Sa1522 HIGH PREVALENCE OF BOWEL URGENCY ACROSS IBD PATIENTS WITH AND WITHOUT REMISSION: RESULTS FROM A LARGE, PROSPECTIVE MULTICENTER COHORT

Gastrointestinal Endoscopy · 2026-05-01

Sa1522 HIGH PREVALENCE OF BOWEL URGENCY ACROSS IBD PATIENTS WITH AND WITHOUT REMISSION: RESULTS FROM A LARGE, PROSPECTIVE MULTICENTER COHORT

Gastroenterology · 2026-05-01

253 INCREASING LEVELS OF TOOLKIT IMPLEMENTATION IN A NATIONWIDE QUALITY IMPROVEMENT INITIATIVE ARE ASSOCIATED WITH DECREASING LEVELS OF URGENT CARE UTILIZATION: RESULTS FROM THE IBD QORUS URGENT CARE BREAKTHROUGH SERIES

Gastrointestinal Endoscopy · 2026-05-01

253 INCREASING LEVELS OF TOOLKIT IMPLEMENTATION IN A NATIONWIDE QUALITY IMPROVEMENT INITIATIVE ARE ASSOCIATED WITH DECREASING LEVELS OF URGENT CARE UTILIZATION: RESULTS FROM THE IBD QORUS URGENT CARE BREAKTHROUGH SERIES

Gastroenterology · 2026-05-01

Treat-to-Target Monitoring Adherence and Rates of Healthcare Utilization in Patients With Inflammatory Bowel Disease in a Regional Healthcare System

Clinical and Translational Gastroenterology · 2025-10-30

INTRODUCTION: The aim of treat-to-target (T2T) algorithms in inflammatory bowel disease was to maximize the benefit of medical therapies by establishing a framework for disease activity assessment to guide therapeutic decisions. There are limited data on adoption rates of T2T monitoring in real-world practice. We aimed to describe rates of T2T monitoring, predictors of completion, and associations with clinical outcomes. METHODS: A retrospective cohort study was conducted from 2015 to 2021 of individuals with inflammatory bowel disease starting new biologic or small molecule therapy within a multistate healthcare system. The completion of biochemical monitoring including fecal calprotectin or C-reactive protein and structural monitoring including endoscopy or enterography, or both, was assessed between 3 and 6 months and 6 and 12 months, respectively. Healthcare utilization (HCU), defined as emergency department visits, hospitalizations, prednisone prescriptions, or abdominal surgery within 2 years, was also assessed. RESULTS: A total of 823 patients were included in the cohort, and 127 (15.4%) completed some form of T2T monitoring. Twenty-two patients (2.7%) completed both biochemical and structural monitoring. The completion of T2T was not associated with lower HCU. The completion of only biochemical T2T, but not structural or both biochemical and structural T2T, was associated with decreased 12-month medication persistence (hazard ratio 0.36, 95% confidence interval 0.17-0.75). The completion of just structural T2T (hazard ratio 1.59, 95% confidence interval 1.05-2.39) was associated with higher HCU. DISCUSSION: In this retrospective cohort of individuals initiating new therapy, the rates of T2T monitoring were low. The completion of all T2T was not associated with lower HCU. The completion of only biochemical T2T monitoring was associated with lower 12-month medication persistence and only structural T2T with higher HCU.

S1997 Presence of Spondyloarthritis Symptoms in IBD Is Associated With Higher Medication Use and Worse-Long Term Outcomes

The American Journal of Gastroenterology · 2025-10-01

Introduction: Musculoskeletal symptoms are the most common extra-intestinal manifestation of inflammatory bowel disease (IBD), with spondyloarthritis (SpA) reported in up to 50% of patients with IBD. In a recent study, we reported that 35% of IBD patients without known rheumatologic disease screened positive for SpA symptoms. In this follow-up study, we assessed the impact of a positive SpA screen on clinical outcomes at 1-year. Methods: We previously administered 2 validated screening questionnaires for the detection of SpA in IBD (DETAIL = DETection of Arthritis in Inflammatory boweL diseases, IBIS-Q = IBD Identification of Spondyloarthritis Questionnaire) to IBD patients without a prior diagnosis of SpA. IBD providers were blinded to the questionnaire results. In this follow-up study, long-term outcomes up to 1 year after SpA screening were assessed by chart review. For all patients with available follow-up, we assessed subsequent rheumatologic evaluation, new medication initiation, and IBD or SpA-related clinical outcomes. Results: This observational cohort included 317 patients (120 ulcerative colitis, 189 Crohn’s disease, 8 IBD-unclassified) with a median age of 38 years (IQR 29–51) and a 29% screen positive rate. When assessing clinical outcomes at 1-year, positive SpA screens were associated with numerically higher rates of a composite outcome of IBD- or SpA-related ED visit, hospitalization or IBD-related surgery (15% vs 8%; P = 0.06). Screen-positive patients also had a significantly higher rate of NSAID use (8% vs 2%; P = 0.02) and numerically higher rates of new biologic, systemic corticosteroid, and opioid use. A positive SpA screen was associated with a higher use of any of these medications as a composite outcome (37% vs 23%; P = 0.02). On multivariate analysis, a positive SpA screen (OR 1.8 [95% CI 1.01-3.1]), and higher number of prior advanced IBD therapy exposures (OR 1.5 [95% CI 1.2-1.9]) were significantly associated with medication use. Among patients with any positive SpA screen, a higher proportion were ultimately seen by a rheumatologist (9% vs 2%; P < 0.01). Conclusion: In patients with IBD, symptoms suggestive of SpA are associated with an increased risk of worse long-term IBD outcomes and a higher use of a combination of biologics, corticosteroids, opioids, and NSAIDs. Rheumatology referral rates remain low however, so strategies are needed to promote early identification and optimize treatment of SpA in patients with IBD.

Prevalence and Risk Factors of Spondyloarthritis Symptoms in a US-Based Multicenter Cohort of Patients With Inflammatory Bowel Disease

The American Journal of Gastroenterology · 2025-01-06 · 4 citations

INTRODUCTION: Spondyloarthritis (SpA), the most common extraintestinal manifestation of inflammatory bowel disease (IBD), is reported in up to 39% of patients with IBD. Despite this high prevalence, risk factors of developing SpA in patients with IBD are not well described. In this study, we aimed to determine the factors associated with SpA symptoms and their prevalence in an IBD cohort. METHODS: Two validated screening questionnaires for the detection of SpA in IBD (DETAIL = DETection of Arthritis in Inflammatory boweL diseases, IBIS-Q = IBD Identification of Spondyloarthritis Questionnaire) were administered to patients with IBD without a prior diagnosis of SpA in 6 US academic medical centers. Demographic data, IBD characteristics, and medication history were recorded. RESULTS: Screening questionnaires were completed by 588 patients (220 ulcerative colitis, 349 Crohn's disease, and 19 IBD-unclassified), with a median age of 40 years (interquartile range 30-53) and median disease duration of 12 years (interquartile range 6-22). The number of positive screens was 130 (22%) for DETAIL, 196 (33%) for IBIS-Q, and 204 (35%) for either DETAIL or IBIS-Q. Age, female sex, history of smoking, prior bowel surgery, and history of any biologic or targeted small molecule exposure were associated with a positive screen on univariate analysis. After multivariate analysis, female sex (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.41-2.93), older age (OR 1.02, 95% CI 1.01-1.04), history of smoking (OR 1.67, 95% CI 1.04-2.69), and history of any biologic or targeted small molecule exposure (OR 2.27, 95% CI 1.34-3.84) were independently associated with positive screens. Higher number of biologic exposures was associated with higher risk of positive screens, with the highest risk seen with 3 or more exposures (OR 3.25, 95% CI 1.75-6.03). DISCUSSION: A substantial number of patients with IBD screen positive for SpA symptoms, indicating a potentially high burden of undiagnosed illness. Factors associated with SpA symptoms include older age, female sex, and more severe disease (based on increased number of advanced therapies or prior surgery), whereas IBD phenotype does not independently increase the risk of a positive SpA screen. Further studies are needed to confirm these findings and better characterize SpA in IBD.

Su1953: COST-EFFECTIVENESS OF A BIOMARKER MONITORING STRATEGY COMPARED TO ENDOSCOPIC MONITORING IN BIOLOGIC-EXPERIENCED POSTOPERATIVE CROHN’S DISEASE

Gastroenterology · 2025-05-01

Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Crohn’s Disease: 2025 AGA Evidence Synthesis

Gastroenterology · 2025-10-20 · 7 citations

Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Ulcerative Colitis: 2024 American Gastroenterological Association Evidence Synthesis

UNC Libraries · 2025-10-19