APR-2026
This month IBD research highlights key advances across multiple domains. Statin use in Crohn’s disease is associated with a ~28–29% reduction in stricture risk, suggesting a potential protective role. Personalized infliximab therapy in acute severe ulcerative colitis shows that pharmacokinetic-guided dosing can accurately predict and reduce colectomy risk. Ustekinumab vs infliximab in perianal Crohn’s disease demonstrates higher overall treatment success and lower relapse rates with ustekinumab. Burden of IBD in India reveals rising incidence and prevalence despite lower overall rates than global data, indicating a growing healthcare challenge. BSG colorectal surveillance guidelines emphasize risk-based, personalized monitoring using advanced endoscopy, AI, and multidisciplinary care to improve cancer prevention. Together, these studies reflect a shift toward precision medicine, improved risk stratification, and better long-term outcomes in IBD management.
Statins in stricturing CD
This propensity score-matched retrospective study evaluated whether statin use reduces the risk of intestinal stricture in Crohn’s disease using two large US databases (EVERSANA and Merative MarketScan). Statins, known for anti-inflammatory and anti-fibrotic effects, were associated with significantly lower stricture risk. In the EVERSANA cohort (1210 statin users vs 25,000 non-users, 3.8-year follow-up), statin use reduced stricture risk by 28% (HR 0.72). Findings were validated in the larger Merative cohort (9577 statin users vs 56,918 non-users, 3.6-year follow-up), showing a 29% reduction (HR 0.71). Outcomes were based on new stricture diagnosis or related procedures. Results suggest statins may have a protective role in preventing fibrostenotic complications in Crohn’s disease, supporting further prospective research.
Personalised therapy in ASUC
This multicenter retrospective study developed a pharmacokinetic-based model to optimize infliximab rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC). Data from 72 patients (152 infliximab levels) were analyzed to predict 90-day colectomy risk. Eleven patients required colectomy. The key predictor was clearance-normalized drug exposure between weeks 2–4 (AUCw2–4/CL), which showed strong predictive accuracy (AUC 0.79). A threshold (log AUCw2–4/CL <5.79) identified high-risk patients with 83% sensitivity and 85% specificity. The model incorporates patient-specific factors such as body weight, CRP, and drug levels to guide individualized dosing. Overall accuracy reached 85%. Findings support a personalized infliximab dosing approach to improve outcomes and reduce colectomy rates in ASUC.
Ustekinumab vs Infliximab for perianal CD
This retrospective study from China compared ustekinumab (UST) and infliximab (IFX) in biologic-naïve patients with perianal fistulizing Crohn’s disease. A total of 97 patients (49 UST, 48 IFX) were evaluated over 6 months. UST demonstrated significantly higher overall treatment success (89.8% vs 50.0%) and better intestinal clinical response (85.7% vs 68.8%) compared to IFX. However, both therapies showed similar outcomes in fistula remission, response, closure, and endoscopic endpoints. Complex fistulas were negatively associated with remission in both groups. During follow-up, IFX-treated patients had higher relapse and surgery rates. Findings suggest UST may offer improved overall effectiveness and durability compared to IFX in this patient population, particularly in real-world settings.
IBD burden in India
This study analyzed the epidemiological trends and burden of inflammatory bowel disease (IBD) in India using Global Burden of Disease 2019 data. In 2019, India reported lower age standardized incidence (2.34), prevalence (20.34), mortality (0.40), and disability rates (13.04) per 100,000 compared to global averages. However, trends show a concerning rise in incidence and prevalence over time, with annual increases higher than global rates. In contrast, mortality and disability-adjusted life years have declined more rapidly in India than globally, indicating improved disease management and outcomes. The study highlights a growing IBD burden in India, especially given its large population, and underscores the need for enhanced healthcare planning and future projections up to 2050.
Update - Dysplasia surveillance in IBD
These updated guidelines from the British Society of Gastroenterology provide comprehensive recommendations for colorectal cancer surveillance in patients with colonic inflammatory bowel disease. Based on a systematic review of 7,599 studies and GRADE methodology, 73 statements were developed covering risk stratification, surveillance intervals, and service delivery. Key areas include use of advanced colonoscopic techniques, biomarkers, and AI assisted detection, along with guidance on dysplasia management, chemoprevention, and multidisciplinary care. Emphasis is placed on personalized risk assessment, shared decision making, and quality standards for endoscopy services. The guidelines also address when to initiate or stop surveillance and highlight cost-effectiveness, sustainability, and patient experience. Sixteen research priorities are identified, aiming to further optimize colorectal cancer prevention strategies in IBD patients.