Review
Gastroenterology & Hepatology
Siddharth Singh, Deborah Proctor, Frank Scott, Yngve Falck-Ytter, Joseph D. Feuerstein
Summary: The global incidence and prevalence of Crohn's disease (CD) is increasing, with patients at high risk for complications, surgery, and hospitalization. Optimal management of moderate to severe CD often requires immunomodulators and/or biologic therapies, but guidelines on comparative efficacy are limited, leading to variability in practice.
Review
Gastroenterology & Hepatology
Nicholas E. Burr, David J. Gracie, Christopher J. Black, Alexander C. Ford
Summary: In a network meta-analysis, upadacitinib 45 mg once daily ranked first for clinical remission in all patients, patients naive to anti-TNF-alpha drugs and patients previously exposed. Infliximab 10 mg/kg ranked first for endoscopic improvement. Most drugs were safe and well tolerated.
Review
Gastroenterology & Hepatology
Stefanos Bonovas, Claudia Pansieri, Daniele Piovani, Fabio Salvatore Macaluso, Ambrogio Orlando, Stefano Festa, Claudio Papi, Daniela Pugliese, Alessandro Armuzzi
Summary: The increased knowledge on the biological mechanisms underlying ulcerative colitis has led to the development of biologics and small molecule drugs, which have posed clinical dilemmas. This technical review provides clinical recommendations based on rigorous evaluation of evidence.
DIGESTIVE AND LIVER DISEASE
(2022)
Article
Gastroenterology & Hepatology
Saurabh Kedia, Tarini Shankar Ghosh, Saransh Jain, Anbumani Desigamani, Ashok Kumar, Vipin Gupta, Sawan Bopanna, Dawesh P. Yadav, Sandeep Goyal, Govind Makharia, Simon P. L. Travis, Bhabatosh Das, Vineet Ahuja
Summary: The gut microbiome of patients with acute severe colitis (ASC) is characterized by lower diversity compared to mild-moderate UC or healthy controls (HCs). The microbiome composition in ASC is increasingly unstable, with distinct abundance of specific genera compared to UC and HCs. Mild-moderate UC falls within the spectrum of gut microbial diversity.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Review
Gastroenterology & Hepatology
Fernando Magro, Maria Manuela Estevinho, Claudia Camila Dias, Luis Correia, Paula Lago, Paula Ministro, Francisco Portela, Roger Feakins, Silvio Danese, Laurent Peyrin-Biroulet
Summary: This study found that histological outcomes are informative in trials of moderate-to-severe ulcerative colitis. Clinical and histological remission, as well as endoscopic response, are concordant in discriminating interventions from placebo.
JOURNAL OF CROHNS & COLITIS
(2021)
Article
Gastroenterology & Hepatology
Floris de Voogd, Elsa A. van Wassenaer, Aart Mookhoek, Steven Bots, Sara van Gennep, Mark Lowenberg, Geert R. D'Haens, Krisztina B. Gecse
Summary: This study evaluated the use of intestinal ultrasound (IUS) in the treatment response of ulcerative colitis (UC). The results showed that bowel wall thickness (BWT) is the most accurate parameter for determining endoscopic improvement and treatment response.
Article
Microbiology
Jie Liu, Huaying Fang, Na Hong, Chaolan Lv, Qihua Zhu, Yinping Feng, Bo Wang, Jiashuang Tian, Yue Yu
Summary: Patients with ulcerative colitis (UC) have low response rates to anti-integrin medications in the latest VARSITY study. Our study aimed to identify differences in the gut microbiome and metabonomics patterns between early remission and nonremission patients, and to explore the diagnostic value in predicting clinical remission to anti-integrin therapy accurately. We found that Verrucomicrobiota, butyric acid, and isobutyric acid improved the diagnosis of early remission to anti-integrin therapy.
MICROBIOLOGY SPECTRUM
(2023)
Review
Gastroenterology & Hepatology
Ferdinando D'Amico, Fernando Magro, Laurent Peyrin-Biroulet, Silvio Danese
Summary: Filgotinib is an effective and safe drug for the treatment of moderate to severe UC, showing similar efficacy but lower risks of thrombosis and herpes zoster infections compared to other JAK inhibitors. However, there may be potential effects on male reproductive organs that require further investigation in human studies.
JOURNAL OF CROHNS & COLITIS
(2022)
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
Baili Chen, Jie Zhong, Xiuling Li, Feng Pan, Yijuan Ding, Yan Zhang, Hong Chen, Fei Liu, Zhenyu Zhang, Ling Zhang, Rafal Drozda, Oleksandr Oliinyk, Aik Han Goh, Xiang Chen, Xiang Sun, David T. Rubin, William J. Sandborn, Minhu Chen
Summary: This study evaluated the efficacy and safety of the selective JAK1 inhibitor ivarmacitinib in patients with moderate-to-severe active UC. The results showed that ivarmacitinib demonstrated clinical efficacy and was well tolerated in treating UC. This provides a promising new treatment option for moderate-to-severe UC.
Article
Pharmacology & Pharmacy
Jun Miyoshi, Minoru Matsuura, Tadakazu Hisamatsu
Summary: Ustekinumab, a human monoclonal antibody targeting IL-12 and IL-23, has shown favorable clinical efficacy and safety profiles for moderately-to-severely active UC. While its positioning in UC treatment strategy is unclear, monotherapy with ustekinumab may be sufficient and safe. Additional studies are needed to further optimize its use in special situations.
EXPERT OPINION ON DRUG SAFETY
(2022)
Article
Medicine, General & Internal
Xiaojuan Li, Zihui Tang, Yanbing Liu, Xinyan Zhu, Fei Liu
Summary: We developed an internal validation model to predict the moderate to severe endoscopic activity of ulcerative colitis patients based on non-invasive or minimally-invasive parameters. Logistic regression and Lasso regression were used to identify the risk factors and establish a prediction model. The model showed good discrimination and calibration in evaluating UC activity.
FRONTIERS IN MEDICINE
(2023)
Review
Gastroenterology & Hepatology
Raj Shah, Perica Davitkov, Barham K. Abu Dayyeh, Monica Saumoy, M. Hassan Murad
Summary: Various strategies are available to address the obesity epidemic, with endoscopic bariatric techniques such as intragastric balloons becoming an attractive alternative. This technical review includes multiple systematic reviews to support the role of intragastric balloons as a tool for weight loss, targeting clinical questions about effectiveness and periprocedural care.
Review
Gastroenterology & Hepatology
Alessandro Armuzzi, Giuseppina Liguori
Summary: Ulcerative colitis, as a chronic inflammatory disease, significantly impacts the quality of life of patients, but effective treatment including biological therapies can restore and improve quality of life. Current treatment options involve conventional medications and biologic therapies, with some issues associated with anti-TNF antibodies, while JAK inhibitors show promise in improving disease manifestations and long-term quality of life outcomes. Further studies are needed to better understand the comparative effects of treatments on quality of life and patient preferences for therapy.
DIGESTIVE AND LIVER DISEASE
(2021)
Review
Medicine, General & Internal
Sarah Bencardino, Ferdinando D'Amico, Ilaria Faggiani, Francesca Bernardi, Mariangela Allocca, Federica Furfaro, Tommaso Lorenzo Parigi, Alessandra Zilli, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
Summary: Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects patients' quality of life. There is a need for new drugs that target new pathways and minimize adverse events. Sphingosine-1-phosphate (S1P) receptor modulators have shown promise in reducing inflammation in UC by controlling the movement of immune cells. Several S1P receptor modulators, including ozanimod, etrasimod, and VTX002, have been developed and tested in UC. Oral administration, rapidity, and safety profile are the advantages of these drugs.
JOURNAL OF CLINICAL MEDICINE
(2023)