Gastroenterología y Hepatología (English Edition)最新文献

{"title":"Efficacy and safety of biological treatment for inflammatory bowel disease in elderly patients: Results from a GETECCU cohort","authors":"Cristina Suárez Ferrer , Francisco Mesonero Gismero , Berta Caballol , Maria Pilar Ballester , Iria Bastón Rey , Andrés Castaño García , Jose Miranda Bautista , Rosa Saiz Chumillas , Jose Manuel Benitez , Laura Sanchez-Delgado , Alicia López-García , Cristina Rubin de Celix , Inmaculada Alonso Abreu , Luigi Melcarne , Rocío Plaza Santos , Miquel Marques-Camí , Antonio Caballero Mateos , César Gómez Díez , Margalida Calafat , Horacio Alonso Galan , Manuel Barreiro-De Acosta","doi":"10.1016/j.gastre.2024.502197","DOIUrl":"10.1016/j.gastre.2024.502197","url":null,"abstract":"<div><h3>Introduction</h3><div>Biological therapies used for the treatment of inflammatory bowel disease (IBD) have shown to be effective and safe, although these results were obtained from studies involving mostly a young population, who are generally included in clinical trials. The aim of our study was to determine the efficacy and safety of the different biological treatments in the elderly population.</div></div><div><h3>Methods</h3><div>Multicenter study was carried out in the GETECCU group. Patients diagnosed with IBD and aged over 65 years at the time of initiating biological therapy (infliximab, adalimumab, golimumab, ustekinumab or vedolizumab) were retrospectively included.</div><div>Among the patients included, clinical response was assessed after drug induction (12 weeks of treatment) and at 52 weeks. Patients’ colonoscopy data in week 52 were assessment, where available. Regarding complications, development of oncological events during follow-up and infectious processes occurring during biological treatment were collected (excluding bowel infection by cytomegalovirus).</div></div><div><h3>Results</h3><div>A total of 1090 patients were included. After induction, at approximately 12–14 weeks of treatment, 419 patients (39.6%) were in clinical remission, 502 patients (47.4%) had responded without remission and 137 patients (12.9%) had no response.</div><div>At 52 weeks of treatment 442 patients (57.1%) had achieved clinical remission, 249 patients had responded without remission (32.2%) and 53 patients had no response to the treatment (6.8%). Before 52 weeks, 129 patients (14.8%) had discontinued treatment due to inefficacy, this being significantly higher (<em>p</em> <!--><<!--> <!-->0.0001) for Golimumab – 9 patients (37.5%) – compared to the other biological treatments analyzed.</div><div>With respect to tumor development, an oncological event was observed in 74 patients (6.9%): 30 patients (8%) on infliximab, 23 (7.14%) on adalimumab, 3 (11.1%) on golimumab, 10 (6.4%) on ustekinumab, and 8 (3.8%) on vedolizumab. The incidence was significantly lower (<em>p</em> <!-->=<!--> <!-->0.04) for the vedolizumab group compared to other treatments.</div><div>As regards infections, these occurred in 160 patients during treatment (14.9%), with no differences between the different biologicals used (<em>p</em> <!-->=<!--> <!-->0.61): 61 patients (19.4%) on infliximab, 39 (12.5%) on adalimumab, 5 (17.8%) on golimumab, 22 (14.1%) on ustekinumab, and 34 (16.5%) on vedolizumab.</div></div><div><h3>Conclusions</h3><div>Biological drug therapies have response rates in elderly patients similar to those described in the general population, Golimumab was the drug that was discontinued most frequently due to inefficacy.</div><div>In our experience, tumor development was more frequent in patients who used anti-TNF therapies compared to other targets, although its incidence was generally low and that this is in line with younger patients based on previou","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 10","pages":"Article 502197"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Oakland score: When low specificity implies excessive costs and time consume","authors":"Camilla Gallo, Lorenzo Dioscoridi, Massimiliano Mutignani","doi":"10.1016/j.gastre.2024.502204","DOIUrl":"10.1016/j.gastre.2024.502204","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502204"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of the LARS Score and POLARS score predictive scale in the ideal treatment of rectal cancer","authors":"Daniel Aparicio López , María Teresa González-Nicolás Trébol , Nieves Sánchez Fuentes , Antonio Martínez Germán , María Victoria Duque Mallén","doi":"10.1016/j.gastre.2024.502191","DOIUrl":"10.1016/j.gastre.2024.502191","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502191"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease: A useful therapeutic tool not just in ulcerative colitis but also in Crohn's disease","authors":"Francisco José Fernández-Pérez ,&nbsp;Nuria Fernández-Moreno ,&nbsp;Estela Soria-López ,&nbsp;Francisco Javier Rodriguez-González ,&nbsp;Francisco José Fernández-Galeote ,&nbsp;Ana Lifante-Oliva ,&nbsp;Concepción Ruíz-Hernández ,&nbsp;Elisabeth Escalante-Quijaite ,&nbsp;Francisco Rivas-Ruiz","doi":"10.1016/j.gastre.2024.502196","DOIUrl":"10.1016/j.gastre.2024.502196","url":null,"abstract":"<div><h3>Introduction</h3><div>Granulocyte and monocyte adsorptive apheresis (GMA) removes neutrophils and monocytes from peripheral blood, preventing their incorporation into the inflamed tissue also influencing cytokine balance. Published therapeutic efficacy in ulcerative colitis (UC) is more consistent than in Crohn's disease (CD). We assessed clinical efficacy of GMA in UC and CD 4 weeks after last induction session, at 3 and 12 months, sustained remission and corticosteroid-free remission.</div></div><div><h3>Patients and method</h3><div>Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions.</div></div><div><h3>Results</h3><div>We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD.</div></div><div><h3>Conclusions</h3><div>GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502196"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreas units within gastroenterology departments. Organizational and operational standards for a patient-centered service","authors":"J. Enrique Domínguez-Muñoz ,&nbsp;Emma Martínez Moneo ,&nbsp;Federico Bolado Concejo ,&nbsp;Fernando Alberca de las Parras ,&nbsp;Fernando Carballo Álvarez ,&nbsp;F. Javier Elola Somoza","doi":"10.1016/j.gastre.2024.04.061","DOIUrl":"10.1016/j.gastre.2024.04.061","url":null,"abstract":"<div><div>The Asociación Española de Pancreatología (AESPANC), Asociación Española de Gastroenterología (AEG), and Sociedad Española de Patología Digestiva (SEPD) have developed a consensus document on the standards and recommendations they consider essential for the organization of pancreas units (PUs) within gastroenterology services (GSs) in order to conduct their activities in an efficient, high-quality manner. The consensus document defines PUs and lays down standards relating to their organization, structure, service portfolio, processes, and teaching and research activities. Standards have been categorized as mandatory (requirements to be met to qualify for certification by the scientific societies responsible for the standards) or recommendations. Standards should be updated at most within five years based on the experience gained in Spanish PUs and the advance of knowledge regarding pancreas disease. Development of health outcome indicators, including patient-reported outcome measures (PROMs), is considered a relevant challenge, as is evidence on the association of PU structure and activity standards with health outcomes.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 102178"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the length of sick leave in patients with inflammatory bowel disease","authors":"Sara Nieves Ramos-Cozar ,&nbsp;Rafael Martín-Masot ,&nbsp;Begoña Rodríguez-Gallego ,&nbsp;Leticia Rubio ,&nbsp;Juan Luis Cabanillas-Moruno ,&nbsp;Víctor Manuel Navas-López","doi":"10.1016/j.gastre.2024.502194","DOIUrl":"10.1016/j.gastre.2024.502194","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammatory bowel disease (IBD) is a chronic disorder that can lead to periods of work-related temporary disability (TD), which may result in the need for permanent disability. The objective was to assess the impact of IBD on patients' temporary disability by analyzing periods, duration, and causes. It also investigates risk factors influencing the severity, frequency, and duration of flare-ups and associated complications in IBD patients.</div></div><div><h3>Method</h3><div>The study includes patients aged 18–65, with at least 1 day of TD in 2019 (Pre-COVID), referred or not by UMEVI, due to reasons related to IBD.</div></div><div><h3>Results</h3><div>A total of 172 patients were included, and in all cases, TD was associated with IBD. TD was higher in patients over 30 years old, with anxious depressive disorder, who required hospitalization and did not receive prednisone treatment (p &lt; 0.05). TD duration was longer in patients belonging to the Special Regime for Self-Employed Workers (RETA): 67 days (IQR: 22–160) versus the General Regime (RG): 33 days (IQR: 8–110), with no statistically significant difference (p = 0.120). The mean cost (€) per worker in this series was €745.5 (IQR: 231–2608.2).</div></div><div><h3>Conclusions</h3><div>IBD has a significant impact on patients' temporary work disability. The duration of TD was longer in patients older than 30 years, with anxious-depressive disorder, who required hospital admission and did not receive steroid treatment.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502194"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding horizons: The benefits of pursuing international fellowship experience","authors":"Ingrid Tapiolas ,&nbsp;Helena Martínez-Lozano ,&nbsp;Beatriz Gros","doi":"10.1016/j.gastre.2024.502240","DOIUrl":"10.1016/j.gastre.2024.502240","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502240"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septated gallbladder","authors":"Cándido Alcázar ,&nbsp;Juan Jesús Rubio ,&nbsp;Víctor Cristóbal ,&nbsp;José M. Ramia","doi":"10.1016/j.gastre.2024.502189","DOIUrl":"10.1016/j.gastre.2024.502189","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502189"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colitis due to hypogammaglobulinemia: IBD-like, the great unknown","authors":"Elena Pérez Campos ,&nbsp;Paula Villegas Pelegrina ,&nbsp;Isabel Moreno Moraleda ,&nbsp;Matilde Amparo Nievas Soriano ,&nbsp;Álvaro Hernández Martínez","doi":"10.1016/j.gastre.2024.502205","DOIUrl":"10.1016/j.gastre.2024.502205","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502205"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of digital health tools in inflammatory bowel disease","authors":"Iago Rodríguez-Lago ,&nbsp;Beatriz Gros ,&nbsp;Kristy Sánchez ,&nbsp;Daniel Arumí ,&nbsp;M. del Pilar Fortes ,&nbsp;Ana Cábez ,&nbsp;Francisco Mesonero Gismero","doi":"10.1016/j.gastre.2024.502200","DOIUrl":"10.1016/j.gastre.2024.502200","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the characteristics and use of digital health tools (DHT) in inflammatory bowel disease (IBD).</div></div><div><h3>Methods</h3><div>We performed a qualitative study based on a narrative literature review, a questionnaire and on the opinion of 3 expert gastroenterologists. Several searches were carried out until September 2022 through Medline to identify articles on the use of DHT in IBD by healthcare professionals. A structured questionnaire was designed to be answered by health professionals involved in the care of patients with IBD. The experts generated a set of recommendations.</div></div><div><h3>Results</h3><div>There are multiple DHT for IBD with different characteristics and contents. We received 29 questionnaires. Almost 50% of the participants were 41–50 years old, the majority were women (83%) and 90% were gastroenterologists. A total of 96% reported the use of several DHT, but 20% used them occasionally or infrequently. Web pages were found the most used (62%). DHT are mostly used to get information (80%), followed by clinical practice issues (70%) and educational purposes (62%). G-Educainflamatoria website is the best known and most used HDS (96% and 64%, respectively). The main barriers to the use of DHT in IBD were the lack of time (55%), doubts about the benefit of DHT (50%) and the excess of information (40%).</div></div><div><h3>Conclusions</h3><div>Healthcare professionals involved in the care of patients with to IBD frequently use DHT, although actions are needed to optimize their use and to guarantee their efficient and safe use.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 9","pages":"Article 502200"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}