{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:26:32Z","timestamp":1793607992678,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The incidence of inflammatory bowel disease (IBD) is rising across Southeast Asia, yet real-world data on clinical phenotypes, treatment strategies, and outcomes in tuberculosis (TB)-endemic, resource-constrained settings remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To characterize disease phenotypes, treatment utilization, and 1-year outcomes in a Vietnamese inception cohort of newly diagnosed IBD patients in a tuberculosis-endemic, resource-constrained setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center, hybrid retrospective\u2013prospective inception cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Consecutive adults diagnosed with Crohn\u2019s disease (CD) or ulcerative colitis (UC) at a tertiary referral center in Ho Chi Minh City, Vietnam, between June 2019 and June 2024. A Baseline Cohort (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u2009126) was analyzed for phenotypic characterization. Patients completing \u2a7e12\u2009months of follow-up comprised the Outcome Cohort (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200966) for assessment of treatment patterns and clinical, biochemical, and endoscopic outcomes. Treatment followed an accelerated step-up strategy with originator anti-tumor necrosis factor (TNF) agents (infliximab\/adalimumab) after mandatory TB screening.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 126 patients (80 CD, 46 UC), CD was characterized by substantial diagnostic delay (median 12\u2009months), with 57.6% presenting stricturing or penetrating behavior and 25.0% having undergone intestinal resection before IBD confirmation. Extensive colitis (E3) predominated among UC patients (63.0%), and 78.3% had moderate-to-severe disease. Anti-TNF utilization increased from 13.6% within the first 2\u2009months after diagnosis to 45.5% at 1\u2009year. In the Outcome Cohort (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200966), steroid-free clinical remission was achieved in 63.6%, and mucosal healing was documented in 62.3% of endoscopically evaluated patients. Serious infections occurred in 9.1%, with TB reactivation in 4.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>IBD in Vietnam presents with diagnostic delays, complicated phenotypes, and high surgical rates at initial presentation. Despite these challenges, an accelerated step-up strategy with early anti-TNF escalation was associated with favorable 1-year steroid-free remission and mucosal healing rates. These findings suggest that treat-to-target care with early biologic escalation may be feasible in selected patients in TB-endemic, resource-constrained settings, provided that structured TB monitoring is implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261455281","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:41:50Z","timestamp":1781073710000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Advanced phenotypes and favorable 1-year outcomes with accelerated step-up strategy in newly diagnosed inflammatory bowel disease in a tuberculosis-endemic, resource-constrained setting"],"prefix":"10.1177","volume":"19","author":[{"given":"Trung Hoang","family":"Dinh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Nam Sai Gon International General Hospital, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9295-4308","authenticated-orcid":false,"given":"Luan Minh","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang Street, Cho Lon Ward, Ho Chi Minh City 700000, Vietnam"},{"name":"Department of Internal Medicine and Gastro-Hepato Integrated Research Team (GHIRT-002.TCM2025), School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7703-0932","authenticated-orcid":false,"given":"Chuong Dinh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam"},{"name":"Clinical Sciences (International Program), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diem Thi-Ngoc","family":"Vo","sequence":"additional","affiliation":[{"name":"Department of Histology\u2013Embryology and Pathology, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-8202","authenticated-orcid":false,"given":"Tien Manh","family":"Huynh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastro-Hepato Integrated Research Team (GHIRT-002.TCM2025), School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thong Duy","family":"Vo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastro-Hepato Integrated Research Team (GHIRT-002.TCM2025), School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"},{"name":"Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoang Huu","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duc Trong","family":"Quach","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastro-Hepato Integrated Research Team (GHIRT-002.TCM2025), School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-025-08940-0"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad189"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.70106"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.09.005"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022216"},{"key":"e_1_3_4_7_2","volume-title":"Global Tuberculosis Report 2025","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. 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