Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Lichtenstein GR, Rutgeerts P, Sandborn WJ, Sands BE, Diamond RH, Blank M, Montello J, Tang L, Cornillie F, Colombel JF. A pooled analysis of infections, malignancy, and mortality in infliximab- and immunomodulator-treated adult patients with inflammatory bowel disease. Am J Gastroenterol 2012;107:1051-63. [PMID: 22613901 PMCID: PMC3390465 DOI: 10.1038/ajg.2012.89] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 03/06/2012] [Indexed: 12/11/2022]

For:	Lichtenstein GR, Rutgeerts P, Sandborn WJ, Sands BE, Diamond RH, Blank M, Montello J, Tang L, Cornillie F, Colombel JF. A pooled analysis of infections, malignancy, and mortality in infliximab- and immunomodulator-treated adult patients with inflammatory bowel disease. Am J Gastroenterol 2012;107:1051-63. [PMID: 22613901 PMCID: PMC3390465 DOI: 10.1038/ajg.2012.89] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 03/06/2012] [Indexed: 12/11/2022]

Number

Cited by Other Article(s)

Chen Z, Zeng L, Cai W, Song X, Xu Q, Xu J, Zhao L, Zeng Y, Zhang X, Wu X, Zhou R, Ying H, Ying K, Chen Y, Yu F. Predictive value of three nutritional indexes for disease activity in patients with inflammatory bowel disease. Ann Med 2025;57:2443256. [PMID: 39705015 DOI: 10.1080/07853890.2024.2443256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 08/27/2024] [Accepted: 11/22/2024] [Indexed: 12/21/2024] Open

Abstract

BACKGROUND

Malnutrition is prevalent in patients with inflammatory bowel disease (IBD); however, its ability to predict the disease activity in IBD remains unexplored. Therefore, this study aimed to explore the association between malnutrition and disease activity in IBD.

METHODS

In this retrospective study, we enrolled 1006 patients diagnosed with IBD from the First Affiliated Hospital of Wenzhou Medical University from 2011 to 2022. Malnutrition was assessed based on the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores. Logistic regression analyses were performed to identify predictors for disease activity. Restricted cubic spline analysis was performed to evaluate the possible nonlinear relations, and subgroup analysis was performed to explore potential interactions. Additionally, prediction performances were compared through receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement.

RESULTS

The prevalence of malnutrition calculated by the PNI, GNRI, and CONUT scores in IBD was 16.9%, 72.1%, and 75.6%, respectively and significant correlations were observed among them. Multivariate logistic regression analysis showed that PNI, GNRI, and CONUT were independent risk factors for disease activity, and no significant nonlinear relationship was observed between disease activity and all three indexes. No statistically significant interactive effect was found in nearly all the subgroups. GNRI showed the highest predictive value compared with PNI and CONUT. Additionally, combining any of the three indexes improved the ability of C-reactive protein to predict IBD activity.

CONCLUSIONS

All three nutritional indexes evaluated malnutrition to be an independent risk factor for IBD activity.

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Affiliation(s)

Zhuoyan Chen Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Liuwei Zeng Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Weimin Cai Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Xian Song Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Qian Xu Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Jun Xu Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Luying Zhao Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Yuan Zeng Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Xiangting Zhang Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Xiao Wu Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Ruoru Zhou Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Huiya Ying Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Kanglei Ying Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Yuhao Chen Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
Fujun Yu Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China

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Lee J, Kil BJ, Choi Y, Chai H, Lee D, Jo HG, Lee D. Fermented Kamut Wheat Diet Prevents DSS-Induced Colitis via Modulating Gut Microbiota in Mice. Int J Mol Sci 2025;26:3017. [PMID: 40243632 PMCID: PMC11988869 DOI: 10.3390/ijms26073017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Revised: 03/05/2025] [Accepted: 03/19/2025] [Indexed: 04/18/2025] Open

Abstract

Inflammatory bowel disease (IBD) is a chronic and relapsing inflammatory disorder of the gastrointestinal tract with limited treatment options. This study investigates the preventive effects of fermented Kamut wheat enzyme (FKW) diet on the progression of dextran sulfate sodium (DSS)-induced colitis in mice, with a focus on gut microbiota modulation and inflammatory cytokine regulation. Female C57BL/6J mice were divided into groups and fed a diet consisting of either a FKW diet (containing 39.80% FKW) or a control diet under 1.25% and 2.50% DSS conditions. The FKW diet was formulated based on the AIN-93G standard rodent formula, with the FKW diet providing comparable amounts of total proteins, crude lipids, and dietary fibers as the control diet. The FKW diet effectively mitigated the progression of colitis, as evidenced by improvements in key indicators such as dietary intake, body weight, colon length, stool consistency, and bleeding, particularly in the 1.25% DSS group. Histopathological analysis revealed preservation of colonic architecture and reduced mucosal damage in the FKW group. The diet also resulted in a significant reduction in pro-inflammatory cytokines (TNF-α, IL-6, IL-1β, and IFN-γ) and myeloperoxidase (MPO) levels, coupled with an increase in anti-inflammatory IL-10. Gut microbiota analysis showed increased abundance of beneficial bacteria such as Muribaculaceae, Lachnospiraceae NK4A136 and Bacteroides acidifaciens and decreased pathogenic bacteria like Escherichia/Shigella and Bilophila. These findings underscore the potential of FKW as a preventive dietary intervention for mitigating the progression of colitis, emphasizing the role of gut microbiota in supporting intestinal health. These results highlight FKW's potential to reduce the risk of colitis development, providing a foundation for future research into its preventive applications.

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Moreau LA, Ford AC, Brookes MJ, Graca S, Guthrie E, Hartley S, Houghton L, Kemp K, Kennedy NA, McKenzie Y, Muir D, Loo Ow P, Probert C, Pryde E, Taylor C, Willis TA, Wright-Hughes A, Farrin AJ. Management of diarrhoea in patients with stable ulcerative colitis with low FODMAP diet, amitriptyline, ondansetron or loperamide: the MODULATE RCT. Health Technol Assess 2025:1-30. [PMID: 40079650 PMCID: PMC11931405 DOI: 10.3310/ghfe4871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2025] Open

Abstract

Background

Many patients with ulcerative colitis report ongoing diarrhoea even when their disease is stable and in remission.

Design

MODULATE was a pragmatic, multicentre, seamless, adaptive, phase 2/3 open-label, parallel-group, multiarm multistage randomised controlled trial.

Setting and participants

People aged over 18 years with stable ulcerative colitis who had diarrhoea, recruited from secondary care sites in the United Kingdom.

Interventions

The control arm consisted of modified first-line dietary advice given to all patients with irritable bowel syndrome; the first interventional arm was amitriptyline, a tricyclic antidepressant, which at low doses slows colonic transit; the second intervention was loperamide, an antidiarrhoeal drug also thought to slow colonic transit; the third was ondansetron, an antiemetic thought to slow colonic transit; and the fourth was a diet low in fermentable oligo-, di-, and mono-saccharides and polyols, which is thought to reduce bloating and gas within the small intestine. All patients randomised to an interventional arm were to receive treatment for 6 months.

Main outcome measures: Primary outcome measures

Phase 2: Improvement in diarrhoea measured using the Gastrointestinal Symptom Rating Scale-irritable bowel syndrome questionnaire at 8 weeks post randomisation: improvement defined as those reporting minor discomfort from diarrhoea or less (scoring ≤ 2 on the diarrhoea subscale).

Secondary outcome measures

Phases 2 and 3: Measured at both 8 weeks and 6 months: Improvement in diarrhoea measured using the Gastrointestinal Symptom Rating Scale-irritable bowel syndrome. Blood for C-reactive protein, stool for faecal calprotectin at 6 months only, reviewing case notes for escalation of medical therapy for ulcerative colitis. Anxiety and depression, via the Hospital Anxiety and Depression Scale.

Results

The MODULATE trial opened in December 2021 and closed in January 2023. Of the eight secondary care sites that completed contracting, only four opened to recruitment during this time, and one person was randomised. Trial timelines coincided with the start of the COVID-19 pandemic, causing substantial delays and, ultimately, its early closure. During this time, the trial underwent two major redesign phases, enabling a fully remote participant pathway incorporating electronic consent, remote data capture, posted blood and stool sample kits for eligibility screening, delivery of the dietary intervention via telephone or video call platform, postage of trial investigational medicinal products directly to participants' homes and all trial follow-up appointments conducted via telephone. The second phase of redesign pushed the trial towards a fully decentralised model. However, this stage was not implemented due to the decision to close the trial early.

Limitations

The study was unable to recruit the necessary sample size, preventing the trial from progressing. The trial met with several challenges. The Trial Steering Committee's root cause analysis concluded that the pandemic was the leading factor in trial closure, especially regarding our ability to recruit both sites and participants.

Conclusions

Although the trial closed early and with insufficient participants to proceed with full statistical analysis, lessons were learnt that could potentially inform future remote trial design and decentralised participant pathways.

Future work

MODULATE was a commissioned call in response to a priority question identified by people living with ulcerative colitis. The question remains important and unanswered; trials to address it are needed. Given the recruitment difficulties we experienced, consideration should be given to conducting these in both primary and secondary care.

Funding

This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/33/03.

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Driscoll CB, Rich JM, Isaacson D, Nicolas J, Jiang Y, Mi X, Yang C, Kocsuta V, Goh R, Patel N, Li E, Siddiqui MR, Meyers T, Witte JS, Kachuri L, Zhang H, Beestrum M, Silberman P, Schaeffer EM, Kundu SD. Tumor Necrosis Factor-Alpha Inhibitor Use and Malignancy Risk: A Systematic Review and Patient Level Meta-Analysis. Cancers (Basel) 2025;17:390. [PMID: 39941759 PMCID: PMC11815771 DOI: 10.3390/cancers17030390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/16/2025] [Accepted: 01/22/2025] [Indexed: 02/16/2025] Open

Affiliation(s)

Conor B. Driscoll Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Jordan M. Rich Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Dylan Isaacson Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Joseph Nicolas Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Yu Jiang Department of Epidemiology and Population Health, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA (J.S.W.); (L.K.)
Xinlei Mi Division of Biostatistics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr, Suite 1400, Chicago, IL 60611, USA; (X.M.); (H.Z.)
Christopher Yang Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Victoria Kocsuta Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Regine Goh Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Niti Patel Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Arkes Suite 2330, Chicago, IL 60611, USA;
Eric Li Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Mohammad Rashid Siddiqui Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Travis Meyers Department of Epidemiology and Biostatistics, University of California at San Francisco, 550 16th St., Floor 2, San Francisco, CA 94143, USA;
John S. Witte Department of Epidemiology and Population Health, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA (J.S.W.); (L.K.) Department of Biomedical Data Science, Stanford University, 1265 Welch Road MC5464MSOB West Wing, Third Floor, Stanford, CA 94305, USA
Linda Kachuri Department of Epidemiology and Population Health, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA (J.S.W.); (L.K.) Department of Biomedical Data Science, Stanford University, 1265 Welch Road MC5464MSOB West Wing, Third Floor, Stanford, CA 94305, USA
Hui Zhang Division of Biostatistics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr, Suite 1400, Chicago, IL 60611, USA; (X.M.); (H.Z.)
Molly Beestrum Galter Health Sciences Library and Learning Center, Northwestern University, 303 E Chicago Ave #2-212, Chicago, IL 60611, USA;
Philip Silberman Department of Information Technology, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Dr, Abbott Hall, 4th Floor, Chicago, IL 60611, USA;
Edward M. Schaeffer Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)
Shilajit D. Kundu Department of Urology, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Suite 2300, Chicago, IL 60611, USA; (J.M.R.); (J.N.); (C.Y.); (V.K.); (R.G.); (E.L.); (M.R.S.); (E.M.S.); (S.D.K.)

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Pau A, Galliano I, Barnini E, Dini M, Pizzol A, Ponte A, Gambarino S, Calvo PL, Bergallo M. Involvement of HLADQA1*05 in Patients with Inflammatory Bowel Disease Treated with Anti-TNF Drugs. MEDICINA (KAUNAS, LITHUANIA) 2025;61:102. [PMID: 39859084 PMCID: PMC11767197 DOI: 10.3390/medicina61010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 01/03/2025] [Accepted: 01/07/2025] [Indexed: 01/27/2025]

Haasis E, Bettenburg A, Lorentz A. Effect of Intermittent Fasting on Immune Parameters and Intestinal Inflammation. Nutrients 2024;16:3956. [PMID: 39599741 PMCID: PMC11597193 DOI: 10.3390/nu16223956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 10/25/2024] [Accepted: 11/17/2024] [Indexed: 11/29/2024] Open

Moon W, Park JJ. [Risks of Cancer Associated with Therapeutic Drugs for Inflammatory Bowel Disease]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2024;83:233-242. [PMID: 38918036 DOI: 10.4166/kjg.2024.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 06/27/2024]

Manrai M, Jha AA, Dawra S, Pachisia AV. Biologics, Small Molecules and More in Inflammatory Bowel Disease: The Present and the Future. FUTURE PHARMACOLOGY 2024;4:279-316. [DOI: 10.3390/futurepharmacol4010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2024]

McDonald C, Kerr H, Gibbons E, Lukose T, Cheriyan D, Harewood G, Patchett S, O’Toole A, Kelly O, Boland K. Higher Ustekinumab Levels in Maintenance Therapy are Associated with Greater Mucosal Healing and Mucosal Response in Crohn's Disease: An Experience of 2 IBD Centers. Inflamm Bowel Dis 2024;30:423-428. [PMID: 37158577 PMCID: PMC10906356 DOI: 10.1093/ibd/izad073] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Indexed: 05/10/2023]

Abstract

BACKGROUND

Ustekinumab (UST), a human monoclonal antibody that binds the p40 subunit of interleukin 12 (IL-12) and IL-23, is licensed for induction and maintenance therapy of moderate to severe inflammatory bowel disease (IBD). To date, there is limited data published on any potential association between ustekinumab serum trough levels and mucosal healing in order to guide treatment strategies and appropriate dosing.

AIM

This study aims to identify a relationship between maintenance ustekinumab serum trough levels and mucosal healing and/or response in patients with Crohn's disease in an observational cohort study.

METHODS

Ustekinumab serum trough levels and antibody titres were analyzed in patients on maintenance drug using an ELISA drug-tolerant assay. Mucosal response (MR) was defined as ≥50% reduction in fecal calprotectin level (FC) and/or ≥50% reduction in the Simple Endoscopic Score for Crohn's Disease (SES-CD score). Mucosal healing (MH) was defined as FC ≤150 µg/mL and/or global SES-CD score ≤5. Median trough levels were analyzed using the Kruskal-Wallis test, and logistic regression was used to determine sensitivity and specificity of levels predicting mucosal response.

RESULTS

Forty-seven patients on maintenance ustekinumab for Crohn's disease were included in this study. The majority were female (66%), with a median age of 40 years (21-78 years). The majority of patients were biologic-experienced (89.4%, n = 42). Patients with histologically confirmed Crohn's disease represented 100% (n = 47) of the cohort. Over one-third of patients (n = 18, 38.3%) were on higher than standard dosing of 90 mg every 8 weeks. Patients with mucosal healing (n = 30) had significantly higher mean serum ustekinumab levels (5.7 µg/mL, SD 6.4) compared with those with no response (1.1 µg/mL, SD 0.52; n = 7, P < .0001). A serum ustekinumab trough level greater than 2.3 µg/mL was associated with MH, with a sensitivity of 100% and specificity of 90.6% (likelihood ratio 10.7). Similarly, for patients with MR (n = 40), we observed a higher mean serum ustekinumab trough level (5.1 µg/mL, SD 6.1) compared with those with no response (1.1 µg/mL, SD 0.52; n = 7, P < .0001). Furthermore, a serum ustekinumab trough level greater than 2.3 µg/mL was associated with a 10-fold increased likelihood of mucosal response vs mucosal nonresponse (sensitivity 100%, specificity 90.5%, likelihood ratio 10.5).

CONCLUSION

This study demonstrates that higher ustekinumab serum trough levels are associated with a greater likelihood of achieving mucosal healing and mucosal response in patients with Crohn's disease regardless of prior biologic exposure. Further prospective studies are required to correlate target maintenance trough levels and the optimal time to dose-escalate in order to improve patient outcomes.

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Tursi A, Mocci G, Del Gaudio A, Papa A. Clinical use of biologics for Crohn's disease in adults: lessons learned from real-world studies. Expert Opin Biol Ther 2024:1-19. [PMID: 38321868 DOI: 10.1080/14712598.2024.2316180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]

van Hoeve K, Thomas D, Hillary T, Hoffman I, Dreesen E. Identifying risk factors of anti-TNF induced skin lesions and other adverse events in paediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024;78:95-104. [PMID: 38291690 DOI: 10.1002/jpn3.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024]

Clinton JW, Cross RK. Personalized Treatment for Crohn's Disease: Current Approaches and Future Directions. Clin Exp Gastroenterol 2023;16:249-276. [PMID: 38111516 PMCID: PMC10726957 DOI: 10.2147/ceg.s360248] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open

Parigi TL, Allocca M, Furfaro F, D’Amico F, Zilli A, Dal Buono A, Gabbiadini R, Bonovas S, Armuzzi A, Danese S, Fiorino G. Treat-to-Target and Regular Surveillance of Inflammatory Bowel Disease Are Associated with Low Incidence and Early-Stage Detection of Malignancies: A Retrospective Cohort Study. Cancers (Basel) 2023;15:5754. [PMID: 38136300 PMCID: PMC10742048 DOI: 10.3390/cancers15245754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/02/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open

Affiliation(s)

Tommaso Lorenzo Parigi Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.) Division of Immunology, Transplantation and Infectious Disease, Università Vita-Salute San Raffaele, 20132 Milan, Italy
Mariangela Allocca Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.)
Federica Furfaro Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.)
Ferdinando D’Amico Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Alessandra Zilli Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.)
Arianna Dal Buono IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.D.B.)
Roberto Gabbiadini IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.D.B.)
Stefanos Bonovas Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Alessandro Armuzzi Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.D.B.)
Silvio Danese Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.) Division of Immunology, Transplantation and Infectious Disease, Università Vita-Salute San Raffaele, 20132 Milan, Italy
Gionata Fiorino Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, 20132 Milan, Italy (M.A.); (F.F.); (F.D.); (A.Z.) IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy

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Li F, Ramirez Y, Yano Y, Daniel CR, Sharma SV, Brown EL, Li R, Moshiree B, Loftfield E, Lan Q, Sinha R, Inoue-Choi M, Vogtmann E. The association between inflammatory bowel disease and all-cause and cause-specific mortality in the UK Biobank. Ann Epidemiol 2023;88:15-22. [PMID: 38013230 PMCID: PMC10842122 DOI: 10.1016/j.annepidem.2023.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]

Abstract

PURPOSE

Inflammatory bowel disease (IBD) has a rising global prevalence. However, the understanding of its impact on mortality remains inconsistent so we explored the association between IBD and all-cause and cause-specific mortality.

METHODS

This study included 502,369 participants from the UK Biobank, a large, population-based, prospective cohort study with mortality data through 2022. IBD was defined by baseline self-report or from primary care or hospital admission data. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality in multivariable Cox proportional hazards regression models.

RESULTS

A total of 5799 (1.2%) participants had a history of IBD at baseline. After a median follow-up of 13.7 years, 44,499 deaths occurred. Having IBD was associated with an increased risk of death from all causes (HR = 1.16, 95% CI = 1.07-1.24) and cancer (HR = 1.16, 95% CI = 1.05-1.30), particularly colorectal cancer (CRC) (HR = 1.56, 95% CI = 1.17-2.09). We observed elevated breast cancer mortality rates for individuals with Crohn's disease, and increased CRC mortality rates for individuals with ulcerative colitis. In stratified analyses of IBD and all-cause mortality, mortality risk differed by individuals' duration of IBD, age at IBD diagnosis, body mass index (BMI) (PHeterogeneity = 0.03) and smoking status (PHeterogeneity = 0.01). Positive associations between IBD and all-cause mortality were detected in individuals diagnosed with IBD for 10 years or longer, those diagnosed before the age of 50, all BMI subgroups except obese individuals, and in never or current, but not former smokers.

CONCLUSIONS

We found that having IBD was associated with increased risks of mortality from all causes, all cancers, and CRC. This underscores the importance of enhanced patient management strategies and targeted prevention efforts in individuals with IBD.

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Lin WC, Tai WC, Chang CH, Tu CH, Feng IC, Shieh MJ, Chung CS, Yen HH, Chou JW, Wong JM, Liu YH, Huang TY, Chuang CH, Tsai TJ, Chiang FF, Lu CY, Hsu WH, Yu FJ, Chao TH, Wu DC, Ho AS, Lin HH, Feng CL, Wu KL, Wong MW, Tung CC, Lin CC, Chen CC, Hu HM, Lu LS, Wang HS, Wu IC, Kuo HY, Wu JF, Yao Shih H, Ni YH, Tang SL, Chen PH, Wei SC. Real-World Evidence of Effectiveness and Safety of Vedolizumab for Inflammatory Bowel Disease in Taiwan: A Prospective Nationwide Registry (VIOLET) Study. Inflamm Bowel Dis 2023;29:1730-1740. [PMID: 36626567 PMCID: PMC10918762 DOI: 10.1093/ibd/izac269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 01/11/2023]

Affiliation(s)

Wei-Chen Lin Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
Wei-Chen Tai Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Chung-Hsin Chang Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
Chia-Hung Tu Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
I-Che Feng Division of Gastroenterology and Hepatology, Chi Mei Medical Center, Tainan, Taiwan
Ming-Jium Shieh Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Chen-Shuan Chung Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
Hsu-Heng Yen Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
Jen-Wei Chou Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
Jau-Min Wong Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Yu-Hwa Liu Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Tien-Yu Huang Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Chiao-Hsiung Chuang Department of Internal Medicine, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
Tzung-Jiun Tsai Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Feng-Fan Chiang Division of Colon and Rectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
Chien-Yu Lu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Wen-Hung Hsu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Fang-Jung Yu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Te-Hsin Chao Division of Colon and Rectal Surgery, Department of Surgery, Chiayi and Wangiao Branch, Taichung Veterans General Hospital, Taichung, Taiwan
Deng-Chyang Wu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Ai-Sheng Ho Division of Gastroenterology, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
Hung-Hsin Lin Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
Chun-Lung Feng Division of Gastroenterology and Hepatology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
Keng-Liang Wu Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Ming-Wun Wong Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
Chien-Chih Tung Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan
Chun-Chi Lin Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
Chia-Chang Chen Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
Huang-Ming Hu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
Lung-Sheng Lu Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Huann-Sheng Wang Division of Colorectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
I-Chen Wu Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Hsin-Yu Kuo Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Jia-Feng Wu Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Hsiang Yao Shih Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Yen-Hsuan Ni Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan
Shu-Lun Tang Takeda Pharmaceuticals Taiwan, Ltd., Taipei, Taiwan
Peng-Hsu Chen Takeda Pharmaceuticals Taiwan, Ltd., Taipei, Taiwan
Shu-Chen Wei Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

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Sarter H, Savoye G, Marot G, Ley D, Turck D, Hugot JP, Vasseur F, Duhamel A, Wils P, Princen F, Colombel JF, Gower-Rousseau C, Fumery M. A Novel 8-Predictors Signature to Predict Complicated Disease Course in Pediatric-onset Crohn's Disease: A Population-based Study. Inflamm Bowel Dis 2023;29:1793-1804. [PMID: 37266570 DOI: 10.1093/ibd/izad090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Indexed: 06/03/2023]

Affiliation(s)

Hélène Sarter Lille Hospital and University, Public Health, Epidemiology and Economic Health, EPIMAD registry, Regional house of clinical research, F-59000 Lille, France University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France
Guillaume Savoye Rouen Hospital and University, Gastroenterology Unit, EPIMAD registry, Rouen, France
Guillemette Marot University of Lille, CHU Lille, ULR 2694-METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France Inria Lille Nord Europe, Modal, Lille, France
Delphine Ley University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille, France
Dominique Turck University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille, France
Jean-Pierre Hugot Centre de Recherche sur l'Inflammation, UMR1149 INSERM et Université de Paris, France Department of Pediatric Gastroenterology, Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
Francis Vasseur University of Lille, CHU Lille, ULR 2694-METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
Alain Duhamel University of Lille, CHU Lille, ULR 2694-METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
Pauline Wils University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France Gastroenterology Unit, Lille Hospital and University, Lille, France
Fred Princen Prometheus Laboratories, San Diego, California
Jean-Frédéric Colombel Icahn School of Medicine at Mount Sinai, Division of Gastroenterology, New York, USA
Corinne Gower-Rousseau Lille Hospital and University, Public Health, Epidemiology and Economic Health, EPIMAD registry, Regional house of clinical research, F-59000 Lille, France University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France Research and Public Health Unit, Reims University & Hospital, Robert-Debré Hospital, Reims, France
Mathurin Fumery Amiens Hospital and University, Gastroenterology Unit, EPIMAD Registry, and PeriTox, UMR I-01, Amiens, France

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Fuentes-Valenzuela E, García-Alonso FJ, Maroto-Martín C, Juan Casamayor L, Garrote JA, Almendros Muñoz R, De Prado Á, Vara Castrodeza A, Marinero MÁ, Calleja Carbajosa R, Barrio J. Influence of HLADQA1*05 Genotype in Adults With Inflammatory Bowel Disease and Anti-TNF Treatment With Proactive Therapeutic Drug Monitoring: A Retrospective Cohort Study. Inflamm Bowel Dis 2023;29:1586-1593. [PMID: 36617284 DOI: 10.1093/ibd/izac259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Indexed: 01/09/2023]

Abstract

BACKGROUND

Carriers of the human leucocyte antigen variant HLADQA1*05 (rs2097432) are at risk of developing antibodies against infliximab and adalimumab with reduced tumor necrosis factor (TNF) antagonist persistence. The impact of proactive therapeutic drug monitoring (PTDM) on this association has been barely assessed.

METHODS

We conducted a retrospective single-center cohort study including patients with inflammatory bowel disease starting anti-TNF therapy between January 2017 and March 2021. Proactive therapeutic drug monitoring was defined as periodic drug level measurement (≥2 determinations during the first year of treatment and ≥1/annual determination during the following years), regardless of clinical condition, followed by dose optimization. Variables associated with treatment persistence were assessed with multivariable Cox regression analysis.

RESULTS

A total of 112 patients were included, 52 (46.4%) HLA-DQA1*05 carriers, with a median follow-up of 73.9 (interquartile range, 35.4-133.1) weeks. Combination therapy with thiopurines was more frequent among HLA-DQA1*05 noncarriers (28 [46.7%] vs 12 [23.1%]; P = .01). Clinical remission rates at week 14 (77.9% vs 73.9%; P = .69) and 56 (73.2% vs 68.4%; P = .64) were similar between HLA-DQA1*05 noncarriers and carriers. Drug persistence was higher among HLA-DQA1*05 carriers (hazard ratio [HR], 0.32; 95% confidence interval, 0.14-0.71; P = .01). Multivariable Cox regression analysis identified systemic steroids at anti-TNF initiation (HR, 4; 95% confidence interval, 1.7-9.7) as a risk factor and HLA-DQA1*05 carriers (HR, 0.31; 95% confidence interval, 0.12-0.81) as a protective factor of treatment cessation.

CONCLUSION

In adult patients with PTDM, a positive HLA-DQA1*05 genotype does not associate a higher risk of treatment cessation nor worse clinical outcomes.

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Sharma P, Joshi RV, Pritchard R, Xu K, Eicher MA. Therapeutic Antibodies in Medicine. Molecules 2023;28:6438. [PMID: 37764213 PMCID: PMC10535987 DOI: 10.3390/molecules28186438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/05/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open

Seishima R, Okabayashi K, Ikeuchi H, Uchino M, Futami K, Noguchi T, Ohge H, Iseki Y, Watanabe K, Itabashi M, Okamoto K, Toiyama Y, Ogino T, Nakamura M, Yamada K, Wakai T, Sato Y, Kimura H, Takahashi K, Hida K, Kinugasa Y, Ishida F, Okuda J, Daito K, Koyama F, Ueno H, Yamamoto T, Yamamoto S, Hanai T, Maemoto A, Arakaki J, Komori K, Akagi Y, Shida D, Yamaguchi S, Matsuda K, Maeda K, Noake T, Nezu R, Sasaki S, Hasegawa J, Sunami E, Kanemitsu Y, Katsumata K, Uehara K, Kiyomatsu T, Suto T, Kazama S, Yamada T, Goi T, Ishihara S, Ajioka Y, Sugihara K. Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study. Am J Gastroenterol 2023;118:1248-1255. [PMID: 36622356 DOI: 10.14309/ajg.0000000000002149] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/21/2022] [Indexed: 01/10/2023]

Affiliation(s)

Ryo Seishima Department of Surgery, Keio University School of Medicine, Tokyo, Japan
Koji Okabayashi Department of Surgery, Keio University School of Medicine, Tokyo, Japan
Hiroki Ikeuchi Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Hyogo, Japan
Motoi Uchino Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Hyogo, Japan
Kitaro Futami Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Tatsuki Noguchi Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
Hiroki Ohge Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
Yasuhito Iseki Surgical Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
Kazuhiro Watanabe Department of Surgery, Tohoku University School of Medicine, Miyagi, Japan
Michio Itabashi Department of Surgery, Division of Inflammatory Bowel Disease Surgery, Tokyo Women's Medical University, Tokyo, Japan
Kinya Okamoto Japan Community Health Care Organization, Tokyo Yamate Medical Center, Tokyo, Japan
Yuji Toiyama Department of Gastrointestinal and Paediatric Surgery, Mie University Graduate School of Medicine, Mie, Tokyo
Takayuki Ogino Department of Gastrointestinal Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
Masafumi Nakamura Kyushu University Department of Surgery and Oncology, Graduate School of Medical Sciences, Fukuoka, Japan
Kazutaka Yamada Takano Hospital, Coloproctology Center, Kumamoto, Japan
Toshifumi Wakai Division of Digestive and General Surgery, Niigata University, Niigata, Japan
Yu Sato Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
Hideaki Kimura Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Kanagawa, Japan
Kenichi Takahashi Inflammatory Bowel Disease Center, Tohoku Rosai Hospital, Miyagi, Japan
Koya Hida Department of Gastrointestinal Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
Yusuke Kinugasa Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
Fumio Ishida Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
Junji Okuda Cancer Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
Koji Daito Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan
Fumikazu Koyama Department of Surgery, Nara Medical University, Nara, Japan
Hideki Ueno Department of Surgery, National Defense Medical College, Saitama, Japan
Takayuki Yamamoto Japan Community Health Care Organization, Yokkaichi Hazu Medical Center, Mie, Japan
Seiichiro Yamamoto Department of Digestive System Surgery, Tokai University School of Medicine, Kanagawa, Japan
Tsunekazu Hanai Department of Surgery, School of Medicine, Fujita Health University, Aichi, Japan
Atsuo Maemoto Institute of Biomedical Research, Sapporo-Higashi Tokushukai Hospital, Hokkaido, Japan
Junya Arakaki Department of Surgery, Center for Gastroenterology, Urasoe General Hospital Okinawa, Japan
Koji Komori Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
Yoshito Akagi Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
Dai Shida Department of Surgery, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Shigeki Yamaguchi Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
Keiji Matsuda Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
Kiyoshi Maeda Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
Toshihiro Noake Kurume Coloproctology Center, Fukuoka, Japan
Riichiro Nezu Department of Surgery, Nishinomiya Municipal Central Hospital, Hyogo, Japan
Shin Sasaki Department of Coloproctological Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
Junichi Hasegawa Department of Surgery, Osaka Rosai Hospital, Osaka, Japan
Eiji Sunami Department of Surgery, Kyorin University, Tokyo, Japan
Yukihide Kanemitsu Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
Kenji Katsumata Department of Gastrointestinal and Paediatric Surgery, Tokyo Medical University, Tokyo, Japan
Kei Uehara Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan
Tomomichi Kiyomatsu Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
Takeshi Suto Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
Shinsuke Kazama Division of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
Takeshi Yamada Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
Takenori Goi First Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
Soichiro Ishihara Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
Yoichi Ajioka Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; and
Kenichi Sugihara Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan

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Holmgren J, Fröborg A, Visuri I, Halfvarson J, Hjortswang H, Karling P, Myrelid P, Olén O, Ludvigsson JF, Grip O. The Risk of Serious Infections Before and After Anti-TNF Therapy in Inflammatory Bowel Disease: A Retrospective Cohort Study. Inflamm Bowel Dis 2023;29:339-348. [PMID: 35776552 PMCID: PMC9977242 DOI: 10.1093/ibd/izac097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Indexed: 12/09/2022]

Colman RJ, Dykes DMH, Arce-Clachar AC, Saeed SA, Minar P. Infliximab Therapy for Pediatric Crohn Disease and Ulcerative Colitis. PEDIATRIC INFLAMMATORY BOWEL DISEASE 2023:407-422. [DOI: 10.1007/978-3-031-14744-9_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]

Supratherapeutic Infliximab Levels Do Not Predict Risk of Short-term Complications in Adults With Crohn's Disease. J Clin Gastroenterol 2023;57:66-73. [PMID: 34907922 DOI: 10.1097/mcg.0000000000001637] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/10/2021] [Indexed: 12/14/2022]

Abstract

BACKGROUND

It is uncertain if higher infliximab trough levels (TLs) confer a greater risk of infectious/noninfectious complications (IC/NIC). We aimed to assess the risk of IC and NIC in patients with different TLs.

METHODS

We retrospectively evaluated a cohort of Crohn's disease (CD) patients treated with infliximab who underwent therapeutic drug monitoring (TDM), at a tertiary inflammatory bowel disease center, between January 1, 2010, and December 1, 2019. TDM was defined as checking of infliximab trough and antibody levels within a 48-hour period before administration. Patients with a minimum of 3-month assessment pre-TDM and post-TDM were included. In the case of multiple TDMs, the highest TL was considered, and patients were distributed across 4 predefined TL groups (A: <5 µg/mL, B: 5 to 10 µg/mL, C: 10 to 15 µg/mL, and D: ≥15 µg/mL). Rates of IC and NIC during the 3-month prior and following TDM were compared across the groups. In addition, duration of exposure, in terms of months up to TDM, was collected to analyze differences in rates of IC and NIC.

RESULTS

Our study included 341 CD patients (median age: 35 y, 58% men). IC and NIC occurred in 52 (15%) and 30 (9%) patients, respectively. Rates of IC and NIC were similar across the 4 TL groups ( P =0.9 and 0.7, respectively for IC and NIC). On multivariable analysis, exposure to infliximab >40 months (as determined by receiver operating characteristic curve analysis) was associated with decreased odds for IC (adjusted odds ratio=0.51, P =0.04), but not NIC (adjusted odds ratio=0.72, P =0.46).

CONCLUSIONS

In this large CD cohort, there was no association between infliximab TL and risk of short-term IC or NIC. Interestingly, a shorter duration of exposure predicted higher rates of IC. This supports the safety of targeting higher infliximab TLs when necessary and greater vigilance during the early stages of treatment.

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Nawaz A, Glick LR, Chaar A, Li DK, Gaidos JK, Proctor DD, Al-Bawardy B. Impact of thiopurine dose in anti-tumor necrosis factor combination therapy on outcomes in inflammatory bowel disease. Ann Gastroenterol 2023;36:39-44. [PMID: 36593807 PMCID: PMC9756033 DOI: 10.20524/aog.2022.0766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open

Advancing Biologic Therapy for Refractory Autoimmune Hepatitis. Dig Dis Sci 2022;67:4979-5005. [PMID: 35147819 DOI: 10.1007/s10620-021-07378-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/27/2021] [Indexed: 01/05/2023]

Abstract

Biologic agents may satisfy an unmet clinical need for treatment of refractory autoimmune hepatitis. The goals of this review are to present the types and results of biologic therapy for refractory autoimmune hepatitis, indicate opportunities to improve and expand biologic treatment, and encourage comparative clinical trials. English abstracts were identified in PubMed by multiple search terms. Full-length articles were selected for review, and secondary and tertiary bibliographies were developed. Rituximab (monoclonal antibodies against CD20 on B cells), infliximab (monoclonal antibodies against tumor necrosis factor-alpha), low-dose recombinant interleukin 2 (regulatory T cell promoter), and belimumab (monoclonal antibodies against B cell activating factor) have induced laboratory improvement in small cohorts with refractory autoimmune hepatitis. Ianalumab (monoclonal antibodies against the receptor for B cell activating factor) is in clinical trial. These agents target critical pathogenic pathways, but they may also have serious side effects. Blockade of the B cell activating factor or its receptors may disrupt pivotal B and T cell responses, and recombinant interleukin 2 complexed with certain interleukin 2 antibodies may selectively expand the regulatory T cell population. A proliferation-inducing ligand that enhances T cell proliferation and survival is an unevaluated, potentially pivotal, therapeutic target. Fully human antibodies, expanded target options, improved targeting precision, more effective delivery systems, and biosimilar agents promise to improve efficacy, safety, and accessibility. In conclusion, biologic agents target key pathogenic pathways in autoimmune hepatitis, and early experiences in refractory disease encourage clarification of the preferred target, rigorous clinical trial, and comparative evaluations.

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Song K, Wu D. Shared decision-making in the management of patients with inflammatory bowel disease. World J Gastroenterol 2022;28:3092-3100. [PMID: 36051346 PMCID: PMC9331519 DOI: 10.3748/wjg.v28.i26.3092] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/21/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023] Open

Moens A, Sadat Seyed Tabib N, Ballet V, Sabino J, Vermeire S, Ferrante M. Safety of sequential biological therapy in inflammatory bowel disease: results from a tertiary referral centre. Aliment Pharmacol Ther 2022;56:271-281. [PMID: 35441398 DOI: 10.1111/apt.16928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/13/2021] [Accepted: 04/01/2022] [Indexed: 12/20/2022]

Abstract

BACKGROUND

Biologicals represent the cornerstone of treatment for moderate-to-severe inflammatory bowel diseases (IBD). Many patients cycle between biologicals when encountering loss of response or adverse events.

AIM

To assess the occurrence of serious infections and malignancies with exposure to several (classes of) biologicals.

METHODS

We performed a retrospective cohort study in a tertiary referral centre including consecutive IBD patients exposed to adalimumab, infliximab, ustekinumab or vedolizumab between 1996 and 2019. All serious infections and malignancies, as well as potential confounders, were accounted for.

RESULTS

In total, 1575 patients were included with a median (interquartile range) follow-up of 10 (6-16) years and a duration of biological therapy of 71 (39-112) months. Incidence rates of serious infections were 3.4 per 100 patients' years (PY) in the post-biological setting. Serious infections after biological exposure were associated with systemic steroids in monotherapy (hazard ratio 2.96 [95% confidence interval 1.78-4.93], p < 0.0001), combination therapy of systemic steroids and a biological (2.44 [1.37-4.34], p = 0.002), female gender (1.25 [1.04-1.51], p = 0.02), and prior serious infections in the pre-biological setting (1.42 [1.03-1.96], p = 0.03). Malignancy rates were 1.06 per 100PY in the post-biological setting and increased with older age at biological initiation (1.04 [1.02-1.05], p < 0.0001). The risk for serious infections or malignancies was independent of type and number of biologicals to which the patient was exposed.

CONCLUSION

This study shows that the sequential use of biological therapy in IBD does not seem to convey an overall higher risk of serious infections or malignancies, but that underlying more refractory disease seems to increase this risk.

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Yalon M, Tahboub Amawi AD, Kelm ZS, Wells ML, Teo LLS, Heiken JP, Sheedy SP, Torbenson MS, Fidler JL, Venkatesh SK. Eosinophilic Disorders of the Gastrointestinal Tract and Associated Abdominal Viscera: Imaging Findings and Diagnosis. Radiographics 2022;42:1081-1102. [PMID: 35749291 DOI: 10.1148/rg.220004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]

Abstract

Eosinophilic gastrointestinal disorders (EGIDs) are inflammatory conditions of the gastrointestinal tract that are characterized by tissue eosinophilia and end-organ dysfunction or damage. Primary EGIDs are associated with atopy and other allergic conditions, whereas secondary EGIDs are associated with underlying systemic diseases or hypereosinophilic syndrome. Within the spectrum of EGIDs, eosinophilic esophagitis is the most prevalent. Eosinophilic gastroenteritis and eosinophilic colitis are relatively uncommon. Eosinophilic infiltration of the liver, biliary tree, and/or pancreas also can occur and mimic other inflammatory and malignant conditions. Although endoscopic evaluation is the method of choice for eosinophilic esophagitis, radiologic evaluation of the esophagus plays an important role in the assessment of disease severity. CT and MR enterography are the modalities of choice for demonstrating specific forms of eosinophilic gastroenteritis. CT and MRI are important in the detection of abdominal visceral involvement in EGIDs. Diagnosis is often challenging and relies on symptoms, imaging findings, histologic confirmation of tissue eosinophilia, and correlation with peripheral eosinophilia. Imaging is crucial for identifying characteristic organ-specific findings, although imaging findings are not specific. When promptly treated, EGIDs usually have a benign clinical course. However, a delayed diagnosis and associated surgical interventions have been associated with morbidity. Therefore, a radiologist's knowledge of the imaging findings of EGIDs in the appropriate clinical settings may aid in early diagnosis and thereby improve patient care. An overview of the clinical features and imaging findings of EGIDs and the eosinophilic disorders of associated abdominal viscera is provided. Online supplemental material is available for this article. ^©RSNA, 2022.

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Affiliation(s)

Mariana Yalon From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Ali D Tahboub Amawi From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Zachary S Kelm From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Michael L Wells From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Lynette L S Teo From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Jay P Heiken From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Shannon P Sheedy From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Michael S Torbenson From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Jeff L Fidler From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)
Sudhakar K Venkatesh From the Department of Radiology (M.Y., A.D.T.A., Z.S.K., M.L.W., J.P.H., S.P.S., J.L.F., S.K.V.) and Department of Laboratory Medicine and Pathology (M.S.T.), Mayo Clinic, 200 2nd St SW, Rochester, MN 55905; and Department of Diagnostic Imaging, National University Health System, Singapore (L.L.S.T.)

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Rolak S, Kane SV. Conventional Therapies for Crohn's Disease. Gastroenterol Clin North Am 2022;51:271-282. [PMID: 35595414 DOI: 10.1016/j.gtc.2021.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]

Sassaki LY, Magro DO, Saad-Hossne R, Baima JP, Flores C, Correia LM, Celani LMS, De Abreu Ferrari MDL, Zacharias P, Feitosa MR, Dos Santos CHM, De Freitas Lins Neto MA, Quaresma AB, De Lima Junior SF, De Vasconcelos GBS, Cassol OS, Dos Santos Pinto A, Kurachi G, Goncalves Filho FDA, Gasparini RG, Furlan TK, Catapani WR, Coy CSR, De Souza Menegassi V, Colombo MM, Fróes RDSB, Teixeira FV, Moraes AC, Santana GO, Parente JML, Vilela EG, Queiroz NSF, Kotze PG, GEDIIB (Brazilian Study Group of IBD). Anti-TNF therapy for ulcerative colitis in Brazil: a comparative real-world national retrospective multicentric study from the Brazilian study group of IBD (GEDIIB). BMC Gastroenterol 2022;22:268. [PMID: 35644668 PMCID: PMC9150299 DOI: 10.1186/s12876-022-02341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open

Abstract

BACKGROUND

Anti-TNF therapy represented a landmark in medical treatment of ulcerative colitis (UC). There is lack of data on the efficacy and safety of these agents in Brazilian patients. The present study aimed to analyze rates of clinical and endoscopic remission comparatively, between adalimumab (ADA) and infliximab (IFX), in Brazilian patients with UC, and evaluate factors associated with clinical and endoscopic remission after 1 year of treatment.

METHODS

A national retrospective multicenter study (24 centers) was performed including patients with UC treated with anti-TNF therapy. Outcomes as clinical response and remission, endoscopic remission and secondary loss of response were measured in different time points of the follow-up. Baseline predictive factors of clinical and endoscopic remission at week 52 were evaluated using logistic regression model. Indirect comparisons among groups (ADA and IFX) were performed using Student's t, Pearson χ2 or Fisher's exact test when appropriated, and Kaplan Meier analysis.

RESULTS

Overall, 393 patients were included (ADA, n = 111; IFX, n = 282). The mean age was 41.86 ± 13.60 years, 61.58% were female, most patients had extensive colitis (62.40%) and 19.39% had previous exposure to a biological agent. Overall, clinical remission rate was 66.78%, 71.62% and 82.82% at weeks 8, 26 and 52, respectively. Remission rates were higher in the IFX group at weeks 26 (75.12% vs. 62.65%, p < 0.0001) and 52 (65.24% vs. 51.35%, p < 0.0001) when compared to ADA. According to Kaplan-Meier survival curve loss of response was less frequent in the Infliximab compared to Adalimumab group (p = 0.001). Overall, endoscopic remission was observed in 50% of patients at week 26 and in 65.98% at week 52, with no difference between the groups (p = 0.114). Colectomy was performed in 23 patients (5.99%). Age, non-prior exposure to biological therapy, use of IFX and endoscopic remission at week 26 were associated with clinical remission after 52 weeks. Variables associated with endoscopic remission were non-prior exposure to biological therapy, and clinical and endoscopic remission at week 26.

CONCLUSIONS

IFX was associated with higher rates of clinical remission after 1 year in comparison to ADA. Non-prior exposure to biological therapy and early response to anti-TNF treatment were associated with higher rates of clinical and endoscopic remission.

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Affiliation(s)

Ligia Yukie Sassaki Department of Internal Medicine, Medical School, São Paulo State University (UNESP), Botucatu, Brazil
Daniela Oliveira Magro Colorectal Surgery Unit, University of Campinas UNICAMP, Campinas, Brazil
Rogerio Saad-Hossne Department of Surgery, Medical School, São Paulo State University Unesp, Botucatu, Brazil
Julio Pinheiro Baima Department of Internal Medicine, Medical School, São Paulo State University (UNESP), Botucatu, Brazil
Cristina Flores Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Lucianna Motta Correia Onofre Lopes Universitary Hospital, Federal University of Rio Grande Do Norte, Natal, Brazil
Lívia Medeiros Soares Celani Onofre Lopes Universitary Hospital, Federal University of Rio Grande Do Norte, Natal, Brazil
Maria De Lourdes De Abreu Ferrari Medical School of the Federal University of the Minas Gerais, Belo Horizonte, Brazil
Patricia Zacharias IBD Outpatient Clinics- Colorectal Surgery Unit, Catholic University or Paraná PUCPR, Curitiba, Brazil
Marley Ribeiro Feitosa Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
Carlos Henrique Marques Dos Santos Surgery Department, Universidade Federal de Mato Grosso Do Sul, Campo Grande, Brazil
Manoel Alvaro De Freitas Lins Neto Federal University of Alagoas, Maceio, Brazil
Abel Botelho Quaresma Surgery, Universidade Do Oeste de Santa Catarina UNOESC, Joaçaba, Brazil
Sergio Figueiredo De Lima Junior Colorectal Surgery Unit, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
Graciana Bandeira Salgado De Vasconcelos Gastroenterologia, Fundação Universidade de Pernambuco, Recife, Brazil
Ornella Sari Cassol Hospital de Clínicas de Passo Fundo, Passo Fundo, Brazil
Arlene Dos Santos Pinto Hospital Universitario Getulio Vargas, Manaus, Brazil
Gustavo Kurachi Gastroenterology, Gastroclinica Cascavel, Cascavel, Brazil
Francisco de Assis Goncalves Filho Department of surgery, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, SP Brazil
Rodrigo Galhardi Gasparini SETE - Specialized Medical Center, Marília, São Paulo, Brazil
Thaísa Kowalski Furlan Gastroenterology, Hospital de Clínicas da Universidade Federal do Paraná - HCUFPR, Curitiba, Brazil
Wilson Roberto Catapani Gastroenterology, Faculdade de Medicina do ABC, Santo André, Brazil
Cláudio Saddy Rodrigues Coy Colorectal Surgery Unit, University of Campinas UNICAMP, Campinas, Brazil
Vivian De Souza Menegassi Hospital Universitário Professor Polydoro Ernani de São Thiago da Universidade Federal de Santa Catarina HU-UFSC, Florianópolis, Santa Catarina Brazil
Marilia Majeski Colombo Gastroenterology, Hospital Doutor Dório Silva, Serra, Brazil
Renata de Sá Brito Fróes Gastroenterology, Gastromed, Rio de Janeiro, Brazil
Fabio Vieira Teixeira GastroSaude Clinic, Marilia, Sao Paulo, Brazil
Antonio Carlos Moraes Hospital Copa D’Or, Rio de Janeiro, Brazil
Genoile Oliveira Santana Bahia State University UNEB, Salvador, Bahia Brazil
José Miguel Luz Parente Gastroenterology Division, Medical Health Center, Federal University of Piaui, Teresina, Brazil
Eduardo Garcia Vilela Gastroenterology, Hospital of the Federal University of Minas Gerais, Belo Horizonte, Brazil
Natália Sousa Freitas Queiroz IBD Outpatient Clinics- Colorectal Surgery Unit, Catholic University or Paraná PUCPR, Curitiba, Brazil
Paulo Gustavo Kotze IBD Outpatient Clinics- Colorectal Surgery Unit, Catholic University or Paraná PUCPR, Curitiba, Brazil
GEDIIB (Brazilian Study Group of IBD) Department of Internal Medicine, Medical School, São Paulo State University (UNESP), Botucatu, Brazil Colorectal Surgery Unit, University of Campinas UNICAMP, Campinas, Brazil Department of Surgery, Medical School, São Paulo State University Unesp, Botucatu, Brazil Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Onofre Lopes Universitary Hospital, Federal University of Rio Grande Do Norte, Natal, Brazil Medical School of the Federal University of the Minas Gerais, Belo Horizonte, Brazil IBD Outpatient Clinics- Colorectal Surgery Unit, Catholic University or Paraná PUCPR, Curitiba, Brazil Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil Surgery Department, Universidade Federal de Mato Grosso Do Sul, Campo Grande, Brazil Federal University of Alagoas, Maceio, Brazil Surgery, Universidade Do Oeste de Santa Catarina UNOESC, Joaçaba, Brazil Colorectal Surgery Unit, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil Gastroenterologia, Fundação Universidade de Pernambuco, Recife, Brazil Hospital de Clínicas de Passo Fundo, Passo Fundo, Brazil Hospital Universitario Getulio Vargas, Manaus, Brazil Gastroenterology, Gastroclinica Cascavel, Cascavel, Brazil Department of surgery, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, SP Brazil SETE - Specialized Medical Center, Marília, São Paulo, Brazil Gastroenterology, Hospital de Clínicas da Universidade Federal do Paraná - HCUFPR, Curitiba, Brazil Gastroenterology, Faculdade de Medicina do ABC, Santo André, Brazil Hospital Universitário Professor Polydoro Ernani de São Thiago da Universidade Federal de Santa Catarina HU-UFSC, Florianópolis, Santa Catarina Brazil Gastroenterology, Hospital Doutor Dório Silva, Serra, Brazil Gastroenterology, Gastromed, Rio de Janeiro, Brazil GastroSaude Clinic, Marilia, Sao Paulo, Brazil Hospital Copa D’Or, Rio de Janeiro, Brazil Bahia State University UNEB, Salvador, Bahia Brazil Gastroenterology Division, Medical Health Center, Federal University of Piaui, Teresina, Brazil Gastroenterology, Hospital of the Federal University of Minas Gerais, Belo Horizonte, Brazil

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Hassanin TM, Fouad Y, Mohamed FE, Abdel-Hafeez EH, Hassnine A. Colonic mucosal eosinophilia and immunohistochemical expression of COX-2 and NF-kB in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol 2022;34:512-517. [PMID: 35275879 DOI: 10.1097/meg.0000000000002363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]

Kim ES, Tae CH, Jung SA, Park DI, Im JP, Eun CS, Yoon H, Jang BI, Ogata H, Fukuhara K, Hirai F, Ohtsuka K, Liu J, Cao Q. Perspectives of East Asian patients and physicians on complementary and alternative medicine use for inflammatory bowel disease: results of a cross-sectional, multinational study. Intest Res 2022;20:192-202. [PMID: 35508953 PMCID: PMC9081987 DOI: 10.5217/ir.2020.00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/12/2021] [Indexed: 11/24/2022] Open

Cytotoxicity of Thiopurine Drugs in Patients with Inflammatory Bowel Disease. TOXICS 2022;10:toxics10040151. [PMID: 35448412 PMCID: PMC9026123 DOI: 10.3390/toxics10040151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023]

Rao Q, Ma GC, Wu H, Li M, Xu W, Wang GJ, Wang D, Zhang CE, Ma ZJ, Zhang ZT. Dendritic cell combination therapy reduces the toxicity of triptolide and ameliorates colitis in murine models. Drug Deliv 2022;29:679-691. [PMID: 35225120 PMCID: PMC8890574 DOI: 10.1080/10717544.2022.2044935] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open

Affiliation(s)

Quan Rao Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
Guang-Chao Ma Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China
Hao Wu Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Meng Li Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Wei Xu Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
Guo-Jun Wang Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
Dong Wang Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
Cong-En Zhang Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Zhi-Jie Ma Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Zhong-Tao Zhang Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China

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Early Change in Fecal Calprotectin Predicts One-Year Outcome in Children Newly Diagnosed With Ulcerative Colitis. J Pediatr Gastroenterol Nutr 2022;74:72-78. [PMID: 34433783 DOI: 10.1097/mpg.0000000000003291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]

Andersson P, Karling P. Impact of treatment with immunomodulators and tumour necrosis factor antagonists on the incidence of infectious events in patients with inflammatory bowel disease. Ups J Med Sci 2022;127:8167. [PMID: 35140875 PMCID: PMC8788654 DOI: 10.48101/ujms.v127.8167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022] Open

Abstract

BACKGROUND

Corticosteroids, immunomodulators (IM) and tumour necrosis factor antagonists (anti-TNF) are commonly used in the treatment of inflammatory bowel disease (IBD) but they also supress the defence against infectious disease. The aim of this study was to analyse the incidence of infectious events in patients with IBD and the association to concomitant medical therapy.

METHODS

We performed a retrospective medical chart review of patients with IBD aged 18-65 years included in the Swedish Registry of Inflammatory Bowel Disease in the catchment area of Umeå University Hospital, Sweden. Data were collected from the period 01 January 2006, to 31 January 2019. An infectious event was defined as an outpatient prescription of antimicrobials or a positive diagnostic test for infection.

RESULTS

During a period of 5,120 observation-years, we observed 1,394 events in 593 patients. The mean number of infectious events per 100 person-years was 27.2 (standard deviation [SD]: 0.46). There were no differences in mean incidence rates between patients treated with no immunosuppression (23.0 events per 100 person-years, SD: 50.4), patients treated with IM monotherapy (27.6 events per 100 person-years, SD: 49.9), patients treated with anti-TNF monotherapy (34.3 events per 100 person-years, SD: 50.1) and patients on combination therapy (22.5 events per 100-person-years, SD: 44.2). In a multivariate logistic regression, female gender (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI]: 1.49-3.37) and combination therapy (AOR: 3.46; 95% CI: 1.52-7.85) were associated with higher risks of infection (>32 events per 100 person years). Also, patients treated with any immunosuppression treatment for 25-75% (AOR: 2.29; 95% CI: 1.21-4.34) and for >75% (AOR: 1.93; 95% CI: 1.19-3.12) of the observation period were at higher risks compared to patients treated with immunosuppression <25% of the observation period.

CONCLUSION

We observed no significant difference in risk for infections between patients on monotherapy with IM or anti-TNF and patients with low use of immunosuppression, but there was a significant risk for combination therapy.

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Martins MM, Ferreira P, Maciel R, Costa C. Vulvar herpes zoster infection: a rare and challenging diagnosis. BMJ Case Rep 2021;14:e246797. [PMID: 34972780 PMCID: PMC8720951 DOI: 10.1136/bcr-2021-246797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 11/03/2022] Open

Mala A, Foteinogiannopoulou K, Koutroubakis IE. Solid extraintestinal malignancies in patients with inflammatory bowel disease. World J Gastrointest Oncol 2021;13:1956-1980. [PMID: 35070035 PMCID: PMC8713323 DOI: 10.4251/wjgo.v13.i12.1956] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/06/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open

Alipour O, Lee V, Tejura TK, Wilson ML, Memel Z, Cho J, Cologne K, Hwang C, Shao L. The assessment of sarcopenia using psoas muscle thickness per height is not predictive of post-operative complications in IBD. Scand J Gastroenterol 2021;56:1175-1181. [PMID: 34344243 DOI: 10.1080/00365521.2021.1958368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]

Abstract

BACKGROUND

Sarcopenia is associated with postoperative complications in inflammatory bowel disease. It has most commonly been defined using the skeletal muscle index, computed after analysis of cross-sectional muscle area at L3. Psoas muscle thickness normalized to height (PMTH), which is easier to derive, is a potential surrogate of SMI and sarcopenia in patients with cirrhosis and chronic pancreatitis. We investigate whether sarcopenia defined by PMTH has utility in predicting post-operative outcomes in patients with inflammatory bowel disease.

METHODS

We performed a retrospective study of adults undergoing IBD-related surgery from 2009 to 2019 at two hospitals. Sarcopenia was defined by sex-specific PMTH at the umbilicus on cross-sectional imaging using a 50^th percentile median cutoff. Predictive models were created using variables (BMI, age, sex, smoking status, albumin, INR, platelets, hemoglobin, hypertension, diabetes, CAD, medications) that may be associated with complications (mortality, reoperation, readmission, transfusions, ICU admission, infection, DVT/PE), and sarcopenia for comparison.

RESULTS

85 patients with IBD were included. Lower albumin level (OR = 0.52, p = 0.039) and biologic use (OR = 5.92, p = 0.006) were associated with postoperative complications. There was no significant difference using PMTH compared to a model incorporating hypoalbuminemia and biologic use in predicting complications. Sarcopenia on univariate analysis was associated with a lower 30 day rate of reoperation (p = 0.04).

CONCLUSIONS

A low status of PMTH was not associated with increased postoperative complications, however hypoalbuminemia and biologic use were. PMTH as a surrogate for sarcopenia requires further study, ideally with prospective studies comparing PMTH with accepted radiographic surrogates for sarcopenia, to determine its role in clinical decision making.

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Vulliemoz M, Brand S, Juillerat P, Mottet C, Ben-Horin S, Michetti P. TNF-Alpha Blockers in Inflammatory Bowel Diseases: Practical Recommendations and a User's Guide: An Update. Digestion 2021;101 Suppl 1:16-26. [PMID: 32739923 DOI: 10.1159/000506898] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 03/01/2020] [Indexed: 02/04/2023]

Duan L, Cheng S, Li L, Liu Y, Wang D, Liu G. Natural Anti-Inflammatory Compounds as Drug Candidates for Inflammatory Bowel Disease. Front Pharmacol 2021;12:684486. [PMID: 34335253 PMCID: PMC8316996 DOI: 10.3389/fphar.2021.684486] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/02/2021] [Indexed: 12/11/2022] Open

Imperatore N, Foggia M, Patturelli M, Rispo A, Calabrese G, Testa A, Pellegrini L, Tosone G, Di Luna I, Nardone OM, Ricciolino S, Castiglione F. Treatment-based risk stratification of infections in inflammatory bowel disease: A comparison between anti-tumor necrosis factor-α and nonbiological exposure in real-world setting. J Gastroenterol Hepatol 2021;36:1859-1868. [PMID: 33283312 DOI: 10.1111/jgh.15367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/21/2020] [Accepted: 11/29/2020] [Indexed: 12/09/2022]

Abstract

BACKGROUND AND AIM

Infective issues about anti-tumor necrosis factor (TNF)-α agents in inflammatory bowel disease (IBD) remain controversial, especially when compared with nonbiological treatments. This study aimed to evaluate the incidence and prevalence of several infections in anti-TNF-α-exposed patients compared with nonbiological treatments.

METHODS

All naïve IBD subjects treated with anti-TNF-α and matched nonbiologic-exposed patients were included.

RESULTS

Among 3453 patients in the database, 288 anti-TNF-α-exposed subjects and 288 nonbiologic-exposed IBD controls met inclusion criteria. Fifty-eight infections (20.1%) occurred during anti-TNF-α treatment versus 23 (8%) in the matched group (odds ratio [OR] 2.9, P < 0.001) (incidence 5.72 vs 0.96/100 patient-years, incidence ratio [IR] 6, P < 0.001). IR was higher for anti-TNF-α versus mesalamine/sulfasalazine (IR 40.8, P < 0.001), similar to azathioprine/6-mercaptopurine/methotrexate (IR 0.78, P = 0.32) and lower than corticosteroids (IR 0.05, P < 0.001). The incidence rate of serious infections was 1.3 in the anti-TNF-α-exposed versus 0.38/100 patient-years in nonexposed subjects (IR 3.44, P = 0.002), without significant difference between anti-TNF-α and azathioprine/6-mercaptopurine/methotrexate (1.3 vs 3.03/100 patient-years, IR 0.43, P = 0.1). Predictors of infections in anti-TNF-α-exposed patients were concomitant use of systemic steroids (OR 1.9, P = 0.02) or azathioprine (OR 2.6, P = 0.01) and a body mass index < 18.5 at time of infection (OR 2.2, P = 0.01).

CONCLUSIONS

The risk of developing infections during anti-TNF-α therapy remains high, although not dissimilar to that found for other immunosuppressants, while concomitant immunosuppression and malnutrition appear the most important causes of infection.

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Petrik M, Palmer B, Khoruts A, Vaughn B. Psychological Features in the Inflammatory Bowel Disease-Irritable Bowel Syndrome Overlap: Developing a Preliminary Understanding of Cognitive and Behavioral Factors. CROHN'S & COLITIS 360 2021;3:otab061. [PMID: 36776665 PMCID: PMC9802046 DOI: 10.1093/crocol/otab061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Indexed: 11/15/2022] Open

Abstract

Background

Inflammatory bowel disease (IBD) patients in clinical remission may experience ongoing symptoms, such as diarrhea and abdominal pain, attributed to IBD-irritable bowel syndrome (IBS) overlap. This study aims to characterize the psychosocial needs of patients with IBD-IBS overlap, particularly in regard to cognitive and behavioral functioning.

Methods

Adults with an established IBD diagnosis were recruited from a gastroenterology clinic. Participants completed self-report questionnaires about psychological functioning and quality of life. The Rome IV Diagnostic Questionnaire for Adults-IBS Module assessed IBS criteria. The treating gastroenterologist completed a clinician rating of IBD activity to determine clinical disease activity. Biomarkers of inflammation collected in routine care within 90 days of the research encounter were obtained via medical record review to further contextualize IBD activity status. Participants were separated into the following groups: "inactive IBD" (IBD activity rating indicating inactive disease and no IBS criteria met), "active IBD" (IBD activity rating indicating mild, moderate, or severe regardless of IBS criteria), or "IBD-IBS overlap" (IBD activity rating indicating inactive disease and IBS criteria met).

Results

One hundred and seventeen participants were recruited. Those with IBD-IBS overlap reported no significant differences in ratings of anxiety, depression, somatization, catastrophic thinking patterns, and behavioral avoidance, to patients with active IBD whereas participants with inactive IBD reported significantly lower ratings on these factors. However, a significant portion of participants with IBD-IBS overlap who were rated as inactive on IBD activity measures had laboratory or endoscopic findings indicating mild inflammation within 90 days of the research encounter.

Conclusions

The study findings provide preliminary evidence that suggests patients with IBD-IBS overlap display similar rates of psychological distress, catastrophic thinking, and avoidance behaviors as those with active IBD. Those with mild ongoing inflammation despite meeting a definition for clinical remission may have similar psychological needs compared to those with moderate-to-severely active IBD. Incorporating a mental health provider with training in psychogastroenterology can help a patient with IBD learn how to effectively with these cognitive and behavioral patterns.

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TNF in the era of immune checkpoint inhibitors: friend or foe? Nat Rev Rheumatol 2021;17:213-223. [PMID: 33686279 PMCID: PMC8366509 DOI: 10.1038/s41584-021-00584-4] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 01/30/2023]

Mahadevan U, Long MD, Kane SV, Roy A, Dubinsky MC, Sands BE, Cohen RD, Chambers CD, Sandborn WJ, Crohn’s Colitis Foundation Clinical Research Alliance. Pregnancy and Neonatal Outcomes After Fetal Exposure to Biologics and Thiopurines Among Women With Inflammatory Bowel Disease. Gastroenterology 2021;160:1131-1139. [PMID: 33227283 PMCID: PMC7956164 DOI: 10.1053/j.gastro.2020.11.038] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023]

Abstract

BACKGROUND & AIMS

Pregnant women with inflammatory bowel disease (IBD) may require biologic or thiopurine therapy to control disease activity. Lack of safety data has led to therapy discontinuation during pregnancy, with health repercussions to mother and child.

METHODS

Between 2007 and 2019, pregnant women with IBD were enrolled in a prospective, observational, multicenter study across the United States. The primary analysis was a comparison of 5 outcomes (congenital malformations, spontaneous abortions, preterm birth, low birth weight, and infant infections) among pregnancies exposed vs unexposed in utero to biologics, thiopurines, or a combination. Bivariate analyses followed by logistic regression models adjusted for relevant confounders were used to determine the independent effects of specific drug classes on outcomes of interest.

RESULTS

Among 1490 completed pregnancies, there were 1431 live births. One-year infant outcomes were available in 1010. Exposure was to thiopurines (n = 242), biologics (n = 642), or both (n = 227) vs unexposed (n = 379). Drug exposure did not increase the rate of congenital malformations, spontaneous abortions, preterm birth, low birth weight, and infections during the first year of life. Higher disease activity was associated with risk of spontaneous abortion (hazard ratio, 3.41; 95% confidence interval, 1.51-7.69) and preterm birth with increased infant infection (odds ratio, 1.73; 95% confidence interval, 1.19-2.51).

CONCLUSIONS

Biologic, thiopurine, or combination therapy exposure during pregnancy was not associated with increased adverse maternal or fetal outcomes at birth or in the first year of life. Therapy with these agents can be continued throughout pregnancy in women with IBD to maintain disease control and reduce pregnancy-related adverse events. ClinicalTrials.gov, Number: NCT00904878.

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Berkovitch G, Cohen S, Lubetzky R, Singer D, Yerushalmy-Feler A. Biologic therapy is associated with a mild decrease in the rate of hospitalizations in pediatric IBD. BMC Pediatr 2021;21:63. [PMID: 33541320 PMCID: PMC7860024 DOI: 10.1186/s12887-021-02526-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/28/2021] [Indexed: 12/11/2022] Open

Landemaine A, Petitcollin A, Brochard C, Miard C, Dewitte M, Le Balc'h E, Grainville T, Bellissant E, Siproudhis L, Bouguen G. Cumulative Exposure to Infliximab, But Not Trough Concentrations, Correlates With Rate of Infection. Clin Gastroenterol Hepatol 2021;19:288-295.e4. [PMID: 32200087 DOI: 10.1016/j.cgh.2020.03.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/13/2020] [Accepted: 03/08/2020] [Indexed: 02/07/2023]

Nakase H, Uchino M, Shinzaki S, Matsuura M, Matsuoka K, Kobayashi T, Saruta M, Hirai F, Hata K, Hiraoka S, Esaki M, Sugimoto K, Fuji T, Watanabe K, Nakamura S, Inoue N, Itoh T, Naganuma M, Hisamatsu T, Watanabe M, Miwa H, Enomoto N, Shimosegawa T, Koike K. Evidence-based clinical practice guidelines for inflammatory bowel disease 2020. J Gastroenterol 2021;56:489-526. [PMID: 33885977 PMCID: PMC8137635 DOI: 10.1007/s00535-021-01784-1] [Citation(s) in RCA: 294] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 02/07/2023]

Affiliation(s)

Hiroshi Nakase Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan ,2grid.263171.00000 0001 0691 0855Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuoku, Sapporo, Hokkaido 060-8543 Japan
Motoi Uchino Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Shinichiro Shinzaki Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Minoru Matsuura Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Katsuyoshi Matsuoka Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Taku Kobayashi Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Masayuki Saruta Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Fumihito Hirai Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Keisuke Hata Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Sakiko Hiraoka Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Motohiro Esaki Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Ken Sugimoto Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Toshimitsu Fuji Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Kenji Watanabe Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Shiro Nakamura Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Nagamu Inoue Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Toshiyuki Itoh Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Makoto Naganuma Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Tadakazu Hisamatsu Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Mamoru Watanabe Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Hiroto Miwa Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Nobuyuki Enomoto Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Tooru Shimosegawa Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan
Kazuhiko Koike Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Inflammatory Bowel Disease”, The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004 Japan

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Hisamatsu T, Kim HJ, Motoya S, Suzuki Y, Ohnishi Y, Fujii N, Matsushima N, Zheng R, Marano CW. Efficacy and safety of ustekinumab in East Asian patients with moderately to severely active ulcerative colitis: a subpopulation analysis of global phase 3 induction and maintenance studies (UNIFI). Intest Res 2020;19:386-397. [PMID: 33249802 PMCID: PMC8566834 DOI: 10.5217/ir.2020.00080] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/03/2020] [Indexed: 11/16/2022] Open

Liu F, Wang X, Li D, Cui Y, Li X. Apple polyphenols extract alleviated dextran sulfate sodium-induced ulcerative colitis in C57BL/6 male mice by restoring bile acid metabolism disorder and gut microbiota dysbiosis. Phytother Res 2020;35:1468-1485. [PMID: 33215776 DOI: 10.1002/ptr.6910] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]

Alkhatry M, Al-Rifai A, Annese V, Georgopoulos F, Jazzar AN, Khassouan AM, Koutoubi Z, Nathwani R, Taha MS, Limdi JK. First United Arab Emirates consensus on diagnosis and management of inflammatory bowel diseases: A 2020 Delphi consensus. World J Gastroenterol 2020;26:6710-6769. [PMID: 33268959 PMCID: PMC7684461 DOI: 10.3748/wjg.v26.i43.6710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/15/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open