Article
Gastroenterology & Hepatology
Eun Mi Song, Eun Hye Oh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Summary: Through retrospective review of 121 Korean patients with SR-ASUC, it was found that there were no significant differences in the rates of treatment failure and colectomy at 3 months between the CsA and IFX treatment groups. Additionally, prior use of azathioprine and Mayo score at the time of rescue therapy were both associated with treatment failure or colectomy within 3 months.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Gaurav Syal, Lori Robbins, Amir Kashani, Nirupama Bonthala, Edward Feldman, Phillip Fleshner, Eric Vasiliauskas, Dermot McGovern, Christina Ha, Stephan Targan, Gil Y. Melmed
Summary: Serum albumin and band neutrophil percentage are independent predictors of failure of infliximab rescue therapy in patients with acute severe ulcerative colitis. The combination of serum albumin <= 2.5 g/dl and band neutrophil count >= 13% has a 100% positive predictive value for 90-day colectomy.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Gastroenterology & Hepatology
Abhishek Bhurwal, Carlos D. Minacapelli, Anish Patel, Hemant Mutneja, Akshay Goel, Ishani Shah, Vikas Bansal, Bhaumik Brahmbhatt, Kiron M. Das
Summary: This study revealed racial and geographical disparities in colectomy rates among hospitalized patients with UC after the introduction of anti-TNF therapy. African American and Hispanic patients had significantly lower colectomy rates compared to White patients, while the western regions of the United States had the highest colectomy rates. Further research is needed to understand the underlying social and biological factors contributing to these disparities.
INFLAMMATORY BOWEL DISEASES
(2022)
Article
Gastroenterology & Hepatology
Jeffrey A. Berinstein, Jessica L. Sheehan, Michael Dias, Elliot M. Berinstein, Calen A. Steiner, Laura A. Johnson, Randolph E. Regal, John I. Allen, Kelly C. Cushing, Ryan W. Stidham, Shrinivas Bishu, Jami A. R. Kinnucan, Shirley A. Cohen-Mekelburg, Akbar K. Waljee, Peter D. R. Higgins
Summary: The study suggests that tofacitinib with concomitant intravenous corticosteroids may reduce the risk of colectomy in ASUC patients, especially with a dosage of 10 mg three times daily. Rates of complications and steroid dependence were similar between the tofacitinib group and controls. Prospective trials are needed to further investigate the safety and optimal dosing of tofacitinib in ASUC patients.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Review
Gastroenterology & Hepatology
Nick Dai, Omar Haidar, Alan Askari, Jonathan P. Segal
Summary: This study aimed to understand the changing prevalence of colectomy in Ulcerative Colitis (UC) over time. The results showed that the overall colectomy rate has decreased over the past three decades. Biologics may have played a role in reducing the risk of colectomy, but the relative risk reduction is likely to be modest.
DIGESTIVE AND LIVER DISEASE
(2023)
Review
Pharmacology & Pharmacy
Alix Demaris, Ella S. K. Widigson, Johan F. K. F. Ilvemark, Casper Steenholdt, Jakob B. Seidelin, Wilhelm Huisinga, Robin Michelet, Linda B. S. Aulin, Charlotte Kloft
Summary: This review aims to analyze the population PK models of infliximab (IFX) in patients with ulcerative colitis (UC) and acute severe UC (ASUC), and assess the impact of disease activity on IFX PK. The results showed that there are still many gaps in the current research, such as a limited number of models specifically developed for UC patients, a lack of studies on severe UC patients, and a lack of evaluation of predictive performance for the models. Therefore, more comprehensive research and adequate reporting and evaluation of the models are needed for clinical application.
Article
Gastroenterology & Hepatology
Brandon K. Chu, Frank I. Scott, Meenakshi Bewtra
Summary: This simulation study suggests that early incorporation of colectomy for patients medically refractory to infliximab and azathioprine combination therapy may lead to better quality of life for patients with steroid-dependent UC. This finding highlights the importance of a combined medical-surgical approach in the treatment of UC.
JOURNAL OF GASTROINTESTINAL SURGERY
(2021)
Article
Gastroenterology & Hepatology
David T. Rubin, Leonardo Salese, Mitchell Cohen, Paulo G. Kotze, John C. Woolcott, Chinyu Su, Rajiv Mundayat, Jerome Paulissen, Joana Torres, Millie D. Long
Summary: This study evaluated colectomy incidence rates and risk factors among patients with ulcerative colitis treated with tofacitinib. The results showed that colectomies were infrequent among patients receiving tofacitinib treatment, and all patients who underwent colectomy had additional risk factors.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Lori A. Zimmerman, Jonathan Spaan, Nathan Weinbren, Krishanth Manokaran, Aravindh Ajithkumar, Anna Bogursky, Enju Liu, Craig Lillehei, Brent R. Weil, Jill M. Zalieckas, Athos Bousvaros, Paul A. Rufo
Summary: This study retrospectively analyzed the outcomes of 170 pediatric patients with acute severe colitis (ASC) who were treated with either IFX or TAC after failing intravenous corticosteroids. The study found that there were no significant differences in the likelihood of colectomy 6 months after initiating IFX or TAC rescue therapy, and the efficacy of both agents was comparable. However, the types of adverse effects differed between the two therapies. These data support the use of either TAC or IFX in children with ASC refractory to intravenous corticosteroids.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2023)
Article
Gastroenterology & Hepatology
Atsushi Kohyama, Kazuhiro Watanabe, Akira Sugita, Kitaro Futami, Hiroki Ikeuchi, Ken-ichi Takahashi, Yasuo Suzuki, Kouhei Fukushima
Summary: This study defined and investigated postoperative ulcerative colitis-related severe enteritis (UCRSE), with 0.8% of cases meeting the criteria. Major symptoms included massive intestinal bleeding, high-output stoma, and intestinal perforation. Some patients developed serious complications, required surgery or long-term maintenance therapy.
JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Helene Hermand, Jeremie H. Lefevre, Conor Shields, Najim Chafai, Clotilde Debove, Laurent Beaugerie, Magali Svrcek, Yann Parc
Summary: The study found that a small proportion of patients undergoing subtotal colectomy may have their diagnosis changed from ulcerative colitis to Crohn's disease postoperatively, with patients with a disease duration of less than 10 years and an initial diagnosis of IBDU being at higher risk for this diagnostic change.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
Michael C. Plietz, Marine Coste, Jeremy Miller, Maia Kayal, Kathryn Ely Pierce Chuquin, Anam Rizvi, Venu Gopal Bangla, Marla C. C. Dubinsky, Sergey Khaitov, Patricia A. A. Sylla, Alexander J. J. Greenstein
Summary: The study aimed to compare rates of postoperative complications between emergent and non-emergent first-stage subtotal colectomies in three-stage IPAA patients. It found that patients who underwent emergent STC were more likely to experience postoperative anastomotic leaks and require additional procedures. However, there was no significant difference in other complications such as obstruction or wound infection.
JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Article
Gastroenterology & Hepatology
Maia Kayal, Hannah Posner, Hadar Meringer Milwidsky, Michael Plietz, Sergey Khaitov, Patricia Sylla, Alexander Greenstein, Marla C. Dubinsky, Saurabh Mehandru, Jean Frederic Colombel
Summary: A retrospective cohort analysis of 416 patients found that acute severe ulcerative colitis was significantly associated with subsequent acute pouchitis. The risk of pouchitis may be influenced by immune activation and disease severity prior to colectomy.
INFLAMMATORY BOWEL DISEASES
(2023)
Review
Medicine, General & Internal
Cristina Calvino-Suarez, Rocio Ferreiro-Iglesias, Iria Baston Rey, Manuel Barreiro-de Acosta
Summary: Management of ulcerative colitis after surgery (total proctocolectomy with ileal-pouch anal anastomosis) is challenging as patients experience uncomfortable symptoms, especially pouchitis. The etiology of chronic pouchitis remains unknown, making it difficult to treat. Antibiotics, budesonide, and biological therapies are recommended, but some may still require a permanent ileostomy.
FRONTIERS IN MEDICINE
(2023)
Review
Medicine, General & Internal
Benjamin L. Gordon, Robert Battat
Summary: Therapeutic drug monitoring (TDM) is a useful strategy in ulcerative colitis (UC), particularly in acute severe UC (ASUC). While there is limited data available for the use of TDM of infliximab in ASUC, observational data suggest that higher serum infliximab concentrations and lower clearance are associated with better clinical outcomes and decreased rates of colectomy. However, more studies are needed to evaluate optimal dosing and TDM targets in this population.
JOURNAL OF CLINICAL MEDICINE
(2023)
Letter
Gastroenterology & Hepatology
Ashish Srinivasan, Peter De Cruz, Daniel R. van Langenberg
Article
Gastroenterology & Hepatology
Michael De Gregorio, Tanya Lee, Krupa Krishnaprasad, Gregory Amos, Yoon-Kyo An, Matthew Bastian-Jordan, Jakob Begun, Nira Borok, Dougal J. M. Brown, Wa Cheung, Susan J. Connor, Jan Gerstenmaier, Lauren E. Gilbert, Robert Gilmore, Bonita Gu, Numan Kutaiba, Allan Lee, Gillian Mahy, Ashish Srinivasan, Lena Thin, Alexander J. Thompson, Christopher J. Welman, Eric X. Z. Yong, Peter De Cruz, Daniel van Langenberg, Miles P. Sparrow, Nik S. Ding
Summary: The study examines the association between anti-TNF drug levels and radiologic outcomes in perianal fistulising Crohn's disease, and finds that higher drug levels are associated with improved radiologic results.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Editorial Material
Gastroenterology & Hepatology
Abhinav Vasudevan, Daniel R. van Langenberg
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Gastroenterology & Hepatology
R. D. Hirsch, C. Keung, D. Con, A. Vasudevan, D. R. Van Langenberg, O. Niewiadomski
Summary: This study aimed to assess the cost of treating perianal Crohn's disease and compare it with non-perianal Crohn's disease patients. The results showed that while overall costs were similar, perianal patients had higher surgical costs, indicating the potential benefit of early intensive treatment to reduce future surgical costs.
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Ashish Srinivasan, Robert Gilmore, Daniel van Langenberg, Peter De Cruz
Summary: Anti-TNF dose intensification is clinically effective in patients with Crohn's disease, particularly within the first 6 months. However, a proportion of patients may fail to demonstrate short-term and/or sustained clinical response. Hence, clinical reassessment remains important, particularly beyond 6 months of dose intensification.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R. van Langenberg, Abhinav Vasudevan
Summary: In this study, CAR and CLR measured on day 3 post infliximab salvage for steroid-refractory ASUC were found to be strong predictors of colectomy, showing potential utility in predicting subsequent treatment outcomes. Prospective studies are needed to further confirm the predictive value of these biomarkers.
INTESTINAL RESEARCH
(2022)
Article
Oncology
Krishneel Dutt, Ashish Srinivasan, Daniel Van Langenberg
Summary: This study evaluated the nocebo effect in patients with inflammatory bowel disease (IBD) who switched from originator to biosimilar medicines. The study found a temporary nocebo effect in the first 16 weeks following non-medical switching, but it was not sustained at week 32. Overcoming negative patient perceptions can be achieved through a patient-inclusive approach to non-medical switching, along with close clinical follow-up and disease monitoring.
Article
Gastroenterology & Hepatology
Alex Barnes, Soong-Yuan J. Ooi, Kate D. Lynch, Nina Parthasarathy, Maria Bishara, Michael Gounder, Rachel Grafton, Peta Leach, Peter Bampton, Alexandra Sechi, Watson Ng, Susan Connor, Daniel van Langenberg, Reme Mountifield, Jane M. Andrews
Summary: This study aimed to evaluate the long-term outcomes of patients on thiopurines following therapeutic drug monitoring (TDM) for the treatment of inflammatory bowel disease (IBD). The findings showed that TDM resulted in a change in management for the majority of patients and led to an increase in the number of patients in remission. Proactive TDM allowed for the identification and management of inappropriate dosing and was associated with higher levels of clinical remission.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Review
Medicine, General & Internal
Anuj Bohra, Abhinav Vasudevan, Numan Kutaiba, Daniel R. Van Langenberg
Summary: Magnetic resonance enterography (MRE) is a commonly used tool for assessing patients with small bowel Crohn's disease. This review examines the impact of image quality on the accuracy of small bowel CD activity assessment and discusses strategies to improve image quality in MRE.
Article
Gastroenterology & Hepatology
Ashish Srinivasan, Peter De Cruz, Melissa Sam, Catherine Toong, Daniel R. van Langenberg
Summary: This study compared two different strategies, repeat infliximab induction and shorter dose interval, for addressing secondary loss of response in patients with inflammatory bowel disease. The study found that both strategies had similar clinical response rates, but they resulted in distinct pharmacokinetic profiles.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Abhinav Vasudevan, Danny Con, Peter De Cruz, Miles P. Sparrow, Antony B. Friedman, Mayur Garg, Soleiman Kashkooli, Peter R. Gibson, Daniel R. van Langenberg
Summary: This study compared the use of thiopurine-allopurinol combination therapy with standard thiopurine therapy in IBD. The results showed that the thiopurine-allopurinol group had better outcomes in the primary efficacy assessment, fewer adverse events, and less frequent thiopurine dose adjustments.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Anuj Bohra, Diana Lewis, Jonathan P. Segal, Abhinav Vasudevan, Daniel R. Van Langenberg, Olga Niewiadomski
Summary: This study examines the diagnostic utility of panenteric Crohn's capsule endoscopy in detecting active small-bowel Crohn's disease when imaging is normal but there is a high clinical suspicion. The results show that Crohn's CE is an effective diagnostic test that can improve quality of life and guide treatment.
Review
Gastroenterology & Hepatology
Anuj Bohra, Daniel R. Van Langenberg, Abhinav Vasudevan
Summary: Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract. Intestinal ultrasound is a noninvasive and objective method for assessing disease activity, with advantages in diagnostic accuracy and disease monitoring, particularly during pregnancy and for fibrosis detection.
GASTROINTESTINAL DISORDERS
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Natalie Yu, Daniel Tassone, Tanya Lee, Steven Phan, Damien M. Wu, Jason Zhang, Luke Wang, Jason Tjahyadi, Krishneel Dutt, Hana Liou, Chamara Basnayake, Emily K. Wright, Mark Lust, Ola Niewiadomski, Michael A. Kamm, William Connell, Alexander Thompson, Ida Hilmi, Raja Affendi Raja Ali, Shu Chen Wei, Peter De Cruz, Antony Friedman, Gregory T. Moore, Daniel R. Van Langenberg, Nik S. Ding
Meeting Abstract
Gastroenterology & Hepatology
Ashish Srinivasan, Peter De Cruz, Melissa Sam, Catherine Toong, Daniel R. Van Langenberg