Development and Validation of a Novel Prediction Model for Differential Diagnosis Between Crohn's Disease and Intestinal Tuberculosis
Conclusions: The new prediction model using a CD prediction score can be useful for calculating the probability of either CD or ITB at initial evaluation (NCT01392365). (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Impact of Infliximab and Cyclosporine on the Risk of Colectomy in Hospitalized Patients with Ulcerative Colitis Complicated by Cytomegalovirus—A Multicenter Retrospective Study
Conclusions: IFX or cyclosporine therapy is not associated with additional risk for colectomy over antiviral therapy alone in hospitalized CMV-positive patients with UC. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Fecal Calprotectin Levels Predict Histological Healing in Ulcerative Colitis
Background: Mucosal healing as measured by endoscopic activity is the therapeutic target for ulcerative colitis (UC) and associated with improved outcomes. We investigated the clinical utility of fecal calprotectin (FC) levels to predict depth of remission, including histological remission in patients with UC.
Methods: We performed a retrospective chart review of patients with UC who underwent a full colonoscopy and FC measured within 6 weeks before colonoscopy at a tertiary inflammatory bowel disease center. Clinical, endoscopic, and histological disease activity was assessed by Patient Reported Outcomes (PRO2), Mayo end...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Combined Detection of NUDT15 Variants Could Highly Predict Thiopurine-induced Leukopenia in Chinese Patients with Inflammatory Bowel Disease: A Multicenter Analysis
Background: NUDT15 c.415C>T was a novel genetic marker confirmed in our center for thiopurine-induced leukopenia in Chinese inflammatory bowel disease (IBD). For validation, a large cohort study is needed. Meanwhile, the newly discovered NUDT15 coding variants (c.36_37insGGAGTC and c.52 G>A) have not been studied in patients with IBD. We aimed to further confirm the influence of 3 NUDT15 variants (c.415C>T, c.36_37insGGAGTC, and c.52G>A) on thiopurine-induced leukopenia in Chinese patients with IBD.
Methods: Patients prescribed on thiopurines for at least 2 weeks were recruited from 4 tertiary hospitals. Clinical data wer...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Long-term Outcomes with Anti-TNF Therapy and Accelerated Step-up in the Prospective Pediatric Belgian Crohn's Disease Registry (BELCRO)
Background: Accelerated step-up or anti–tumor necrosis factor (TNF) before first remission is currently not recommended in pediatric Crohn's disease.
Methods: Five-year follow-up data from a prospective observational cohort of children diagnosed with Crohn's disease in Belgium were analyzed. Disease severity was scored as inactive, mild, or moderate to severe. Remission or inactive disease was defined as sustained if lasting ≥2 years. Univariate analyses were performed between anti-TNF–exposed versus naive patients and anti-TNF before versus after first remission and correlations assessed with primary outcomes avera...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Longitudinal Patterns of Medication Nonadherence and Associated Health Care Costs
Conclusions: Medication nonadherence is related to increased health care costs after controlling for disease severity. Patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients. In addition, patients whose adherence improves over time incur approximately the same costs as those who are consistently adherent. This suggests that, in addition to leveraging prevention efforts to keep patients from becoming more nonadherent as treatment continues, efforts aimed at modifying adherence behavior may result in significant cost savings over time. (Source: Inflamm...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Clinical Predictors of Future Nonadherence in Inflammatory Bowel Disease
Background: Nonadherence to medical therapy is frequently encountered in patients with inflammatory bowel disease (IBD). We aimed to identify predictors for future (non)adherence in IBD.
Methods: We conducted a multicenter prospective cohort study with adult patients with Crohn's disease (CD) and ulcerative colitis (UC). Data were collected by means of 3-monthly questionnaires on the course of disease and healthcare utilization. Medication adherence was assessed using a visual analogue scale, ranging from 0% to 100%. Levels (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Articles Source Type: research
Combination Therapy with Dose Optimized Thiopurine and Adalimumab in Crohn's Disease
No abstract available (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Commentary Source Type: research
Thiopurines Dosed to a Therapeutic 6-Thioguanine Level in Combination with Adalimumab Are More Effective Than Subtherapeutic Thiopurine-based Combination Therapy or Adalimumab Monotherapy During Induction and Maintenance in Patients with Long-standing Crohn's Disease
Background: The benefit of concomitant immunomodulation with adalimumab (ADA) in Crohn's disease is poorly understood. We aimed to compare ADA monotherapy with combination therapy with thiopurines, stratified by thioguanine nucleotides (TGNs).
Methods: Retrospective observational study of ADA induction and maintenance. Thiopurines were classified according to TGNs (>235 pmol/8 × 108 red blood cell therapeutic).
Results: At induction, response was more frequent in combination than ADA monotherapy (83% versus 61%, P = 0.02) and with therapeutic compared with subtherapeutic TGNs (87% versus 70% P = 0.011). Among 280 mainte...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Clinical Article Source Type: research
Integrated Analysis of Biopsies from Inflammatory Bowel Disease Patients Identifies SAA1 as a Link Between Mucosal Microbes with TH17 and TH22 Cells
Conclusions: This study identifies expression of SAA1 as an important link between mucosal T cells, microbial communities, and their tissue environment in patients with IBD. A combination of T cell effector function data, gene expression and microbial profiling can distinguish between intestinal inflammatory states in IBD regardless of disease types. (Source: Inflammatory Bowel Diseases)
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Basic Science Articles Source Type: research
E-cadherin Mediates the Preventive Effect of Vitamin D3 in Colitis-associated Carcinogenesis
Abstract: Vitamin D3 is beneficial in ameliorating or preventing inflammation and carcinogenesis. Here, we evaluated if vitamin D3 has a preventive effect on colitis-associated carcinogenesis. Administration of azoxymethane (AOM), followed with dextran sulfate sodium (DSS), was used to simulate colitis-associated colon cancer in mice. The supplement of vitamin D3 at different dosages (15, 30, 60 IU·g−1·w−1), started before AOM or immediately after DSS treatment (post 60), was sustained to the end of the experiment. Dietary vitamin D3 significantly reduced the number of tumors and tumor burden in a dose-dependent mann...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Basic Science Articles Source Type: research
CD103+ Dendritic Cell Function Is Altered in the Colons of Patients with Ulcerative Colitis
This study characterized CD103+ DCs in the colon and investigated whether these cells are implicated in the pathogenesis of ulcerative colitis (UC).
Methods: Normal intestinal mucosa was obtained from intact sites of patients with colorectal cancer (n = 24). Noninflamed and inflamed colonic tissues were obtained from surgically resected specimens of patients with UC (n = 13). Among Lin−CD45+HLA-DRhigh intestinal lamina propria cells, CD14+ cells and CD103+ DCs were sorted and analyzed for microRNA expression of cytokines and toll-like receptors by quantitative real-time polymerase chain reaction. In addition, IL-4/IL-5/...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Original Basic Science Articles Source Type: research
Machine Learning–Based Gene Prioritization Identifies Novel Candidate Risk Genes for Inflammatory Bowel Disease
Background: The inflammatory bowel diseases (IBDs) are chronic inflammatory disorders, associated with genetic, immunologic, and environmental factors. Although hundreds of genes are implicated in IBD etiology, it is likely that additional genes play a role in the disease process. We developed a machine learning–based gene prioritization method to identify novel IBD-risk genes.
Methods: Known IBD genes were collected from genome-wide association studies and annotated with expression and pathway information. Using these genes, a model was trained to identify IBD-risk genes. A comprehensive list of 16,390 genes was then s...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Future Directions and Methods for IBD Research Source Type: research
Therapeutic Drug Monitoring During Induction of Anti–Tumor Necrosis Factor Therapy in Inflammatory Bowel Disease: Defining a Therapeutic Drug Window
Abstract: Anti–tumor necrosis factor (TNF) therapy has revolutionized the treatment of inflammatory bowel disease (IBD). However, up to 30% of patients with IBD show no clinical benefit and are defined as having a primary nonresponse. Primary nonresponse to a biologic can be attributed to either pharmacokinetic or pharmacodynamic issues, such as those involved in secondary loss of response. Pharmacokinetic issues are linked to undetectable or subtherapeutic drug concentrations because of either an accelerated non–immune-mediated clearance or immunogenicity and the development of antidrug antibodies, whereas pharmacodyn...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Clinical Review Articles Source Type: research
Inflammatory Bowel Diseases: Review of Known Environmental Protective and Risk Factors Involved
Abstract: Inflammatory bowel diseases consisting of Crohn's disease and ulcerative colitis are chronic inflammatory diseases of the gastrointestinal tract. In addition to genetic susceptibility and disturbances of the microbiome, environmental exposures forming the exposome play an important role. Starting at birth, the cumulative effect of different environmental exposures combined with a predetermined genetic susceptibility is thought to cause inflammatory bowel disease. All these environmental factors are part of a Western lifestyle, suiting the high incidence rates in Europe and the United States. Whereas receiving bre...
Source: Inflammatory Bowel Diseases - August 26, 2017 Category: Gastroenterology Tags: Clinical Review Articles Source Type: research
