Best Practice and Research. Clinical Gastroenterology 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Should we use vedolizumab as mono or combo therapy in ulcerative colitis?
Publication date: Available online 12 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Charlotte Hedin, Jonas HalfvarsonAbstractRandomized controlled trials comparing the efficacy of vedolizumab monotherapy with combination therapy of vedolizumab and an immunomodulator in patients with ulcerative colitis (UC) are lacking. Emerging pharmacokinetic data indicate that vedolizumab concentrations correlate with clinical outcomes, although the correlation may be less strong for vedolizumab compared with an anti-TNF agents. Associations between concomitant use of immunomodulators and decreased immunoge...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Which evidence for a treat to target strategy in ulcerative colitis?
Publication date: Available online 12 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Aude Marchal BressenotAbstractThe main therapeutic goal of in ulcerative colitis is to maintain disease remission. The new concept of deep remission implies also a complete mucosal healing. Histological assessment of disease in UC seems to be an important prognostic factor to predict disease outcome. In this article we review current definitions of mucosal healing, histological healing, histological remission and available histological scores assessing histological activity of disease in ulcerative colitis. Co...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Should we use anti-tumor necrosis factor agents or vedolizumab as first-line biological therapy in ulcerative colitis?
Publication date: Available online 12 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Lieven Pouillon, Johan Van Stappen, Peter Bossuyt, Silvio Danese, Laurent Peyrin-BirouletAbstractRandomized controlled trials with direct comparisons between the different available biological agents in ulcerative colitis are lacking. The comparative efficacy, safety and tolerability, patient profile, patient preference and costs should be taken into account when choosing an appropriate first-line biological. Tumor necrosis factor antagonists have a systemic mode of action, while vedolizumab is mainly gut-sele...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Acute severe ulcerative colitis: State of the art treatment
Publication date: Available online 12 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Javier P. Gisbert, María ChaparroAbstractAcute severe ulcerative colitis (ASUC) is a potentially life-threatening condition. In the present review, we give a broad overview of the state of the art in the management of this condition. A systematic bibliographic search was performed in PubMed. Patient with ASUC should be hospitalized and managed by a multidisciplinary team (gastroenterologist plus surgeon). Intravenous corticosteroids remain the cornerstone of medical therapy. However, about 30% of patients do ...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Geoepidemiology and (epi-)genetics in primary biliary cholangitis
Publication date: Available online 16 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Rosa Roberto, Cristoferi Laura, Tanaka Atsushi, Invernizzi PietroAbstractPrimary biliary cholangitis (PBC) is a rare female preponderant chronic autoimmune cholestatic liver disease, characterized by intrahepatic ductopenia and progressive fibrosis. During last decades incidence and prevalence showed an increasing rate which vary widely worldwide demonstrating an important interaction between environmental and genetic factors. Heritability suggested by familial occurrence and monozygotic twins concordance have...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
The risk of cancer in ulcerative colitis: Can we prevent it?
Publication date: Available online 16 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Anthony Lopez, Lieven Pouillon, Laurent Beaugerie, Silvio Danese, Laurent Peyrin-BirouletAbstractUlcerative colitis is characterized by chronic inflammation, which may lead to the accumulation of high levels of pro-inflammatory cytokines within the colonic mucosa, and thus to dysplastic lesions and cancer. Although the trend is decreasing, ulcerative colitis patients still have a 2.4 fold higher risk of colorectal cancer compared to the general population. The key task is to control colonic inflammation, and a...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Refractory ulcerative proctitis: How to treat it?
Publication date: Available online 18 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Guillaume Pineton de Chambrun, Barbara Tassy, Laura Kollen, Gaspard Dufour, Jean-Christophe Valats, Michael Bismuth, Natalie Funakoshi, Fabrizio Panaro, Pierre BlancAbstractUlcerative proctitis is defined as a mucosal inflammation limited to the rectum. Ulcerative proctitis is responsible for distressing symptoms and alteration of patient quality of life. Effective treatment is important to prevent or delay proximal extension of the disease and to improve quality of life. Refractory ulcerative proctitis is def...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
PBC and related extrahepatic diseases
Publication date: Available online 23 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Floreani Annarosa, Cazzagon NoraAbstractPatients with PBC have at least 60% of probability to have an autoimmune extrahepatic condition. The pathogenesis of these conditions includes a common mechanism involving both innate and adaptive immune responses targeting cholangiocytes and different extrahepatic tissues. The recent EASL guidelines recommend the management of these conditions, although detailed practical treatments have not been indicated. Autoimmune extrahepatic conditions may include: rheumatologic, ...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
JAK inhibitors: Novel developments in management of ulcerative colitis
Publication date: Available online 23 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Gionata Fiorino, Ferdinando D'Amico, Angelo Italia, Daniela Gilardi, Federica Furfaro, Silvio DaneseAbstractJanus kinase inhibitors are small molecules, orally administered, under development for the treatment of ulcerative colitis. These molecules reduce the immune response, blocking the signal transduction of multiple cytokines implicated in the activation of inflammation. Currently multiple JAK inhibitors are being evaluated in clinical trials. The aim of this review is to examine the efficacy and the safet...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Can IL-23 be a good target for ulcerative colitis?
Publication date: Available online 23 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Mariangela Allocca, Federica Furfaro, Gionata Fiorino, Daniela Gilardi, Silvia D'Alessio, Silvio DaneseAbstractA considerable percentage of patients with ulcerative colitis (UC) do not respond to therapies, including anti-tumor necrosis factor (TNF) drugs and vedolizumab, or lose response over time. Hence the continuing need to find new therapeutic strategies and novel drugs to control this chronic debilitating disease. Increased levels of interleukin (IL)-23 and T helper (Th) 17 cell cytokines have been fou...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Pathophysiology of primary biliary cholangitis
Publication date: Available online 24 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Aliya F. Gulamhusein, Gideon M. HirschfieldAbstractPrimary biliary cholangitis is a prototypical autoimmune disease characterized by an overwhelming female predominance, a distinct clinical phenotype, and disease specific anti-mitochondrial antibodies targeted against a well-defined auto-antigen. In a genetically susceptible host, multi-lineage loss of tolerance to the E2 component of the 2-oxo-dehydrogenase pathway and dysregulated immune pathways directed at biliary epithelial cells leads to cholestasis, pro...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Biosimilars in ulcerative colitis: When and for who?
Publication date: Available online 26 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Akos Ilias, Lorant Gonczi, Zuszsanna Kurti, Peter L. LakatosAbstractThe introduction of biological agents has revolutionized the management of ulcerative colitis (UC). Biosimilars are considered to be equivalent to the reference biologic products in terms of pharmacokinetic properties, clinical effectiveness and safety and have now been approved in inflammatory bowel diseases (IBD). CT-P13 was the first biosimilar to infliximab that obtained regulatory approval by the EMA and US FDA. Accumulating data on biosi...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
The impact of biologics in surgical outcomes in ulcerative colitis
Publication date: Available online 8 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Marjorie C. Argollo, Paulo Gustavo Kotze, Antonino Spinelli, Tarcia N.F. Gomes, Silvio DaneseAbstractUlcerative Colitis (UC) is an immune mediated condition characterized by inflammation of colonic mucosa, associated with progressive damage of the colon and possible complications, such as hemorrhage, perforation and cancer. It is strongly advocated a treat to target approach in patients with UC consisting in an early and aggressive inflammatory control. Some patients can require colectomy for medically refract...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Safety of biological therapies in ulcerative colitis: An umbrella review of meta-analyses
Publication date: Available online 11 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Stefanos Bonovas, Katerina Pantavou, Despo Evripidou, Anan Judina Bastiampillai, Georgios K. Nikolopoulos, Laurent Peyrin-Biroulet, Silvio DaneseAbstractBiological agents have proven clinical efficacy in the treatment of ulcerative colitis (UC). Their adverse effects have also been studied in a substantial number of primary studies and meta-analyses. Given the large volume of information that has been published, the aim of this umbrella review was to effectively summarize the accumulated evidence from randomi...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
Variant syndromes of primary biliary cholangitis
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Lisa Schulz, Marcial Sebode, Sören A. Weidemann, Ansgar W. LohseAbstractPatients with primary biliary cholangitis (PBC) can show biochemical, serological and/or histological features of autoimmune hepatitis (AIH). The term ‘AIH-PBC overlap syndrome’ has been used frequently for these cases and implies the coexistence of two separate diseases. However, the boundaries between ‘classical’ PBC, PBC with features of AIH and ‘classical’ AIH are difficult to define, and therefore the term ‘variant syn...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research
