Sa489 DEPRESSION BEFORE AND AFTER THE DIAGNOSIS OF INFLAMMATORY BOWEL DISEASE: A NATIONWIDE POPULATION STUDY

Background and Aims: The COVID-19 pandemic poses a great challenge to healthcare. We aimed to investigate the impact of COVID-19 on the healthcare of patients with inflammatory bowel disease (IBD) in epicenter and non-epicenter areas.Methods: Patients with IBD from Hubei province (the epicenter of COVID-19) and Guangdong province (a non-epicenter area), China were surveyed during the pandemic. The questionnaire included change of medications (steroids, immunomodulators, and biologics), procedures (lab tests, endoscopy, and elective surgery), and healthcare mode (standard healthcare vs. telemedicine) during 1 month before and after the outbreak of COVID-19.Results: In total, 324 IBD patients from Guangdong province (non-epicenter) and 149 from Hubei province (epicenter) completed the questionnaire with comparable demographic characteristics. Compared to patients in Guangdong province (non-epicenter), significantly more patients in Hubei (epicenter) had delayed lab tests/endoscopy procedures [61.1% (91/149) vs. 25.3% (82/324), p < 0.001], drug withdrawal [28.6% (43/149) vs. 9.3% (30/324), p < 0.001], delayed biologics infusions [60.4% (90/149) vs. 19.1% (62/324), p < 0.001], and postponed elective surgery [16.1% (24/149) vs. 3.7% (12/324), p < 0.001]. There was an increased use of telemedicine after the outbreak compared to before the outbreak in Hubei province [38.9% (58/149) vs. 15.4% (23/149), p < 0.001], while such a significant increase was not observed in Guangdong province [21.9% (71/324) vs. 18.8% (61/324), p = 0.38]. Approximately two-thirds of IBD patients from both sites agreed that telemedicine should be increasingly used in future medical care.Conclusions: Our patient-based survey study in a real-world setting showed that COVID-19 resulted in a great impact on the healthcare of patients with IBD, and such an impact was more obvious in the epicenter compared to the non-epicenter area of COVID-19. Telemedicine offers a good solution to counteract the challenges in an unprecedented situation such as COVID-19.

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Sa1899 CLINICAL IMPLICATIONS OF INFLIXIMAB AND ADALIMUMAB THERAPEUTIC DRUG MONITORING BEFORE AND AFTER THE IMPLEMENTATION OF CORRECTIVE MEASURES FOR THE HOMOGENEOUS MOBILITY SHIFT ASSAY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Gastroenterology ◽

10.1016/s0016-5085(20)31858-8 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-471

Author(s):

Konstantinos Papamichail ◽

William Clarke ◽

Katharine A. Germansky ◽

Sarah N. Flier ◽

Joseph D. Feuerstein ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Therapeutic Drug Monitoring ◽

Bowel Disease ◽

Drug Monitoring ◽

Therapeutic Drug ◽

Clinical Implications ◽

Mobility Shift ◽

Before And After ◽

Inflammatory Bowel ◽

Mobility Shift Assay

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QuantiFERON-TB Gold Test Conversion Is Associated with Active Tuberculosis Development in Inflammatory Bowel Disease Patients Treated with Biological Agents: An Experience of a Medical Center in Taiwan

Gastroenterology Research and Practice ◽

10.1155/2019/7132875 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Hsiang-Chun Lai ◽

Chia-Hsi Chang ◽

Ken-Sheng Cheng ◽

Tsung-Wei Chen ◽

Yuan-Yao Tsai ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Biological Treatment ◽

Medical Center ◽

Biological Agents ◽

Baseline Serum ◽

Tertiary Referral Center ◽

Western Countries ◽

Before And After ◽

Inflammatory Bowel

Taiwan has a lower prevalence of inflammatory bowel disease (IBD) and a higher prevalence of tuberculosis (TB) infection than Western countries. The aim of this study was to investigate the prevalence of latent TB (LTB) and active TB infection in IBD patients treated with biological agents. From January 2000 to September 2018, we retrospectively collected data from IBD patients treated with biological agents at a tertiary referral center. Patients underwent a QuantiFERON-TB Gold test (QFT) to screen for TB infection before and after biological treatment courses. The diagnostic age, sex, body mass index, hepatitis B virus infection, biochemistry profile, treatment regimens, and the results of the QFT were analyzed. Overall, 130 IBD patients who received biological treatment were enrolled. The results of the QFT before biological treatment were determined in 120 patients (92%); of these, 10 were positive (8%), 110 were negative (85%), and 10 were indeterminate (9%). Six patients demonstrated seroconversion after biological treatment, as determined by the QFT. Three patients (2.4%) developed active pulmonary TB after biological treatment. In subgroup analysis, the positive QFT patients had a trend of lower baseline serum C-reactive protein and erythrocyte sedimentation rate levels than the negative QFT group. The present study demonstrates that the prevalence of LTB before and after biological treatment is higher in Taiwan than in most Western countries and similar to other Asian countries. Therefore, screening and monitoring of TB infection are necessary for IBD patients before and during biological treatments in Taiwan.

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P077 A NEW TREATMENT APPROACH FOR INFLAMMATORY BOWEL DISEASE: INTRACOLONIC BIFIDOBACTERIUM AND XYLOGLUCAN APPLICATION

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.090 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S35-S36

Author(s):

Hüseyin Bozkurt

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mucosal Healing ◽

Single Administration ◽

Diagnostic Strategies ◽

Bifidobacterium Animalis ◽

Mayo Score ◽

Before And After ◽

Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) pathogenesis includes the altered gut microbiota, environmental factors, human immune responses and genetic. Reduced bifidobacteria level is associated with IBD. Xyloglucan is a plant based prebiotic oligosaccharide. Bifidobacteria level is increased in the presence of xyloglucan. In this article we aim to share the results of our cases; Ulcerative colitis (UC) patients treated by intracolonic single administration of Bifidobacterium animalis subsp. lactis and Xyloglucan combination. Methods Ten UC patients were evaluated; before and after intracolonic single administration of Bifidobacterium animalis subsp. lactis and Xyloglucan combination with colonoscopic laboratory and clinical examination. Results Age, sex, diagnosis, disease location, previous medications are summarized in Table 1. All the patients had active ulcerative colitis disease before the administration. The Mayo Score was used to assess the severity of UC. 2 cases had extensive colitis and 8 patients had left-sided colitis. After 6 weeks of the administration mucosal healing and resolution of colonic symptoms were seen. These results are summarized in Table 2. Of the 10 cases, 7 were undertaken 5-ASA +Azathiopurine and three were undertaken vedolizumab treatment. Intracolonic single Bifidobacterium animalis subsp. lactis and xyloglucan administration was found effective in the mucosal healing and resolution of colonic symptoms in ulcerative colitis patients. Conclusions Herein we reported the importance of Bifidobacterium and xylooligosaccharide combination in IBD. Colonoscopic single Bifidobacterium animalis subsp. lactis and xyloglucan administration is a new method that has no side effect and easy to apply for treatment of IBD.This application might provide enhancement of non-stimulatory status and higher biodiversity in colonic mucosa so mucosal healing may be improved rapidly. However, it would be necessary to develop diagnostic strategies in order to discriminate which patients would benefit from this strategy.

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P564 Psychological acceptance of surgery in patients with inflammatory bowel disease undergoing intestinal resection

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.692 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S475-S476

Author(s):

Y Hirano ◽

M Itabashi ◽

T Saito ◽

K Uchida ◽

M Inoue ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Interpersonal Relationships ◽

Bowel Disease ◽

Intestinal Resection ◽

Cross Sectional ◽

Age At Surgery ◽

Before And After ◽

Vas Scores ◽

Inflammatory Bowel ◽

Psychological Acceptance

Abstract Background To decision to undergo surgical intestinal resection is among the most difficult that patients with inflammatory bowel disease (IBD) may be required to make during the disease course. Although the clinical outcomes and QoL after intestinal resection are well established, few studies have focused on psychological acceptance of the surgery, that is, how patients feel about the results of intestinal resection. The aim of this study was therefore to evaluate psychological acceptance of the surgical outcome in patients undergoing intestinal resection. Methods We administered a cross-sectional questionnaire survey to patients at five IBD centres in Japan who had undergone intestinal resection at least 1 month before the survey. Patients were asked to complete a visual analogue scale (VAS) questionnaire, consisting of 20 questions related to surgical acceptance and concerns related to IBD (body image, burden of treatment, interpersonal relationships), before and after surgery. The VAS scores before surgery were described by the patient looking back on recollection. Pre- and post-surgical VAS scores were compared using a Wilcoxon’s rank-sum test. Results A total of 64 patients participated in this study (median age at surgery 37.9 (range 12–67) years, median years after surgery 5.0 (range 0.1–21) years). The VAS scores before and after surgery were summarised in the figure. The score for ‘pleased to have surgical resection of my intestine’ improved significantly after the surgery in both UC and CD (p < .0001).Furthermore, the score for ‘burdened with treatment for my IBD’ improved significantly after surgery in UC patients (p < .0001). Conclusion Our findings indicate that surgical intestinal resection outcomes were psychologically well accepted by most IBD patients.

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Prenatal exposure of extra vitamin D from fortification and later risk of inflammatory bowel disease

European Journal of Public Health ◽

10.1093/eurpub/ckz187.135 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

K S Duus ◽

C M Moos ◽

P Frederiksen ◽

V Andersen ◽

B L Heitmann

Keyword(s):

Inflammatory Bowel Disease ◽

Vitamin D ◽

Prenatal Exposure ◽

Bowel Disease ◽

Therapeutic Effects ◽

Birth Cohorts ◽

Birth Registry ◽

Fortified Food ◽

Before And After ◽

Inflammatory Bowel

Abstract Introduction Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory disease that can affect the entire digestive tract. Approximately 1% of the Danish population has IBD today. Both the incidence and prevalence of IBD are increasing globally, but the etiology of IBD is still not fully understood. Some, but not all studies find that vitamin D has both protective and therapeutic effects on IBD. To our knowledge, no other study has investigated prenatal exposure to extra vitamin D from either fortified food, diet or supplements in relation to IBD. The aim of this study was to investigate whether a small extra dose of vitamin D from fortification during gestation, was associated with a lower risk of developing IBD in the offspring. Methods In 1985 mandatory fortification of margarine with vitamin D in Denmark was canceled. To investigate the effect of this policy change we selected all individuals from 2 full year birth cohorts before and after the termination of the mandatory fortification. All individuals were followed for 30 years. By merging data from the Medical Birth Registry with the Danish National Patient Registry, we identified individuals with IBD. Results 217,249 individuals were included in the analysis. 875 among the exposed and 1102 among the unexposed fulfilled the criteria for being diagnosed with IBD. A lower odds ratio OR = 0.867 (95% CI: 0.792;0.947) for IBD was observed among those who had been exposed to extra vitamin D from fortified margarine during gestation, compared to those who had not been exposed. The analysis was adjusted for sex and season of birth, but results were essentially similar before and after this adjustment. Conclusions This study shows, that a small extra dose of vitamin D from fortified margarine during gestation may lower the risk of developing IBD in the offspring, until the age of 30. If these results can be replicated, fortification with vitamin D could be recommended to prevent IBD on a public level. Key messages Prenatal exposure of vitamin D from fortified food could lower the risk of IBD later in life. Fortification with vitamin D even at a relatively low level could have public health benefits.

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