{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:22:19Z","timestamp":1790889739770,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"am","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Inflammatory Bowel Disease (IBD) is increasing across Latin America (LATAM). We aimed to determine the frequency and characteristics of difficult-to-treat IBD (DTT-IBD) in this region, using international consensus criteria.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective study using data from IBD registries across eleven LATAM countries: the EPILATAM-IBD study (nine countries), the Brazilian national IBD registry, and two Argentinian single-center registries. Adults with ulcerative colitis (UC), Crohn\u2019s disease (CD), or unclassified IBD were included. DTT-IBD was defined as meeting at least one of the following criteria: failure of\u2009\u2265\u20092 advanced mechanisms of action, chronic antibiotic-refractory pouchitis, CD recurrence after \u22652 resections, or complex perianal CD. Comparisons between DTT and non-DTT groups were performed using Mann-Whitney and Chi-square\/Fisher exact tests (p\u2009&lt;\u20090.05).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 5,699 patients with complete data [40% CD, median disease duration 9 years (Q1-Q3: 5-15)], 747 (13%) met DTT-IBD criteria. DTT prevalence was higher among CD (30%) than among UC patients (2%). Complex perianal disease predominated in DTT-CD (91%), whereas failure of\u2009\u2265\u20092 advanced mechanisms of action predominated in DTT-UC (93%). Compared to non-DTT patients, those with DTT-IBD were younger at symptom onset [median age 24 (19-34) years] and IBD diagnosis [26 (21\u201337) years], and had longer time until diagnosis (p-value &lt;0.001). DTT-CD was associated with penetrating behavior (39%) and ileocolonic disease (46%); DTT-UC with extensive colitis (83%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n DTT-IBD affected 13% of patients treated in LATAM, with nearly one-third of individuals with CD presenting more severe phenotypic features. These findings highlight the need for comprehensive IBD care strategies in this complex patient population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/crocol\/otag058","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:23:26Z","timestamp":1781501006000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical Characterization and Healthcare Burden of Difficult-to-Treat Inflammatory Bowel Disease in Latin America: a real-world registry-based study"],"prefix":"10.1093","author":[{"given":"Jesus Kazuo","family":"Yamamoto-Furusho","sequence":"first","affiliation":[{"name":"Inflammatory Bowel Disease Clinic , Department of Gastroenterology, ,","place":["Mexico"]},{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n. Mexico City , Department of Gastroenterology, ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Froes","sequence":"additional","affiliation":[{"name":"CLIGED Clinic. Rio de Janeiro Gastroenterology Department, ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Flores","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease and Immunomediated Disease Center \u2013 DIIMUNO . Porto Alegre,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingo","family":"Balderramo","sequence":"additional","affiliation":[{"name":"Hospital Privado Universitario de C\u00f3rdoba. C\u00f3rdoba Gastroenterology and Endoscopy Department, ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Sebastian","family":"Lasa","sequence":"additional","affiliation":[{"name":"Clinical Research Norberto Quirno (CEMIC) Gastroenterology Department, Center for Medical Education and . Buenos Aires,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00e1rcia Nogueira Ferreira","family":"Gomes","sequence":"additional","affiliation":[{"name":"Johnson & Johnson LATAM . S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f3crates Bautista","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Centros de Diagn\u00f3stico y Medicina Avanzada y de Conferencias M\u00e9dicas y Telemedicina (CEDIMAT) Gastroenterology Center, . Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Veitia","sequence":"additional","affiliation":[{"name":"Hospital Vargas de Caracas. Caracas Gastroenterology Department, , Venezuela"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Iade-Vergara","sequence":"additional","affiliation":[{"name":"del Sindicato M\u00e9dico del Uruguay (CASMU) Gastroenterology Department, Centro de Asistencia . Montevideo,","place":["Uruguay"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma Parra","family":"Holgu\u00edn","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Clinic , Department of Gastroenterology, ,","place":["Mexico"]},{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n. Mexico City , Department of Gastroenterology, ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Yaeza","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Johnson & Johnson LATAM . S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milene","family":"Fernandes","sequence":"additional","affiliation":[{"name":"CTI \u2013 Clinical Trial & Consulting Services . Lisboa,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Vicente","sequence":"additional","affiliation":[{"name":"CTI \u2013 Clinical Trial & Consulting Services . Lisboa,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Juliao-Ba\u00f1os","sequence":"additional","affiliation":[{"name":"Intestinal Inflammatory Disease Clinic, Hospital Pablo Tob\u00f3n Uribe . Medell\u00edn","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,13]]},"container-title":["Crohn's & Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag058\/68524523\/otag058.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag058\/68524523\/otag058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:23:27Z","timestamp":1781501007000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article\/doi\/10.1093\/crocol\/otag058\/8707845"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/crocol\/otag058","relation":{},"ISSN":["2631-827X"],"issn-type":[{"value":"2631-827X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"article-number":"otag058"}}