The CROCO (CROhn's Disease COhort Study) - study design and protocol.

Background: Crohn's disease (CD) is a chronic, relapsing and remitting inflammatory bowel disease that can be associated with significant bowel damage and disability. The Lémann Index (LI) is a validated tool for measuring cumulative bowel damage in CD patients through a comprehensive assessment of stricturing, penetrating and surgical lesions. However, prospective studies evaluating bowel damage progression in recently diagnosed CD patients remain limited.

Systematic Review With Meta-Analysis: Safety and Effectiveness of Combining Biologics and Small Molecules in Inflammatory Bowel Diseases.

Background: The systematic review and meta-analysis (SRMA) evaluates the safety and effectiveness of combining biologics and/or small molecules in treating refractory inflammatory bowel diseases (IBD).

Methods: Our 2022 SRMA identified 13 studies published until November 3, 2020. An updated systematic search was completed from May 2020 through January 31, 2024.

Environmental and Inflammatory Factors Drive Perinuclear-Antineutrophil Cytoplasmic Antibodies (pANCA) in Ulcerative Colitis: A European Twin Study.

Background: Perinuclear-antineutrophil cytoplasmic antibodies (pANCA) have been identified in familial ulcerative colitis (UC), but the mechanism underlying their expression remains elusive. We assessed the role of genetic predisposition, environmental factors and systemic subclinical inflammation in the development of pANCA in a twin cohort with UC.

Methods: A total of 48 twin pairs (Leuven, Belgium n = 4, Maastricht, The Netherlands n = 6 and Örebro, Sweden n = 38) with UC were included.

Identifying Potential Targets for the Interception of Inflammatory Bowel Disease: Toward Precision Prevention.

There is growing recognition that inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is preceded by a prolonged preclinical phase marked by subtle but measurable changes in the immune system, gut microbiome, and epithelial barrier function. These early alterations, often detectable years before diagnosis, offer a window of opportunity for disease interception. In this review, we examine the current evidence for environmental, microbial, and molecular factors that may contribute to the initiation of IBD, with a particular focus on modifiable risk pathways.

Patient and First-Degree Relatives Perceptions About Prediction and Prevention of Inflammatory Bowel Disease-A Multinational Survey.

Background And Objective: While significant advances have been made in identifying biomarkers for predicting inflammatory bowel disease (IBD) onset, little is known about the willingness of at-risk individuals to undergo predictive testing and preventive interventions. This study aimed to assess acceptance of predictive tests and preventive interventions among individuals at risk of inflammatory bowel disease and identify factors influencing their decisions.

Methods: An anonymized electronic survey was distributed to parents of children at risk of inflammatory bowel disease and first-degree relatives (FDRs) of IBD patients via clinicians and patient associations.

Maternal IBD-related antibodies are associated with early life gut inflammatory status and microbiota composition: insights from cord blood.

Purpose: Antibodies in peripheral blood are used to aid in the diagnosis of inflammatory bowel disease (IBD), but their presence in neonatal cord blood and potential effects on early life development remain unknown.

Methods: We measured anti-CBir1, ANCA, anti-OmpC, ASCA IgA, and ASCA IgG levels in the cord blood of babies born to 78 mothers with or without IBD. Their association with fecal calprotectin (FC), and microbiota composition, characterized by 16S rRNA sequencing, was assessed throughout pregnancy and during the first 3 years of life using linear mixed-effects models.

The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn's Disease.

Background & Aims: A primary aim in managing Crohn's disease (CD) is preventing bowel damage. The Lémann index (LI) quantifies structural bowel damage using magnetic resonance enterography (MRE) or computed tomography enterography (CTE) and, for colonic CD, colonoscopy. Intestinal ultrasonography (IUS) provides a noninvasive imaging alternative, although its role in LI assessment remains unexplored.

Impact of diet on inflammatory bowel disease risk: systematic review, meta-analyses and implications for prevention.

Background: Data on dietary risk factors for inflammatory bowel disease (IBD), while extensive, are inconsistent. Our aim was to systematically review and meta-analyze available data unraveling the relationship between diet and IBD subtypes, Crohn's disease (CD) and ulcerative colitis (UC).

Methods: We conducted a systematic literature review following PRISMA guidelines, from inception to May 8 2025, using OVID Medline, Embase, and Scopus databases, to identify prospective cohorts of healthy participants, on the association between diet and the risk of CD or UC.

Scoring indices for assessing endoscopic disease activity in acute severe ulcerative colitis: A systematic review.

Background And Aims: Endoscopy is important for assessing disease severity and potentially predicting treatment response in acute severe ulcerative colitis (ASUC). We aimed to identify and determine the operating properties of existing endoscopic indices/items used to assess disease activity in ASUC.

Methods: MEDLINE, Embase, and Cochrane CENTRAL were searched from database inception to 17 April 2024 to identify individual items and scoring indices used to evaluate endoscopic disease activity in patients with ASUC.

Mirikizumab impact on disease clearance in patients with moderately to severely active ulcerative colitis: analysis of a pre-specified LUCENT trial endpoint.

Background And Aims: Concurrent achievement of symptomatic, endoscopic, and histologic remission, known as disease clearance, has been proposed as a treatment target in ulcerative colitis. Mirikizumab, an anti-interleukin-23 p19 antibody, has demonstrated long-term efficacy and safety, as reported in the LUCENT Phase 3 trials (NCT03518086, NCT03524092, and NCT03519945). The current analysis evaluates the impact of mirikizumab on disease clearance and the association with other clinical and patient-reported outcomes (PROs).

Evaluation and Management of Glucocorticoid-Induced Adrenal Insufficiency in IBD: An Expert Opinion.

Background And Aims: Glucocorticoid-induced adrenal insufficiency (GC-AI) is a potentially life-threatening side effect of glucocorticoid therapy. Currently, there is no consensus on monitoring and treating GC-AI in inflammatory bowel disease (IBD) patients. This systematic review and meta-analysis aimed to determine the prevalence of GC-AI in IBD patients following glucocorticoid use.

A randomized controlled trial of antibiotics targeting adherent and invasive Escherichia coli versus placebo in Crohn's disease: the TEOREM trial.

Background: A subset of patients with ileal Crohn's disease (CD) are colonized with adherent-invasive Escherichia coli (AIEC).

Objective: This prospective trial tested the efficacy of antibiotics for endoscopic response in CD patients colonized with AIEC.

Design: Patients with endoscopically active, ileal CD, colonized with AIEC, were randomized to receive oral ciprofloxacin and rifaximin or double placebo for 12 weeks.

Adherent-invasive in Crohn's disease: the 25th anniversary.

In 1998, Arlette Darfeuille-Michaud, Christel Neut and Jean-Frederic Colombel discovered a novel pathovar of , adherent and invasive (AIEC), in the ileum of patients with Crohn's disease (CD), that was genetically distinct from diarrheagenic , could adhere to and invade intestinal epithelial cells and survive in macrophages. The consistent association between AIEC and CD (approximately 30% across the world), their ability to exploit CD-associated genetic traits, and virulence in preclinical colitis models but not healthy hosts spurred global research to elucidate their pathogenicity. Research focused on integrating AIEC with the microbiome, metabolome, metagenome, host response and the impact of diet and antimicrobials has linked the luminal microenvironment and AIEC metabolism to health and disease.

An International Consensus on Appropriate Management of Corticosteroids in Clinical Trials in Inflammatory Bowel Disease.

Background & Aims: Approval of new therapies for inflammatory bowel disease (IBD) requires rigorously designed and well-executed randomized controlled trials (RCTs). Corticosteroids remain a cornerstone of IBD induction therapy, and many patients in trials are enrolled while taking corticosteroids. Despite this, approaches to corticosteroid management in RCTs have been highly heterogeneous, often differing from clinical practice.

Distinct perturbances in metabolic pathways associate with disease progression in inflammatory bowel disease.

Background And Aims: Patients with inflammatory bowel disease (IBD) exhibit distinct shifts in circulating metabolite levels linked to disease activity and phenotype, but associations with disease progression remain unexplored. Our aim was to investigate relationships between circulating metabolites and metabolic pathways with disease progression risk in patients with IBD.

Methods: We performed an observational cohort study using the Mount Sinai Crohn's and Colitis Registry.

Long-term efficacy and safety of upadacitinib in patients with moderately to severely active ulcerative colitis: an interim analysis of the phase 3 U-ACTIVATE long-term extension study.

Background: The U-ACTIVATE long-term extension study aims to evaluate the long-term efficacy and safety of upadacitinib in patients with moderately to severely active ulcerative colitis. Here, we report interim results after 3 years of total treatment.

Methods: U-ACTIVATE is an ongoing, 288-week, phase 3, long-term extension study done at 307 centres across 43 countries (active sites on Dec 31, 2021, are presented as part of this interim analysis) and began on Jan 31, 2017.

Comparing Outcomes With Subcutaneous Infliximab (CT-P13 SC) by Baseline Immunosuppressant Use: A Post Hoc Analysis of the LIBERTY-CD and LIBERTY-UC Studies.

Background: Superior efficacy of subcutaneous infliximab (CT-P13 SC) over placebo for maintenance therapy in patients with Crohn's disease (CD) and ulcerative colitis (UC) was demonstrated in the randomized LIBERTY-CD and LIBERTY-UC studies. The current post hoc analysis compared outcomes with CT-P13 SC by baseline immunosuppressant use.

Methods: Patients with moderately to severely active CD or UC randomized to the CT-P13 SC maintenance arm of the 54-week LIBERTY trials at week 10 and who were treated in the open-label extension (weeks 56-102) were included.

Subcutaneous infliximab (CT-P13 SC) as maintenance therapy for Crohn's disease and ulcerative colitis: 2-year results from open-label extensions of two randomized controlled trials (LIBERTY).

Background And Aims: In the LIBERTY phase 3 studies in Crohn's disease (CD) or ulcerative colitis (UC), maintenance CT-P13 subcutaneous (SC) 120 mg was more effective than placebo after 1 year. Here we report 2-year data from the LIBERTY open-label extensions.

Methods: Two randomized, placebo-controlled, double-blind studies evaluated the efficacy and safety of CT-P13 SC maintenance in moderate-to-severe CD or UC.

Biologic Switch Timing and Risk of Infection in Patients With Ulcerative Colitis/Crohn's Disease: A Retrospective Study.

Background & Aims: There is limited evidence on real-world patterns and safety of biologic switch timing in patients with ulcerative colitis (UC)/Crohn's disease (CD). This study investigated biologic therapy switch occurrence in real-world practice and compared the risk of any infection and serious infection between patients with overlapping (OS) vs non-overlapping switches (NOS).

Methods: This retrospective observational study identified patients with UC/CD initiating biologic therapy between September 1, 2017, and August 31, 2022, in Optum's de-identified Clinformatics Data Mart Database.