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2. Test Characteristics of Cross-sectional Imaging and Concordance With Endoscopy in Postoperative Crohn’s Disease

Author

Bachour, Salam P., Shah, Ravi S., Lyu, Ruishen, Nakamura, Takahiro, Shen, Michael, Li, Terry, Dane, Bari, Barnes, Edward L., Rieder, Florian, Cohen, Benjamin, Qazi, Taha, Lashner, Bret, Achkar, Jean Paul, Philpott, Jessica, Holubar, Stefan D., Lightner, Amy L., Regueiro, Miguel, Axelrad, Jordan, Baker, Mark E., and Click, Benjamin

Published
2022
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8. Effectiveness and Safety of Fecal Microbiota Transplantation for Clostridioides Difficile Infection: Results From a 5344-Patient Cohort Study

Author

Osman, Majdi, primary, Budree, Shrish, additional, Kelly, Colleen R., additional, Panchal, Pratik, additional, Allegretti, Jessica R., additional, Kassam, Zain, additional, Olesen, Scott W., additional, Ramakrishna, Bharat, additional, Dubois, Nancy, additional, O’Brien, Kelsey, additional, Fischer, Monika, additional, Stollman, Neil, additional, Hays, R. Ann, additional, Kelly, Ciarán P., additional, Amaratunga, Kanchana, additional, Qazi, Taha, additional, Crothers, Jessica W., additional, Abend, Audrey, additional, Bougas, Michael, additional, Burns, Laura, additional, Decaille-Hodge, Imani, additional, Dickens, Michael, additional, Edelstein, Carolyn, additional, Gabdrakhmanova, Dinara, additional, Kerwin, Clara, additional, Landry, Richard, additional, Ling, Kelly, additional, Martin, Daniel, additional, Medina, Geraldine, additional, Mendolia, Gina, additional, Muñoz, Rodrigo, additional, Rao, Sanjay, additional, Seng, Monica, additional, Smith, Mark, additional, Stehler, Laura, additional, Yoder, Karl, additional, and Zellmer, Caroline, additional

Published
2022
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9. 719: POSTOPERATIVE CROHN'S DISEASE RECURRENCE RISK AND OPTIMAL BIOLOGIC TIMING AFTER TEMPORARY DIVERSION FOLLOWING ILEOCECAL RESECTION

Author

Joseph, Abel, primary, Bachour, Salam P., additional, Shah, Ravi S., additional, Halabi, Jessica El, additional, Cohen, Benjamin L., additional, Rieder, Florian, additional, Achkar, Jean-Paul, additional, Philpott, Jessica, additional, Qazi, Taha, additional, Lightner, Amy L., additional, Hull, Tracy L., additional, Lipman, Jeremy M., additional, Holubar, Stefan D., additional, Regueiro, Miguel D., additional, and Click, Benjamin, additional

Published
2022
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11. Sa1591: INTRAABDOMINAL SEPTIC COMPLICATIONS AFTER ILEOCOLIC RESECTION INCREASES ENDOSCOPIC POSTOPERATIVE CROHN'S DISEASE RECURRENCE

Author

Bachour, Salam P., primary, Shah, Ravi S., additional, Rieder, Florian, additional, Qazi, Taha, additional, Achkar, Jean-Paul, additional, Philpott, Jessica, additional, Holubar, Stefan D., additional, Lightner, Amy L., additional, Barnes, Edward L., additional, Axelrad, Jordan E., additional, Regueiro, Miguel D., additional, Click, Benjamin, additional, and Cohen, Benjamin L., additional

Published
2022
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12. Mo1555: PRE-OPERATIVE USE OF MULTIPLE BIOLOGIC AND SMALL MOLECULE DRUGS IS NOT ASSOCIATED WITH SUBSEQUENT ENDOSCOPIC INFLAMMATORY POUCH DISEASES

Author

Powers, Joseph C., primary, Cohen, Benjamin L., additional, Rieder, Florian, additional, Lyu, Ruishen, additional, Lashner, Bret, additional, Click, Benjamin, additional, Achkar, Jean-Paul, additional, Philpott, Jessica, additional, Holubar, Stefan D., additional, Agarwal, Mitali, additional, Regueiro, Miguel D., additional, and Qazi, Taha, additional

Published
2022
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13. 456: CHRONOLOGIC AGE IS NOT ASSOCIATED WITH RISK OF POSTOPERATIVE RECURRENCE IN CROHN'S DISEASE

Author

Halabi, Jessica El, primary, Bachour, Salam P., additional, Shah, Ravi S., additional, Joseph, Abel, additional, Cohen, Benjamin L., additional, Rieder, Florian, additional, Achkar, Jean-Paul, additional, Philpott, Jessica, additional, Qazi, Taha, additional, Lightner, Amy L., additional, Hull, Tracy L., additional, Lipman, Jeremy M., additional, Holubar, Stefan D., additional, Regueiro, Miguel D., additional, and Click, Benjamin, additional

Published
2022
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15. 401: ANASTOMOTIC CONFIGURATION AND DIVERTING OSTOMY DOES NOT INCREASE THE RISK OF POSTOPERATIVE ANASTOMOTIC STRICTURES IN CROHN'S DISEASE

Author

Khan, Muhammad Zarrar, primary, Bachour, Salam P., additional, Shah, Ravi S., additional, Cohen, Benjamin L., additional, Rieder, Florian, additional, Achkar, Jean-Paul, additional, Philpott, Jessica, additional, Qazi, Taha, additional, Lightner, Amy L., additional, Hull, Tracy L., additional, Lipman, Jeremy M., additional, Holubar, Stefan D., additional, Barnes, Edward L., additional, Axelrad, Jordan E., additional, Regueiro, Miguel D., additional, and Click, Benjamin, additional

Published
2022
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16. Mild neoterminal ileal post‐operative recurrence of Crohn’s disease conveys higher risk for severe endoscopic disease progression than isolated anastomotic lesions

Author

Bachour, Salam P., primary, Shah, Ravi S., additional, Lyu, Ruishen, additional, Rieder, Florian, additional, Qazi, Taha, additional, Lashner, Bret, additional, Achkar, Jean Paul, additional, Philpott, Jessica, additional, Barnes, Edward L., additional, Axelrad, Jordan, additional, Holubar, Stefan D., additional, Lightner, Amy L., additional, Regueiro, Miguel, additional, Cohen, Benjamin L., additional, and Click, Benjamin H., additional

Published
2022
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17. IBD MIMICS PRESENTED AT IBD LIVE: WHEN IT IS NOT INFLAMMATORY BOWEL DISEASE

Author

Ward, Christopher, primary, Shah, Samir, additional, Farraye, Francis, additional, Goyal, Alka, additional, Hanson, John, additional, Holubar, Stefan, additional, Watson, Andrew, additional, Wexner, Steven, additional, Binion, David, additional, Gaidos, Jill, additional, Hull, Tracy, additional, Al-Bawardy, Badr, additional, Al Hashash, Jana, additional, Brand, Myron, additional, Bruckel, Tanya, additional, Clarke, Kofi, additional, Cohen, Benjamin, additional, Cross, Raymond, additional, Dueker, Jeffrey, additional, Fine, Sean, additional, Forster, Erin, additional, Herfath, Hans, additional, Kelly, Colleen, additional, Lazarev, Mark, additional, Levy, L. Campbell, additional, Lightner, Amy, additional, Qazi, Taha, additional, Rosh, Joel, additional, Rupawala, Abbas, additional, Siegel, Corey, additional, and Regueiro, Miguel, additional

Published
2022
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21. Sa545 STRICTURE LENGTH, DURATION AND OBSTRUCTIVE SYMPTOMS PREDIT TIME TO INTERVENTION IN CROHN'S DISEASE – A DERIVATION AND VALIDATION STUDY

Author

Ouali, Sara El, primary, Baker, Mark E., additional, Lyu, Ruishen, additional, Fletcher, Joel G., additional, Braining, David H., additional, Bena, James, additional, Holubar, Stefan D., additional, Click, Benjamin H., additional, Qazi, Taha, additional, Cohen, Benjamin L., additional, and Rieder, Florian, additional

Published
2021
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23. Su487 VEDOLIZUMAB AND USTEKINUMAB FOR THE TREATMENT OF SYMPTOMATIC SMALL BOWEL STRICTURING CROHN'S DISEASE - RESULTS FROM AN OBSERVATIONAL COHORT STUDY

Author

Ouali, Sara El, primary, Ottichilo, Ronald K., additional, Atkinson, Norma, additional, Lu, Cathy, additional, Bruining, David H., additional, Qazi, Taha, additional, Achkar, Jean-Paul, additional, Sleiman, Joseph, additional, Holubar, Stefan D., additional, Baker, Mark E., additional, Gandhi, Namita S., additional, Fletcher, Joel G., additional, Click, Benjamin H., additional, Cohen, Benjamin L., additional, and Rieder, Florian, additional

Published
2021
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31. Validation of stricture length, duration and obstructive symptoms as predictors for intervention in ileal stricturing Crohn's disease

Author

Ouali, Sara, Baker, Mark E., Lyu, Ruishen, Fletcher, Joel G., Bruining, David H., Holubar, Stefan D., Click, Benjamin, Qazi, Taha, Cohen, Benjamin L., and Rieder, Florian

Abstract

Risk factors for intervention in terminal ileal (TI) stricturing Crohn's disease (CD) are poorly defined. Novel and rigorous definitions for TI strictures recently became available. We aimed to describe the rates of symptoms or need for endoscopic balloon dilation (EBD) or surgery as well as risk factors of progression in a well‐defined stricturing CD cohort. Consecutive adult patients with non‐penetrating stricturing TI CD, as defined by centrally‐read magnetic resonance enterography CONSTRICT criteria, were separated into a derivation and validation cohort. Clinical and imaging characteristics were collected following prespecified scoring conventions. Primary outcome was a composite endpoint of EBD or surgery (“intervention”). Multivariable analysis was performed. Eighty‐six patients (48.8% female, median age 36 years) met selection criteria, 17.4% had prior EBD, 59.3% previously received biologics and 58.1% of strictures were anastomotic. Median follow‐up was 63.4 [95% CI: 57, 68.9] months. In the derivation cohort, at 12 and 48 months, 26% and 45% of patients had intervention, respectively. Multivariable analysis showed obstructive symptoms (Hazard ratio [HR] 1.444; 95% CI 1.126–1.852), stricture duration (HR 0.974; 95% CI, 0.954–0.995) and length (HR 1.039; 95% CI, 1.011–1.069) predicted intervention. The concordance index for split‐sample validation was 0.74 and 0.67, respectively. Biologics were not associated with intervention. An online risk calculator was constructed. In patients with TI stricturing CD, 26% and 45% required intervention at 1 and 4 years. Obstructive symptoms, stricture duration and length were independent and validated predictors of the need for intervention. These findings are important for clinical practice and aid in the design of future trials for CD strictures.

Published
2022
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46. IBD MIMICS PRESENTED AT IBD LIVE: WHEN IT IS NOT INFLAMMATORY BOWEL DISEASE

Author

Ward, Christopher, Shah, Samir, Farraye, Francis, Goyal, Alka, Hanson, John, Stefan D. Holubar MD, MS, FACS, FASCRS, Watson, Andrew, Wexner, Steven, Binion, David, Gaidos, Jill, Hull, Tracy, Al-Bawardy, Badr, Al Hashash, Jana, Brand, Myron, Bruckel, Tanya, Clarke, Kofi, Cohen, Benjamin, Cross, Raymond, Dueker, Jeffrey, Fine, Sean, Forster, Erin, Herfath, Hans, Kelly, Colleen, Lazarev, Mark, Levy, L. Campbell, Lightner, Amy, Qazi, Taha, Rosh, Joel, Rupawala, Abbas, Siegel, Corey, and Regueiro, Miguel

Subjects
Hepatology, Gastroenterology, Immunology and Allergy, digestive system diseases
Abstract

BACKGROUND A group of Inflammatory Bowel Disease (IBD) specialists have been utilizing a weekly live video conference “IBD Live” to discuss multidisciplinary management of challenging cases. Since 2009 the conference has featured robust interactive case discussions among 150-200 gastroenterologists and colorectal surgeons from multiple academic institutions. Although the majority of cases presented are IBD, there have been a number of cases where IBD was not the ultimate diagnosis. Hence, we sought to characterize these “IBD mimics” to provide a structure for differential diagnosis. METHODS All 106 hours of case conferences recorded and archived between May 2018 and June 2021 were reviewed. A total of 183 of the 215 cases discussed had an IBD diagnosis including 124 Crohn’s disease (CD), 54 ulcerative colitis (UC) and 5 IBD unclassified. RESULTS Many of the remaining 32 (14.9%) cases (Table 1) were referred to a specialist with a prior diagnosis of IBD. There were 10 cases of colonic inflammation initially diagnosed as UC. Etiologies included drug-induced colitis secondary to checkpoint inhibitors for cancers, ocrelizumab for multiple sclerosis, and nintedanib for pulmonary fibrosis. There were cases of ischemic colitis, idiopathic myointimal hyperplasia of mesenteric veins, segmental colitis associated with diverticulosis, and diversion colitis. There were 8 cases of systemic diseases, diagnosed as Common Variable Immunodeficiency, sarcoidosis and vasculitis, including cases of Henoch–Schönlein purpura and CTLA4 haploinsufficiency with autoimmune infiltrates. There were 5 cases of ileal disorders, ultimately diagnosed as lymphoma, tuberculosis, Meckel’s diverticulum, and appendiceal carcinoid all previously thought to be CD. There were small bowel mucosal disorders including collagenous sprue and autoimmune enteropathy, and 2 polyposis cases secondary to Cronkhite-Canada and juvenile polyposis syndromes. There were also cases thought to be penetrating complications of CD, including a case of abdominal actinomyces infection. Finally, there were 3 cases where no consensus diagnosis was made, with broad differential diagnoses including cryptogenic multifocal ulcerous stenosis enteritis. CONCLUSIONS IBD mimics were found in 15% of cases presented at a global IBD webinar in a 3-year period. Clinicians should have a high level of suspicion and actively pursue alternative etiologies when patients do not respond as anticipated to IBD therapy and/or when the disease characteristics are not completely consistent with IBD. These non-IBD diagnoses will lead to a significant change in medical, surgical and pharmacological treatment approaches, which will impact total cost, unplanned care and quality. Our IBD Live conference has positively impacted the care of our patients, and magnified the importance of considering a broad differential for IBD "mimics."

47. Rare Metastasis of Prostate Cancer in a Man With Ulcerative Colitis After Creation of an Ileal Pouch.

Author

Zemanek M, Powers JC, Westbrook K, Dester E, Smith R, and Qazi T

Abstract

Prostate cancer is one of the most common globally diagnosed cancers in men. It most frequently metastasizes to bones, lymph nodes, lungs, or the liver. There are limited data investigating the impact of prostate cancer on patients who have undergone ileal pouch-anal anastomosis. We explore the case and the diagnosis of a 68-year-old man with prostate adenocarcinoma that metastasized to the ileal pouch and ultimately required pouch explant. In addition, we discuss the challenges associated with screening and treating prostate cancer in patients with ileal pouch-anal anastomosis., (© 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Published
2024
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48. Clinical Decision Making in Inflammatory Bowel Disease Mimics: Practice Management from Inflammatory Bowel Disease LIVE.

Author

Fiske HW, Ward C, Shah SA, Holubar SD, Al-Bawardy B, Barnes EL, Binion D, Bohm M, Brand M, Clarke K, Cohen BL, Cross RK, Dueker J, Engels M, Farraye FA, Fine S, Forster E, Gaidos J, Ginsburg P, Goyal A, Hanson J, Herfath H, Hull T, Kelly CR, Lazarev M, Levy LC, Melia J, Philpott J, Qazi T, Siegel CA, Watson A, Wexner SD, Williams ED, and Regueiro M

Abstract

Background: Since 2009, inflammatory bowel disease (IBD) specialists have utilized "IBD LIVE," a weekly live video conference with a global audience, to discuss the multidisciplinary management of their most challenging cases. While most cases presented were confirmed IBD, a substantial number were diseases that mimic IBD. We have categorized all IBD LIVE cases and identified "IBD-mimics" with consequent clinical management implications., Methods: Cases have been recorded/archived since May 2018; we reviewed all 371 cases from May 2018-February 2023. IBD-mimics were analyzed/categorized according to their diagnostic and therapeutic workup., Results: Confirmed IBD cases made up 82.5% (306/371; 193 Crohn's disease, 107 ulcerative colitis, and 6 IBD-unclassified). Sixty-five (17.5%) cases were found to be mimics, most commonly medication-induced ( n  = 8) or vasculitis ( n  = 7). The evaluations that ultimately resulted in correct diagnosis included additional endoscopic biopsies ( n  = 13, 21%), surgical exploration/pathology ( n  = 10, 16.5%), biopsies from outside the GI tract ( n  = 10, 16.5%), genetic/laboratory testing ( n  = 8, 13%), extensive review of patient history ( n  = 8, 13%), imaging ( n  = 5, 8%), balloon enteroscopy ( n  = 5, 8%), and capsule endoscopy ( n  = 2, 3%). Twenty-five patients (25/65, 38%) were treated with biologics for presumed IBD, 5 of whom subsequently experienced adverse events requiring discontinuation of the biologic. Many patients were prescribed steroids, azathioprine, mercaptopurine, or methotrexate, and 3 were trialed on tofacitinib., Conclusions: The diverse presentation of IBD and IBD-mimics necessitates periodic consideration of the differential diagnosis, and reassessment of treatment in presumed IBD patients without appropriate clinical response. The substantial differences and often conflicting treatment approaches to IBD versus IBD-mimics directly impact the quality and cost of patient care., Competing Interests: HWF: None to disclose. CW: None to disclose. SAS: Board of Trustees for the American College of Gastroenterology. SDH: Consultant for Takeda. Recipient of grants from the Crohn’s and Colitis Foundation and American Society of Colorectal Surgeons. BAB: Speaker fees from AbbVie, Takeda, Bristol-Myers Squibb, and Janssen Pharmaceuticals. Advisory Board for Bristol-Myers Squibb and Pfizer. ELB: Consultant for Target RWE. DB: Research Grants/ Investigator-Initiated Studies with Abbvie, Merck, Takeda. MB: Consultant for Abbvie, Prometheus, BMS, and Cristcot. MB: None to disclose. KC: Consultant for Takeda and AbbVie. Advisory Board for AbbVie and Janssen. Speakers bureau for Takeda, AbbVie, Janssen, and Pfizer. KC holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. LC: Consultant for Abbvie, Takeda, Target RWE. Speaker for Abbvie. Educational grant from Pfizer. RKC: Consulting Fee for Abbvie, Adiso, BMS, Fzata, Fresenius Kabi, IBD Education Group, Janssen, Magellan Health, Option Care, Pfizer, Samsung Bioepis, Sandoz, Sebela, and Takeda. Scientific Co-Director for CorEvitas Registry. Research Grant from Janssen. JD: None to disclose. ME: Speakers Bureau for Abbvie, Pfizer. Advisory Board for Bristol Myers Squibb. FAF: Consulting fee for Avalo Therapeutics, BMS, Braintree Labs, Fresenius Kabi, GI Reviewers, GSK, IBD Educational Group, Iterative Health, Janssen, Pharmacosmos, Pfizer, Sandoz Immunology and Viatris. DSMB for Lilly Pharmaceuticals. SF: Advisory Board for BMS, Janssen, Abbvie. Consultant for BMS, Abbvie. EF: Consultant for Abbvie, BMS, Janssen, Takeda. EF holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. JG: Consulting for MRM Health, Yiviva. Advisory Board for Pfizer, Takeda. Research Support from Bristol Myers Squibb. PG: Consultant and Speaker for Abbvie, Janssen, and Takeda. AG: None that is relevant to this topic. Spouse employed by and has equity in Rapt Therapeutics. JH: None to disclose. HH: Consulting fees for Alivio, AMAG, BMS, Boehringer, ExeGI Finch, Fresenius Kabi, Galapagos Gilead, Janssen, Lycera, Merck, Otsuka, Pfizer, PureTech, Seres, Ventyx. Research support from Allakos, Artizan Biosciences, Novo Nordisk, Pfizer. TH: None to disclose. CRK: None to disclose. ML: Advisory Board for Janssen. LCL: None to disclose. LCL holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. JM: Research funding from Pfizer. Fellowship funding from JNJ. Site PI for clinical trial for Seres Pharmaceutical. JP: Awaiting disclosures. TQ: Awaiting disclosures. CAS: Consultant and Advisory Board for Abbvie, BMS, Boomerang, Buhlmann, Janssen, Lilly, Napo Pharmaceuticals, Pfizer, Prometheus Biosciences, Prometheus Labs, Roivant, Takeda, Trellus Health. Speaker for CME Activities for Abbvie, Janssen, Pfizer, and Takeda. Grand Support from Abbvie, Janssen, Pfizer, and Takeda. AW: None to declare. SDW: Consulting fees for ARC/Corvus, Baxter, BD, GI Supply, Glaxo Smith Kline, ICON Clinical Research Limited, Intuitive Surgical, Leading BioSciences/PalisadeBio, Livsmed, Medtronic, Olympus, OstomyCure, Stryker, Takeda, Virtual Ports. Royalties for Inventor’s Income Intellectual Property for Intuitive Surgical, Karl Storz Endoscopy America Inc, Medtronic, Unique Surgical Innovations LLC. Inactive Consulting Agreements with CRH Medical, Intuitive Surgical, Pragme/GibLib, Renew Medical. EDW: Consultant and Speaker for Abbvie and Pfizer. MR: Advisory board and Consultant for Abbvie, Janssen, UCB, Takeda, Pfizer, BMS, Organon, Amgen, Genentech, Gilead, Salix, Prometheus, Lilly, Celgene, Boehringer Ingelheim Pharmaceuticals Inc (BIPI). MR holds the position of Editor-in-Chief for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.)

Published
2024
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49. Validation of stricture length, duration and obstructive symptoms as predictors for intervention in ileal stricturing Crohn's disease.

Author

El Ouali S, Baker ME, Lyu R, Fletcher JG, Bruining DH, Holubar SD, Click B, Qazi T, Cohen BL, and Rieder F

Subjects
Humans, Female, Adult, Male, Crohn Disease diagnosis, Crohn Disease surgery
Abstract

Background: Risk factors for intervention in terminal ileal (TI) stricturing Crohn's disease (CD) are poorly defined. Novel and rigorous definitions for TI strictures recently became available., Objective: We aimed to describe the rates of symptoms or need for endoscopic balloon dilation (EBD) or surgery as well as risk factors of progression in a well-defined stricturing CD cohort., Methods: Consecutive adult patients with non-penetrating stricturing TI CD, as defined by centrally-read magnetic resonance enterography CONSTRICT criteria, were separated into a derivation and validation cohort. Clinical and imaging characteristics were collected following prespecified scoring conventions. Primary outcome was a composite endpoint of EBD or surgery ("intervention"). Multivariable analysis was performed., Results: Eighty-six patients (48.8% female, median age 36 years) met selection criteria, 17.4% had prior EBD, 59.3% previously received biologics and 58.1% of strictures were anastomotic. Median follow-up was 63.4 [95% CI: 57, 68.9] months. In the derivation cohort, at 12 and 48 months, 26% and 45% of patients had intervention, respectively. Multivariable analysis showed obstructive symptoms (Hazard ratio [HR] 1.444; 95% CI 1.126-1.852), stricture duration (HR 0.974; 95% CI, 0.954-0.995) and length (HR 1.039; 95% CI, 1.011-1.069) predicted intervention. The concordance index for split-sample validation was 0.74 and 0.67, respectively. Biologics were not associated with intervention. An online risk calculator was constructed., Conclusion: In patients with TI stricturing CD, 26% and 45% required intervention at 1 and 4 years. Obstructive symptoms, stricture duration and length were independent and validated predictors of the need for intervention. These findings are important for clinical practice and aid in the design of future trials for CD strictures., (© 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Published
2022
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