International Magnetic Resonance Imaging Consensus for use in Luminal Crohn's Disease Trials and Clinical Practice.

Background And Aims: Cross sectional imaging is an integral part of evaluating disease activity and complications in Crohn's disease. There remains a need to develop guidance that may be for both clinical trials and clinical practice. This initiative aimed to develop consensus statements for definitions of response and remission, transmural healing, optimal timing for assessing, and evaluation of treatment efficacy in patients with Crohn's disease using magnetic resonance enterography (MRE) in clinical trials and clinical practice.

Is Transmural Healing an Achievable Goal in Inflammatory Bowel Disease?

: In the era of treat-to-target strategies in inflammatory bowel disease (IBD), transmural healing (TH) is gaining recognition as a promising therapeutic goal. TH has been associated with significantly better long-term outcomes, including reduced rates of hospitalization, surgery, and the need for therapy escalation. Cross-sectional imaging techniques, such as intestinal ultrasound (IUS), magnetic resonance imaging (MRI), and computed tomography enterography (CTE), offer a comprehensive, non-invasive means to assess this deeper level of healing.

Impact of Type 2 Diabetes on Clinical Outcomes and Advanced Therapy Use in Patients with Crohn's Disease: a Real-World Propensity Score-Matched Analysis.

Background: Type 2 diabetes mellitus (T2DM) may adversely affect the course and treatment outcomes of Crohn's disease (CD). However, data remain inconsistent.

Aims: To evaluate the impact of T2DM on clinical outcomes and advanced therapy use in patients with CD using real-world electronic health record data.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in Endoscopy, Radiology and Histology in IBD Diagnostics.

In this review, a comprehensive overview of the current state of artificial intelligence (AI) research in Inflammatory Bowel Disease (IBD) diagnostics in the domains of endoscopy, radiology and histology is presented. Moreover, key considerations for development of AI algorithms in medical image analysis are discussed. AI presents a potential breakthrough in real-time, objective and rapid endoscopic assessment, with implications for predicting disease progression.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in medical management and precision medicine.

Background And Aims: Artificial intelligence (AI) is increasingly being applied in various fields of medicine, including Inflammatory Bowel Diseases (IBD). This systematic review, conducted as part of the ECCO 9th Scientific Workshop on AI in IBD, explores AI applications in multiomic precision medicine, large language models (LLMs) for textual tasks and utilisation of wearable and remote care technologies.

Methods: A comprehensive systematic analysis of the literature was undertaken, emphasising three topics: multiomic predictive models in IBD; natural language processing (NLP) and LLMs for clinical practice, research and patient communication; and the role of remote monitoring and wearable devices.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in IBD: Regulatory and Methodological Considerations.

With the rapid growth of artificial intelligence (AI) applications in the field of inflammatory bowel disease (IBD), an increasing number of regulatory and methodological considerations have become apparent. Currently, there remains much uncertainty and limited experience in the field of IBD regarding some of the regulatory and methodological pitfalls to be considered when developing and deploying AI applications for positive clinical and health system impact. Accordingly, an expert panel was convened by the European Crohn's and Colitis Organisation (ECCO) to review the published literature and provide an overview of key regulatory aspects for the application of AI in IBD.

Results of the Ninth Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial intelligence in IBD surgery: opportunities and limitations.

In this narrative review we present the current status of developments in artificial intelligence in the filed of IBD surgery. We lay down the foundations for how IBD surgery may utilise the potential opportunities in utilizing the rapid advances in AI technology as it used in other surgical disciplines. The main areas of potential utility are in the areas of surgical training, risk prediction in the pre, intra and post operative period in IBD patients undergoing surgery and in IBD surgical research.

Biobetters and biosimilars in inflammatory bowel disease.

Biological therapies have revolutionized the management of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Among these, biosimilars and biobetters represent a growing area of therapeutic development. Biosimilars are nearly identical copies of original biologic drugs (reference products) with comparable safety, efficacy, and quality, but they offer the advantage of reduced costs and broader access.

The role of diet in inflammatory bowel disease: A comprehensive review of the literature.

Diet is increasingly recognized as a modifiable factor in the pathogenesis and management of inflammatory bowel disease (IBD), particularly in mild to moderate cases. While most evidence comes from pediatric studies, adult data, especially randomized controlled trials (RCTs), remain limited. Current guidelines recommend a Mediterranean diet for patients with IBD, avoiding fruits and vegetables during disease flares.

ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1.

The current consensus guideline offers a comprehensive and practical guidance on the diagnostic and monitoring of patients with inflammatory bowel disease (IBD). It provides recommendations on requirements for initial diagnosis, detection of complications, the use of monitoring tools in patients with IBD and diagnostics in specific situations, such as pregnancy, postoperatively and for cancer surveillance. The guideline is a joint project of the European Crohn's and Colitis Organization (ECCO), the European Society of Gastrointestinal and Abdominal Radiology, the European Society of Pathology, and the International Bowel Ultrasonography Group under the leadership of ECCO.

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.

The Role of Vitamin D in Inflammatory Bowel Diseases: From Deficiency to Targeted Therapeutics and Precise Nutrition Strategies.

Background: Vitamin D plays a crucial role in immune modulation, gut barrier integrity, and inflammation regulation, making it highly relevant in inflammatory bowel disease (IBD). IBD patients often exhibit vitamin D deficiency, which has been linked to increased disease activity, impaired mucosal healing, and a higher risk of complications, including infections and osteoporosis.

Methods: This review examines the biological functions of vitamin D in maintaining intestinal homeostasis, particularly in the context of IBD.

JAK Inhibitors and Risk of Cancer in IBD Patients.

Janus kinase inhibitors, including tofacitinib, filgotinib, and upadacitinib, have emerged as effective therapeutic options for the management of inflammatory bowel diseases (IBDs). By targeting the JAK-STAT signaling pathway, these agents modulate immune responses and reduce inflammation. However, concerns regarding the potential risk of malignancy associated with their use have gained significant attention.

Role of Noninvasive Imaging in the Diagnosis and Management of Patients With Suspected and Established Inflammatory Bowel Disease.

In a treat-to-target era, objective disease assessment in inflammatory bowel disease has become increasingly important. For many years, endoscopy has been generally accepted as the gold standard for evaluating the bowel mucosa, additionally facilitating biopsy. However, noninvasive disease assessment is now increasingly demanded, and cross-sectional imaging techniques, as well as video capsule endoscopy, have markedly improved.

Advanced Therapies for Inflammatory Bowel Disease and Risk of Skin Cancer: What's New?

The introduction of biologic therapies and small molecule drugs has revolutionized the management of inflammatory bowel disease (IBD), providing targeted control of inflammation. However, concerns remain regarding their long-term safety profiles, particularly in relation to cancer risk. Chronic inflammation and immunosuppressive therapies contribute to malignancy risk, including skin cancers, such as melanoma and non-melanoma skin cancer (NMSC).

Vedolizumab in inflammatory bowel disease: Real-world outcomes and their prediction with machine learning-the IG-IBD LIVE study.

Background And Aims: Real-world studies on vedolizumab in inflammatory bowel disease (IBD) are often limited by small sample size and short follow-up. In this study, we investigated the 2-year effectiveness and safety of vedolizumab in patients with IBD, and applied eXplainable Artificial Intelligence (XAI) to identify predictors of both.

Methods: The Long-term Italian Vedolizumab Effectiveness (LIVE) study is multicentric, ambispective, observational study enrolling 1111 IBD patients (563 Crohn's disease, CD, 542 ulcerative colitis, UC).

ECCO Topical Review on Predictive Models on Inflammatory Bowel Disease Disease Course and Treatment Response.

Background And Aims: Inflammatory bowel disease (IBD) poses a clinical challenge due to its variable progression and treatment response. Despite the development of predictive models, their clinical application remains limited due to validation and methodological inconsistencies. The current topical review examines existing predictive models, assesses their relevance, and discusses the barriers to their clinical implementation.

Management of Patients with IBD and History of Cancer.

The use of advanced therapies, including biologics and small molecules, has become an established clinical practice for the treatment of moderate-to-severe ulcerative colitis (UC) and Crohn's disease (CD). However, certain patient populations, such as those with a history of cancer, are often excluded from clinical trials evaluating the efficacy and safety of these therapies. This exclusion has historically left clinicians with limited evidence to guide treatment decisions in this high-risk group.

Dual Therapy in Inflammatory Bowel Disease.

Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic and complex autoimmune conditions. Despite the advancements in biologics and small molecules, the therapeutic ceiling persists, posing significant treatment challenges and contributing to the concept of difficult-to-treat IBD. Dual-targeted therapy (DTT), combining two biologic agents or biologics with small molecules, has emerged as a novel approach to address this unmet need by targeting multiple inflammatory pathways simultaneously.

Unlocking hope: The future of ustekinumab biosimilars in Crohn's disease treatment.

Biologic therapies have revolutionized Crohn's disease (CD) management, but their high costs pose a significant barrier to access. Biosimilars can provide increased access to treatment because of significant cost-savings. Ustekinumab is a biological drug against interleukin 12-23 that is employed in treating moderate-to-severe CD.

Assessment of activity and severity of inflammatory bowel disease in cross-sectional imaging techniques: a systematic review.

Background And Aims: Cross-sectional imaging techniques, including intestinal ultrasonography (IUS), computed tomography enterography (CTE), magnetic resonance enterography (MRE), are increasingly used for the evaluation of inflammatory bowel diseases (IBD). We aimed to systematically review literature evidence on the assessment of disease activity, and/or severity through cross-sectional imaging in IBD patients, and to offer guidance on their most effective utilization.

Methods: We performed a systematic review of PubMed, EMBASE, and Scopus to identify citations pertaining to the assessment of disease activity and/or severity at cross-sectional imaging techniques compared to a reference standard (ie, other radiological techniques, endoscopy, histopathology, and surgery) in IBD patients published until December 2023.

Advancing Therapeutic Targets in IBD: Emerging Goals and Precision Medicine Approaches.

Inflammatory bowel diseases (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) are chronic, relapsing conditions characterized by dysregulated immune responses and persistent intestinal inflammation. This review aims to examine new potential therapeutic targets in IBD starting from the STRIDE-II statements. Key targets now include clinical remission, endoscopic remission, and biomarker normalization (such as C-reactive protein and fecal calprotectin).