Crohn's & Colitis 360最新文献

{"title":"Abdominal Pain in Inflammatory Bowel Disease: An Evidence-Based, Multidisciplinary Review.","authors":"Matthew D Coates, Kofi Clarke, Emmanuelle Williams, Nimalan Jeganathan, Sanjay Yadav, David Giampetro, Vitaly Gordin, Sadie Smith, Kent Vrana, Anne Bobb, Thu Thi Gazzio, Heather Tressler, Shannon Dalessio","doi":"10.1093/crocol/otad055","DOIUrl":"10.1093/crocol/otad055","url":null,"abstract":"<p><p>Abdominal pain is one of the most common and impactful symptoms associated with inflammatory bowel disease (IBD), including both Crohn's disease and ulcerative colitis. A great deal of research has been undertaken over the past several years to improve our understanding and to optimize management of this issue. Unfortunately, there is still significant confusion about the underlying pathophysiology of abdominal pain in these conditions and the evidence underlying treatment options in this context. There is also a relative paucity of comprehensive reviews on this topic, including those that simultaneously evaluate pharmacological and nonpharmacological therapeutic options. In this review, our multidisciplinary team examines evidence for various currently available medical, surgical, and other analgesic options to manage abdominal pain in IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad055"},"PeriodicalIF":1.4,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689166","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":"Editorial: Rectal Urgency Among Patients with Ulcerative Colitis or Crohn's Disease: Analyses from a Global Survey.","authors":"Mackenzie Moon, Reezwana Chowdhury, Aline Charabaty","doi":"10.1093/crocol/otad054","DOIUrl":"10.1093/crocol/otad054","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad054"},"PeriodicalIF":1.8,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479171","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":"Rectal Urgency Among Patients With Ulcerative Colitis or Crohn's Disease: Analyses from a Global Survey.","authors":"Christina Ha,&nbsp;April N Naegeli,&nbsp;Rina Lukanova,&nbsp;Mingyang Shan,&nbsp;Rosie Wild,&nbsp;Fritha Hennessy,&nbsp;Uma Jyothi Kommoju,&nbsp;Alison Potts Bleakman,&nbsp;Theresa Hunter Gibble","doi":"10.1093/crocol/otad052","DOIUrl":"https://doi.org/10.1093/crocol/otad052","url":null,"abstract":"<p><strong>Background: </strong>Rectal urgency is a common but under-reported inflammatory bowel disease (IBD) symptom. The present study assessed the prevalence of rectal urgency and its association with disease activity and patient-reported outcomes (PROs) among patients with ulcerative colitis (UC) or Crohn's disease (CD) in a real-world setting.</p><p><strong>Methods: </strong>Data were drawn from the 2017-2018 Adelphi IBD Disease Specific Programme™, a multi-center, point-in-time survey of gastroenterologists and consulting adult patients with UC or CD in France, Germany, Italy, Spain, the United Kingdom, and the United States. Gastroenterologists completed patient record forms and patients completed self-reported forms. Analyses were conducted separately for patients with UC or CD. Patient demographics, clinical characteristics, disease activity, symptoms, and PROs were compared between patients with and without rectal urgency.</p><p><strong>Results: </strong>In total, 1057 patients with UC and 1228 patients with CD were included. Rectal urgency was reported in 20.2% of patients with UC and 16.4% with CD. Patients with rectal urgency were more likely to have moderate or severe disease (UC or CD: <i>P</i> < .0001), higher mean Mayo score (UC: <i>P</i> < .0001), higher mean Crohn's Disease Activity Index score (CD: <i>P</i> < .0001), lower Short IBD Questionnaire scores (UC or CD: <i>P</i> < .0001), and higher work impairment (UC: <i>P</i> < .0001; CD: <i>P</i> = .0001) than patients without rectal urgency.</p><p><strong>Conclusions: </strong>Rectal urgency is a common symptom associated with high disease activity, decreased work productivity, and worse quality of life. Further studies are needed to include rectal urgency assessment in routine clinical practice to better gauge disease activity in patients with UC or CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad052"},"PeriodicalIF":1.4,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71491090","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":"Vedolizumab in Mild-to-Moderate Crohn's Disease Patients Naïve to Biological Therapy: A Multicentric Observational Study.","authors":"Adriana Zanoni Dotti,&nbsp;Daniela Oliveira Magro,&nbsp;Eduardo Garcia Vilela,&nbsp;Julio Maria Fonseca Chebli,&nbsp;Liliana Andrade Chebli,&nbsp;Flavio Steinwurz,&nbsp;Marjorie Argollo,&nbsp;Nayara Salgado Carvalho,&nbsp;Jose Miguel Luz Parente,&nbsp;Murilo Moura Lima,&nbsp;Rogério Serafim Parra,&nbsp;Ramir Luan Perin,&nbsp;Cristina Flores,&nbsp;Eloá Marussi Morsoletto,&nbsp;Sandro da Costa Ferreira,&nbsp;Juliano Coelho Ludvig,&nbsp;Roberto Luiz Kaiser Junior,&nbsp;Mikaell Alexandre Gouvea Faria,&nbsp;Guilherme Mattioli Nicollelli,&nbsp;Adriana Ribas Andrade,&nbsp;Natalia Sousa Freitas Queiroz,&nbsp;Paulo Gustavo Kotze","doi":"10.1093/crocol/otad053","DOIUrl":"https://doi.org/10.1093/crocol/otad053","url":null,"abstract":"<p><strong>Background: </strong>In real-world experience, the number of patients using vedolizumab as first-line biological therapy was low. We aimed to evaluate the effectiveness and safety of vedolizumab in mild-to-moderate Crohn's disease (CD) biologic-naïve patients.</p><p><strong>Methods: </strong>We performed a retrospective multicentric cohort study with patients who had clinical activity scores (Harvey-Bradshaw Index [HBI]) measured at baseline and weeks 12, 26, 52, as well as at the last follow-up. Clinical response was defined as a reduction ≥3 in HBI, whereas clinical remission as HBI ≤4. Mucosal healing was defined as the complete absence of ulcers in control colonoscopies. Kaplan-Meier survival analysis was used to assess the persistence with vedolizumab.</p><p><strong>Results: </strong>From a total of 66 patients, 53% (35/66) reached clinical remission at week 12. This percentage increased to 69.7% (46/66) at week 26, and 78.8% (52/66) at week 52. Mucosal healing was achieved in 62.3% (33/53) of patients. Vedolizumab was well tolerated, and most adverse events were minor. During vedolizumab treatment, 3/66 patients underwent surgery.</p><p><strong>Conclusions: </strong>This study demonstrates the effectiveness and safety of vedolizumab as a first-line biological agent in patients with mild-to-moderate CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad053"},"PeriodicalIF":1.4,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675302","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":"Bedside Intestinal Ultrasound Performed in an Inflammatory Bowel Disease Urgent Assessment Clinic Improves Clinical Decision-Making and Resource Utilization.","authors":"Joëlle St-Pierre,&nbsp;Maxime Delisle,&nbsp;Hengameh Kheirkhahrahimabadi,&nbsp;Thomas M Goodsall,&nbsp;Robert V Bryant,&nbsp;Britt Christensen,&nbsp;Rose Vaughan,&nbsp;Aysha Al-Ani,&nbsp;Richard J M Ingram,&nbsp;Joan Heatherington,&nbsp;Dan Carter,&nbsp;Cathy Lu,&nbsp;Christopher Ma,&nbsp;Kerri L Novak","doi":"10.1093/crocol/otad050","DOIUrl":"10.1093/crocol/otad050","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) require accessible, timely, and noninvasive strategies to monitor disease. The aim was to assess the integration of intestinal ultrasound (IUS) on decision-making and endoscopy utilization in a standardized care pathway.</p><p><strong>Methods: </strong>This prospective, multicenter, international, observational cohort study included patients seen within a centralized model for IBD care was conducted during the COVID pandemic. Patients were evaluated with IUS alone or in combination with an in-clinic, unsedated sigmoidoscopy. Demographic, clinical, laboratory, and imaging data, clinical decisions, and need for urgent endoscopy, hospitalization, and surgeries were recorded.</p><p><strong>Results: </strong>Of the 158 patients included, the majority had an established diagnosis of Crohn's disease (<i>n</i> = 123, 78%), and 47% (<i>n</i> = 75) of patients were on biologic therapy. IUS identified active inflammation in 65% (<i>n</i> = 102) of patients, and strictures in 14% (<i>n</i> = 22). Fecal calprotectin levels correlated with inflammation detected on IUS (median of 50 μg/g [Q1-Q3: 26-107 μg/g] without inflammation and 270 μg/g [Q1-Q3: 61-556 μg/g] with inflammation; <i>p</i> = 0.0271). In the majority of patients, clinical assessment with IUS led to an acute change in IBD-specific medications (57%, <i>n</i> = 90) and avoided or delayed the need for urgent endoscopy (85%, <i>n</i> = 134). Four patients were referred for urgent surgical consultation.</p><p><strong>Conclusions: </strong>Point-of-care IUS used in a flare clinic pathway is a useful strategy to improve effective IBD care delivery and to assist in therapeutic management decisions, in many cases avoiding the acute need for endoscopy.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad050"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10558199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115874","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":"Correction to: Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn's Disease Might Be Associated With Increased Rates of Stoma Construction.","authors":"","doi":"10.1093/crocol/otad049","DOIUrl":"https://doi.org/10.1093/crocol/otad049","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/crocol/otad038.].</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 3","pages":"otad049"},"PeriodicalIF":1.4,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/1f/otad049.PMC10506167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113195","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":"Real-World Persistency for Inflammatory Bowel Disease Biologics Using Patient Registry Data.","authors":"Tia Goss Sawhney, Angela Dobes, Sirimon O'Charoen","doi":"10.1093/crocol/otad051","DOIUrl":"10.1093/crocol/otad051","url":null,"abstract":"<p><strong>Background: </strong>Although it is a truism that drugs benefit patients only when taken, surprisingly little is known about real-world drug-use persistence and discontinuation, even for expensive biologic drugs.</p><p><strong>Methods: </strong>We used longitudinal self-reported drug-use data from the inflammatory bowel disease (IBD) Partners registry of people with IBD to construct Kaplan-Meier drug-use persistency graphs for biologic drug-use spans that started between 2017 and 2022.</p><p><strong>Results: </strong>We examined 2034 drug-use spans for 1594 survey participants. Most of the biologic drugs had a 75%+ persistency rate around the one-year mark and 60%+ persistency at the 3-year mark. The overall persistency and the differences in persistency between drugs were aligned with published literature.</p><p><strong>Conclusions: </strong>This analysis demonstrates the feasibility of collecting IBD-specific patient-reported drug persistency data via a voluntary patient registry. Patient-reported persistency provides real-world drug persistency data and the patient's perspectives as to why they discontinued use of the drug-a combination of data and perspective that is not available from any other real-world medical record, claim, and pharmacy data source that are valuable to physician, patients, payers, healthcare policymakers, and health technology assessment organizations.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 4","pages":"otad051"},"PeriodicalIF":1.4,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520772","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":"Golimumab for Ulcerative Colitis: One More Option to SAVE the Colon.","authors":"Sang Hyoung Park","doi":"10.1093/crocol/otad046","DOIUrl":"10.1093/crocol/otad046","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 3","pages":"otad046"},"PeriodicalIF":1.8,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492443/pdf/otad046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221766","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":"Practical Primer Addressing Real-World Use Scenarios of Subcutaneous Vedolizumab in Ulcerative Colitis and Crohn's Disease: Post Hoc Analyses of VISIBLE Studies.","authors":"William J Sandborn, Jingjing Chen, Krisztina Kisfalvi, Edward V Loftus, Geert D'Haens, Ninfa Candela, Karen Lasch, Douglas C Wolf, Sharif M Uddin, Silvio Danese","doi":"10.1093/crocol/otad034","DOIUrl":"10.1093/crocol/otad034","url":null,"abstract":"<p><strong>Background: </strong>Vedolizumab, an anti-α₄β₇ integrin approved for intravenous (IV) treatment of moderately to severely active ulcerative colitis (UC) and Crohn's disease (CD), was evaluated as a subcutaneous (SC) formulation in maintenance therapy for UC and CD in phase 3 VISIBLE 1, 2, and open-label extension studies, and recently approved in Europe, Australia, and Canada. Our aim was to evaluate efficacy and safety of IV and SC vedolizumab in clinically relevant UC and CD scenarios.</p><p><strong>Methods: </strong>Post hoc data analyses from VISIBLE trials examined: (1) whether baseline characteristics predict clinical response to 2 vs 3 IV vedolizumab induction doses; (2) efficacy and safety of switching during maintenance vedolizumab IV to SC in patients with UC; (3) vedolizumab SC after treatment interruption of 1-46 weeks; (4) increasing dose frequency of vedolizumab SC from every 2 weeks (Q2W) to every week (QW) after disease worsening.</p><p><strong>Results: </strong>No baseline characteristics were identified as strong predictors of response to 2 vs 3 vedolizumab infusions. Most patients achieved clinical response after 2 or 3 doses of IV vedolizumab maintained with SC treatment. Clinical remission and response rates were maintained in patients transitioned from maintenance vedolizumab IV to SC treatment. Of patients with UC, ≥75% achieved response following resumption after dose interruption. Escalation to QW dosing resulted in ≥45% of patients regaining response after loss while receiving vedolizumab Q2W.</p><p><strong>Conclusions: </strong>Clinical real-world scenarios with vedolizumab SC were reviewed using VISIBLE studies data. Vedolizumab SC provides an additional dosing option for patients with UC and CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 3","pages":"otad034"},"PeriodicalIF":1.4,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111091","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":"Integrating Intestinal Ultrasound into an Inflammatory Bowel Disease Practice: How to Get Started.","authors":"Bincy P Abraham,&nbsp;Dheeraj Reddy,&nbsp;Adam Saleh","doi":"10.1093/crocol/otad043","DOIUrl":"10.1093/crocol/otad043","url":null,"abstract":"<p><p>Intestinal ultrasound (IUS) offers a safe, noninvasive, point-of-care tool for diagnosing and monitoring disease activity in patients with inflammatory bowel disease (IBD). IUS is used widely in Europe and Canada for IBD, but it remains underutilized in the United States. Growing interest in IUS in the United States has prompted many IBD centers to train their faculty in IUS. This, however, raises questions about how to effectively use this new tool in the United States, which does not use a social medicine model like those implemented in Europe and Canada. Here, we provide a practical framework for incorporating IUS in an IBD practice in the United States, including training requirements, equipment, and protocols for implementing IUS in daily practice.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"5 3","pages":"otad043"},"PeriodicalIF":1.4,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/fd/otad043.PMC10500970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10635107","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}