Publications by authors named "Janneke van der Woude"

Background: The impact of prophylactic medication following ileocecal resection (ICR) for Crohn's disease (CD) merits further elucidation. Prophylactic medication following ileocecal resection (ICR) is recommended in patients with Crohn's disease (CD), particularly in patients at increased risk of recurrence, but the impact on long-term outcomes needs to be further elucidated.

Aim: To evaluate the effect of postoperative prophylactic medication on long-term prognosis.

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Fatigue is prevalent in immune-mediated inflammatory and neurodegenerative diseases, yet its assessment relies largely on patient-reported outcomes, which capture perception but not fluctuations over time. Wearable sensors, like inertial measurement units (IMUs), offer a way to monitor daily activities and evaluate functional capacity. This study investigates the relationship between sit-to-stand and stand-to-sit transitions and self-reported physical and mental fatigue in participants with Parkinson's, Huntington's, rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren's syndrome and inflammatory bowel disease.

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Perianal fistulizing disease, commonly associated with Crohn's disease, poses significant diagnostic and therapeutic challenges due to its complex anatomy and high recurrence rates. Radiological imaging plays a pivotal role in the accurate diagnosis, classification, and management of this condition. This article reviews the current radiological modalities employed in the evaluation of perianal fistulizing disease, including magnetic resonance imaging (MRI), endoanal ultrasound, and computed tomography (CT).

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  • Patients with Immune Mediated Inflammatory Diseases (IMIDs) on immunosuppressive therapy are at higher risk for vaccine-preventable infections, prompting this study to assess their vaccination rates against guidelines.
  • A survey sent to IMID patients at a Rotterdam hospital revealed that while 92% were vaccinated per national guidelines, many still lacked vaccinations for measles and diphtheria/tetanus/polio, and only a fraction received regular pneumococcal and influenza vaccines.
  • The study concludes that vaccination rates for these patients do not meet guidelines, and suggests focused efforts to improve vaccination compliance, especially for measles, diphtheria/tetanus/polio, and regular pneumococcal and influenza vaccinations.
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  • Risk stratification for endoscopic post-operative recurrence (ePOR) in Crohn's disease is crucial for identifying patients who would benefit from preventive treatments and closer monitoring.
  • A comprehensive review of 47 studies highlighted key risk factors for ePOR, such as active smoking, male gender, and previous bowel surgeries, but many factors listed in current guidelines lacked consistent evidence.
  • The findings suggest a need for personalized treatment strategies based on reliable risk factors to improve patient outcomes following ileocolic surgeries for Crohn's disease.
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Background: Many individuals with neurodegenerative (NDD) and immune-mediated inflammatory disorders (IMID) experience debilitating fatigue. Currently, assessments of fatigue rely on patient reported outcomes (PROs), which are subjective and prone to recall biases. Wearable devices, however, provide objective and reliable estimates of gait, an essential component of health, and may present objective evidence of fatigue.

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  • The study investigates the differences in anti-tumour necrosis factor (TNF) treatment response between pediatric (pIBD) and adult (aIBD) inflammatory bowel disease patients, highlighting that children often experience a loss of response in their first year on medication.
  • Researchers conducted a prospective, observational study comparing biomarkers from both groups, monitoring treatment escalation and drug levels over 18 months.
  • The findings revealed that treatment escalation occurred more frequently in pIBD patients, and while no biomarkers for maintained response were identified, nine pro-inflammatory proteins emerged as potential predictors for loss of response in this group.
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  • A study examined variations in treatment outcomes and costs of inflammatory bowel disease (IBD) across 8 hospitals in the Netherlands, focusing on how these differences can inform quality and cost improvements in care.
  • The study included 1010 patients and found that while clinicians reported high remission rates (83%), patient-reported rates were significantly lower (40%), indicating discrepancies in perceived outcomes.
  • Most variations in treatment outcomes and costs were linked to individual patient factors rather than the hospitals themselves, suggesting that future efforts should concentrate on enhancing patient-level care rather than evaluating hospitals based on these variations.
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  • In the LADI trial, researchers found that extending adalimumab (ADA) dosing intervals was just as effective as standard dosing for Crohn's disease patients in remission.
  • The study aimed to create a prediction model to identify patients who could successfully increase their dosing intervals based on trial data.
  • Results showed that 60.6% of patients successfully extended their dosing, with certain factors (like smoking and prior surgeries) making success less likely; the model's effectiveness needs further external validation before clinical use.
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Background: Faecal microbiota transplantation [FMT] shows some efficacy in treating patients with ulcerative colitis [UC], although variability has been observed among donors and treatment regimens. We investigated the effect of FMT using rationally selected donors after pretreatment with budesonide or placebo in active UC.

Methods: Patients ≥18 years old with mild to moderate active UC were randomly assigned to 3 weeks of budesonide [9 mg] or placebo followed by 4-weekly infusions of a donor faeces suspension.

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Background: Fatigue is a prominent symptom in many diseases and is strongly associated with impaired daily function. The measurement of daily function is currently almost always done with questionnaires, which are subjective and imprecise. With the recent advances of digital wearable technologies, novel approaches to evaluate daily function quantitatively and objectively in real-life conditions are increasingly possible.

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Background And Aims: The modified Rutgeerts score (mRS) is widely used for the assessment of endoscopic postoperative recurrence (ePOR) in Crohn's disease (CD) after ileocolic resection to guide therapeutic decisions. To improve the validity and prognostic value of this endoscopic assessment, 2 new scores have been proposed. This study assessed the interobserver agreement of the current score (mRS) and the new endoscopic score for ePOR in CD.

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Background: Evidence on ustekinumab safety in pregnancy is gradually expanding, but its clearance in the postnatal period is unknown. The aim of this study was to investigate ustekinumab concentrations in umbilical cord blood and rates of clearance after birth, as well as how these correlate with maternal drug concentrations, risk of infection, and developmental milestones during the first year of life.

Methods: Pregnant women with inflammatory bowel disease were prospectively recruited from 19 hospitals in Denmark and the Netherlands between 2018 and 2022.

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Current assessments of fatigue and sleepiness rely on patient reported outcomes (PROs), which are subjective and prone to recall bias. The current study investigated the use of gait variability in the "real world" to identify patient fatigue and daytime sleepiness. Inertial measurement units were worn on the lower backs of 159 participants (117 with six different immune and neurodegenerative disorders and 42 healthy controls) for up to 20 days, whom completed regular PROs.

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Background And Aims: Standardising health outcome measurements supports delivery of care and enables data-driven learning systems and secondary data use for research. As part of the Health Outcomes Observatory [H2O] initiative, and building on existing knowledge, a core outcome set [COS] for inflammatory bowel diseases [IBD] was defined through an international modified Delphi method.

Methods: Stakeholders rated 90 variables on a 9-point importance scale twice, allowing score modification based on feedback displayed per stakeholder group.

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Background: The International Consortium for Health Outcomes Measurement has selected the self-administered comorbidity questionnaire (SCQ) to adjust case-mix when comparing outcomes of inflammatory bowel disease (IBD) treatment between healthcare providers. However, the SCQ has not been validated for use in IBD patients.

Objectives: We assessed the validity of the SCQ for measuring comorbidities in IBD patients.

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Purpose: Recently, recommendations on perioperative care have been published to optimize postoperative outcomes in preoperative patients with inflammatory bowel disease. This study evaluated the current use of preoperative screening and prehabilitation strategies (PS) prior to elective ileocolic resection (ICR) in patients with Crohn's disease (CD).

Methods: Patients with CD who underwent an elective ICR were identified from a Dutch prospective cohort study.

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Article Synopsis
  • The study aimed to validate an anti-TNFα clearance model to inform the timing of live vaccinations in infants who were exposed to these drugs during pregnancy.
  • By analyzing data from newborns and using Bayesian optimization, the model accurately predicted drug concentrations in the PETIT cohort.
  • Results showed that the model had high predictive accuracy, with 94% of adalimumab and 93% of infliximab levels falling within the expected range, thus providing reliable guidance for clinicians on vaccination timing.
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Background: The advantage of early ileocecal resection after Crohn's disease diagnosis is a matter of debate. This study aims to assess the timing of ileocecal resection on prognosis, after correction for possible confounders.

Methods: Patients with Crohn's disease with primary ileocecal resection between 2000 and 2019 were included in a retrospective multicentre cohort.

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Introduction: The prognostic value of the modified Rutgeerts score (mRS) in patients with Crohn's disease (CD) needs to be further elucidated. This study assessed the prognostic value of the mRS for long-term outcomes after primary ileocecal resection in patients with CD.

Methods: Patients with CD after primary ileocecal resection with an available mRS at first postoperative ileocolonoscopy (index mRS) were retrospectively included.

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Background: Patients with inflammatory bowel disease (IBD) have an attenuated serologic response to COVID-19 vaccination. It is unclear whether an impaired immune response in vaccinated IBD patients impacts the susceptibility to SARS-CoV-2 infection and occurrence of severe COVID-19.

Objectives: To evaluate SARS-CoV-2 breakthrough infection rates and the disease course of COVID-19 in vaccinated IBD patients.

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Background: The risk of relapse after anti-tumour necrosis factor [TNF] therapy discontinuation in Crohn's disease patients with perianal fistulas [pCD] is unclear. We aimed to assess this risk.

Methods: A systematic literature search was conducted to identify cohort studies on the incidence of relapse following anti-TNF discontinuation in pCD patients.

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Article Synopsis
  • The study aimed to evaluate the cost-effectiveness of lengthening adalimumab dosing intervals for patients with Crohn's disease who are in stable remission, compared to the standard two-week interval.
  • A total of 174 patients participated, with results showing no significant difference in overall quality of life and total costs between the extended interval and control groups, although medication costs were lower in the extended group.
  • Increased dosing intervals were deemed cost-effective if the value of a quality-adjusted life year is below €53,960, suggesting that for higher valuations, the conventional dosing remains more favorable.
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