2025
Sleep tracking and sleep hygiene counseling improve fatigue in pediatric patients with inflammatory bowel disease
Kuzoian S, Jerson B, Brimacombe M, Schneeberg L, Hyams J. Sleep tracking and sleep hygiene counseling improve fatigue in pediatric patients with inflammatory bowel disease. Journal Of Pediatric Gastroenterology And Nutrition 2025, 81: 62-68. PMID: 40341610, DOI: 10.1002/jpn3.70066.Peer-Reviewed Original ResearchConceptsSleep hygiene counselingIntervention groupFatigue scoresSleep behaviour changeHygiene counselingSleep logsBehavioral changesSleep improvement interventionsInflammatory bowel diseasePresence of fatigueRandomized Controlled TrialsSleep/rest fatigueIntervention implementationAssessed 2 weeksPediatric QualityFatigue ScaleImprovement interventionsSleep counselingReduce fatigueSleep trackingImprove fatigueIn-personImprove sleepInadequate sleepCounselingUncovering shared genetic features between inflammatory bowel disease and systemic lupus erythematosus
Shaw V, Byun J, Zhu C, Pettit R, Cohen J, Han Y, Amos C. Uncovering shared genetic features between inflammatory bowel disease and systemic lupus erythematosus. Scientific Reports 2025, 15: 15309. PMID: 40312552, PMCID: PMC12046011, DOI: 10.1038/s41598-025-98991-0.Peer-Reviewed Original ResearchMeSH KeywordsFemaleGenetic Predisposition to DiseaseGenome-Wide Association StudyHumansInflammatory Bowel DiseasesLupus Erythematosus, SystemicMalePolymorphism, Single NucleotideConceptsGenetic correlation analysisHeritability enrichment analysisSummary level dataGenetic featuresGene-level collapsing analysisLocal genetic correlation analysisEnrichment analysisLocal genomic regionsUs Research ProgramInflammatory bowel diseaseGenomic regionsSNP heritabilityAssociation studiesInflammatory bowel disease phenotypeAssociation analysisFunctional categoriesExtra-intestinal manifestationsDisease variantsSystemic lupus erythematosus signalingRare variantsComplex autoimmune diseaseOdds ratioInflammatory Bowel Disease EtiologyGenetic correlationsAoURPTreat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial
Singh S, Nguyen J, Fudman D, Gerich M, Shah S, Hudesman D, McConnell R, Lukin D, Flynn A, Hwang C, Sprung B, Gaidos J, Mattar M, Rubin D, Hashash J, Metwally M, Ali T, Ma C, Hoentjen F, Narula N, Bessissow T, Rosenfeld G, McCurdy J, Ananthakrishnan A, Cross R, Gaytan J, Gurrola E, Patel S, Siegel C, Melmed G, Weaver S, Power S, Zou G, Jairath V, Hou J. Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial. BMJ Open Gastroenterology 2025, 12: e001615. PMID: 40164445, PMCID: PMC11962770, DOI: 10.1136/bmjgast-2024-001615.Peer-Reviewed Original ResearchConceptsInflammatory bowel diseaseAdvanced therapiesTreat-to-targetSymptomatic remissionBowel inflammationOpen-labelAsymptomatic patientsPatient-Centered Outcomes Research InstituteBowel diseaseControlled TrialsSafety of switchingClinical practiceActive bowel inflammationReduced bowel inflammationDeep remissionEndoscopic remissionTreatment failurePrimary endpointRandomised controlled trialsTargeted immunomodulationRemissionTherapyPatientsGood clinical practiceInformed consentSleep Deficiency and Fatigue in Adults with Inflammatory Bowel Disease: A Systematic Review
Conley S, Hwang Y, Al-Saleh S, Kamp K, Cahalan A, Redeker N. Sleep Deficiency and Fatigue in Adults with Inflammatory Bowel Disease: A Systematic Review. Western Journal Of Nursing Research 2025, 47: 292-307. PMID: 39882819, DOI: 10.1177/01939459251314941.Peer-Reviewed Original ResearchMeSH KeywordsAdultFatigueFemaleHumansInflammatory Bowel DiseasesMaleSleep Wake DisordersSurveys and QuestionnairesConceptsSystematic reviewSleep qualityAssociated with more severe fatigueFactors associated with fatigueSleep deficiencyAssociated with fatigueInflammatory bowel diseasePreferred Reporting ItemsPoor sleep qualitySelf-report questionnairesDiagnosis of inflammatory bowel diseaseMeasure fatigueImprove fatigueModifiable contributorReporting ItemsTreat fatigueBowel diseaseSevere fatigueSleep interventionsInclusion criteriaIntervention workDisabling symptomsAssessment of disease activityYounger ageIntervention
2024
Higher Rates of Delay in Starting Advanced Inflammatory Bowel Disease Therapies Linked to Insurance Delays, Intravenous Infusions, and Lack of Pharmacy Support
Gottesman S, Xiao K, Nguyen H, Hernandez E, Saweris E, Jagannathan P, Jafri F, Davis J, Tong K, Tang Z, Gaidos J, Feagins L. Higher Rates of Delay in Starting Advanced Inflammatory Bowel Disease Therapies Linked to Insurance Delays, Intravenous Infusions, and Lack of Pharmacy Support. Clinical And Translational Gastroenterology 2024, 16: e00808. PMID: 39718220, PMCID: PMC11932631, DOI: 10.14309/ctg.0000000000000808.Peer-Reviewed Original ResearchConceptsAdvanced therapiesRisk factorsMulticenter studyMulticenter study of patientsInflammatory bowel disease therapyStudy of patientsAdult inflammatory bowel diseasePatient-related factorsIntravenous drug deliverySmall molecule therapiesLogistic regression analysisInflammatory bowel diseaseBaseline demographicsDisease activityIntravenous infusionMolecule therapiesDisease characteristicsGastroenterology practiceTherapyBowel diseaseInsurance denialPatientsDoseIntravenous inductionCare teamSleep Deficiency A Symptoms Perspective: Exemplars from Chronic Heart Failure, Inflammatory Bowel Disease, and Breast Cancer
Redeker N, Conley S, Hwang Y. Sleep Deficiency A Symptoms Perspective: Exemplars from Chronic Heart Failure, Inflammatory Bowel Disease, and Breast Cancer. Sleep Medicine Clinics 2024, 19: 537-548. PMID: 39455175, DOI: 10.1016/j.jsmc.2024.07.003.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsChronic DiseaseFatigueFemaleHeart FailureHumansInflammatory Bowel DiseasesSleep Wake DisordersConceptsExcessive daytime sleepinessChronic heart failureInflammatory bowel diseaseBreast cancerHeart failureBowel diseaseContributions of sleep deficiencySleep disordersSleep deficiencyPrevalence of fatigueDaytime sleepinessDaytime symptomsChronic conditionsBreastCancerDeficiencySymptomsDiseaseSleepDisordersFatigueCryptosporidiosis in individuals with inflammatory bowel disease: a scoping review protocol
Liu B, Schnider A, DeArmond M, Banach D, Haubrich B. Cryptosporidiosis in individuals with inflammatory bowel disease: a scoping review protocol. BMJ Open 2024, 14: e086529. PMID: 39414295, PMCID: PMC11481120, DOI: 10.1136/bmjopen-2024-086529.Peer-Reviewed Original ResearchMeSH KeywordsCryptosporidiosisDiarrheaHumansImmunocompromised HostInflammatory Bowel DiseasesResearch DesignReview Literature as TopicRisk FactorsConceptsInflammatory bowel diseaseJoanna Briggs InstituteBowel diseaseAssociated with significant morbidityModerate-to-severe diarrheaPublished clinical literatureTreatment of cryptosporidiosisPeer-reviewed journalsImmunosuppressive therapyInstitutional review boardRisk of infectionSignificant morbidityImmunocompromised individualsTheses GlobalCrohn's diseaseGastrointestinal infectionsGrey literatureReview protocolRisk factorsAdult studiesCochrane LibrarySelf-limitingPatientsEpidemiological correlationReview teamWhen Perfect Is the Enemy of Good: Results of a RAND Appropriateness Panel on Treat to Target in Asymptomatic Inflammatory Bowel Disease
Systrom H, Rai V, Singh S, Baidoo L, Cheifetz A, Devlin S, Gecse K, Irving P, Kaplan G, Kozuch P, Ullman T, Sparrow M, Melmed G, Siegel C. When Perfect Is the Enemy of Good: Results of a RAND Appropriateness Panel on Treat to Target in Asymptomatic Inflammatory Bowel Disease. The American Journal Of Gastroenterology 2024, 120: 420-430. PMID: 39008539, DOI: 10.14309/ajg.0000000000002964.Peer-Reviewed Original ResearchConceptsInflammatory bowel diseaseAsymptomatic patientsChanging therapyStable diseaseEndoscopic remissionEndoscopic activityBowel diseaseAsymptomatic inflammatory bowel diseaseRAND/University of California Los Angeles Appropriateness MethodTreat-to-target strategyActive endoscopic diseaseUlcerative colitis patientsCrohn's disease patientsLos Angeles Appropriateness MethodExtensive diseaseDisease extentPatient ageAphthous ulcersRandomized studyEndoscopic diseaseClinical decision-makingColitis patientsAdvanced therapiesTreatment adjustmentAnonymous surveyChallenges in IBD Research 2024: Preclinical Human IBD Mechanisms
Ciorba M, Konnikova L, Hirota S, Lucchetta E, Turner J, Slavin A, Johnson K, Condray C, Hong S, Cressall B, Pizarro T, Hurtado-Lorenzo A, Heller C, Moss A, Swantek J, Garrett W. Challenges in IBD Research 2024: Preclinical Human IBD Mechanisms. Inflammatory Bowel Diseases 2024, 30: s5-s18. PMID: 38778627, PMCID: PMC11491665, DOI: 10.1093/ibd/izae081.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsBiomedical ResearchGastrointestinal MicrobiomeHumansInflammatory Bowel DiseasesPrecision MedicineConceptsInflammatory bowel diseasePreclinical human IBD mechanismsInflammatory bowel disease researchHuman inflammatory bowel diseaseCell statesRisk allelesUnmet medical needExtraintestinal manifestationsPrecision medicineInflammatory bowel disease complicationsPreclinical researchBowel diseasePragmatic clinical researchMultidisciplinary inputBarrier functionDisease researchEnvironmental triggersMedical needClinical researchTranslational scientistsMicrobiomeAllelesEpigeneticsGeneticsRemissionIL-23 past, present, and future: a roadmap to advancing IL-23 science and therapy
Krueger J, Eyerich K, Kuchroo V, Ritchlin C, Abreu M, Elloso M, Fourie A, Fakharzadeh S, Sherlock J, Yang Y, J. D, McInnes I. IL-23 past, present, and future: a roadmap to advancing IL-23 science and therapy. Frontiers In Immunology 2024, 15: 1331217. PMID: 38686385, PMCID: PMC11056518, DOI: 10.3389/fimmu.2024.1331217.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsArthritis, PsoriaticHumansInflammatory Bowel DiseasesInterleukin-23PsoriasisSignal TransductionConceptsImmune-mediated inflammatory diseasesIL-23 inhibitionIL-23Anti-IL-23 therapyOptimal identification of patientsTreat immune-mediated inflammatory diseasesIL-12 cytokine family memberInterleukin (IL)-23Identification of patientsIL-23 signalingCytokine family membersInflammatory bowel diseaseMolecular ontologiesRegulatory cytokinesIL-12Psoriatic arthritisInflammatory diseasesBowel diseaseDiseaseTherapyFamily membersBiologyDHX9 maintains epithelial homeostasis by restraining R-loop-mediated genomic instability in intestinal stem cells
Ren X, Liu Q, Zhou P, Zhou T, Wang D, Mei Q, Flavell R, Liu Z, Li M, Pan W, Zhu S. DHX9 maintains epithelial homeostasis by restraining R-loop-mediated genomic instability in intestinal stem cells. Nature Communications 2024, 15: 3080. PMID: 38594251, PMCID: PMC11004185, DOI: 10.1038/s41467-024-47235-2.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsDEAD-box RNA HelicasesEpithelial CellsHomeostasisHumansInflammatory Bowel DiseasesIntestinal MucosaMiceNeoplasm ProteinsPaneth CellsR-Loop StructuresStem CellsConceptsInflammatory bowel diseaseIntestinal stem cellsIntestinal epithelial cellsEpithelial homeostasisSusceptibility to experimental colitisIncreased susceptibility to experimental colitisImpaired ISC functionStem cellsEpithelial barrier dysfunctionGenomic instabilityInflammatory bowel disease patientsPathogenesis of inflammatory bowel diseaseR-loop-mediated genome instabilityHallmarks of inflammatory bowel diseaseContinuous self-renewalBarrier dysfunctionExperimental colitisCrypt destructionEpithelial cellsInflammatory responseSelf-RenewalBowel diseaseRisk factorsIntestinal epitheliumProtein levelsAfrican American race does not confer an increased risk of clinical events in patients with primary sclerosing cholangitis.
Yazdanfar M, Zepeda J, Dean R, Wu J, Levy C, Goldberg D, Lammert C, Prenner S, Reddy K, Pratt D, Forman L, Assis D, Lytvyak E, Montano-Loza A, Gordon S, Carey E, Ahn J, Schlansky B, Korzenik J, Karagozian R, Hameed B, Chandna S, Yu L, Bowlus C. African American race does not confer an increased risk of clinical events in patients with primary sclerosing cholangitis. Hepatology Communications 2024, 8 PMID: 38285883, PMCID: PMC10830082, DOI: 10.1097/hc9.0000000000000366.Peer-Reviewed Original ResearchMeSH KeywordsBlack or African AmericanCholangitis, SclerosingDelayed DiagnosisEnd Stage Liver DiseaseHumansInflammatory Bowel DiseasesRetrospective StudiesSeverity of Illness IndexConceptsPrimary sclerosing cholangitisTransplant-free survivalInflammatory bowel diseaseHepatic decompensationNon-Hispanic whitesSclerosing cholangitisIncreased risk of clinical eventsNatural history of primary sclerosing cholangitisAssociated with transplant-free survivalHistory of primary sclerosing cholangitisAssociated with hepatic decompensationBowel diseaseProgression to hepatic decompensationRisk of clinical eventsDecompensation-free survivalMayo risk scoreAbnormal liver testsPerformance of prognostic modelsAfrican American raceRates of inflammatory bowel diseaseDeath/liver transplantationAA patientsLiver testsDiagnostic delayAA race“Deficiency in ELF4, X-Linked”: a Monogenic Disease Entity Resembling Behçet’s Syndrome and Inflammatory Bowel Disease
Olyha S, O’Connor S, Kribis M, Bucklin M, Uthaya Kumar D, Tyler P, Alam F, Jones K, Sheikha H, Konnikova L, Lakhani S, Montgomery R, Catanzaro J, Du H, DiGiacomo D, Rothermel H, Moran C, Fiedler K, Warner N, Hoppenreijs E, van der Made C, Hoischen A, Olbrich P, Neth O, Rodríguez-Martínez A, Lucena Soto J, van Rossum A, Dalm V, Muise A, Lucas C. “Deficiency in ELF4, X-Linked”: a Monogenic Disease Entity Resembling Behçet’s Syndrome and Inflammatory Bowel Disease. Journal Of Clinical Immunology 2024, 44: 44. PMID: 38231408, PMCID: PMC10929603, DOI: 10.1007/s10875-023-01610-8.Peer-Reviewed Original ResearchMeSH KeywordsArthralgiaArthritisBehcet SyndromeBiological ProductsDNA-Binding ProteinsHumansInflammatory Bowel DiseasesMaleTranscription FactorsConceptsDEX patientsClass-switched memory B cellsInborn errors of immunityTreated with anti-inflammatory agentsLow natural killerX-linkedMemory B cellsErrors of immunityCohort of patientsIncreased inflammatory cytokinesLoss-of-function variantsHeterogeneous clinical phenotypesInflammatory bowel diseaseTargeted therapeutic interventionsNatural killerAnti-inflammatory agentsAphthous ulcersTherapeutic responseAutoinflammatory syndromeInflammatory markersClinical manifestationsB cellsBehcet's syndromeGastrointestinal symptomsMechanisms of diseasePsoriasis associated with inflammatory bowel disease: a cross‐sectional analysis in the NIH All of Us Research Program
Joel M, Wride A, Cohen J. Psoriasis associated with inflammatory bowel disease: a cross‐sectional analysis in the NIH All of Us Research Program. International Journal Of Dermatology 2024, 63: e82-e83. PMID: 38204174, PMCID: PMC10922412, DOI: 10.1111/ijd.17015.Peer-Reviewed Original Research
2023
The association between inflammatory bowel disease and all-cause and cause-specific mortality in the UK Biobank
Li F, Ramirez Y, Yano Y, Daniel C, Sharma S, Brown E, Li R, Moshiree B, Loftfield E, Lan Q, Sinha R, Inoue-Choi M, Vogtmann E. The association between inflammatory bowel disease and all-cause and cause-specific mortality in the UK Biobank. Annals Of Epidemiology 2023, 88: 15-22. PMID: 38013230, PMCID: PMC10842122, DOI: 10.1016/j.annepidem.2023.10.008.Peer-Reviewed Original ResearchMeSH KeywordsBiological Specimen BanksCause of DeathHumansInflammatory Bowel DiseasesNeoplasmsProspective StudiesRisk FactorsUnited KingdomConceptsInflammatory bowel diseaseCause-specific mortalityBody mass indexColorectal cancerCause mortalityHazard ratioBowel diseaseMortality rateMultivariable Cox proportional hazards regression modelsHistory of IBDCox proportional hazards regression modelProportional hazards regression modelsBreast cancer mortality ratesProspective cohort studyCRC mortality ratesRisk of deathHazards regression modelsRisk of mortalityConfidence intervalsHospital admission dataPatient management strategiesCancer mortality ratesUK BiobankIBD diagnosisCohort studyComparison of Disease Phenotype and Course among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East
Vosoghinia H, Saberzadeh-Ardestani B, Anushiravani A, Mansour-Ghanaei F, Fakheri H, Vahedi H, Sheikhesmaeili F, Yazdanbod A, Moosavy S, Maleki I, Nasseri-Moghaddam S, Khosravi B, Malekzadeh M, Kasaeian A, Alatab S, Sadeghi A, Kolahdoozan S, Amani M, Saberhosseini S, Rayatpisheh M, Ahadi M, Colombel J, Ungaro R, Sima A, Malekzadeh R. Comparison of Disease Phenotype and Course among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East. Archives Of Iranian Medicine 2023, 26: 481-488. PMID: 38310403, PMCID: PMC10862057, DOI: 10.34172/aim.2023.73.Peer-Reviewed Original ResearchMeSH KeywordsAgedColitis, UlcerativeCrohn DiseaseHumansImmunologic FactorsInflammatory Bowel DiseasesIranPhenotypePrednisoloneRetrospective StudiesTumor Necrosis Factor InhibitorsConceptsElderly-onset inflammatory bowel diseaseInflammatory bowel diseaseEarly-onset inflammatory bowel diseaseInflammatory bowel disease patientsUC patientsAggressive phenotypeElderly-onset IBD patientsCrohn's diseaseAnti-tumor necrosis factorDisease phenotypeUlcerative colitisBowel diseaseElderly-onset UCAnti-TNF useLeft-sided colitisRetrospective cohort studyIBD-related surgeryRelative risk of ageEarly-onset casesIleocolonic locationPhenotype of diseaseAnti-TNFEarly-onset CDElderly-onsetClinical manifestationsOutcomes of Infliximab-Treated inflammatory bowel disease patients undergoing therapeutic drug monitoring with two different assays
Al-Bawardy B, Jenkins S, Snyder M, Frinack J, Ladwig P, Loftus E, Willrich M. Outcomes of Infliximab-Treated inflammatory bowel disease patients undergoing therapeutic drug monitoring with two different assays. Clinical Biochemistry 2023, 119: 110618. PMID: 37507083, DOI: 10.1016/j.clinbiochem.2023.110618.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChromatography, LiquidDrug MonitoringFemaleHumansInflammatory Bowel DiseasesInfliximabMaleMiddle AgedTandem Mass SpectrometryYoung AdultConceptsInflammatory bowel disease patientsBowel disease patientsEndoscopic healingClinical remissionDisease patientsMcg/Normal serum C-reactive proteinDrug monitoringSerum C-reactive proteinLC-MS/MSInfliximab drug levelsFavorable clinical outcomeC-reactive proteinTherapeutic drug monitoringIBD patientsNormal CRPClinical outcomesDrug levelsPatientsECLIARemissionDifferent assaysOutcomesMcgAssaysThe global, regional, and national burden of inflammatory bowel diseases, 1990–2019: A systematic analysis for the global burden of disease study 2019
Park J, Jeong G, Song M, Yon D, Lee S, Koyanagi A, Jacob L, Kostev K, Dragioti E, Radua J, Cheon J, Shin J, Smith L. The global, regional, and national burden of inflammatory bowel diseases, 1990–2019: A systematic analysis for the global burden of disease study 2019. Digestive And Liver Disease 2023, 55: 1352-1359. PMID: 37137806, DOI: 10.1016/j.dld.2023.04.003.Peer-Reviewed Original ResearchMeSH KeywordsGlobal Burden of DiseaseGlobal HealthHumansIncidenceInflammatory Bowel DiseasesPersons with DisabilitiesPrevalenceQuality-Adjusted Life YearsConceptsAge-standardized prevalence rateDisability-adjusted life yearsPrevalence ratesAge-standardized death ratesGlobal burdenBurden of inflammatory bowel diseaseEpidemiology of inflammatory bowel diseaseGlobal Burden of DiseaseHighest age-standardized prevalence ratesAnnual percentage changeHigh-income Asia PacificInflammatory bowel diseaseRisk Factors StudyDeath rateBurden of diseasePrevalence of inflammatory bowel diseaseYears of lifeHigher socioeconomic indexGBD studyCrude prevalenceNational burdenSocioeconomic indexLife yearsFactor studiesDisease StudyAssessment of Inflammatory Bowel Disease Training Among Gastroenterology Fellows
Al-Bawardy B, Malter L, Ehrlich A, Rieder F, Gaidos J, Proctor D, Windish D. Assessment of Inflammatory Bowel Disease Training Among Gastroenterology Fellows. Inflammatory Bowel Diseases 2023, 29: 1990-1992. PMID: 36810663, PMCID: PMC11491607, DOI: 10.1093/ibd/izad030.Peer-Reviewed Original ResearchUse, Durability, and Risks for Discontinuation of Initial and Subsequent Biologics in a Large Pediatric‐Onset IBD Cohort
Kaplan J, Liu C, King E, Bass J, Patel A, Tung J, Chen S, Lissoos T, Candela N, Saeed S, Colletti R, Network I, Adler J, Baron H, Cabrera J, Dorsey J, Dykes D, Ebach D, Garin‐Laflam M, Gold B, Grunow J, Higuchi L, Jester T, Lapsia S, Leibowitz I, Linvlle T, Morhardt T, Moses J, Moulton D, Nasiri‐Blomgren S, Niklinska‐Schirtz B, Ogunmola N, Palomo P, Park K, Pashankar D, Pasternak B, Radano M, Samson C, Sandberg K, Schaefer M, Shashidhar H, Steiner S, Sullivan J, Tomer G, Verstraete S. Use, Durability, and Risks for Discontinuation of Initial and Subsequent Biologics in a Large Pediatric‐Onset IBD Cohort. Journal Of Pediatric Gastroenterology And Nutrition 2023, 76: 566-575. PMID: 36804501, PMCID: PMC10097486, DOI: 10.1097/mpg.0000000000003734.Peer-Reviewed Original ResearchMeSH KeywordsAdalimumabAdolescentBiological FactorsBiological ProductsChildColitis, UlcerativeCrohn DiseaseHumansInflammatory Bowel DiseasesInfliximabConceptsCrohn's diseaseUlcerative colitisLoss of responseFirst biologicSubsequent biologicsBiologic agentsBiologic medicationsBiologic treatmentAnti-tumor necrosis factor agentsUpper gastrointestinal tract involvementGastrointestinal tract involvementNecrosis factor agentsActive Crohn's diseaseFirst biologic agentIBD cohortInitial biologicSecond biologicTract involvementCorticosteroid useFactor agentsPediatric IBDBiologic initiationDisease courseUnivariate analysisSevere disease
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