2021.00069
AbstractAbstract PDFPubReaderePub
Background/Aims
To study role of fecal microbiota transplantation (FMT) in induction, maintenance, and rescue in patients with corticosteroid-dependent ulcerative colitis (CDUC).
Methods
Patients with active CDUC received 3 fortnightly sessions of colonoscopic induction FMT (iFMT) in addition to standard of care. In patients who achieved clinical remission (CR) or response, prednisolone was tapered from week 4 and azathioprine from week 12. Responders were advised maintenance FMT (mFMT) every 6 months. Those with relapse were offered rescue FMT (rFMT), and low dose prednisolone was added if there was no improvement in 2 weeks.
Results
All 27 patients enrolled completed iFMT and were followed up for 39 months (range, 9–71 months). The mean Mayo score decreased from 6.4±2.5 at baseline to 2.6±3.7 at week 4, 2.6±3.4 at week 12, and 2.8±3.8 at week 24 (P<0.05). Corticosteroid-free CR and clinical response at week 12 were seen in 13 patients (48%) and 1 patient (3.7%), respectively. Corticosteroid and azathioprine-free CR at week 24 was seen in 13 patients (48%) and in them histological response was seen in 2 patients (15.2%) at week 4, 5 patients (38.4%) at week 12, and 10 patients (76.9%) at week 24. First relapse was seen in 10 of 13 responders (76.9%) at a median of 14.8 months (range, 6–34 months) after iFMT and was less frequent in patients on mFMT. Relapse was treated successfully with rFMT alone in 4 patients (40%) and rFMT with low dose steroids in 5 patients (50%).
Conclusions
iFMT, mFMT, and rFMT may have a role in treatment of selected patients with CDUC.

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    Anna Kamlárová, Monika Kvaková, Ľuboš Ambro, René Link, Izabela Bertková, Zdenka Hertelyová, Martin Janíčko, Emília Hijová, Jana Štofilová
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    Umang Arora, Saurabh Kedia, Vineet Ahuja
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    Cureus.2024;[Epub]     CrossRef
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    Suranjana Banik, Balamurugan Ramadass
    Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(2): 44.     CrossRef
  • Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: A Systematic Review and Meta-analysis
    Benoît Levast, Mathieu Fontaine, Stéphane Nancey, Pierre Dechelotte, Joël Doré, Philippe Lehert
    Clinical and Translational Gastroenterology.2023; 14(5): e00568.     CrossRef
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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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Reviews
IBD
Landscape of inflammatory bowel disease in Singapore
Daren Low, Nidhi Swarup, Toshiyuki Okada, Emiko Mizoguchi
Intest Res 2022;20(3):291-296.   Published online January 7, 2022
DOI: https://doi.org/10.5217/ir.2021.00089
AbstractAbstract PDFPubReaderePub
Inflammatory bowel disease (IBD), primarily Crohn’s disease and ulcerative colitis, had been widely recognized to affect the Western population. However, the notable rise in prevalence of IBD in Asia, including Singapore, had garnered much attention to the causal role of the shift in trend, and more importantly, effective and safe management of the conditions of these groups of patients in terms of therapy, healthcare economics as well as patient well-being. This review presents a summary of the current landscape of IBD in Singapore, and discuss on areas that can be explored to improve and better understand the local condition, as prevalence continues to grow.

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    You Sun Kim, Min Jeong Na, Byong Duk Ye, Jae Hee Cheon, Jong Pil Im, Joo Sung Kim
    Gut and Liver.2022; 16(6): 995.     CrossRef
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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
AbstractAbstract PDFPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • Machine Learning Models for the Assessment of the Mayo Endoscopic Score in Ulcerative Colitis Trial Endpoints: A Systematic Review
    David T Rubin, Walter Reinisch, Neeraj Narula, Daniel R Colucci, William Eastman, Klaus Gottlieb, Ana P Lacerda, F Stephen Laroux, Irene Modesto, Emma E Navajas, Charles C Owen, Yeli Wang, Shrujal Baxi
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    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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    Soyoung Kim, Sang Hyoung Park
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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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    Yinghao Sun, Gechong Ruan, Xiaoyin Bai, Wei Han, Minglan Yang, Lixin Jin, Yanni Huang, Xiaoxia Hou, Ke Shu, Yingying Liu, Yafeng Lu, Yan Zhao, Jie Zhong, Hong Yang
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    Min Kyu Kim, Sung Wook Hwang
    Clinical Endoscopy.2024; 57(6): 725.     CrossRef
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    Joaquim Carreras
    Journal of Clinical and Experimental Hematopathology.2023; 63(3): 152.     CrossRef
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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
Real-world data for golimumab treatment in patients with ulcerative colitis in Japan: interim analysis in post-marketing surveillance
Shiro Nakamura, Teita Asano, Hiroaki Tsuchiya, Kanami Sugimoto, Yuya Imai, Seiji Yokoyama, Yasuo Suzuki
Intest Res 2022;20(3):329-341.   Published online August 4, 2021
DOI: https://doi.org/10.5217/ir.2021.00032
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Golimumab (GLM) is an anti-tumor necrosis factor-α drug approved for treating moderate-to-severe active ulcerative colitis (UC). A 52-week post-marketing surveillance (PMS) was initiated to evaluate its safety and effectiveness in patients with UC in Japan. We present an interim report of the ongoing PMS.
Methods
Patients received 200 mg of subcutaneous GLM at week 0, 100 mg at week 2, and 100 mg 4 weekly thereafter. The safety analysis set included 392 patients with UC, and the effectiveness analysis set 387 patients. Safety and effectiveness were assessed at week 6.
Results
Adverse drug reactions (ADRs) were reported in 8.2% (32/392) and serious ADRs in 4.6% (18/392). The most frequent ADRs were infection and infestation (3.3%), with herpes zoster being the most common. ADRs were significantly higher in patients with concomitant corticosteroid use (odds ratio [OR], 3.45; 95% confidence interval [CI], 1.40–9.68). No significant difference in ADR incidence was observed between patients aged ≥65 and <65 years (OR, 1.23; 95% CI, 0.35–3.47). Six-week effectiveness of GLM was confirmed by a decrease in the partial Mayo score (–2.3; 95% CI, –2.6 to –2.1) and C-reactive protein levels (–0.64; 95% CI, –0.92 to –0.36), including in the biologics-experienced population.
Conclusions
The safety and effectiveness of GLM at week 6 in a real-world setting were demonstrated in patients with UC in Japan. ADR patterns were consistent with previous reports with no new safety signals. Concomitant corticosteroid use may be associated with increased ADR incidence. The final results of the ongoing PMS are necessary for further evaluation.

Citations

Citations to this article as recorded by  
  • Health-related quality of life, work productivity, and persisting challenges in treated ulcerative colitis patients: a Japanese National Health and Wellness Survey
    Sakiko Hiraoka, Zhezhou Huang, Fei Qin, Fatima Megala Nathan Arokianathan, Kiran Davé, Shweta Shah, Hyunchung Kim
    Intestinal Research.2025; 23(4): 524.     CrossRef
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    Peter M. Irving, Peter Hur, Raju Gautam, Xiang Guo, Severine Vermeire
    Journal of Managed Care & Specialty Pharmacy.2024; 30(9): 1026.     CrossRef
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    Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
    Intestinal Research.2023; 21(2): 174.     CrossRef
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    Sang Hyoung Park
    Crohn's & Colitis 360.2023;[Epub]     CrossRef
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    Soo-Young Na
    The Korean Journal of Medicine.2023; 98(5): 223.     CrossRef
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    Ji Young Chang, Jae Hee Cheon
    Precision and Future Medicine.2021; 5(4): 151.     CrossRef
  • 9,018 View
  • 682 Download
  • 5 Web of Science
  • 6 Crossref
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IBD
Evaluation of nutritional status using bioelectrical impedance analysis in patients with inflammatory bowel disease
Seung Hyuk Kim, You Sun Kim, Si Hyeong Lee, Hyun Mi Lee, Won Eui Yoon, Seo Hyun Kim, Hee Jun Myung, Jeong Seop Moon
Intest Res 2022;20(3):321-328.   Published online July 20, 2021
DOI: https://doi.org/10.5217/ir.2021.00022
AbstractAbstract PDFPubReaderePub
Background/Aims
Nutritional status influences quality of life among patients with inflammatory bowel disease (IBD), although there is no clear method to evaluate nutritional status in this setting. Therefore, this study examined whether bioelectrical impedance analysis (BIA) could be used to evaluate the nutritional status of patients with IBD.
Methods
We retrospectively analyzed data from 139 Korean patients with IBD who were treated between November 2018 and November 2019. Patients were categorized as having active or inactive IBD based on the Harvey-Bradshaw index (a score of ≥5 indicates active Crohn’s disease) and the partial Mayo scoring index (a score of ≥2 indicates active ulcerative colitis). BIA results and serum nutritional markers were analyzed according to disease activity.
Results
The mean patient age was 45.11±17.71 years. The study included 47 patients with ulcerative colitis and 92 patients with Crohn’s disease. Relative to the group with active disease (n=72), the group with inactive disease (n=67) had significantly higher values for hemoglobin (P<0.001), total protein (P<0.001), and albumin (P<0.001). Furthermore, the group with inactive disease had higher BIA values for body moisture (P=0.047), muscle mass (P=0.046), skeletal muscle mass (P=0.042), body mass index (P=0.027), and mineral content (P=0.034). Moreover, the serum nutritional markers were positively correlated with the BIA results.
Conclusions
Nutritional markers evaluated using BIA were correlated with serum nutritional markers and inversely correlated with disease activity. Therefore, we suggest that BIA may be a useful tool that can help existing nutritional tests monitor the nutritional status of IBD patients.

Citations

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  • Preoperative phase angle and postoperative complications in Crohn’s disease patients undergoing ileocolic resection: a retrospective cohort study
    Weilin Qi, Huaying Liu, Huiping Liang, Wei Liu, Linna Ye, Qian Cao, Xiaolong Ge, Wei Zhou
    International Journal of Colorectal Disease.2026;[Epub]     CrossRef
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    Bo Young Choi, Sae Yeon Jung, Hee Kyeong Lee, Min Jung Lee, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2025; 306: 154.     CrossRef
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    Rui Fan, Zhihan Zhang, Qinlian Huang, Linqi Liu, Wenjun Que, Dan Lu, Sisi Jing, Yaoqi Gan, Shiyi Liu, Fei Xiao
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    Małgorzata Godala, Ewelina Gaszyńska, Konrad Walczak, Ewa Małecka-Wojciesko
    Nutrients.2025; 17(8): 1369.     CrossRef
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    Rebeca Araújo Passos, Raquel Rocha dos Santos
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    Yunzheng Di, Yamei Chen, Xiaoping Zhu, Rong Wang, Sijia Zhang, Pengcheng Sun
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    Isadora Sayuri Macedo TUMA, Maria Paula Carlin CAMBI, Thyago Proença de MORAES, Daniéla Oliveira MAGRO, Paulo Gustavo KOTZE
    Arquivos de Gastroenterologia.2024;[Epub]     CrossRef
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    Valentin Calvez, Guia Becherucci, Carlo Covello, Giulia Piccirilli, Irene Mignini, Giorgio Esposto, Lucrezia Laterza, Maria Elena Ainora, Franco Scaldaferri, Antonio Gasbarrini, Maria Assunta Zocco
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    Jian Kang, Xize Wu, Yue Li, Shuangli Zhao, Shixuan Wang, Dongdong Yu
    Frontiers in Immunology.2024;[Epub]     CrossRef
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    Joonhee Han, Hyun Joo Song, Min Sook Kang, Hogyung Jun, Heung Up Kim, Ki Soo Kang, Donghyoun Lee
    Nutrients.2024; 16(21): 3763.     CrossRef
  • Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn’s Disease
    Arshdeep Singh, Vandana Midha, Ramit Mahajan, Shruti Verma, Chandan Kakkar, Jasmine Grover, Dharmatma Singh, Ramandeep Kaur, Abhishek Masih, Namita Bansal, Catherine Wall, Ajit Sood
    Digestive Diseases and Sciences.2023; 68(2): 580.     CrossRef
  • Response to Ustekinumab Therapy Is Associated with an Improvement of Nutritional Status in Patients with Crohn’s Disease
    Lorenzo Bertani, Claudia D’Alessandro, Marco Fornili, Francesca Coppini, Federico Zanzi, Luca Carmisciano, Francesca Geri, Giovanni Baiano Svizzero, Emma Maria Rosi, Alice De Bernardi, Linda Ceccarelli, Maria Gloria Mumolo, Laura Baglietto, Massimo Bellin
    Journal of Clinical Medicine.2023; 12(19): 6118.     CrossRef
  • Clinical Implications of Dietary Probiotic Supplement (Associated with L-Glutamine and Biotin) in Ulcerative Colitis Patients’ Body Composition and Quality of Life
    Flavia Maria Pavel, Simona Gabriela Bungau, Delia Mirela Tit, Timea Claudia Ghitea, Ruxandra Cristina Marin, Andrei-Flavius Radu, Radu Dumitru Moleriu, Tiberia Ilias, Cristian Bustea, Cosmin Mihai Vesa
    Nutrients.2023; 15(24): 5049.     CrossRef
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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
AbstractAbstract PDFPubReaderePub
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.

Citations

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  • 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
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    Arshdeep Singh, Ajit Sood
    Indian Journal of Gastroenterology.2025;[Epub]     CrossRef
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    Manqin Sun, Fengjun Ni, Yong Yao, Huayuan Yang
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    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
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    Santhosh Rajendran, Ratnakar Kini, K. Muthukumaran, I. Shubha, A. Chezhian, R. Murali
    Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 127.     CrossRef
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    Soo-Young Na
    The Korean Journal of Medicine.2023; 98(5): 223.     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
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    Alexander Keith Turbayne, Miles Patrick Sparrow
    Digestive Diseases and Sciences.2022; 67(12): 5382.     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
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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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  • 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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Close layer
Inflammatory Bowel Diseases
Clinical characteristics of inflammatory bowel disease patients with immunoglobulin A nephropathy
Ryohei Hayashi, Yoshitaka Ueno, Shinji Tanaka, Kana Onishi, Takeshi Takasago, Masaki Wakai, Toshikatsu Naito, Kensuke Sasaki, Shigehiro Doi, Takao Masaki, Kazuaki Chayama
Intest Res 2021;19(4):430-437.   Published online November 9, 2020
DOI: https://doi.org/10.5217/ir.2020.00067
AbstractAbstract PDFPubReaderePub
Background/Aims
Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract. Some patients with this condition have been reported to present with immunoglobulin A nephropathy (IgAN), a renal complication that can cause end-stage renal failure, but the frequency of this comorbidity has not been described. Thus, the aim of this study was to investigate the frequency of IgAN in patients with IBD.
Methods
This study included 620 patients with IBD (338 with ulcerative colitis [UC] and 282 with Crohn’s disease [CD]) from the Hiroshima University Hospital outpatient department. IgAN cases were identified from medical interviews, blood examinations (serum immunoglobulin A), and urinalyses (occult blood, proteinuria). Definitive IgAN cases were diagnosed by renal biopsies, while those detected through the clinical course and test results, but not clinically recommended for renal biopsy, were defined as suspected IgAN.
Results
We analyzed 427 cases meeting the inclusion criteria (220 with UC and 207 with CD). The incidence of IgAN across all patients with IBD was 3.0%. The frequency of IgAN was significantly higher in patients with CD (11/207, 5.3%) than in those with UC (2/220, 0.9%) (P< 0.01). Moreover, a significant correlation was found between CD patients with ileostomy or colostomy and a diagnosis of IgAN.
Conclusions
Patients with IBD present a high incidence of IgAN, especially those with CD who have undergone ileostomy or colostomy.

Citations

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    Songyan Wan, Han Chen, Siqi Liu, Zhenliang Fan, Junfen Fan
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    Ga Hee Kim, Minjun Kim, Kyuwon Kim, Jung-Bin Park, Ji Eun Baek, June Hwa Bae, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
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    Jussi Pohjonen, Katri Kaukinen, Heini Huhtala, Ilkka Pörsti, Katri Lindfors, Jukka Mustonen, Satu Mäkelä
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  • 184 Download
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Review
IBD
Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment
Shintaro Akiyama, Victoria Rai, David T. Rubin
Intest Res 2021;19(1):1-11.   Published online November 5, 2020
DOI: https://doi.org/10.5217/ir.2020.00047
AbstractAbstract PDFPubReaderePub
Patients with inflammatory bowel disease (IBD) occasionally need a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) because of medically refractory colitis or dysplasia/cancer. However, pouchitis may develop in up to 70% of patients after this procedure and significantly impair quality of life, more so if the inflammation becomes a chronic condition. About 10% of patients with IBD who develop pouchitis require pouch excision, and several risk factors of the failure have been reported. A phenotype that has features similar to Crohn’s disease may develop in a subset of ulcerative colitis patients following proctocolectomy with IPAA and is the most frequent reason for pouch failure. In this review, we discuss the diagnosis and prognosis of pouchitis, risk factors for pouchitis development, and treatment options for pouchitis, including the newer biological agents.

Citations

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  • Research Communication: Comparative Effectiveness of Ustekinumab and Vedolizumab in the Management of Chronic Pouchitis—A Population‐Based Study
    Saqr Alsakarneh, June Tome, Francis A. Farraye, Darrell S. Pardi
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    兴宗 黄
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Original Articles
Inflammatory Bowel Diseases
Efficacy and safety of vedolizumab in ulcerative colitis in patients from Asian countries in the GEMINI 1 study
Choon Jin Ooi, Ida Normiha Hilmi, Hyo-Jong Kim, Umesh Jalihal, Deng-Chyang Wu, Dirk Demuth, Dirk Lindner, Shashi Adsul
Intest Res 2021;19(1):71-82.   Published online September 4, 2020
DOI: https://doi.org/10.5217/ir.2019.09159
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The efficacy and safety of vedolizumab in moderate to severely active ulcerative colitis (UC) have been demonstrated in the GEMINI 1 study (NCT00783718). This post-hoc exploratory analysis sought to establish the efficacy and safety of vedolizumab in a subgroup of patients from Asian countries with UC from GEMINI 1.
Methods
Efficacy outcomes of interest were clinical response, clinical remission and mucosal healing at week 6 (induction phase); and clinical remission, durable clinical response, durable clinical remission, mucosal healing and glucocorticoid-free remission at week 52 (maintenance phase). Differences in outcome rates between vedolizumab and placebo in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) were assessed using descriptive analyses, and efficacy and safety compared between Asian and non-Asian countries.
Results
During induction, in Asian countries (n = 58), clinical response rates at week 6 with vedolizumab and placebo were 55.2% and 24.1%, respectively (difference 31.0%; 95% confidence interval: 7.2%–54.9%). In non-Asian countries (n = 316), response rates at week 6 with vedolizumab and placebo were 45.9% and 25.8%, respectively. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 8 weeks, vedolizumab administered every 4 weeks and placebo were 9.1%, 36.8%, and 31.6%, respectively; corresponding rates for mucosal healing were 45.5%, 47.4%, and 47.4%, respectively. Vedolizumab was well-tolerated; adverse event frequency was comparable in Asian and non-Asian countries.
Conclusions
In patients from Asian countries, the efficacy and safety of vedolizumab in treatment of UC were broadly consistent with that in the overall study population.

Citations

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  • Efficacy and safety of vedolizumab in elderly and younger patients with moderate-to-severe ulcerative colitis: a retrospective real-world study in China
    Hao Zhang, Xue-Li Ding, Yong-Hong Xu, Jun Wu, Yue-Yuan Wang, Shu-Xian Liu, Jing Yan, Hua Liu, Zi-Bin Tian, Ai-Ling Liu
    BMC Gastroenterology.2025;[Epub]     CrossRef
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    Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun‐Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk‐Kyun Yang, Byong Duk Ye
    Alimentary Pharmacology & Therapeutics.2024; 59(12): 1539.     CrossRef
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    Tsukasa Yamakawa, Takakazu Miyake, Yoshihiro Yokoyama, Tomoe Kazama, Yuki Hayashi, Daisuke Hirayama, Shinji Yoshii, Hiro‐o Yamano, Satoshi Takahashi, Hiroshi Nakase
    JGH Open.2024;[Epub]     CrossRef
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    Jun Lee
    Intestinal Research.2023; 21(1): 168.     CrossRef
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    Yu Chen, Guolin Zhang, Yuewen Yang, Shuangshuang Zhang, Haozheng Jiang, Kang Tian, Arenbaoligao, Dapeng Chen
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    Journal of the Formosan Medical Association.2022; 121(9): 1689.     CrossRef
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    Vitaliy Y. Poylin, Jose Cataneo Serrato, Jonathan Pastrana Del Valle, Joseph D. Feuerstein
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    Hye Kyung Hyun, Hyun-Soo Zhang, Jongwook Yu, Eun Ae Kang, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
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    Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
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    Su Hyun Park, Sang Hyoung Park
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    Seung Hwan Shin, Sang Hyoung Park
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    Eun Mi Song, Suk-Kyun Yang
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    Hyo Yeop Song, Geom Seog Seo
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    P Pinton
    Journal of Gastroenterology and Hepatology.2021; 36(12): 3556.     CrossRef
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    Ann-Lorie Gagnon, William Beauchesne, Laurence Tessier, Charles David, Djamal Berbiche, Alexandre Lavoie, Alban Michaud-Herbst, Karine Tremblay
    Crohn's & Colitis 360.2021;[Epub]     CrossRef
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    Prasanta Debnath, Pravin M. Rathi
    Inflammatory Intestinal Diseases.2021; 6(1): 1.     CrossRef
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Inflammatory Bowel Diseases
Is there a correlation between infliximab trough levels and the development of adverse events in patients with inflammatory bowel disease?
Eirini Theodoraki, Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou, Evangelia Legaki, Maria Gazouli, Ioannis E. Koutroubakis
Intest Res 2021;19(4):461-467.   Published online August 18, 2020
DOI: https://doi.org/10.5217/ir.2020.00042
AbstractAbstract PDFPubReaderePub
Background/Aims
The measurement of infliximab trough levels (IFX-TLs) in patients with inflammatory bowel disease (IBD) is performed to optimize treatment. However, the association between the development of adverse events (AEs) and IFX-TLs has not been sufficiently studied thus far. To investigate the possible association of IFX-TLs with AEs in Greek patients with IBD receiving maintenance treatment with IFX.
Methods
A retrospective analysis of the registry data of the Gastroenterology Department of the University Hospital of Heraklion, from IBD patients with at least one available IFX-TL measurement during the years 2016 to 2017 was conducted. AEs reported 4 months before and 4 months after the measured IFX-TLs were recorded. The IFX-TLs of patients with or without AEs were compared.
Results
Of a total of 83 IBD patients (61 Crohn’s disease [73%]; 52 men [63%]; mean age ± standard deviation, 43.3 ± 16.0 years), 147 measurements of IFX-TLs were available (median 4.69 μg/ mL [1.32–9.16]), and 99 AEs (67.3%, 14 severe) were registered. The median IFX-TL of patients with AEs was 5.79 μg/mL (1.36– 10.25), higher than the median IFX-TL of patients without AEs (3.40 μg/mL [1.30–5.92]), but the difference was not significant (P= 0.97). The presence of infections or dermatologic reactions was not correlated with IFX-TLs. There was no difference in the prevalence of the total AEs (66.7% vs. 73.3%, P= 0.77) or in the analysis of AEs by group between patients with IFX-TLs ≥ 15 μg/ mL and patients with IFX-TLs < 15 μg/mL.
Conclusions
IFX-TLs are not significantly associated with the development of AEs in IBD patients receiving maintenance treatment with IFX.

Citations

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  • Identifying risk factors of anti‐TNF induced skin lesions and other adverse events in paediatric patients with inflammatory bowel disease
    Karen van Hoeve, Debby Thomas, Tom Hillary, Ilse Hoffman, Erwin Dreesen
    Journal of Pediatric Gastroenterology and Nutrition.2024; 78(1): 95.     CrossRef
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    Daniela Kosorínová, Pavlína Suchá, Zuzana Havlíčeková, Marek Pršo, Pavol Dvoran, Peter Bánovčin
    Česko-slovenská pediatrie.2024; 79(4): 213.     CrossRef
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    Eun Soo Kim, Sung Kook Kim, Dong Il Park, Hyo Jong Kim, Yoo Jin Lee, Ja Seol Koo, Eun Sun Kim, Hyuk Yoon, Ji Hyun Lee, Ji Won Kim, Sung Jae Shin, Hyung Wook Kim, Hyun-Soo Kim, Young Sook Park, You Sun Kim, Tae Oh Kim, Jun Lee, Chang Hwan Choi, Dong Soo Ha
    Journal of Clinical Gastroenterology.2023; 57(6): 601.     CrossRef
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    Eirini Theodoraki, Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou, Nikolaos-Panagiotis Andreou, Maria Gazouli, Ioannis E. Koutroubakis
    International Journal of Colorectal Disease.2022; 37(3): 639.     CrossRef
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    Jihye Park, Jae Hee Cheon
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    Ji Young Chang, Jae Hee Cheon
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Inflammatory Bowel Diseases
Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis
Shin Ju Oh, Ga Young Shin, Hosim Soh, Jae Gon Lee, Jong Pil Im, Chang Soo Eun, Kang-Moon Lee, Dong Il Park, Dong Soo Han, Hyo Jong Kim, Chang Kyun Lee
Intest Res 2021;19(3):323-331.   Published online August 18, 2020
DOI: https://doi.org/10.5217/ir.2020.00039
AbstractAbstract PDFPubReaderePub
Background/Aims
Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort.
Methods
We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit.
Results
A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities.
Conclusions
Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC.

Citations

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    Wei-Chen Lin, Chun-Chi Lin, Wen-Hung Hsu, Feng-Fan Chiang, Chen-Wang Chang, Tzu-Chi Hsu, Deng-Chyang Wu, Horng-Yuan Wang, Jau-Min Wong, Shu-Chen Wei
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    Fuyixuan Zheng, Yuemei Sun, Minghui Zhao, Rong Wang, Wenbin Li
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    Arshdeep Singh, Manjeet Kumar Goyal, Vandana Midha, Ramit Mahajan, Kirandeep Kaur, Yogesh Kumar Gupta, Dharmatma Singh, Namita Bansal, Ramandeep Kaur, Shivam Kalra, Omesh Goyal, Varun Mehta, Ajit Sood
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    Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
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Inflammatory Bowel Diseases
Temporal trend in the natural history of ulcerative colitis in a country with a low incidence of ulcerative colitis from 2000 through 2018
Satimai Aniwan, Julajak Limsrivilai, Supot Pongprasobchai, Nonthalee Pausawasdi, Piyapan Prueksapanich, Natanong Kongtub, Rungsun Rerknimitr
Intest Res 2021;19(2):186-193.   Published online August 18, 2020
DOI: https://doi.org/10.5217/ir.2020.00028
AbstractAbstract PDFPubReaderePub
Background/Aims
The incidence of ulcerative colitis (UC) in Thailand (crude incidence rate of 0.28 per 100,000 persons) is much lower than in the West. The burden of UC varies in different populations. The aim of this study was to evaluate the natural history of UC over the two decades in Bangkok, Thailand.
Methods
This retrospective study included patients who were diagnosed with UC between 2000 and 2018 in 2 university hospitals. To evaluate changes in the disease course, we stratified patients into 2000–2009 cohort and 2010–2018 cohort. The cumulative probability of endoscopic healing, UC-related hospitalization and colectomy was estimated using the Kaplan-Meier method.
Results
A total of 291 UC patients were followed for total of 2,228 person-years. Comparison between 2 cohorts, there were no differences in disease pattern and severity whereas an increase in the combination use of oral and topical mesalamine and the early use of thiopurine was observed. Only 1% of patients for each cohort required biologic agent at 5 years. The rate of achieving mucosal healing increased from 15% to 46% at 3 years (P< 0.01). The rate of UC-related hospitalization decreased from 30% to 21% at 5 years (P< 0.05). The rate of colectomy decreased from 6% to 2% at 5 years (P< 0.05).
Conclusions
The natural history of UC in a low incidence country was less aggressive than the West. Over the past two decades, the rates of UC-related hospitalization and colectomy have been decreasing which were similar to the West.

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    Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
    Journal of Personalized Medicine.2022; 12(3): 507.     CrossRef
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    Sang Hyoung Park
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Review
Inflammatory bowel diseases
Colitis and Crohn’s Foundation (India) consensus statements on use of 5-aminosalicylic acid in inflammatory bowel disease
Ajit Sood, Vineet Ahuja, Vandana Midha, Saroj Kant Sinha, C. Ganesh Pai, Saurabh Kedia, Varun Mehta, Sawan Bopanna, Philip Abraham, Rupa Banerjee, Shobna Bhatia, Karmabir Chakravartty, Sunil Dadhich, Devendra Desai, Manisha Dwivedi, Bhabhadev Goswami, Kirandeep Kaur, Rajeev Khosla, Ajay Kumar, Ramit Mahajan, S. P. Misra, Kiran Peddi, Shivaram Prasad Singh, Arshdeep Singh
Intest Res 2020;18(4):355-378.   Published online July 13, 2020
DOI: https://doi.org/10.5217/ir.2019.09176
AbstractAbstract PDFPubReaderePub
Despite several recent advances in therapy in inflammatory bowel disease (IBD), 5-aminosalicylic acid (5-ASA) therapy has retained its place especially in ulcerative colitis. This consensus on 5-ASA is obtained through a modified Delphi process, and includes guiding statements and recommendations based on literature evidence (randomized trials, and observational studies), clinical practice, and expert opinion on use of 5-ASA in IBD by Indian gastroenterologists. The aim is to aid practitioners in selecting appropriate treatment strategies and facilitate optimal use of 5-ASA in patients with IBD.

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Original Articles
Inflammatory Bowel Diseases
Colitis and Crohn’s Foundation (India): a first nationwide inflammatory bowel disease registry
Ajit Sood, Kirandeep Kaur, Ramit Mahajan, Vandana Midha, Arshdeep Singh, Sarit Sharma, Amarender Singh Puri, Bhabhadev Goswami, Devendra Desai, C. Ganesh Pai, Kiran Peddi, Mathew Philip, Rakesh Kochhar, Sandeep Nijhawan, Shobna Bhatia, N. Sridhara Rao
Intest Res 2021;19(2):206-216.   Published online July 13, 2020
DOI: https://doi.org/10.5217/ir.2019.09169
AbstractAbstract PDFPubReaderePub
Background/Aims
The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.
Methods
A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.
Results
A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.
Conclusions
The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.

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Inflammatory Bowel Diseases
Population pharmacokinetics of vedolizumab in Asian and non-Asian patients with ulcerative colitis and Crohn’s disease
Hiroyuki Okamoto, Nathanael L. Dirks, Maria Rosario, Tetsuharu Hori, Toshifumi Hibi
Intest Res 2021;19(1):95-105.   Published online July 10, 2020
DOI: https://doi.org/10.5217/ir.2019.09167
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Vedolizumab is indicated for moderately-to-severely active ulcerative colitis (UC) and Crohn’s disease (CD). Because multiple factors may result in different pharmacokinetics and clinical efficacies, understanding determinants of vedolizumab clearance may enhance dose and treatment strategies. The aim was to characterize vedolizumab pharmacokinetics in Asian and non-Asian UC and CD patients.
Methods
Population pharmacokinetic analysis for repeated measures, using data from 5 studies, was conducted using nonlinear mixed-effects modeling. A Bayesian estimation approach in NONMEM 7.3 was utilized to leverage the predominantly sparse data available for this analysis with results from a prior population pharmacokinetic analysis of vedolizumab.
Results
Vedolizumab pharmacokinetics were described by a 2-compartment model with parallel linear and nonlinear elimination. Using reference covariate values, linear elimination half life of vedolizumab was 24.7 days for anti-vedolizumab antibody (AVA)-negative patients and 18.1 days for AVA-positive patients; linear clearance (CLL) was 0.165 L/day for AVA-negative patients and 0.246 L/day for AVA-positive patients; central (Vc) and peripheral compartment volumes of distribution were 3.16 L and 1.84 L, respectively. Interindividual variabilities (percent coefficient of variation) were 30.8% for CLL and 19% for Vc; interoccasion variability on CLL was 20.3%; residual variance was 17.8%. For albumin, body weight and AVA, only extreme values were identified as potentially clinically important predictors of CLL. The effect of race (Asian/non-Asian) and diagnosis (UC/CD) on CLL was negligible and likely not of clinical importance.
Conclusions
Pharmacokinetic parameters were similar in Asian and non-Asian patients with moderately-to-severely active UC and CD. This analysis supports use of vedolizumab flat-fixed dosing in these patients. (Clinicaltrials.gov Identifiers: NCT00783718 (GEMINI 1); NCT00783692 (GEMINI 2). CCT 101; NCT02039505 and CCT-001; NCT02038920)

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Review
Inflammatory bowel diseases
Capsule endoscopy in inflammatory bowel disease: when and how
Ida Hilmi, Taku Kobayashi
Intest Res 2020;18(3):265-274.   Published online July 7, 2020
DOI: https://doi.org/10.5217/ir.2019.09165
AbstractAbstract PDFPubReaderePub
Capsule endoscopy (CE) is emerging as an important investigation in inflammatory bowel disease (IBD); common types include the standard small bowel CE and colon CE. More recently, the pan-enteric CE was developed to assess the large and small bowel in patients with Crohn’s disease (CD). Emerging indications include noninvasive assessment for mucosal healing (both in the small bowel and the colon) and detection of postoperative recurrence in patients with CD. Given the increasing adoption, several CE scoring systems have been specifically developed for IBD. The greatest concern with performing CE, particularly in CD, is capsule retention, but this can be overcome by performing cross-sectional imaging such as magnetic resonance enterography and using patency capsules before performing the procedure. The development of software for automated detection of mucosal abnormalities typically seen in IBD may further increase its adoption.

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Case Report
Infection
Whipple disease mimicking inflammatory bowel disease
Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa
Intest Res 2021;19(1):119-125.   Published online July 3, 2020
DOI: https://doi.org/10.5217/ir.2019.09177
AbstractAbstract PDFPubReaderePub
Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.

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Original Articles
Inflammatory Bowel Diseases
The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis
Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park
Intest Res 2021;19(1):62-70.   Published online May 8, 2020
DOI: https://doi.org/10.5217/ir.2019.09156
AbstractAbstract PDFPubReaderePub
Background/Aims
Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can serve as biomarkers for diagnosing and assessing disease activity in ulcerative colitis (UC). We investigated their clinical significance in UC.
Methods
We analyzed 48 patients with UC who underwent measurement of fecal calprotectin (FC) and endoscopy and 96 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. The endoscopic activity was divided into 2 groups: group 1 (mild to moderate inflammation) and group 2 (severe inflammation) according to the Mayo endoscopic subscore in UC.
Results
To diagnose UC, the optimal cutoff of NLR and PLR was 2.26 (sensitivity 54.2%; specificity 90.6%; positive likelihood ratio 5.778, 95% confidence interval [CI] 2.944–11.339; area under the curve [AUC] 0.774, 95% CI, 0.690–0.859) and 179.8 (sensitivity 35.4%; specificity 90.6%; positive likelihood ratio 3.778, 95% CI 1.821–7.838; AUC 0.654, 95% CI 0.556–0.753), respectively. The optimal cutoff to differentiate group 1 and group 2 was 3.44, 175.9, and 453 µg/g for NLR, PLR, and FC, respectively (sensitivity, 63.6% vs. 90.9% vs. 81.8%; specificity, 81.1% vs. 78.4% vs. 73.0%; positive likelihood ratio, 3.364 vs. 4.205 vs. 3.027; AUC, 0.714 vs. 0.897 vs. 0.813). PLR had the highest AUC and positive likelihood ratio.
Conclusions
NLR and PLR help differentiate patients with UC from healthy controls. NLR, PLR, and FC indicate endoscopic activity and may reflect intestinal mucosal conditions.

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Inflammatory bowel diseases
Pathophysiological role of Atg5 in human ulcerative colitis
Razieh Ardali, Nasrin Kazemipour, Saeed Nazifi, Kamran Bagheri Lankarani, Iman Razeghian Jahromi, Masood Sepehrimanesh
Intest Res 2020;18(4):421-429.   Published online May 8, 2020
DOI: https://doi.org/10.5217/ir.2019.00120
AbstractAbstract PDFPubReaderePub
Background/Aims
Ulcerative colitis (UC), along with Crohn’s disease, is one of the main types of inflammatory bowel disease (IBD). On the other hand, deregulated autophagy is involved in many chronic diseases, including IBD. In this study, we aimed to investigate the role of Atg5 and microRNA-181a (miR-181a) in the pathophysiology of UC.
Methods
Colon biopsy, stool, and blood samples of 6 men and 9 women were confirmed for UC. Also, 13 men and 17 women were selected as healthy control (HC). Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to measure the Atg-5 content of the colon biopsies. Besides, the serum and stool levels of Atg5 were measured using ELISA. Moreover, the total RNA of blood cells was extracted and evaluated for the expression of miR-181a.
Results
We found 1.2 ng/mL versus 0.46 ng/mL, 0.34 ng/mL versus 0.24 ng/mL, and 0.082 ng/mL versus 0.062 ng/mL of Atg5 in stool, intestinal tissue, and serum of UC and HCs, respectively. There was no significant difference in the expression of miR-181a in the blood samples of UC and HCs. Immunohistochemistry showed high positivity without any significant difference between the 2 groups in the quantitative analysis.
Conclusions
The significant difference observed between the stool Atg5 content of the HCs and UC patients may provide new insight into using this protein as a diagnostic biomarker, however, considering the small size of our studied population further studies are needed.

Citations

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  • Chronic Gastrointestinal Disorders and miRNA-Associated Disease: An Up-to-Date
    Alessandro Giammona, Bruno Giovanni Galuzzi, Elena Imperia, Clarissa Gervasoni, Sofia Remedia, Laura Restaneo, Martina Nespoli, Laura De Gara, Flaminia Tani, Michele Cicala, Michele Pier Luca Guarino, Danilo Porro, Antonio Cerasa, Alessia Lo Dico, Annamar
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    Le Yang, Huahui Li, Min Tang, Lingnan He, Lijun Yang
    Frontiers in Immunology.2025;[Epub]     CrossRef
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    Jiao Zhou, Chunxia Li, Meng Lu, Gaoyue Jiang, Shanze Chen, Huihui Li, Kefeng Lu, Hans-Uwe Simon
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    Wei Zhang, Menglong Zou, Jia Fu, Yin Xu, Ying Zhu
    Biomedicine & Pharmacotherapy.2024; 176: 116891.     CrossRef
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    Yi-Qun Zhang, Ta Xiao, Chang-Jun Song, Yang-Ying Ke, Xiang Gao, Min Li, Heng Gu, Xu Chen
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    Yan Xu, Yuxi Tian, Fujun Li, Ying Wang, Junwen Yang, Hui Gong, Xiaoping Wan, Miao Ouyang
    Inflammatory Bowel Diseases.2022; 28(2): 273.     CrossRef
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    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
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    Soo-Young Na, You Sun Kim
    The Korean Journal of Internal Medicine.2022; 37(5): 906.     CrossRef
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    Fatemeh Abbasi Teshnizi, Nasrin Kazemipour, Saeed Nazifi, Kamran Bagheri Lankarani, Masood Sepehrimanesh, Iman Razeghian Jahromi
    Physiological Reports.2021;[Epub]     CrossRef
  • Regulation of Endoplasmic Reticulum Stress-Autophagy: A Potential Therapeutic Target for Ulcerative Colitis
    Dan Qiao, Ziwei Zhang, Yali Zhang, Qian Chen, Yujun Chen, Yingjue Tang, Xiong Sun, Zhipeng Tang, Yancheng Dai
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
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  • 139 Download
  • 9 Web of Science
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Inflammatory Bowel Diseases
Efficacy of biologic therapies for biologic-naïve Japanese patients with moderately to severely active ulcerative colitis: a network meta-analysis
Toshifumi Hibi, Isao Kamae, Philippe Pinton, Lyann Ursos, Ryuichi Iwakiri, Greg Hather, Haridarshan Patel
Intest Res 2021;19(1):53-61.   Published online April 22, 2020
DOI: https://doi.org/10.5217/ir.2019.09146
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Several biologic therapies are approved in Japan to treat moderately to severely active ulcerative colitis (UC), but there are no published comparative efficacy studies in a Japanese population. We compared the efficacy of biologics approved in Japan (adalimumab, infliximab, golimumab, and vedolizumab) for treating biologic-naïve patients with UC at their approved doses.
Methods
A targeted literature review identified 4 randomized controlled trials of biologics for UC in biologicnaïve Japanese patients. For each study, efficacy outcome data from induction (weeks 6–12) and maintenance (weeks 30–60) treatment were extracted for analysis. Treatment effects on clinical response, clinical remission, and mucosal healing relative to the average placebo results across all trials were estimated using network meta-analyses followed by transformation into probabilities and odds ratios (OR).
Results
At the end of induction, the likelihood of clinical response and clinical remission was highest with infliximab (OR: 2.12 and 2.35, respectively) and vedolizumab (OR: 2.10 and 2.32, respectively); the likelihood of mucosal healing was highest with infliximab (OR: 2.24) and adalimumab (OR: 1.86). During maintenance, the likelihood of clinical response and clinical remission was highest with vedolizumab (OR: 6.44 and 4.68, respectively) and golimumab (OR: 5.13 and 3.84, respectively); the likelihood of mucosal healing was significantly higher than placebo with all biologics.
Conclusions
All active treatments were efficacious compared with placebo. Infliximab and vedolizumab had the highest odds for induction of clinical response, remission, and mucosal healing. Golimumab and vedolizumab had numerically higher odds of achieving efficacy outcomes in the maintenance phase.

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Case Report
Inflammatory bowel diseases
Incidental benefits after fecal microbiota transplant for ulcerative colitis
Ramit Mahajan, Vandana Midha, Arshdeep Singh, Varun Mehta, Yogesh Gupta, Kirandeep Kaur, Ritu Sudhakar, Anmol Singh Pannu, Dharmatma Singh, Ajit Sood
Intest Res 2020;18(3):337-340.   Published online April 22, 2020
DOI: https://doi.org/10.5217/ir.2019.00108
AbstractAbstract PDFPubReaderePub
Gut dysbiosis can result in several diseases, including infections (Clostridium difficile infection and infectious gastroenteritis), autoimmune diseases (inflammatory bowel disease, diabetes, and allergic disorders), behavioral disorders and other conditions like metabolic syndrome and functional gastrointestinal disorders. Amongst various therapies targeting gut microbiome, fecal microbiota transplantation (FMT) is becoming a focus in the public media and peer reviewed literature. We have been using FMT for induction of remission in patients with moderate to severe active ulcerative colitis (UC) and also for subsequent maintenance of remission. Four cases reported incidental benefits while being treated with FMT for UC. These included weight loss (n=1), improvement in hair loss (n=1), amelioration of axial arthritis (n=1) and improvement in allergic rhinitis (n=1), thereby suggesting potential clinical applications of FMT in treating extraintestinal diseases associated with gut dysbiosis.

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Original Articles
Inflammatory bowel diseases
Changes in prevalence and perception of complementary and alternative medicine use in Korean inflammatory bowel disease patients: results of an 8-year follow-up survey
Sun-Ho Lee, Kiju Chang, Ki Seok Seo, Yun Kyung Cho, Eun Mi Song, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Intest Res 2020;18(2):192-199.   Published online April 3, 2020
DOI: https://doi.org/10.5217/ir.2019.00115
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The use of complementary and alternative medicine (CAM) is a global phenomenon, including inflammatory bowel disease (IBD) patients. We aimed to assess the change in prevalence and patterns of CAM use, and attitudes towards CAM over an 8-year time interval (2006 vs. 2014) among IBD patients in Korea.
Methods
A total of 221 IBD patients (CD=142, UC=79) were asked to complete a questionnaire regarding CAM at two time points: at enrollment (2006) and 8 years later (2014/2015).
Results
The proportion of patients ever using CAM increased significantly from 60.2% in 2006 to 79.6% in 2014 (P<0.001), while the proportion of current CAM users increased slightly (35.7% to 38.0%, P=0.635); 21.7% used CAM consistently at both time points. The proportion of patients who felt CAM was less effective (P<0.001) and more expensive (P=0.04) than conventional treatments increased over time. Also, the proportion among ever CAM users who perceived a positive effect from CAM significantly decreased in 2014 compared to 2006 (P=0.004). Higher education (adjusted odds ratio [aOR], 2.10), prior side effects to conventional therapies (aOR, 2.23), and prior use of corticosteroids (aOR, 2.51) were associated with CAM use. Interestingly, use of CAM before IBD diagnosis (aOR, 2.73) was significantly associated with consistent CAM use.
Conclusions
Although the attitudes toward CAM have become less favorable, the majority of IBD patients have experienced CAM with an overall increase of current CAM users over time. Moreover, more than half of current CAM users used CAM consistently over time.

Citations

Citations to this article as recorded by  
  • Validation of the Korean Version of a Knowledge Assessment Tool for Children With Inflammatory Bowel Disease
    Sowon Park, Jihye Noh, Chaelin Kim, Hyeji Lim, Eun Joo Lee, Hong Koh, Andrew S Day, Angharad Vernon-Roberts
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • Effects of self-acupressure on quality of life and abdominal pain severity among patients with inflammatory bowel disease: A randomized sham-controlled trial
    Nahid Rajai, Zahra Abbasi, Amir Hosein Pishgooie, Fatemeh Teymouri, Mohammad Imanipour
    Journal of Ayurveda and Integrative Medicine.2025; 16(2): 101080.     CrossRef
  • Use of Complementary and Alternative Medicine by Greek Patients with Inflammatory Bowel Disease
    John Triantafillidis, Aristofanis Gikas, Georgia Kontrarou, Manousos Konstantoulakis, Apostolos Papalois
    Nutrients.2024; 16(21): 3679.     CrossRef
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    Hsiao-Yun Chang, Yu-Yao Huang, Chin-Jung Chung, Feng-Hsuan Liu
    BMC Complementary Medicine and Therapies.2023;[Epub]     CrossRef
  • Perspectives of East Asian patients and physicians on complementary and alternative medicine use for inflammatory bowel disease: results of a cross-sectional, multinational study
    Eun Soo Kim, Chung Hyun Tae, Sung-Ae Jung, Dong Il Park, Jong Pil Im, Chang Soo Eun, Hyuk Yoon, Byung Ik Jang, Haruhiko Ogata, Kayoko Fukuhara, Fumihito Hirai, Kazuo Ohtsuka, Jing Liu, Qian Cao
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    Jae Song Kim, Min Jung Geum, Eun Sun Son, Yun Mi Yu, Jae Hee Cheon, Kyeng Hee Kwon
    Gut and Liver.2022; 16(5): 736.     CrossRef
  • Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD)
    Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
    Expert Review of Clinical Pharmacology.2021; 14(7): 865.     CrossRef
  • Complementary and alternative medicine in patients with inflammatory bowel disease: hype or evidence?
    Jae Myung Cha
    Intestinal Research.2020; 18(2): 141.     CrossRef
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  • 126 Download
  • 7 Web of Science
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Inflammatory bowel diseases
Concordance between tuberculin skin test and interferon-gamma release assay for latent tuberculosis screening in inflammatory bowel disease
Saad Alrajhi, Pascale Germain, Myriam Martel, Peter Lakatos, Talat Bessissow, Talal Al-Taweel, Waqqas Afif
Intest Res 2020;18(3):306-314.   Published online March 20, 2020
DOI: https://doi.org/10.5217/ir.2019.00116
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Latent tuberculosis screening is mandatory prior to initiating anti-tumor necrosis factor (anti-TNF) medications. Guidelines recommend interferon-gamma release assays (IGRA) as first line screening method for the general population. Studies provided conflicting evidence on IGRA and tuberculin skin test (TST) performance in inflammatory bowel disease (IBD) patients. We assessed test concordance and the effects of immunosuppression on their performance in IBD patients.
Methods
We searched MEDLINE, Embase and Cochrane databases (2011–2018) for studies testing TST and IGRA in IBD. Primary outcome was TST and IGRA concordance. Secondary outcomes were effects of immunosuppressive therapy on performance. Immunosuppression defined as either steroids, thiopurine, methotrexate or cyclosporine use. We used the pooled random effects model to adjust for heterogeneity analyzed using (I2–Q statistics). We compared the fixed model to exclude smaller study effects.
Results
Sixteen studies (2,488 patients) were included. Pooled TST and IGRA concordance was 85% (95% confidence interval [CI], 81%–88%; P=0.01). Effects of immunosuppression were reported in 8 studies (814 patients). The odds ratio of testing positive by IGRA decreased to 0.57 if immunosuppressed (95% CI, 0.31–1.03; P=0.06). The odds ratio of testing positive by TST if immunosuppressed was 1.14 (95% CI, 0.61–2.12; P=0.69). The fixed model yielded similar results, however the negative effect of immunosuppression on IGRA reached statistical significance (P=0.01).
Conclusions
While concordance was 85% between TST and IGRA, the performance of IGRA seems to be negatively affected by immunosuppression. Given the importance of detecting latent tuberculosis prior to anti-TNF initiation, further randomized controlled trials comparing the performance of TST and IGRA in IBD patients are needed.

Citations

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    Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
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    Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
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    Fen Liu, Jian Tang, Lingna Ye, Jinyu Tan, Yun Qiu, Fan Hu, Jinshen He, Baili Chen, Yao He, Zhirong Zeng, Ren Mao, Qian Cao, Xiang Gao, Minhu Chen
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    Jihye Park, Jae Hee Cheon
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    Byung Chul Jin, Hee Jin Moon, Sang Wook Kim
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    Seung Wook Hong, Sang Hyoung Park, Byong Duk Ye, Suk-Kyun Yang
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Inflammatory Bowel Diseases
Quality of life in inflammatory bowel diseases: it is not all about the bowel
Ronald Keller, Nazar Mazurak, Laura Fantasia, Stefano Fusco, Nisar P Malek, Jan Wehkamp, Paul Enck, Thomas Klag
Intest Res 2021;19(1):45-52.   Published online February 27, 2020
DOI: https://doi.org/10.5217/ir.2019.00135
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD) are chronic diseases mostly affecting young patients. As they are diseases accompanying patients for their entire life, and the quality of life (QUOL) interacts with disease activity, improving QUOL should be one of the main goals of therapy. This study aims to identify factors contributing to good or impaired QUOL.
Methods
Questionnaires addressing health-related QUOL and other psychological and social features were positioned on our institutions’ webpage and on the webpage of the largest self-help group for IBD in Germany. Patients were subdivided according to their QUOL score with a cutoff of <60. We used the Short Inflammatory Bowel Disease Questionnaire, the Assessment of the Demand for Additional Psychological Treatment, and the Fear of Progression Questionnaire Short Form.
Results
High numbers of patients in both subgroups showed an impaired QUOL (87.34% in UC, 91.08% in CD). Active extraintestinal manifestations, smoking, high fear of progression and high demand for psychotherapy were associated with reduced QUOL. In addition, polypharmacological interventions did not result in a good QUOL, but ostomies are linked to improved QUOL especially in CD patients.
Conclusions
Scores used in clinical day-to-day-practice mainly focusing on somatic factors do not sufficiently address important aspects concerning QUOL. Most importantly, extraintestinal manifestations show a hitherto underestimated impact on QUOL.

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Review
Inflammatory bowel diseases
Biosimilars: concept, current status, and future perspectives in inflammatory bowel diseases
Sang Hyoung Park, Jae Cheol Park, Milan Lukas, Martin Kolar, Edward V. Loftus, Jr
Intest Res 2020;18(1):34-44.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.09147
AbstractAbstract PDFPubReaderePub
The inflammatory bowel diseases (IBD), which consist of Crohn’s disease and ulcerative colitis, are chronic, incurable immunemediated inflammatory disorders of the intestine. As IBD incidence continues to increase globally and its mortality is low, prevalent cases of IBD are rapidly increasing, thereby leading to a substantial increase in health care costs. Although the introduction of biologic agents for IBD management has revolutionized the armamentarium of IBD therapy, the high cost of this therapy is concerning. With the expirations of patents for existing biologic agents (originals), biosimilars with cheaper costs have been highlighted in the field of IBD. Despite concerns regarding their short- and long-term efficacy, safety, immunogenicity, and interchangeability, increasing evidence via prospective observations and phase III or IV clinical trials, which aim to prove the “biosimilarity” of biosimilars to originals, has partly confirmed their efficacy, safety, and interchangeability. Additionally, although patients and physicians are reluctant to use biosimilars, a positive budget impact has been reported owing to their use in different countries. In the near future, multiple biosimilars with lower costs, and efficacy and safety profile similar to originals, could be used to treat IBD; thus, further consideration and knowledge dissemination are warranted in this new era of biosimilars.

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Original Articles
Inflammatory bowel diseases
5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis
Shinta Mizuno, Keiko Ono, Yohei Mikami, Makoto Naganuma, Tomohiro Fukuda, Kazuhiro Minami, Tatsuhiro Masaoka, Soichiro Terada, Takeshi Yoshida, Keiichiro Saigusa, Norimichi Hirahara, Hiroaki Miyata, Wataru Suda, Masahira Hattori, Takanori Kanai
Intest Res 2020;18(1):69-78.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.
Methods
We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.
Results
Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).
Conclusions
In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.

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Inflammatory bowel diseases
Predictive factors for achievement of mucosal healing by budesonide 2-mg foam in ulcerative colitis: a pooled analysis of data from two clinical trials
Toshifumi Hibi, Makoto Naganuma, Eisei Oda, Yoji Yamada, Yoshitomo Chujoh, Ryoichi Yoshihara, Mamoru Watanabe
Intest Res 2020;18(1):56-68.   Published online December 11, 2019
DOI: https://doi.org/10.5217/ir.2019.00064
AbstractAbstract PDFPubReaderePub
Background/Aims
Mucosal healing (MH) of distal lesions in ulcerative colitis (UC) has recently been confirmed with budesonide 2-mg foam (BF) treatment in 2 clinical trials; however, few studies have investigated the predictive factors for complete MH.
Methods
We conducted a post hoc analysis using pooled data from phase II and III clinical trials evaluating the efficacy and safety of BF for UC. Additionally, we analyzed the relationships between complete MH and baseline factors and clinical symptoms from baseline to week 6.
Results
Among the 291 Japanese patients from the 2 pooled clinical studies, 119 patients in the BF twice a day group and 117 in the placebo group were included in the full analysis set. The proportion of patients with a rectal bleeding (RB) subscore of 0 was significantly higher in the BF group than in the placebo group after a 5-day treatment (P<0.05). After a 2-day treatment, significantly more patients in the BF group had a stool frequency (SF) subscore of 0 than patients in the placebo group (P<0.05). Multivariate analysis showed that complete MH at week 6 was influenced by baseline SF subscore and 5-aminosalicylic acid (5-ASA) enema or suppository use (P=0.0086 and P=0.0015, respectively). The relationship between complete MH at week 6 and RB subscore after week 2 was also confirmed.
Conclusions
Normal SF at baseline, history of 5-ASA topical product use, and elimination of RB after week 2 are suggested predictors of complete MH at week 6 with twice-daily BF treatment.

Citations

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    Eun Ae Kang
    Gut and Liver.2022; 16(3): 487.     CrossRef
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    Ryosuke Miyazaki, Toshiyuki Sakurai, Mariko Shimada, Yuko Iwashita, Naoki Shibuya, Yoshihiro Akita, Haruna Miyashita, Yuki Maruyama, Masayuki Saruta
    BMC Gastroenterology.2022;[Epub]     CrossRef
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    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
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    Jihye Park, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2022; 37(5): 895.     CrossRef
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Focused Review
IBD
Nutritional approach as therapeutic manipulation in inflammatory bowel disease
Jin Young Yoon
Intest Res 2019;17(4):463-475.   Published online October 28, 2019
DOI: https://doi.org/10.5217/ir.2019.00078
AbstractAbstract PDFPubReaderePub
Malnutrition is observed more frequently in patients with inflammatory bowel disease (IBD) than in the general population and associated with adverse clinical outcomes. This study aimed to review the current knowledge regarding the efficacy of dietary and nutritional intervention in IBD patients. Exclusive enteral nutrition might be inferior to corticosteroid treatment in adults with active Crohn’s disease (CD) but might even be superior considering the adverse effects of corticosteroid treatment in children. Total parenteral nutrition has no advantage over enteral nutrition, which is considered a more physiologic modality in organ function. Current guidelines do not yet recommend ω3-polyunsaturated fatty acid supplementation for the prevention and maintenance of remission in IBD patients. Dietary fiber supplementation could be effective in the relief of symptoms and maintenance of remission in ulcerative colitis (UC). Although vitamin D may be favorable to clinical course of IBD and bone density. Probiotic supplementation has proven to be effective in preventing and treating pouchitis for UC but is less effective in treating CD. Nutritional interventions not only correct nutritional deficiencies but also improve symptoms and clinical courses of the disease. Hence, nutritional approaches need to be developed to significantly evaluate the effectiveness of dietary interventions used to treat IBD.

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Original Articles
Inflammatory bowel diseases
Polypharmacy is a risk factor for disease flare in adult patients with ulcerative colitis: a retrospective cohort study
Jingzhou Wang, Takahiro I Nakamura, Anne G Tuskey, Brian W Behm
Intest Res 2019;17(4):496-503.   Published online October 14, 2019
DOI: https://doi.org/10.5217/ir.2019.00050
AbstractAbstract PDFPubReaderePub
Background/Aims
Polypharmacy is a common clinical problem with chronic diseases that can be associated with adverse patient outcomes. The present study aimed to determine the prevalence and patient-specific characteristics associated with polypharmacy in an ulcerative colitis (UC) population and to assess the impact of polypharmacy on disease outcomes.
Methods
A retrospective chart review of patients with UC who visited a tertiary medical center outpatient clinic between 2006 and 2011 was performed. Polypharmacy was defined as major ( ≥ 5 non-UC medications) or minor (2–4 non-UC medications). UC medications were excluded in the polypharmacy grouping to minimize the confounding between disease severity and polypharmacy. Outcomes of interest include disease flare, therapy escalation, UC-related hospitalization, and surgery within 5 years of the initial visit.
Results
A total of 457 patients with UC were eligible for baseline analysis. Major polypharmacy was identified in 29.8% of patients, and minor polypharmacy was identified in 40.9% of the population. Polypharmacy at baseline was associated with advanced age (P< 0.001), female sex (P= 0.019), functional gastrointestinal (GI) disorders (P< 0.001), and psychiatric disease (P< 0.001). Over 5 years of follow-up, 265 patients remained eligible for analysis. After adjusting for age, sex, functional GI disorders, and psychiatric disease, major polypharmacy was found to be significantly associated with an increased risk of disease flare (odds ratio, 4.00; 95% confidence interval, 1.66–9.62). However, major polypharmacy was not associated with the risk of therapy escalation, hospitalization, or surgery.
Conclusions
Polypharmacy from non-inflammatory bowel disease medications was present in a substantial proportion of adult patients with UC and was associated with an increased risk of disease flare.

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    Ekaterina Safroneeva, Helen Thorne, Ortrud Gerstner, Raphaël Laoun
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Inflammatory bowel diseases
Familial aggregation of inflammatory bowel disease in India: prevalence, risks and impact on disease behavior
Rupa Banerjee, Partha Pal, Susan Hutfless, B Girish Ganesh, D Nageshwar Reddy
Intest Res 2019;17(4):486-495.   Published online August 6, 2019
DOI: https://doi.org/10.5217/ir.2018.00174
AbstractAbstract PDFPubReaderePub
Background/Aims
Information about familial aggregation of inflammatory bowel disease (IBD) in Asia is limited. We aimed to analyze the prevalence and risk of familial IBD in an Indian cohort and compare familial and sporadic cases.
Methods
Familial IBD cases were identified from a large prospectively maintained IBD registry. The prevalence of IBD in first- and seconddegree relatives of index cases was evaluated. The disease behavior was compared to that of sporadic cases.
Results
Total 3,553 patients (ulcerative colitis [UC], 2,053; Crohn’s disease [CD], 1,500) were included. Familial IBD was noted in 4.13% of CD and 4.34% of UC patients. Family history was commoner in pediatric group (< 18 years) (P= 0.0002; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.6–4.8). Majority had paternal transmission (UC, 67.42%; CD, 70.97%). Concordance of disease type was higher in UC (79.7%) compared to CD (37.1%). Familial IBD was associated with higher cumulative relapse rate (CD, P< 0.001; UC, P< 0.001), higher cumulative rate of surgery (CD, P< 0.001; UC, P< 0.001) and higher rate of biologic use (CD, P= 0.010; UC, P= 0.015). Pan-colitis was higher in familial UC (P= 0.003; OR, 1.935; 95% CI, 1.248–3.000). Fistulizing disease was commoner in familial CD (P= 0.041; OR, 2.044; 95% CI, 1.030–4.056).
Conclusions
The prevalence of familial IBD in India appears comparable to rest of Asia but lower than the West. It is associated with a younger age of onset, higher incidence of pan-colitis in UC and fistulizing complications in CD. Familial IBD has higher cumulative relapse, surgery and biologic use rates. Hence, family history of IBD could have important prognostic implications.

Citations

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