Inflammatory Bowel Diseases最新文献

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Obesity, Sarcopenia and Myosteatosis: Impact on Clinical Outcomes in the Operative Management of Crohn's Disease. 肥胖、肌肉萎缩和脂肪变性:克罗恩病手术治疗对临床结果的影响。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-09-03 DOI: 10.1093/ibd/izad225
Mark Donnelly, Dorothee Driever, Éanna J Ryan, Jessie A Elliott, John Finnegan, Deirdre McNamara, Ian Murphy, Kevin C Conlon, Paul C Neary, Dara O Kavanagh, James M O'Riordan
{"title":"Obesity, Sarcopenia and Myosteatosis: Impact on Clinical Outcomes in the Operative Management of Crohn's Disease.","authors":"Mark Donnelly, Dorothee Driever, Éanna J Ryan, Jessie A Elliott, John Finnegan, Deirdre McNamara, Ian Murphy, Kevin C Conlon, Paul C Neary, Dara O Kavanagh, James M O'Riordan","doi":"10.1093/ibd/izad225","DOIUrl":"10.1093/ibd/izad225","url":null,"abstract":"<p><strong>Background: </strong>Obesity, sarcopenia, and myosteatosis in inflammatory bowel disease may confer negative outcomes, but their prevalence and impact among patients with Crohn's disease (CD) have not been systematically studied. The aim of this study was to assess nutritional status and body composition among patients undergoing resectional surgery for CD and determine impact on operative outcomes.</p><p><strong>Methods: </strong>Consecutive patients with CD undergoing resection from 2000 to 2018 were studied. Total, subcutaneous, and visceral fat areas and lean tissue area (LTA) and intramuscular adipose tissue (IMAT) were determined preoperatively by computed tomography at L3 using SliceOmatic (Tomovision, Canada). Univariable and multivariable linear, logistic, and Cox proportional hazards regression were performed.</p><p><strong>Results: </strong>One hundred twenty-four consecutive patients were studied (ileocolonic disease 53%, n = 62, biologic therapy 34.4% n = 43). Mean fat mass was 22.7 kg, with visceral obesity evident in 23.9% (n = 27). Increased fat stores were associated with reduced risk of emergency presentation but increased corticosteroid use (β 9.09, standard error 3.49; P = .011). Mean LBM was 9.9 kg. Sarcopenia and myosteatosis were associated with impaired baseline nutritional markers. Myosteatosis markers IMAT (P = .002) and muscle attenuation (P = .0003) were associated with increased grade of complication. On multivariable analysis, IMAT was independently associated with increased postoperative morbidity (odds ratio [OR], 1.08; 95% confidence interval (CI), 1.01-1.16; P = .037) and comprehensive complications index (P = .029). Measures of adiposity were not associated with overall morbidity; however, increased visceral fat area independently predicted venous thromboembolism (OR, 1.02; 95% CI, 1.00-1.05; P = .028), and TFA was associated with increased wound infection (OR, 1.00; 95% CI, 1.00-1.01; P = .042) on multivariable analysis.</p><p><strong>Conclusion: </strong>Myosteatosis is associated with nutritional impairment and predicts increased overall postoperative morbidity following resection for CD. Despite its association with specific increased postoperative risks, increased adiposity does not increase overall morbidity, reflecting preservation of nutritional status and relatively more quiescent disease phenotype. Impaired muscle mass and function represent an appealing target for patient optimization to improve outcomes in the surgical management of CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49677142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Anti-Tumor Necrosis Factor Alpha in Very Early Onset Inflammatory Bowel Disease. 抗肿瘤坏死因子α治疗早期炎症性肠病的疗效和安全性。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-09-03 DOI: 10.1093/ibd/izad196
Lauren V Collen, Vanessa Mitsialis, David Y Kim, Mairead Bresnahan, Jessica Yang, Margaret Tuthill, Abigail Combs, Jared Barends, Michael Field, Enju Liu, Richelle Bearup, Ibeawuchi Okoroafor, Christoph Klein, Aleixo M Muise, Athos Bousvaros, Jodie Ouahed, Scott B Snapper
{"title":"Efficacy and Safety of Anti-Tumor Necrosis Factor Alpha in Very Early Onset Inflammatory Bowel Disease.","authors":"Lauren V Collen, Vanessa Mitsialis, David Y Kim, Mairead Bresnahan, Jessica Yang, Margaret Tuthill, Abigail Combs, Jared Barends, Michael Field, Enju Liu, Richelle Bearup, Ibeawuchi Okoroafor, Christoph Klein, Aleixo M Muise, Athos Bousvaros, Jodie Ouahed, Scott B Snapper","doi":"10.1093/ibd/izad196","DOIUrl":"10.1093/ibd/izad196","url":null,"abstract":"<p><strong>Background: </strong>Very early onset inflammatory bowel disease (VEOIBD) is defined as disease onset in patients younger than 6 years. Challenges in treatment of VEOIBD include lack of approved therapies and increased incidence of monogenic immunodeficiencies. We report on patterns of anti-TNF use, efficacy, and safety in a large cohort of patients with VEOIBD.</p><p><strong>Methods: </strong>Very early onset inflammatory bowel disease patients receiving care at a single center were prospectively enrolled in a data registry and biorepository starting in 2012. Whole exome sequencing was available to all patients. Clinical data including IBD medication use and response were extracted from the medical record. We examined antitumor necrosis factor (anti-TNF) cumulative exposure and time to failure and evaluated the effect of covariates on anti-TNF failure using Cox proportional hazard regression.</p><p><strong>Results: </strong>In this cohort of 216 VEOIBD patients with median 5.8-year follow-up, 116 (53.7%) were TNF-exposed. Sixty-two TNF-exposed patients (53.4%) received their first dose at younger than 6 years. Cumulative exposure to anti-TNF was 23.6% at 1 year, 38.4% at 3 years, and 43.4% at 5 years after diagnosis. Cumulative exposure was greater in patients with Crohn's disease (P = .0004) and in those diagnosed in 2012 or later (P < .0001). Tumor necrosis factor failure occurred in 50.9% of those exposed. Features predictive of anti-TNF failure included ulcerative colitis/IBD-unclassified (hazard ratio, 1.94; P = .03), stricturing (hazard ratio, 2.20; P = .04), and younger age at diagnosis (hazard ratio, 1.25; P = .01). Adverse events occurred in 22.6% of infliximab-exposed and 14.3% of adalimumab-exposed.</p><p><strong>Conclusions: </strong>Efficacy and safety of anti-TNFs in VEOIBD is comparable to what has previously been reported in older patients.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Efficacy of an Over-the-Counter Multivitamin and Mineral Supplement to Prevent Infections in Patients With Inflammatory Bowel Disease in Remission With Immunomodulators and/or Biological Agents: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. 使用免疫调节剂和/或生物制剂预防炎症性肠病缓解期患者感染的非处方多种维生素和矿物质补充剂的疗效:一项随机、双盲、安慰剂对照的临床试验。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-09-03 DOI: 10.1093/ibd/izad216
Robin L H Laheij, Yara M W van Knippenberg, Annelijn L J Heil, Britt J W Mannaerts, Karlien F Bruin, Maurice W M D Lutgens, Marjolein Sikkema, Ulrike de Wit, Robert J F Laheij
{"title":"The Efficacy of an Over-the-Counter Multivitamin and Mineral Supplement to Prevent Infections in Patients With Inflammatory Bowel Disease in Remission With Immunomodulators and/or Biological Agents: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.","authors":"Robin L H Laheij, Yara M W van Knippenberg, Annelijn L J Heil, Britt J W Mannaerts, Karlien F Bruin, Maurice W M D Lutgens, Marjolein Sikkema, Ulrike de Wit, Robert J F Laheij","doi":"10.1093/ibd/izad216","DOIUrl":"10.1093/ibd/izad216","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) treated with immunomodulators or biologic therapy are at increased risk of infections. Malnutrition and vitamin or mineral deficiencies are common among patients with IBD. The results of various studies have indicate that vitamin deficiencies might increase the risk of infections. To evaluate the efficacy of a multivitamin and mineral supplement on the incidence of infections in patients with IBD treated with immunomodulators, biologic therapy, or combination therapy.</p><p><strong>Methods: </strong>This was a single-center, randomized, double-blind, placebo-controlled clinical trial to compare a multivitamin and mineral supplement (supplemented group) vs identical-in-appearance placebo (placebo group) in a total of 320 non-vitamin-deficient patients with IBD (Crohn's disease or ulcerative colitis) in remission with immunomodulators, biologic therapy, or combination therapy. Participants were asked to take a daily multivitamin and mineral supplement or placebo and report the occurrence of infections during a 24-week period of follow-up.</p><p><strong>Results: </strong>Treatment arms consisted of 162 and 158 patients for the supplement and placebo, respectively. In both treatment groups, 107 patients reported an infection during the 24-week follow-up period (unadjusted odds ratio, 0.93; 95% confidence interval, 0.56-1.48). In the supplemented group, 32 patients received antibiotics for an infection compared with 21 patients in the placebo group (unadjusted odds ratio, 1.61; 95% confidence interval, 0.88-2.93).</p><p><strong>Conclusions: </strong>An over-the-counter multivitamin and mineral supplement did not reduce the risk of infection for patients with IBD in remission with immunomodulators, biologic therapy, or combination therapy.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adverse Events and Compliance Among Inflammatory Bowel Disease Patients Treated With Home- vs Office-Based Biologic Infusions. 炎症性肠病患者接受家庭和办公室生物输液治疗的不良事件和依从性。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-09-03 DOI: 10.1093/ibd/izad226
Christopher J Schmoyer, Kelly Sun, Jeremy Zack, Priyanka Kumar, Raina Shivashankar
{"title":"Adverse Events and Compliance Among Inflammatory Bowel Disease Patients Treated With Home- vs Office-Based Biologic Infusions.","authors":"Christopher J Schmoyer, Kelly Sun, Jeremy Zack, Priyanka Kumar, Raina Shivashankar","doi":"10.1093/ibd/izad226","DOIUrl":"10.1093/ibd/izad226","url":null,"abstract":"<p><strong>Background: </strong>Biologic medications are a common therapy for those with inflammatory bowel disease (IBD). There are limited data on the outcomes of home-based biologic infusions for patients with IBD. The aim of this study was to compare the safety and efficacy of biologic infusions for IBD patients who receive either home- or office-based administration.</p><p><strong>Methods: </strong>Patients receiving infliximab or vedolizumab were analyzed retrospectively over a period of 152 weeks. Survival free of major adverse events including delayed infusion reaction, steroid initiation, drug discontinuation, or IBD-related emergency department visits, admission, and surgery were compared using a Kaplan-Meier curve. Individual adverse events, infusion-.related quality measures, and markers of patient adherence were analyzed.</p><p><strong>Results: </strong>Adverse event-free survival was greater among those receiving home-based infusion (n = 154) compared with office-based infusion (n = 133). The office infusion cohort had higher rates of delayed infusion reactions (4 vs 0), IBD-related surgery (6 vs 0), and drug discontinuation (44 vs 35); this was a sicker cohort of patients compared with those in the home infusion group. Home infusion patients were less likely to receive correct weight-based dosing for infliximab (71.7% vs 89.3%), obtain labs for drug monitoring (53.2% vs 71.4%), and adhere to routine clinic visits (37.9% vs 58.1%).</p><p><strong>Conclusions: </strong>The home-based infusion of biologics for IBD appears safe with lower rates of major adverse events compared with office-based infusions. However, those receiving home infusion were less likely to receive correct weight-based dosing for infliximab and were poorly adherent to routine follow-up.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TolDC Restores the Balance of Th17/Treg via Aryl Hydrocarbon Receptor to Attenuate Colitis. TolDC通过芳基烃受体恢复Th17/Treg的平衡以缓解结肠炎
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-09-03 DOI: 10.1093/ibd/izae022
Shu Wang, Ying Xu, Lu Wang, Junjie Lin, Chenjing Xu, Xiaojing Zhao, Hongjie Zhang
{"title":"TolDC Restores the Balance of Th17/Treg via Aryl Hydrocarbon Receptor to Attenuate Colitis.","authors":"Shu Wang, Ying Xu, Lu Wang, Junjie Lin, Chenjing Xu, Xiaojing Zhao, Hongjie Zhang","doi":"10.1093/ibd/izae022","DOIUrl":"10.1093/ibd/izae022","url":null,"abstract":"<p><strong>Background: </strong>Tolerogenic dendritic cells (TolDCs) have been evidenced to trigger regulatory T cell's (Treg's) differentiation and be involved in the pathogenesis of Crohn's disease (CD). Aryl hydrocarbon receptor (AhR) plays a crucial role in the differentiation of TolDCs, although the mechanism remains vague. This study aimed to evaluate the role of AhR in TolDCs formation, which may affect Th17/Treg balance in CD.</p><p><strong>Methods: </strong>Colon biopsy specimens were obtained from healthy controls and patients with CD. Wild type (WT) and AhR-/- mice were induced colitis by drinking dextran sulphate sodium (DSS) with or without 6-formylindolo 3,2-b carbazole (FICZ) treatment. Wild type and AhR-/- bone marrow-derived cells (BMDCs) were cultured under TolDCs polarization condition. Ratios of DCs surface markers were determined by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) was performed to quantify the levels of interleukin (IL)-1β, transforming growth factor (TGF)-β and IL-10. Tolerogenic dendritic cells differentiated from BMDCs of WT or AhR-/- mice were adoptively transferred to DSS-induced WT colitis mice.</p><p><strong>Results: </strong>Patients with CD showed less AhR expression and activation in their inflamed colon regions. Compared with WT mice, AhR-/- mice experienced more severe colitis. Tolerogenic dendritic cells and Tregs were both decreased in the colon of AhR-/- colitis mice, while Th17 cells were upregulated. In vitro, compared with WT DCs, AhR-deficient DCs led to less TolDC formation. Furthermore, intestinal inflammation in WT colitis mice, which transferred with AhR-/- TolDCs, showed no obvious improvement compared with those transferred with WT TolDCs, as evidenced by no rescues of Th17/Treg balance.</p><p><strong>Conclusions: </strong>Activation of AhR attenuates experimental colitis by modulating the balance of TolDCs and Th17/Treg. The AhR modulation of TolDCs may be a viable therapeutic approach for CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic Skipping, Stricturing, and Penetrating Complications in Crohn's Disease on Tandem Ileo-colonoscopy and Cross-sectional Imaging: A Retrospective Cohort Study. 串联回肠结肠镜检查和横断面成像中克罗恩病的内镜跳过、狭窄和穿透并发症:一项回顾性队列研究
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-08-31 DOI: 10.1093/ibd/izae192
Virginia Solitano, Sudheer Kumar Vuyyuru, Achuthan Aruljothy, Maan Alkhattabi, Joshua Zou, Melanie Beaton, Jamie Gregor, Zahra Kassam, Rocio Sedano, Harry Marshall, Darryl Ramsewak, Michael Sey, Vipul Jairath
{"title":"Endoscopic Skipping, Stricturing, and Penetrating Complications in Crohn's Disease on Tandem Ileo-colonoscopy and Cross-sectional Imaging: A Retrospective Cohort Study.","authors":"Virginia Solitano, Sudheer Kumar Vuyyuru, Achuthan Aruljothy, Maan Alkhattabi, Joshua Zou, Melanie Beaton, Jamie Gregor, Zahra Kassam, Rocio Sedano, Harry Marshall, Darryl Ramsewak, Michael Sey, Vipul Jairath","doi":"10.1093/ibd/izae192","DOIUrl":"https://doi.org/10.1093/ibd/izae192","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is characterized by discontinuous inflammation. Failure to identify skipping lesions of the terminal ileum (TI) or transmural changes can lead to incorrect management.</p><p><strong>Methods: </strong>Eligible adult patients with CD undergoing ileo-colonoscopy and computed tomography enterography or magnetic resonance enterography within 6 months. We determined the prevalence of endoscopic skipping (normal ileum on colonoscopy but proximal small bowel inflammation on cross-sectional imaging), skip lesions (discontinuous inflammation along the gastrointestinal tract identified on cross-sectional imaging), structuring, and penetrating complications.</p><p><strong>Results: </strong>Among 202 patients, 45 (22.3%) had endoscopic skipping proximal to TI intubation. Fifty patients (24.5%) had small bowel skip lesions, primarily in the ileum. Strictures were identified in 34 patients (16.8%) through both imaging and ileo-colonoscopy, in 21 patients (10.4%) solely through cross-sectional imaging, and in 3 patients (1.5%) solely through ileo-colonoscopy. Approximately 36.2% of stricturing cases would be missed without cross-sectional imaging. Penetrating complications, including abscesses (2.5%) and various fistula types (4.9%), were detected in 15 (7.4%) patients.</p><p><strong>Conclusions: </strong>Ileo-colonoscopy missed detection of active CD in approximately one-fifth of cases due to more proximal disease location. Stricturing disease might be missed in more than a third of cases if cross-sectional imaging is not performed.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low Placental Transfer Rates of Risankizumab Among Pregnant Women With Inflammatory Bowel Disease. 患有炎症性肠病的孕妇服用利坦珠单抗后胎盘转移率低。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-08-31 DOI: 10.1093/ibd/izae182
Uma Mahadevan, Millie Long
{"title":"Low Placental Transfer Rates of Risankizumab Among Pregnant Women With Inflammatory Bowel Disease.","authors":"Uma Mahadevan, Millie Long","doi":"10.1093/ibd/izae182","DOIUrl":"https://doi.org/10.1093/ibd/izae182","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined Advanced Targeted Therapy in Inflammatory Bowel Diseases: An Extensive Update. 炎症性肠病的先进靶向联合疗法:广泛更新。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-08-29 DOI: 10.1093/ibd/izae189
Nicole Cornet, Aiya Aboubakr, Waseem Ahmed, Robert Battat
{"title":"Combined Advanced Targeted Therapy in Inflammatory Bowel Diseases: An Extensive Update.","authors":"Nicole Cornet, Aiya Aboubakr, Waseem Ahmed, Robert Battat","doi":"10.1093/ibd/izae189","DOIUrl":"https://doi.org/10.1093/ibd/izae189","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Does an Integrated Pharmacist Add Value in the Management of Inflammatory Bowel Disease in the Era of Values-Based Healthcare? 在以价值为导向的医疗保健时代,综合药剂师如何为炎症性肠病的治疗增添价值?
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-08-29 DOI: 10.1093/ibd/izae196
Patrick Hilley, Darren Wong, Peter De Cruz
{"title":"How Does an Integrated Pharmacist Add Value in the Management of Inflammatory Bowel Disease in the Era of Values-Based Healthcare?","authors":"Patrick Hilley, Darren Wong, Peter De Cruz","doi":"10.1093/ibd/izae196","DOIUrl":"https://doi.org/10.1093/ibd/izae196","url":null,"abstract":"<p><p>The World Health Organization has recommended that the management of chronic diseases such as inflammatory bowel disease (IBD) should be undertaken using an integrated approach delivered by a multidisciplinary team. Although the composition of an IBD multidisciplinary team has been well described, the inclusion of an IBD pharmacist as a core member has been more recent, with variable uptake within IBD services internationally. While pharmacists continue to play the traditional role of safe prescribing and monitoring of immunosuppressive therapies, their role within the IBD team is rapidly expanding; however, the value, in terms of both clinical outcomes as well as financial savings (where available), which they add to IBD services has been less well described. In this narrative review, we perform a comprehensive evaluation of the literature detailing the expanding roles that IBD pharmacists play and describe opportunities that exist for integrated pharmacists to add value to IBD service delivery. Medication and adherence counseling, immunosuppressive monitoring, uptake of biosimilars, therapeutic drug monitoring, health promotion and prevention appear to be key areas where integrated pharmacists can add the most value to IBD patients and services. In particular, integrated IBD pharmacists can improve patient outcomes via rigorous monitoring pre and post initiation of drug therapies; focused medication counseling; advice on improving adherence; implementation of novel approaches to medication usage, and; strategies to help sustain IBD service delivery. These data can be used to further build a case for those seeking to add pharmacists to their team/services. Future studies should focus on evaluating the impact of an integrated IBD pharmacist on quality-of-care delivery together with the clinical and financial value added to IBD services compared to services that lack an integrated IBD pharmacist role.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meta-analysis of the Therapeutic Impact of Cannabinoids in Inflammatory Bowel Disease. 大麻素对炎症性肠病治疗效果的元分析》(Meta-analysis of the Therapeutic Impact of Cannabinoids in Inflammatory Bowel Disease)。
IF 4.5 3区 医学
Inflammatory Bowel Diseases Pub Date : 2024-08-28 DOI: 10.1093/ibd/izae158
Hansol Kang, Christopher J Schmoyer, Alexandra Weiss, James D Lewis
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