Impact of Individual Colonic Segment Histological Activity on Disease Relapse in Patients with Ulcerative Colitis.

: The aim of this study was to assess the role of histological activity in individual segments of the colon in predicting disease relapse in patients with ulcerative colitis. : This was a prospective observational study on patients with ulcerative colitis in clinical remission. Biopsies were taken of multiple segments of the colon, and histological activity was assessed using the Geboes (GB) score.

Network Meta-Analysis: Comparative Efficacy of Biologics and Small Molecules in the Induction and Maintenance of Remission in Crohn's Disease.

Background: Advances in medical management of Crohn's disease (CD) have transformed therapeutic goals. Clinical and endoscopic remission are important endpoints.

Aim: To compare the efficacy of different advanced therapies in patients with CD.

Upadacitinib for the Treatment of Upper Gastrointestinal Crohn's Disease.

Data on the use of antitumor necrosis factor therapy have shown some positive outcomes in case reports or small observational studies such as the data showing the benefit of adalimumab in this rare presentation of Crohn's disease. To our knowledge, there is no published data on the use of upadacitinib in the treatment of upper gastrointestinal Crohn's disease. We present a case report of a young patient with severe oral and esophageal Crohn's disease that was successfully treated with upadacitinib.

Assessing the role of ustekinumab dose escalation in Crohn's disease patients with loss of response: an observational study.

Background/aims: Among Crohn's disease patients with loss of response or non-response to ustekinumab (UST), there remains no clear strategy for dose escalation. Moreover, clinical associations and the role of therapeutic drug monitoring (TDM) are poorly understood. This study assessed response to escalation of UST therapy via increased dosing frequency or re-induction, as well as assessed associations of response.

Effectiveness and Safety of Advanced Combination Treatment in Patients With Refractory Inflammatory Bowel Disease or Concomitant Immune-Mediated Disease or Extraintestinal Manifestations: A Multicenter Canadian Study.

Introduction: Owing to the therapeutic ceiling associated with inflammatory bowel disease (IBD) therapies, some patients may require 2 advanced therapeutic agents, known as advanced combination treatment (ACT) to control disease or treat associated extraintestinal manifestations (EIMs).

Methods: We included adult patients with IBD from 9 Canadian centers treated with either 2 biological therapies, a biological plus an oral small molecule, or 2 small molecules. Indications for ACT were the following: (i) refractory IBD, (ii) uncontrolled immune mediated diseases, and (iii) uncontrolled EIMs.

Gastrointestinal Tract Perineuriomas and Benign Fibroblastic Polyps: Case Report and Comprehensive Systematic Review.

Perineurioma is a rare benign peripheral nerve sheath tumor that can arise in various body locations. In the gastrointestinal (GI) tract, perineuriomas are uncommon and have only been reported in case reports and case series. In addition, a new classification suggests reclassifying benign fibroblastic polyps as perineurioma when they show positive markers of perineurial differentiation.

The Role of Histology Alongside Clinical and Endoscopic Evaluation in the Management of IBD-A Narrative Review.

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions requiring continuous monitoring. Today, endoscopy is the gold standard for assessing disease activity, with histological evaluation providing additional insights. Studies suggest that persistent histological inflammation, despite endoscopic remission, may be associated with a higher risk of relapse in UC, suggesting its role in treatment decisions.

Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial.

Introduction: Targeted immunomodulators (eg, advanced therapies) effectively achieve symptomatic remission in patients with inflammatory bowel disease (IBD). However, ~25%-50% of patients with IBD achieving symptomatic remission with an advanced therapy may have continued endoscopically/radiologically active bowel inflammation, and it is uncertain whether changing alternative advanced therapies in asymptomatic patients with IBD will reduce bowel inflammation and achieve durable deep remission.

Methods And Analysis: The QUality Outcomes Treating IBD to Target (QUOTIENT) study is an open-label, multicentre, pragmatic, randomised, controlled trial that aims to compare the efficacy and safety of switching to an alternative advanced therapy targeting endoscopic/radiological remission (treat-to-target) versus continuing the initial, or index, advanced therapy, in asymptomatic patients with IBD with moderate-to-severe endoscopic/radiological bowel inflammation.

The Impact of Setons on Perianal Fistula Outcomes in Patients With Crohn's Disease Treated With Anti-TNF Therapy: A Multicentre Study.

Background And Aims: We aimed to assess the impact of setons on perianal fistula outcomes in patients with perianal fistulising Crohn's disease (PFCD) treated with anti-TNF therapy.

Methods: We included patients treated with their first anti-TNF therapy for PFCD after undergoing a pelvic MRI between 2005 and 2022 from 6 North American centres. Our exposure was one or more setons at the time of anti-TNF therapy.

Tofacitinib for Hospitalized Acute Severe Ulcerative Colitis Management (The TRIUMPH Study).

Background: Tofacitinib is a rapidly acting Janus kinase (JAK) inhibitor with increasing evidence of effectiveness in patients with acute severe ulcerative colitis (ASUC). However, there are scarce prospective data analyzing the efficacy and rapidity of action in hospitalized ASUC.

Methods: The TRIUMPH study is a prospective open-label interventional trial of tofacitinib in hospitalized patients with ASUC conducted in 5 hospitals across Canada (Clinicaltrials.

Management of Refractory Esophageal Variceal Bleeding when TIPSS Is Not Possible: Review of a Challenging Case.

Introduction: Esophageal variceal bleeding (EVB) is a common complication of portal hypertension. Guidelines recommend initiation of vasoactive agents in combination with antimicrobial therapy prior to endoscopic variceal ligation. In cases of refractory EVB, trans-jugular intrahepatic portosystemic shunt (TIPSS) is recommended; however, it is contraindicated in up to 35% of cases.

Nanoencapsulation enhanced the performance of β-carotene for ameliorating inflammation in patient-derived organoids.

Aim: This study aims to develop a nanocarrier system for the oral delivery of β-Carotene (BC) (as a model therapeutic agent) and to test its efficacy in ameliorating inflammation in an ulcerative colitis (UC) patient-derived organoid.

Materials & Methods: BC was encapsulated in a zein protein nano-cage surface-functionalized with pectin and polyethyleneglycol (PEG). The nanoencapsulated BC (nBC) was characterized for physicochemical properties (size, charge, surface chemistry) and functional properties (radical scavenging, mucoadhesion and penetration, release in simulated digestive fluids).

The Importance of Post-Inflammatory Polyps (PIPs) in Colorectal Cancer Surveillance in Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBDs), encompassing Ulcerative Colitis (UC) and Crohn's Disease (CD), are chronic inflammatory disorders affecting the gastrointestinal tract. The association between IBD and colorectal cancer (CRC) is well-documented. Multiple factors have been identified as contributors to the risk of developing CRC in patients with IBD, including duration of disease, disease extension, family history of CRC, co-existance of primary sclerosing cholangitis (PSC), and potentially the presence of post-inflammatory polyps (PIPs).

Network Meta-Analysis: Comparison of Endoscopic Dysplasia Detection Technologies in Inflammatory Bowel Disease.

Background: Novel colorectal cancer endoscopic surveillance techniques for inflammatory bowel disease (IBD) have recently been developed.

Aims: Compare the efficacy of currently available techniques for dysplasia detection in colonic IBD.

Methods: We conducted a systematic literature search from inception to March 2024 for randomized controlled trials (RCTs) or prospective cohort studies enrolling adults with IBD and having surveillance colonoscopy for dysplasia screening.

Real-World Effectiveness and Safety of Selective JAK Inhibitors in Ulcerative Colitis and Crohn's Disease: A Retrospective, Multicentre Study.

: Data on the real-world effectiveness and safety of selective JAK inhibitors (JAKis) in ulcerative colitis (UC) and Crohn's disease (CD) are limited. : We conducted a multicentre, retrospective study to assess clinical, biochemical, and endoscopic outcomes of selective JAKis in bio-experienced UC and CD. : A total of 246 patients (mean age: 40.

Effectiveness of Ustekinumab for Patients With Moderate-to-Severe Ulcerative Colitis: A Multicenter Real-World Canadian Study.

Introduction: We aimed to evaluate the real-world effectiveness and safety of ustekinumab for the treatment of both bio-naive and bio-exposed ulcerative colitis patients in a real-world setting.

Methods: Retrospective, Canadian multicenter cohort study. Primary outcomes were clinical remission and endoscopic remission.

Association Between Serum Ustekinumab Concentrations and Endoscopic Disease Activity in Moderate-to-Severe Crohn's Disease Patients.

Background/aims: The role of ustekinumab therapeutic drug monitoring in patients with Crohn's disease (CD) remains ambiguous. Examination of the association serum ustekinumab concentrations and endoscopic outcomes has yielded inconsistent results. Our study examined whether serum ustekinumab concentrations were associated with endoscopic healing in patients with moderate-to-severe CD.