Publications by authors named "Kopylov U"

Background: Small bowel video capsule endoscopy (SB-VCE) assesses mucosal inflammation in Crohn's disease (CD), while intestinal ultrasound (IUS) examines transmural involvement. We aimed to correlate SB-VCE with IUS in evaluating active CD and monitoring treatment response over time.

Methods: Patients with active SB-CD who initiated biologics were prospectively followed with fecal calprotectin (FC), SB-VCE, and IUS at baseline and after 14 and 52 weeks.

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Background: Inflammatory bowel disease (IBD) presents unique challenges in elderly patients due to comorbidities and treatment-related risks.

Objectives: This study evaluates ustekinumab (UST) and vedolizumab (VDZ) efficacy and safety in elderly Crohn's disease (CD) patients.

Design: A retrospective cohort study at a tertiary medical center.

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Background: Intestinal ultrasound (IUS) is used to assess disease activity, complications, and treatment follow-up in Crohn's disease (CD). Less is known about the association of disease activity on IUS with the risk of future disease relapse during biologically sustained clinical remission in CD.

Aim: The study aimed to investigate the association between IUS activity parameters and subsequent therapy failure in asymptomatic biologically treated patients with CD.

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Capsule endoscopy has been proven as an efficient and accurate tool in the diagnosing and monitoring patients with inflammatory bowel disease, especially Crohn's disease (CD). The current European Crohn's and Colitis Organization guidelines recommend small bowel disease assessment in newly diagnosed CD, wherein small bowel capsule endoscopy (SBCE) is of prime importance. SBCE plays an essential role in assessing mucosal healing in patients with CD, serving as a monitoring tool in a treat to target strategy, and is capable of identifying high-risk patients for future flares.

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Background: The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation.

Objectives: Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers.

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Article Synopsis
  • A study was conducted to compare two preparation protocols for patients with Crohn's disease who ingested a patency capsule (PC) to assess its effectiveness in reducing failed PC rates.
  • The pro-motility group, which followed a specific diet and took medication, showed a significantly lower failed PC rate (12.0%) compared to the control group (24.7%).
  • Findings suggest that the pro-motility protocol not only enhances the success rate of the patency test but may also help minimize the risk of complications related to capsule retention.
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Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by increased stool frequency, rectal bleeding, and urgency. To streamline the quantitative assessment of histopathology using the Nancy Index in UC patients, we developed a novel artificial intelligence (AI) tool based on deep learning and tested it in a proof-of-concept trial. In this study, we report the performance of a modified version of the AI tool.

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Background: Previous studies highlighted a more extensive phenotype for paediatric-onset than adult-onset inflammatory bowel disease (IBD). However, most lacked long-term follow-up, and some were conducted before the era of biologics.

Aims: The aim of this study is to compare disease characteristics and treatment exposures between paediatric-onset and adult-onset IBD.

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Introduction: Complicated perianal disease (cPD) may be the sole presentation of Crohn's disease (CD). The role of small-bowel capsule endoscopy (SBCE) in the diagnostic algorithm of cPD is unclear. We aimed to evaluate the role of SBCE as a diagnostic tool, in patients with cPD, after a negative standard workup for CD.

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Background And Aims: Fecal calprotectin (FC) is known to be a sensitive biomarker of colonic inflammation but to a lesser degree of small bowel (SB) inflammation. Moreover, data on FC's diagnostic levels in different SB segments are scarce. We aimed to examine FC's diagnostic levels along the SB-axis in CD.

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Article Synopsis
  • The objective was to create a web-based AI tool that predicts drug sustainability (DS) for infliximab and vedolizumab in patients with moderate-to-severe Ulcerative Colitis (UC), addressing a gap in reliable prediction methods.!
  • The study included data from three Israeli medical centers, analyzing patients treated for over 54 weeks without corticosteroids, hospitalizations, or surgeries, using machine learning for accurate predictions based on baseline clinical data.!
  • The developed model showed strong predictive performance with an area under the ROC curve of 0.86 and accuracy ranging from 65.5% to 76.9%, promising improvements in clinical decision-making for managing UC while enhancing precision medicine practices.!
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This article is the second in a series of two publications on the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of Crohn's disease. The first article covers medical management; the present article addresses surgical management, including preoperative aspects and drug management before surgery. It also provides technical advice for a variety of common clinical situations.

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Background And Aims: Pan-enteric capsule endoscopy (PillCam Crohn's capsule [PCC]) is a useful tool in diagnosing and monitoring Crohn's disease [CD]. Eliakim score [ES] reliability and its strong correlation to Lewis score [LS] and to inflammatory biomarkers have been previously demonstrated using PCC in quiescent CD. We aimed to examine ES performance in active CD and its responsiveness to clinical/biochemical change over time.

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Article Synopsis
  • A study compared the effectiveness of tofacitinib and ustekinumab as third-line treatments for patients with moderate to severe ulcerative colitis (UC) who did not respond to earlier therapies (anti-TNF and vedolizumab).
  • Out of 117 patients followed for about 11.6 months, 54% experienced disease progression, with ustekinumab being associated with a higher risk of progression compared to tofacitinib.
  • While tofacitinib showed better results in preventing disease progression, no major differences were noted in secondary outcomes or adverse events, highlighting the need for more extensive clinical trials to validate these findings.
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Background: Heterogeneity in demographic and outcomes data with corresponding measurement instruments [MIs] creates barriers to data pooling and analysis. Several core outcome sets have been developed in inflammatory bowel disease [IBD] to homogenize outcomes data. A parallel Minimum Data Set [MDS] for baseline characteristics is lacking.

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Introduction: Artificial intelligence (AI) could minimize the operator-dependent variation in colonoscopy quality. Computer-aided detection (CADe) has improved adenoma detection rate (ADR) and adenomas per colonoscopy (APC) in randomized controlled trials. There is a need to assess the impact of CADe in real-world settings.

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Background: The link between ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) is well-established, with concurrent prevalence estimates ranging from 5-10%. However, there are still significant gaps in our understanding, and a comprehensive treatment guideline for these co-diagnosed patients has yet to be established. Our objective was to explore patterns of treatment alterations following the diagnosis of AS in patients previously diagnosed with IBD, and vice versa.

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  • A study investigated the effectiveness of adalimumab, an anti-TNFα monoclonal antibody, in ulcerative colitis (UC) patients, revealing that fewer UC patients continued treatment compared to those with Crohn's disease (CD).
  • In a cohort of 50 UC patients, only 22% maintained treatment through the follow-up period, while 51% of 98 CD patients did.
  • The loss of response to treatment was notably higher in UC patients, with 34% developing antibodies against adalimumab, although immunogenicity rates were similar between both patient groups.
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Article Synopsis
  • - Ustekinumab is a monoclonal antibody used to treat Crohn's disease, with about 50% of patients achieving clinical remission after one year; the study aimed to find predictors of response to this treatment by analyzing blood samples before initiation.
  • - RNA from blood samples of 36 adults with Crohn's was sequenced, identifying 22 responders and 14 nonresponders, but no significant gene expression signature was found between the two groups after correcting for false discovery rates.
  • - Despite the lack of major differences in gene expression, nonresponders showed an increased inflammatory response with certain cytokine and chemokine receptor pathways, suggesting that further research with a larger sample is needed for validation.
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Background: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated.

Methods: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers.

Results: Seventeen patients (4.

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This study explores the potential of OpenAI's ChatGPT as a decision support tool for acute ulcerative colitis presentations in the setting of an emergency department. We assessed ChatGPT's performance in determining disease severity using TrueLove and Witts criteria and the necessity of hospitalization for patients with ulcerative colitis, comparing results with those of expert gastroenterologists. Of 20 cases, ChatGPT's assessments were found to be 80% consistent with gastroenterologist evaluations and indicated a high degree of reliability.

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Background: Jejunal disease is associated with worse prognosis in Crohn's disease. The added value of diffusion weighted imaging for evaluating jejunal inflammation related to Crohn's Disease is scarce.

Objectives: To compare diffusion weighted imaging, video capsule endoscopy, and inflammatory biomarkers in the assessment of Crohn's disease involving the jejunum.

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