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LEVEL OF FECAL CALPROTECTIN AS PREDICTOR OF COLONIC DIVERTICULOSIS SEVERITY

Mohammed Hussien Ahmed 1, Rasha Ibrahim Salama Ibrahim 2

Affiliations

1 Kafrelsheikh Unversity, Kafrelsheikh, Egypt

2 Zagazig Hospital, Zagazig, Egypt

Summary

AI Generated

A study of 360 patients evaluated fecal calprotectin as a non-invasive marker for assessing colonic diverticulosis severity, finding significant correlations with disease classification and distinct cutoff values for mild, moderate, and severe disease.

Fecal calprotectin significantly positively correlated with CRP, neutrophil inflammatory score, and Hinchey classification in patients with diverticulosis
Mild diverticulosis showed a cutoff greater than 65 with 97.0% sensitivity and 82.8% specificity
Moderate diverticulosis showed a cutoff between 162 and 175 with 83.3% sensitivity and 96.0% specificity
Severe diverticulosis showed a cutoff greater than 175 with 85.0% sensitivity and 92.5% specificity
The study concludes that fecal calprotectin may serve as a predictor of diverticulosis disease severity in non-IBD patients

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Diverticulosis was once regarded as an uncommon anatomic variant with different types of complication, Faecal calprotectin (FC) is a cytoplasmic antimicrobial
compound prominent in granulocytes, monocytes, and macrophages (1).

Aims & Methods

we aim to assess the fecal calprotectin values in colonic diferticulosis as a non invasive marker of disease severity.

Results

We enrolled in this study 360 consecutive patients who had undergone a total colonoscopy and MSCT on Abdomen and complete laboratory investigation including fecal calportectin, Age was distributed as 46.61±11.57 with minimum 15 and maximum 80 years and regard sex distribution female were majority with 59.7% fecal calportectin significantly positive correlated with CRP, NIS and Hinchey classification. Mild diverticulosis showed Significant area under curve with cutoff >65 and with sensitivity 97.0%and specificity 82.8%. moderate diverticuosis showed Significant area under curve with cutoff >162 <175 and with sensitivity 83.3%and specificity 96.0%. Severe Significant area under curve with cutoff >175 and with sensitivity 85.0%and specificity 92.5%.

Conclusion

Faecal calprotectin (FC) is inflammatory marker considered as a stronger predictor of diverticulosis diseases in Non IBD Patients.

References

(1) Roseth AG, Fagerhol M, Aadland E, Schjonsby H (1992) Assessment of neutrophil dominating protein calprotectin in feces. A methodological study. Scand J Gastroenterol 27:793–798

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

More Like This:

LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Yoon-Kyo An

ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

Mark Löwenberg

SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Inés Constanze Hammel

RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

Hend Ayadi

EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat

UEG Presentation

New

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LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

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LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Robert Gilmore 1,2, Richard Fernandes 1,2, Naeman Goetz 1, Simone Chin 3, Daniel Con 3, Peter de Cruz 3, Kathryn Demase 4, Unknown Unknown 4, Sarah Lucas 5, Mayur Garg 5, Zachary Tuttle 6, Nichloas Clark 6, Daniel Tassone 6, Nik Ding 6, Moshe Loebenstein 7, Andrew Nguyen 7, Gregory Moore 7,8, Lena Thin 9, Kirsty Macfarlane 10, Kate D Lynch 10, Delo Subhaharan 11, Waled Mohsen 11, Adam Haig 12, Melissa Day 12, Lauren White 12, Justin Baker 13, Kannan Venugopal 13, Bhuwan Tandon 14, Robert Bryant 14, Amirah Etchegaray 15, George Tambakis 15, Gareth Walker 15, Anita Pelecanos 16, Jakob Begun 2,1, Yoon-Kyo An 2,1

Affiliations

1 Mater Hospital Brisbane, Brisbane, Australia

2 University of Queensland, Brisbane, Australia

3 Austin Health, Heidelberg, Australia

4 Alfred Health, Melbourne, Australia

5 Northern Health, Epping, Australia

6 St Vincent's Hospital Melbourne, Melbourne, Australia

7 Monash Health, Clayton, Australia

8 Monash University, Victoria, Australia

9 Fiona Stanley Hospital, Perth, Australia

10 Royal Adelaide Hospital, Adelaide, Australia

11 Gold Coast University Hospital, Gold Coast, Australia

12 Sunshine Coast University Hospital, Birtinya, Australia

13 Royal Perth Hospital, Perth, Australia

14 The Queen Elizabeth Hospital, Australia, Australia

15 Royal Brisbane and Women's Hospital, Brisbane, Australia

16 QIMR Berghofer, Brisbane, Australia

Summary

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Abstract

Introduction

Acute Severe Ulcerative Colitis (ASUC) remains a medical emergency with limited medical options beyond intravenous corticosteroids and rescue advanced therapy. Upadacitinib and tofacitinib are Janus kinase (JAK) inhibitors with a rapid onset of action and are increasingly used as rescue therapy for ASUC. However, comparative real-world data, particularly for sequential salvage use following infliximab failure remain limited. We evaluated outcomes of upadacitinib and tofacitinib in ASUC and compared JAK inhibitor used as rescue or sequential salvage therapy.

Aims & Methods

We performed a nationwide multicentre retrospective cohort study across 13 Australian inflammatory bowel disease centres. Adults (≥18 years) meeting Truelove and Witt’s criteria for ASUC who commenced upadacitinib or tofacitinib from April 2021 to April 2024 were included. Outcomes were assessed during index admission and at week 8, 16, and 52 following JAK inhibitor initiation. The primary outcome examined was colectomy by week 52. Secondary outcomes included colectomy at earlier timepoints and clinical, corticosteroid free clinical (CFCR), biochemical, and endoscopic remission.

Results

A total of 150 patients were included (median age 34 years; 48% female). Upadacitinib was used in 51% and tofacitinib in 48%. JAK inhibitor was commenced as rescue therapy in 69% and as sequential salvage therapy after infliximab failure in 31%. Colectomy occurred in 11% of patients during index admission, 21% by week 8, 29% by week 16, and 33% by week 52. By week 52, colectomy was significantly lower with upadacitinib than with tofacitinib (23.4% vs 42.5%, adjusted absolute risk difference -0.18 (95% confidence interval -0.34 - -0.03), p=0.022), with no statistically significant difference at earlier timepoints. Upadacitinib was consistently associated with higher rates of clinical remission, CFCR and biochemical remission throughout follow-up. Despite numerically higher rates of colectomy, there was no statistically significant difference between cumulative colectomy rates for patients receiving rescue or sequential salvage JAK therapy at any timepoint. Adverse events occurred in 21%, serious adverse events in 7% and both were similar between JAK therapies and rescue vs sequential therapy. No venous thromboembolism, major adverse cardiovascular events, or malignancy were observed during the 52-week follow-up.

Conclusion

In this large multicentre real-world ASUC cohort, JAK inhibitors were effective when used as rescue or sequential salvage therapy with a reassuring safety profile. Upadacitinib use was associated with a significantly lower rate of colectomy by 52 weeks compared to tofacitinib and higher rates of clinical remission, CFCR, and biochemical remission during follow-up. Variability in initiation timing, dosing, and prophylaxis practices highlights the need for prospective studies to define optimal treatment pathways and patient selection. Sequential Salvage therapy may represent a viable therapeutic option for patients otherwise facing colectomy for ASUC.

Disclosure

YA reports grants from Janssen, during the conduct of the study; has received speaking and consulting fees from Abbvie, Bristol Myers Squibb, Celltrion, Chiesi, Dr Falk, Ferring, Janssen, Pfizer, Sandoz, Shire and Takeda; served on advisory boards member for Abbvie, Bristol Myers Squibb, Chiesi, Janssen, NPS Medicine wise; received research and educational funding from Abbvie, Celltrion, Dr Falk, Janssen, Pfizer, Sandoz and Takeda.
MG has served on the advisory board of Abbvie, Pfizer and Ferring, and has received speaker fees, research or travel grants from Abbvie, Celltrion, Dr Falk, Ferring, Fresenius Kabi, Janssen, Pfizer, and Takeda.
JB has received speaking and consulting fees from Abbvie, Bristol Myers Squibb, Celltrion, Chiesi, Dr Falk, Ferring, Janssen, Pfizer, Sandoz, Shire, and Takeda; served on advisory boards member for Abbvie, Takeda, Ferring, Celltrion, Bristol Myers Squibb, Chiesi, Janssen, NPS Medicine wise, Anatara, Microba; received research and educational funding from Abbvie, Janssen, Pfizer, Ferring and Takeda.
DL reports advisory board membership, speaker fees or research grants with AbbVie, Janssen, Eli Lilly, Pfizer.
AS has received speaker or consultancy fees from Abbvie, Takeda, Janssen, Pfizer and Dr Falk Pharma
GTM has received speaker or consultancy fees or advisory board fees for AbbVie, BMS, Celgene, Celltrion, Chiesi, Dr Falk Pharma, Eli-Lilly, Ferring, Janssen, MSD, Pfizer, Takeda and research support from CCA, The Gutsy Group and MRFF.
RVB has received grant/research support/speaker fees from AbbVie, Ferring, Janssen, BMS, Shire, Takeda, Dr Falk Pharma, GSK and Emerge Health; and is a shareholder in Biomebank.
CC has received grant/research support/speaker fees from Janssen, Abbvie, Chiesi, Takeda, Ferring, Falk and GESA.
MPS has received educational grants or research support from Gilead and Celltrion, speakers fees from Janssen, Abbvie, Ferring, Takeda, Pfizer, Shire, Celltrion, Eli-Lilly and Dr. Falk Pharma, and has served on advisory boards or received consultancy fees from Janssen, Takeda, Pfizer, Celgene, Abbvie, MSD, Emerge Health, Gilead, BMS, Celltrion, Eli-Lilly and Alimentiv.
KDL declares speaker’s honoraria, advisory board fees, and/or conference travel/registration support from Abbvie, Bristol Myers Squibb, Chiesi, Dr Falk, Ferring, Gilead, Guidepoint, Intercept Pharmaceuticals, Ipsen, Johnson & Johnson, Norgine, Pfizer, Pliant, Sandoz, Takeda, The Limbic, and the RAH Research Fund
PDC has received research educational grants or research support from Janssen, AbbVie, Shire and Celltrion, speaker fees from AbbVie, Ferring, Shire, Janssen, Pfizer, Takeda, Dr Falk and The Limbic and has served on advisory boards or received consultancy fees from Janssen, Takeda, Pfizer, Abbvie, Emerge Health, Celltrion and Ferring. PDC is supported by an NHMRC Emerging Leader 2 Fellowship.
LT has received research funding support from research from: Pfizer, Takeda, Celltrion, advisory board member consultancy work: Takeda, Abbvie, Janssen, Pfizer, Celltrion, BMS, Sandoz and speaker fees from Abbvie, Janssen, Pfizer, Celltrion, Takeda, BMS, FALK
LW has received research funding, speakers honoraria, advisory board fees and/or educational support from Shire, BMS, Ferring, Sandoz, Janssen, Abbvie, Takeda, Pfizer, Frensius-Kabi, The Helmsley Charitable Trust and Dr Falk.

Event

UEG Week Barcelona 2026

Topics

Surgery IBD

Submission format

Abstract

Session

Real-world observations in IBD: Things we don't see in clinical trials

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Yoon-Kyo An

ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

Mark Löwenberg

SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Inés Constanze Hammel

RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

Hend Ayadi

EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

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ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

Dalia Alexia Lartey 1, Jie Su 2, Maqsood M. Yaqub 1, Kelly van Wijnbergen 1, Joep Grootjans 1, Sanne E. Wiegers 1, Marieke Barnhoorn 2, Geert R. D'Haens 1, Gerben J. C. Zwezerijnen 1, Manon E. Wildenberg 1, Mark Löwenberg 1

Affiliations

1 Amsterdam UMC, Amsterdam, Netherlands

2 Leiden University Medical Center, Leiden, Netherlands

Summary

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Abstract

Introduction

Although Janus kinase (JAK) inhibitors have been suggested to exert anti-fibrotic activities in various chronic inflammatory diseases, including ulcerative colitis (UC), this has not been proven yet. ¹ We here investigated whether the preferential JAK-1 inhibitor filgotinib can exert anti-fibrotic effects in UC, where the potential for therapeutic modulation of fibrosis remains largely unexplored. To this end, paired colonic biopsies were analysed for gene expression analysis using single-cell RNA sequencing and a subset of patients underwent serial imaging using fibroblast activation protein inhibitor positron emission tomography/computed tomography (⁶⁸Ga-FAPi-PET/CT) to visualize and quantify in vivo fibrosis. ²

Aims & Methods

We performed a prospective longitudinal open label study (INTERACT), enrolling UC patients who underwent endoscopic assessment with singular biopsy collection, taken from the mostly affected segments, at week 0 (baseline) and at week 24. Endoscopic response (reduction of ≥1 point from baseline using the Mayo Endoscopic Score (MES)) and endoscopic remission (MES score: 0 or 1) were assessed. Colonic biopsies were analysed using single-cell RNA sequencing with pathway enrichment analysis to identify treatment-associated modulation in fibrosis-associated pathways. Five out of 12 patients underwent serial total-body ⁶⁸Ga-FAPi-PET/CT imaging at week 0 and week 24 with tracer uptake quantified using early (10–20 minutes post-injection) and late (50–70 minutes post-injection) standardized uptake values (SUVs) in predefined colonic segments. Time-activity curves (TACs) were generated to assess tracer pharmacokinetics over time.

Results

In total, 12 patients were enrolled, of whom 5 underwent FAPi-PET/CT imaging at baseline and at week 24. One patient discontinued filgotinib treatment due to lack of clinical response at week 8. Single-cell RNA sequencing of paired mucosal biopsies identified treatment-associated changes in immune and stromal compartments. Compositional analysis demonstrated reduced immune cell abundance after treatment, particularly Ig-producing B cells and inflammatory macrophages. JAK-signal transducer and activator of transcription (STAT) signalling was impaired across immune cell populations, most prominently in myeloid cells. Pathway analysis within the stromal compartment revealed reduced JAK-STAT signalling and decreased expression of extracellular matrix (ECM)-associated genes, including collagens, laminins and integrins. Although myofibroblast abundance increased, reduced ECM and contractile pathway activity suggested a shift toward a less activated stromal state. FAP RNA expression was detected in endothelial cells and stromal fibroblast populations and decreased after treatment in 9 out of 10 patients. Serial FAPi-PET/CT imaging revealed reduced FAPi tracer uptake, with decreases in both early and late SUVs in affected colonic segments. The late-to-early SUV ratio decreased in 4 of 5 patients, suggesting reduced FAPi tracer retention and altered fibroblast activation-associated tracer kinetics following treatment.

Conclusion

This study is the first to show that filgotinib treatment leads to inhibition of fibrosis-associated cellular pathways and reduced FAPi-PET tracer uptake in UC. These findings suggest that filgotinib treatment influences intestinal fibrotic remodelling and support ⁶⁸Ga-FAPi-PET/CT as a candidate imaging tool for monitoring anti-fibrotic treatment effects.

References

1. Su J, Lartey DA, Zanella G, et al. Therapeutic potential of Janus kinase inhibitors for the management of fibrosis in inflammatory bowel disease. J Crohns Colitis 2025;19.
2. Debus J, von Gotze I, Brandt J, et al. (68)Ga-FAPI PET/CT for non-invasive characterization and activity assessment of ulcerative colitis and Crohn s disease. Eur J Nucl Med Mol Imaging 2026.

Disclosure

This study is funded by Alfasigma S.p.A

Event

UEG Week Barcelona 2026

Topics

Histopathology Surgery Radiology & Imaging Mechanisms & Personalised Medicine Immunology IBD

Submission format

Late-Breaking Abstract

Session

Late-Breaking in IBD: From translational discoveries to treatment

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Yoon-Kyo An

ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

Mark Löwenberg

SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Inés Constanze Hammel

RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

Hend Ayadi

EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat

UEG Presentation

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SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

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SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Dania Rocio Diaz-Rodriguez 1, Monica Granados Martin 2, Liliana La Rosa-Huertas 3, Inés Constanze Hammel 4

Affiliations

1 Hospital Universitario del Henares, Madrid, Spain

2 Hospital de Fuenlabrada, Fuenlabrada, Spain

3 Universidad Señor de Sipán, Lims, Peru

4 Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain

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Abstract

Introduction

Smoking is an environmental and conductual risk factor for the development of Chron’s Disease (CD) and is associated with a more severe course of CD. In contrast, a protective effect is shown in the development and a mild course of Ulcerative Colitis (UC). Smoking leads to cardiovascular disease, cancer and other chronic diseases, and social isolation, anxiety and depression. It is also a predictor of poorer adherence to treatment in young patients.

Results & Findings

50% were women, 52 years old (SD: 12.6). 58.6% suffered CD, 39.7% more than 10 years from onset of disease, 60.7% with biologics; 54.4% in remission and 29.8% mild activity. 24% were active smokers, 60% ex-smokers and 15.5% has never smoked. 60.3% were regular exercisers, and 66% consume alcoholic beverages regularly.
Of those who smoked, 64% were women, 57% suffered CD, 46% was in remission. 85.7% with anxiety and 52.7% with depression, 61.5% perceived their health status as suboptimal. 64.3% consumed alcoholic beverages, 57.1% no physical exercise.
The mean anxiety score was 9 (SD: 3.6), depression score was 5.76 (SD: 3.7). 67.2% had anxiety levels and 32.8% depression. Perceived health status as optimal was 57.9%.
In the bilateral analysis between smoking and the independent variables, only depression and anxiety was associated.

Summary & Discussion

Smoking is an environmental risk factor for the development and course of CD. The aim of this study iis to determine smoking habits and associated factors in patients with Inflammatory Bowel Disease (IBD) in Hospital Universitario del Henares (Madrid).
A transversal study was carried out. Data were collected in a questionnaire ad-hoc and HADS.
Patients with IBD are active smokers, and their percentage is bigger to regular population in Comunidad de Madrid (21.9%). On the other hand, the percentage of ex-smokers with IBD (60%) is much higher than with no IBD; it may be related to IBD development.
It is well known the relationship between IBD and psicosocial aspects. In this study we show the high prevalence of anxiety and depression, which is higher than in general population.
Nurses can play an important role in the psychological care of patients with IBD, especially in prevention and early detection.

Conclusion

Patients with IBD showed a high tobacco consumption, most of which were women and with no healthy habits.
Smoking in patients with IBD is associated with anxiety and depression.

References

(1) Bisgaard TH, Allin KH, Keefer L, Ananthakrishnan AN, Jess T. Depression and anxiety in inflammatory bowel disease: epidemiology, mechanisms and treatment. Nat Rev Gastroenterol Hepatol. 2022;19(11):717-726.
(2) Feng L, Cai X, Zou Q, et al. Exploring the management and treatment of IBD from the perspective of psychological comorbidities. Therap Adv Gastroenterol. 2024;17:17562848241290685.
(3) Barreiro-de Acosta M, Marín-Jiménez I, Panadero A, et al. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients. Gastroenterol Hepatol. 2018;41(2):118-127.
(4) Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277-83.
(5) Comunidad de Madrid. Dirección de Salud Pública. Resultados del Sistema de Vigilancia Integral del Tabaquismo (VITa). Informe 2023.

Event

UEG Week Berlin 2025

Topics

Nurses

Submission format

Abstract

Session

Abstracts II: Patient care and endoscopic techniques

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Yoon-Kyo An

ANTI-FIBROTIC EFFECTS INDUCED BY FILGOTINIB IN ULCERATIVE COLITIS PATIENTS DETECTED BY MOLECULAR ANALYSIS AND FAPI PET/CT: THE INTERACT TRIAL

Mark Löwenberg

SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Inés Constanze Hammel

RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

Hend Ayadi

EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

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RESULTS OF THE ANGH COHORT ON MILD TO SEVERE ACUTE BILIARY PANCREATITIS (CAPABLES): EVALUATING DIFFERENT FEEDING MODALITIES PRIOR TO CHOLECYSTECTOMY

Frederick Moryoussef 1, Charles De Ponthaud 2, Denis Grasset 3, ANDRE JEAN REMY 4, Serge Bellon 5, Pierre Mayer 6, Mathias Vidon 7, Augustin Drouet D'Aubigny 8, Caroline Lemaitre 9, christophe locher 10, Mourad MEDMOUN 11, Florence Skinazi 12, vincent quentin 13, Marie-Pierre Ripault 14, Mehdi Kaassis 15, Clara Yzet 16, Julien Lollivier 17, Guillaume Allard 18, Florent Ehrard 19, Romain Gerard 20, Hend Ayadi 21, Félix Goutorbe 22, Gaelle Boudoux d'Hautefeuille 23, Oana Maria Zaharia 24, Jeremie Albouys 25, Frédéric HELUWAERT 26, Emily Siegel 27, Thomas Grainville 28, Christelle d'Engremont 29, Nicolas Etchepare 30, Cristina Levi 31, Antoine Martin 32, Gabriela Chitic 33, Wasim Al Rafei 34, Oussama Daboussi 35, Adrian Culetto 36, Aymeric Becq 37, Armand Garioud 38, Renato Micelli Lupinacci 39, Enrique Perez 40, Roxana Stan Iuga 41, David Cuen 42, Anthony Caldiero 43, Claire Charpignon 44, Ludovic Caillo 45, Eve Gelsi 46, Sylvie Peschard 47, Julia Travagli 1, Vinciane Rebours 48, gilles macaigne 49

Affiliations

1 CH Poissy-Saint-Germain-En-Laye, Poissy, France

2 Pitie Salpétrière University Hospital, Paris, France

3 CHBA Service de Gastroentérologie, Vannes, France

4 CH Perpignan, Perpignan, France

5 Centre Hospitalier d'Avignon Henri Duffaut, Perpignan, France

6 Hepato-gastroenterology, Strasbourg, France

7 Centre Hospitalier Intercommunal de Creteil, Creteil, France

8 CH Cornouaille, Quimper, France

9 CH Le havre, Le Havre, France

10 CH Meaux, Meaux, France

11 CH Creil, Creil, France

12 CH Delafontaine, Saint Denis, France

13 Y Le Foll, Saint Brieuc, France

14 CH Narbonne, Narbonne, France

15 CH DE CHOLET, Cholet Cedex, France

16 Amiens univerisity hospital, Amiens, France

17 CH Valenciennes, Valenciennes, France

18 CH Aix-en-provence, Aix-en-provence, France

19 CH Lorient, Lorient, France

20 Inserm, Lille, France

21 CH Marne-la-vallée, Marne-la-vallée, France

22 CH Cote basque, Bayonne, France

23 CH Mteropole Savoie, Aix-les-bains, France

24 CH Dunkerque, Dunkerque, France

25 CHU Limoges / University of Limoges, Limoges, France

26 CH Annecy, Annecy, France

27 CH Mulhouse, Mulhouse, France

28 CHU Rennes, Rennes, France

29 Grenoble University Hospital, Grenoble, France

30 CH Valence, Valence, France

31 CH sud-francilien, Corbeilles-en-Essone, France

32 Kremlin Bicetre University Hospital, Kremlin Bicetre, France

33 CH Gonesse, Gonesse, France

34 CH Portes de Provencd, Montelimar, France

35 CH Chartres, Chartes, France

36 University Hospital Le Rangueuil, Toulouse, France

37 Mondor University Hospital, Creteil, France

38 CH Villeneuve-saint-georges, Villeneuve, France

39 Ambroise Paré University Hospital, Boulogne Billancourt, France

40 University Hospital Georges Pompidou, Paris, France

41 CH Dreux, Dreux, France

42 CH Saint-malo, Saint-malo, France

43 Tenon University Hospital, Paris, France

44 Montsouris Institute, Paris, France

45 CHU DE NIMES, Nîmes, France

46 Nice University Hospital, Nice, France

47 CH Meulan, Meulan-les-mureaux, France

48 Hopital Beaujon, Clichy, France

49 CH Montfermeil, Montfermeil, France

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Abstract

Introduction

Therapeutic management of acute biliary pancreatitis (ABP) includes endoscopic sphincterotomy and cholecystectomy. However, the optimal feeding strategy prior to cholecystectomy—early oral intake or exclusive enteral nutrition—remains debated, particularly given the risk of recurrent biliary events (BEs) before surgery, especially when surgery is delayed.

Aims & Methods

The primary objective was to evaluate the likehood of BEs (biliary colic/migration, stone impaction, cholangitis, recurrent acute pancreatitis, and acute cholecystitis) prior to cholecystectomy, comparing feeding methods: oral vs. exclusive enteral nutrition. The secondary objective was to evaluate cholecystectomy rates during the initial hospitalization and the reasons for non-performance. Data were collected during hospitalization, at 3 months, and at 6 months if surgery had not been performed by month 3. BEs and feeding modalities at those times were documented. Analyses included Cox models and Chi-square tests.

Results

From October 2022 to December 2023, 1,172 patients with ABP were prospectively enrolled by 60 French hospitals, with 1,167 included in the final analysis. Sixty patients (5%) were lost to follow-up, and 34 deaths (3%) were reported. Severe ABP was observed in 27.2% (n=317) of patients. After 48–72 hours, oral feeding was resumed in 62% (n=724), enteral feeding in 16% (n=192), and fasting/parenteral feeding in 21% (n=249). During follow-up, 236 BEs occurred in 172 patients, meaning 15.5% experienced at least one event, with a median onset time of 26 days (range: 9–57 days). Specifically, 6% had at least one episode of biliary colic/migration, 2.1% experienced stone impaction, 2.3% developed cholangitis, 6.1% had recurrent AP (9% of which were severe), and 1.6% developed acute cholecystitis.
Univariate analysis identified several factors associated with a higher risk of BE recurrence (p < 0.10): age ≥52 years (p=0.093), obesity (BMI ≥30, p=0.032), ASA score >2 (p=0.097), total bilirubin ≥60 µmol/L (p=0.010), CRP >150 mg/L, diagnostic delay ≥21 days (p=0.009), and prior sphincterotomy (p=0.136). No difference in BE incidence was observed between severe and non-severe ABP (p=0.497) when analyzing the first 172 BEs.
Over the full follow-up period, despite the 87 BEs analyzed and potential biases, there remained no significant association between nutrition type (oral vs. exclusive enteral nutrition ) and the likelihood of BE occurrence (p=0.447).
In patients with non-severe ABP, cholecystectomy was performed during the initial hospitalization in only 33% of cases. The main reasons for non-performance were structural (e.g., lack of availability or surgeon refusal), accounting for 45% of cases.

Conclusion

BEs are frequent and clinically relevant: 15.5% of patients experienced at least one before surgery, with 6% developing recurrent ABP (9% of which were severe). Cholecystectomy remains underutilized; only one-third of patients with non-severe ABP underwent it during their initial stay, often due to modifiable reasons. Neither ABP severity nor nutritional type-oral vs enteral nutrition (despite potential biases, missing data, and ongoing analysis)-appeared to be associated with the occurrence of BEs prior to surgery. Early cholecystectomy, when possible, remains the only reliable strategy for preventing BEs.

Disclosure

This study received a research grant from Fresenius Kabi.

Event

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

From The Lion King to Waterland: A journey through pancreatitis

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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UEG Presentation

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EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

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EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Christoph Ammer-Herrmenau 1, Richard Meier 1, Kai Antweiler 1, Thomas Asendorf 1, Georg Beyer 2, Silke Cameron 1, Gabriele Capurso 3, Marko Damm 4, Linh Dang 1, Fabian Frost 5, Jacob Hamm 1, Albrecht Hoffmeister 6, Robert Jaster 7, Christian Meinhardt 8, Lukasz Nawacki 9, Arpad Panyko 10, Veit Phillip 11, Aldis Pukitis 12, Diana Riekstina 12, Ecaterina Rinja 13, Lourdes Ruiz-Rebollo 14, Arlett Patricia Gloria Schäfer 2, Rahel Scholz 1, Julian Seelig 6, Simon Sirtl 2, Vasile Sandru 13, Volker Ellenrieder 1, Albrecht Neesse 1

Affiliations

1 University Medical Centre Goettingen, Goettingen, Germany

2 University Hospital LMU Munich, München, Germany

3 San Raffaele Scientific Institute Irccs, Rome, Italy

4 University Hospital Halle, Halle, Germany

5 Universität Greifswald, Greifswald, Germany

6 University Hospital of Leipzig, Leipzig, Germany

7 Rostock University Medical Center, Rostock, Germany

8 Klinikum Oldenburg AöR, Oldenburg, Germany

9 The Jan Kochanowski University in Kielce, Kielce, Poland

10 University Hospital Bratislava, Bratislava, Slovakia

11 Technische Universität München, München, Germany

12 Pauls Stradins Clininic University Hopital Gastroenterology Center, Riga, Latvia

13 Bucharest Clinical Emergency Hospital, Bucharest, Romania

14 Hospital Clínico Universitario de Valladolid, Valladolid, Spain

Summary

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Abstract

Introduction

Growing evidence suggests an increased morbidity and mortality following an episode of acute pancreatitis (AP)¹. To date, there are no robust biomarkers predicting recurrent acute pancreatitis (RAP), occurrence of post discharge mortality, and the development of diabetes mellitus and pancreatic exocrine insufficiency (PEI). In a European-wide multicenter study the orointestinal microbiome could be used to predict severity of AP². Here, we now aim to assess the early-phase microbiome to predict post-discharge mortality and morbidity.

Aims & Methods

Between 2019 and 2022, buccal and rectal swabs were prospectively collected from 424 patients with acute pancreatitis within 72h after hospital admission in 15 European centers (P-MAPS-study)². Follow-up data regarding the outcome after discharge of the index AP were collected using a RedCAP database until December 2024 via telephone interviews and/or from patient medical records. Endpoints included the association of the buccal and rectal microbiome with post discharge mortality, development of RAP, PEI, diabetes, development of chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDA). Existing 16S rRNA (buccal) and metagenomic (rectal) Nanopore sequencing data were reclassified with an updated library. For α- and β-diversity statistics, multiple regression models or distance-based redundancy analysis (db-RDA) were used controlling for potential confounders, such as age, body mass index, medication and concomitant diseases.

Results

Post discharge data were available for 294 participants with a median time of follow-up of 2.7 years. During this period 66 patients (22.4%) developed RAP, 16 (5.4%) CP, 23 (7.8%) PEI, 25 (8.5%) diabetes, 4 (1.4%) PDA, and 20 (6.8%) died after hospital discharge. Sequencing data from 267 buccal and 265 rectal samples were deemed suitable for subsequent analysis. Notably, preliminary analysis revealed significant associations between the buccal and rectal microbiome and post discharge development of diabetes (db-RDA p-value 0.021* and 0.016*) buccal samples and post discharge mortality (db-RDA p-value 0.049*) and rectal samples and RAP (db-RDA p-value 0.011*). No significant differences were found regarding CP, PEI and PDA.

Conclusion

Microbial sequencing collected at the initial phase of acute pancreatitis in the emergency room show significant association with long-term complications after AP and post-discharge mortality emphasizing the role of the orointestinal microbiota in acute pancreatitis.

References

Czapári D., Váradi A. & Farkas N. Detailed Characteristics of Post-discharge Mortality in Acute Pancreatitis. Gastroenterology 2023 Sep;165(3):682-695
Ammer-Herrmenau C., Antweiler K. & Asendorf T. Gut microbiota predicts severity and reveals novel metabolic signatures in acute pancreatitis. Gut. 2024 Feb 23;73(3):485-495

Event

UEG Week Berlin 2025

Topics

Pancreas

Submission format

Abstract

Session

From The Lion King to Waterland: A journey through pancreatitis

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Yoon-Kyo An

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Mark Löwenberg

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Inés Constanze Hammel

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Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

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RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Rawen Kader 1,2, Paul Bassett 3, Yusuf Kabir 1, Sharon Cheung 1, Lester Macabodbod 1, Archana Jayanthi 1, Manish Chand 2, Laurence B. Lovat 1,2

Affiliations

1 Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), London, United Kingdom

2 University College London Hospital, London, United Kingdom

3 Statsconsultancy Ltd, London, United Kingdom

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Abstract

Introduction

Colorectal Cancer (CRC) is the third commonest cancer in men and women¹. Most CRCs develop from adenomatous polyps, with colonoscopy as the gold standard for screening. However, up to 27% of polyps are missed during colonoscopy². Artificial intelligence (AI) in endoscopy has been gaining increasing attention for its role in automated lesion detection and characterisation but clinical studies to date are limited to AI models that are deployed locally using computer hardware whilst polyp detection studies largely focus on expert colonoscopists in screening populations such as the UK bowel cancer screening programme (BCSP)³.

Aims & Methods

In this multi-centre, prospective randomized controlled parallel design trial, we aimed to assess whether the real-time cloud-based AI polyp detection system CADDIE improves adenoma detection rate (ADR) in symptomatic and surveillance patients when colonoscopy is undertaken by non-expert colonoscopists in routine clinical settings.
We enrolled 739 patients between April 2021 and Dec 2022, scoped by 32 endoscopists in 9 UK hospitals. Participants scheduled for surveillance or symptomatic colonoscopy aged 18 years or older were invited to participate. Exclusions included inpatient procedures, known inflammatory bowel disease (IBD), colorectal cancer, polyposis syndromes, previous resections, and planned therapy. Each endoscopist was limited to a maximum of 60 procedures and required to perform more than 20% of this target. The study was powered to show an increase in ADR between the two arms, using a two-group z-test with 80% power, a two-sided α level of 0.05 and accounting for an expected dropout rate of 10%. Patients were block randomised in a 1:1 ratio to standard of care (SOC) or intervention (CADDIE), stratified by endoscopist and indication. The primary end point was the difference in endoscopist ADR between intervention and SOC arms.

Results

There were 614 evaluable patients. ADR was significantly higher in the CADDIE group compared to SOC (Table 1). Adenomas were detected in 7.6% more patients in the CADDIE group than the SOC group (P=0.03). Proximal ADR was also 6.1% higher in the CADDIE group (P=0.01). Over 50% more adenomas were removed per colonoscopy (APC) in the CADDIE group compared to SOC (P=0.008). Although results were not significant for other outcomes, the general trend was towards higher detection in the CADDIE group.
We excluded 125 patients from data analysis as pre-defined in the study protocol (e.g. endoscopist moving hospital before meeting minimum recruitment target). Despite this, the study reached its recruitment goals.

Results Table

Mean (S.D)	Standard of Care (n=308)	Intervention (CADDIE) (n=306)	Adjusted Analysis (for sex, age and indication)
Age, mean ± S.D	57.8 ± 14.7	59.5 ± 14.7
Male sex, number (%)	153 (49.7%)	147 (48.0%)
Indication (symptomatic / surveillance)	91.9% / 8.1%	91.2%/8.8%
ADR	78 (25.3%)	103 (33.7%)	7.6%; P = 0.03
Proximal adenoma detection rate (pADR)	47 (15.3%)	72 (23.5%)	6.1% P = 0.01
Mean adenomas per colonoscopy (APC) ± S.D.	0.42 ± 0.98	0.66 ± 1.44	0.23; P = 0.008
Adenomas per extraction (APE)	129 (61.1%)	202 (67.6%)	4.5% P = 0.39
SSLs per colonoscopy (SLPC)	0.05 ± 0.26	0.07 ± 0.31	2.0% P = 0.40

Conclusion

We have shown a significant improvement in adenoma detection of almost 8% using the cloud-based CADDIE AI system in a non-screening population across a wide range of UK hospitals, where the endoscopists were independent but not BCSP trained. This increased detection was also seen in the proximal colon, where many hard to detect lesions are found. Furthermore, total numbers of adenomas removed per colonoscopy, which is increasingly recognised as an important metric of procedure quality, was significantly increased.

References

1. Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol. 2021 Oct;14(10):101174. doi: 10.1016/j.tranon.2021.101174. Epub 2021 Jul 6. PMID: 34243011; PMCID: PMC8273208.
2. Zhao S, Wang S, Pan P, Xia T, Chang X, Yang X, Guo L, Meng Q, Yang F, Qian W, Xu Z, Wang Y, Wang Z, Gu L, Wang R, Jia F, Yao J, Li Z, Bai Y. Magnitude, Risk Factors, and Factors Associated With Adenoma Miss Rate of Tandem Colonoscopy: A Systematic Review and Meta-analysis. Gastroenterology. 2019 May;156(6):1661-1674.e11. doi: 10.1053/j.gastro.2019.01.260. Epub 2019 Feb 6. PMID: 30738046.
3. Hassan C, Spadaccini M, Iannone A, Maselli R, Jovani M, Chandrasekar VT, Antonelli G, Yu H, Areia M, Dinis-Ribeiro M, Bhandari P, Sharma P, Rex DK, Rösch T, Wallace M, Repici A. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc. 2021 Jan;93(1):77-85.e6. doi: 10.1016/j.gie.2020.06.059. Epub 2020 Jun 26. PMID: 32598963.

Disclosure

Laurence B Lovat is a consultant for, and minority shareholder in Odin Vision

Event

UEG Week Copenhagen 2023

Topics

Colorectal Digestive Oncology Endoscopy Mechanisms & Personalised Medicine

Submission format

Abstract

Session

AI in lower GI endoscopy

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

More Like This:

LONG-TERM OUTCOMES OF UPADACITINIB VERSUS TOFACITINIB FOR THE MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A MULTICENTRE REAL-WORLD STUDY COMPARING RESCUE AND SEQUENTIAL SALVAGE THERAPY

Yoon-Kyo An

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Mark Löwenberg

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Inés Constanze Hammel

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Hend Ayadi

EARLY PHASE MICROBIOME IS ASSOCIATED WITH POST DISCHARGE DIABETES, RECURRENT ACUTE PANCREATITIS AND MORTALITY- RESULTS FROM THE MULTICENTER PROSPECTIVE MAMBA-TRIAL

Albrecht Neesse

RANDOMISED CONTROLLED TRIAL OF A CLOUD-BASED ARTIFICIAL INTELLIGENCE POLYP DETECTION SYSTEM (CADDIE)

Laurence B. Lovat