Background and Aims: The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, real-world German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods: Patients with CD receiving UST treatment in three hospitals and two outpatient centers were included and retrospectively analyzed. Rates for short- and long-term remission and response were analyzed with the help of clinical (Harvey–Bradshaw Index (HBI)) and biochemical (C-reactive protein (CRP), Fecal calprotectin (fCal)) parameters for disease activity. Results: Data from 180 patients were evaluated. One-hundred-and-six patients had a follow-up of at least eight weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin antibodies. The median follow-up was 49.1 weeks (95% CI 42.03-56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 48 (51.6%) responded to UST, and 25 patients (26.9%) were in remission. Steroid-free response and remission at week eight was achieved by 30.1% and 19.3% of patients, respectively. At week 48, 37.6% showed steroid-free response to UST, and 20.4% of the initial patient population was in steroid-free remission. Conclusion: Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment-exposed patients.

Background: The pancreas undergoes a continuous aging process leading to alterations such as atrophy, fatty infiltration and fibrosis. Objective: The aim of this study was to determine the normal ultrasonic aspect of the pancreas and any relationship to age with special regard to pancreatic echogenicity and pancreatic duct diameter. Methods: In the study on pancreatic echogenicity 131 patients (56 male, 75 female), aged 18–92 (median 52) years, with normal weight were examined prospectively. The echogenicity of the pancreas was compared with the normal liver and divided into four different categories. The prospective investigation into any age relationship of pancreatic duct diameter was performed on 101 patients (44 male, 57 female), ages 18–91 (median 53) years, with normal weight. In both studies, the patients were split into seven age groups. For statistical analysis the chi-square test for independence was used. Results: With advancing age, ultrasonography demonstrated an increasing echogenicity of the pancreas, beginning in the 4th decade of life. Most patients over 50 years, and all patients over 80 had a marked echogenicity, distinctly higher than that found in the liver. The mean pancreatic duct diameter of all patients in the second study was 1.9 mm. Younger subjects had a smaller diameter – average 1.5 mm in the group 18–29 years – but with advancing age a distinct duct enlargement was observed: mean 1.9 mm in the group 40–49 years, mean 2.3 mm in patients over 80 years, but not exceeding 3 mm. Conclusion: On ultrasonography, the aging process of the pancreas leads to an increase of echogenicity. In the aged, a very high echogenicity is a normal ultrasonic finding. The pancreatic duct diameter also increases with advancing age. Even in advanced age, a diameter of more than 3 mm, however, should be regarded as a pathological finding.

AIM:To examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. METHODS:A total of 25 patients (20 female and five male: aged 18-75 years), with at least one symptom of stricture not passable with the standard colonoscope and with a confirmed scarred Crohn's stricture of the lower gastrointestinal tract, were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control.

Background The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, Real-World German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods Patients with CD receiving UST treatment in three hospitals and two outpatient centres were included and retrospectively analysed. Rates for short- and long-term remission and response were analysed with the help of clinical (Harvey–Bradshaw Index [HBI]) and biochemical (C-reactive protein [CRP], faecal calprotectin [fCal]) parameters for disease activity. Results Data from 180 patients were evaluated. One hundred six patients had a follow-up of at least 8 weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin. The median follow-up was 49.1 weeks (95% CI 42.03–56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 39 (41.9%) responded to UST, and 20 patients (21.5%) were in remission. Steroid-free response and remission at week eight were achieved by 30.1%, and 19.3% of patients. At week 48, 26.9% showed steroid-free response to UST, and 15.1% of the initial patient population was in steroid-free remission. Clinical response at week 16 was independently associated with remission at week 48. Conclusion Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment exposed patients.

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