HSOA journal of gastroenterology & hepatology research最新文献_第5页

Utilization and Clinical Outcome Following 5-Aminosalicylate Therapy for Crohn's Disease in Children 5-氨基水杨酸盐治疗儿童克罗恩病的疗效及应用

HSOA journal of gastroenterology & hepatology research Pub Date : 2018-06-30 DOI: 10.24966/GHR-2566/100016

B. Zeisler

{"title":"Utilization and Clinical Outcome Following 5-Aminosalicylate Therapy for Crohn's Disease in Children","authors":"B. Zeisler","doi":"10.24966/GHR-2566/100016","DOIUrl":"https://doi.org/10.24966/GHR-2566/100016","url":null,"abstract":"Objectives: Despite little data on efficacy, 5-Aminosalicylates (5ASA) are commonly used in pediatric Crohn’s Disease (CD). Our aim was to assess prevalence of 5-ASA utilization in children newly diagnosed with CD, as well as clinical outcomes among these patients. Study design: Data were obtained from a large observational inception cohort from 2002-2014. First, we analyzed initial treatments received immediately following diagnosis. Then, clinical outcome and disease activity were measured using the “Physician Global Assessment” (PGA) scale. The primary outcome was a PGA of “inactive”, without corticosteroids (CS), immunomodulators, biologics or surgery one year following diagnosis in patients receiving 5-ASA ± CS only as initial therapy following diagnosis. Results: 440/1297 subjects with CD (34%) received 5-ASA ± CS only as initial therapy, and were the focus of this study. No baseline differences were observed between the 5-ASA + CS (n=263) vs. 5-ASA CS (n=177) treatment groups for age, gender, disease distribution or disease behavior. Baseline moderate/severe PGA was more common in the 5-ASA + CS group compared with the 5-ASA alone group (70% vs. 38%, p<0.001). The primary outcome was achieved by 34% of those treated with 5-ASA alone vs. 18% of those treated with 5-ASA + CS (p<0.001). In multivariate models, achieving the primary outcome was significantly associated with initially mild disease severity and no initial CS use. Conclusion: The prevalence of 5-ASA utilization for pediatric CD is high despite a low likelihood of achieving clinical remission on 5-ASA therapy, although somewhat more favorable for select children with mild disease who do not receive CS at diagnosis.","PeriodicalId":92206,"journal":{"name":"HSOA journal of gastroenterology & hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46808864","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}

引用次数: 1

Delays in the Placement of Nasogastric Tube: Where are they 鼻导管放置延迟：它们在哪里

HSOA journal of gastroenterology & hepatology research Pub Date : 2018-06-30 DOI: 10.24966/ghr-2566/100015

D. Smithard

引用次数: 1

Feeding Aversion in Children with Neurodisability and its Assessment Using CEBQ: A Tertiary Feeding Clinic Experience 神经功能障碍儿童的进食厌恶及其CEBQ评估:第三次进食临床经验

HSOA journal of gastroenterology & hepatology research Pub Date : 2018-06-30 DOI: 10.24966/ghr-2566/100017

Kulshrestha R

引用次数: 1

Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis. 复合口服粘性布地奈德治疗嗜酸性食管炎有效且持久。

HSOA journal of gastroenterology & hepatology research Pub Date : 2018-02-21 DOI: 10.17554/J.ISSN.2224-3992.2018.07.750

Craig C Reed, C. Fan, N. Koutlas, Zoe Stefanadis, S. Eluri, N. Shaheen, E. Dellon

{"title":"Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis.","authors":"Craig C Reed, C. Fan, N. Koutlas, Zoe Stefanadis, S. Eluri, N. Shaheen, E. Dellon","doi":"10.17554/J.ISSN.2224-3992.2018.07.750","DOIUrl":"https://doi.org/10.17554/J.ISSN.2224-3992.2018.07.750","url":null,"abstract":"Aim\u0000Because no approved medications exist for eosinophilic esophagitis (EoE), patients must use off-label drugs or create their own formulations. We assessed the efficacy of a standardized compounded budesonide suspension for treatment of EoE.\u0000\u0000\u0000Materials and methods\u0000We conducted a retrospective cohort study of EoE patients at the University of North Carolina treated with compounded budesonide dispensed by a specialty compounding pharmacy. Outcomes (symptomatic global response [yes/no], endoscopic response [% with individual findings], and histologic response [absolute eosinophil count; % with <15 eos/hpf])were assessed after the initial and last treatment in our system.\u0000\u0000\u0000Results\u0000We identified 48 patients treated with compounded budesonide (mean age 33.6; 69% male; 96% white; 2.4 mg mean initial dose). After a mean length of follow-up of 17.0 months (range: 4.2 - 56.3), there was a significant decrease in symptoms of dysphagia (95% vs. 32%, p < 0.001), improvements in heartburn (37% vs. 11%, p=0.06) and global symptom response (81%). The median of the peak eosinophil counts decreased from 55 to 20 eos/hpf (p<0.001) with 42% achieving a response of <15 eos/hpf. Esophageal candidiasis was rare (6%). In the 18 patients with prior non-response to corticosteroids or dietary elimination, 83% had symptomatic and 38% had histologic response.\u0000\u0000\u0000Conclusion\u0000Compounded budesonide suspension produced a durable symptomatic, endoscopic, and histologic response in a cohort followed for more than a year. Many patients previously refractory to prior therapy responded to compounded budesonide. This formulation can be used clinically until there are approved drugs with esophageal formulations for EoE.","PeriodicalId":92206,"journal":{"name":"HSOA journal of gastroenterology & hepatology research","volume":"21 3 1","pages":"2509-2515"},"PeriodicalIF":0.0,"publicationDate":"2018-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77858915","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}

引用次数: 21

Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis. 复合口服粘性布地奈德治疗嗜酸性食管炎有效且持久。

HSOA journal of gastroenterology & hepatology research Pub Date : 2018-01-01 Epub Date: 2018-02-21

Craig C Reed, Claire Fan, Nathaniel Koutlas, Zoe Stefanadis, Swathi Eluri, Nicholas J Shaheen, Evan S Dellon

{"title":"Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis.","authors":"Craig C Reed, Claire Fan, Nathaniel Koutlas, Zoe Stefanadis, Swathi Eluri, Nicholas J Shaheen, Evan S Dellon","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Because no approved medications exist for eosinophilic esophagitis (EoE), patients must use off-label drugs or create their own formulations. We assessed the efficacy of a standardized compounded budesonide suspension for treatment of EoE.Materials and methods: We conducted a retrospective cohort study of EoE patients at the University of North Carolina treated with compounded budesonide dispensed by a specialty compounding pharmacy. Outcomes (symptomatic global response [yes/no], endoscopic response [% with individual findings], and histologic response [absolute eosinophil count; % with <15 eos/hpf])were assessed after the initial and last treatment in our system.Results: We identified 48 patients treated with compounded budesonide (mean age 33.6; 69% male; 96% white; 2.4 mg mean initial dose). After a mean length of follow-up of 17.0 months (range: 4.2 - 56.3), there was a significant decrease in symptoms of dysphagia (95% vs. 32%, p < 0.001), improvements in heartburn (37% vs. 11%, p=0.06) and global symptom response (81%). The median of the peak eosinophil counts decreased from 55 to 20 eos/hpf (p<0.001) with 42% achieving a response of <15 eos/hpf. Esophageal candidiasis was rare (6%). In the 18 patients with prior non-response to corticosteroids or dietary elimination, 83% had symptomatic and 38% had histologic response.Conclusion: Compounded budesonide suspension produced a durable symptomatic, endoscopic, and histologic response in a cohort followed for more than a year. Many patients previously refractory to prior therapy responded to compounded budesonide. This formulation can be used clinically until there are approved drugs with esophageal formulations for EoE.","PeriodicalId":92206,"journal":{"name":"HSOA journal of gastroenterology & hepatology research","volume":"7 1","pages":"2509-2515"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875939/pdf/nihms944992.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35969917","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}

引用次数: 0