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Therapeutic Advances in Gastroenterology

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https://www.readbyqxmd.com/read/29774052/therapeutic-drug-monitoring-of-vedolizumab-in-inflammatory-bowel-disease-current-data-and-future-directions
#1
REVIEW
Mark G Ward, Miles P Sparrow, Xavier Roblin
The introduction of vedolizumab, a lymphocyte adhesion inhibitor, has expanded the relatively limited therapeutic armamentarium available for Crohn's disease and ulcerative colitis. Despite its effectiveness, both primary nonresponse and secondary loss of response to vedolizumab do occur, as is observed with the use of anti-tumour necrosis factor (TNF) therapy. Further, in a proportion, onset of efficacy may be relatively slow. A large body of data support an exposure-response relationship with anti-TNF drug levels, which has led to therapeutic drug monitoring becoming incorporated into everyday clinical management...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29774051/alosetron-use-in-clinical-practice-significant-improvement-in-irritable-bowel-syndrome-symptoms-evaluated-using-the-us-food-and-drug-administration-composite-endpoint
#2
Brian E Lacy, Jean Paul Nicandro, Emil Chuang, David L Earnest
Background: Alosetron is approved to treat women with severe IBS and diarrhea (IBS-D) who have failed standard therapy. In our study, we aimed to evaluate alosetron efficacy using new US Food and Drug Administration (FDA) endpoints and utilization in clinical practice. Methods: This prospective, open-label, multicenter, observational 12-week study evaluated women with severe IBS-D enrolled in the alosetron prescribing program. The coprimary FDA endpoints were changes from baseline in stool consistency and abdominal pain severity...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29760785/monitoring-crohn-s-disease-activity-endoscopy-fecal-markers-and-computed-tomography-enterography
#3
Susana Lopes, Patrícia Andrade, Joana Afonso, Rui Cunha, Eduardo Rodrigues Pinto, Isabel Ramos, Guilherme Macedo, Fernando Magro
Background: The treatment goal of Crohn's disease (CD) has moved towards achieving mucosal healing, resolution of transmural inflammation, and normalization of biomarkers. The purpose of this study was to evaluate how well computed tomography enterography (CTE) and fecal calprotectin (FC) correlated with endoscopic activity in newly diagnosed patients with CD and after 1 year of therapy. Methods: Consecutive patients with newly diagnosed CD were evaluated by endoscopy, CTE, and FC at diagnosis and 12 months after beginning immunosuppression...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29760784/practical-guidance-for-the-management-of-iron-deficiency-in-patients-with-inflammatory-bowel-disease
#4
REVIEW
Dorothea Niepel, Thomas Klag, Nisar P Malek, Jan Wehkamp
Iron deficiency or iron deficiency anemia (IDA) are some of the most common systemic complications of inflammatory bowel diseases (IBD). Symptoms such as fatigue, reduced ability to concentrate and reduced exercise tolerance can mimic common symptoms of IBD and can therefore easily be overseen. Furthermore, clinicians tend to see mild to moderate anemia as an inevitable accompaniment of IBD that is sufficiently explained by the underlying disease and does not require further workup. But in contrast to these clinical routines, current guidelines recommend that any degree of anemia in patients with IBD should be further evaluated and treated...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29760783/minor-digestive-symptoms-and-their-impact-in-the-general-population-a-cluster-analysis-approach
#5
Diane L'Heureux-Bouron, Sophie Legrain-Raspaud, Helen R Carruthers, P J Whorwell
Background: The classification and treatment of patients who do not meet the criteria for a functional gastrointestinal (GI) disorder has not been well established. This study aimed to record the prevalence of minor digestive symptoms (MDSs) in the general population attempting to divide them into symptom clusters as well as trying to assess their impact and the way sufferers cope with them. Methods: Following face-to-face interviews, a web-based, self-administered questionnaire was designed to capture a range of GI sensations using 34 questions and 12 images depicting abdominal symptoms...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29707039/emerging-concepts-in-non-invasive-monitoring-of-crohn-s-disease
#6
REVIEW
Wojciech Marlicz, Karolina Skonieczna-Żydecka, Konstantinos John Dabos, Igor Łoniewski, Anastasios Koulaouzidis
Inflammatory bowel disease (IBD) is an umbrella term for Crohn's disease (CD) and ulcerative colitis (UC). In light of evolving epidemiology of CD, its clinical management is still complex and remains a challenge for contemporary physicians. With the advent of new diagnostic and treatment paradigms, there is a growing need for new biomarkers to guide decision-making, differential diagnosis, disease activity monitoring, as well as prognosis. However, both clinical and endoscopic scoring systems, widely utilized for disease monitoring and prognosis, have drawbacks and limitations...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29686731/a-review-of-magnetic-resonance-enterography-based-indices-for-quantification-of-crohn-s-disease-inflammation
#7
REVIEW
Noa Rozendorn, Marianne Michal Amitai, Rami Abraham Eliakim, Uri Kopylov, Eyal Klang
Magnetic resonance enterography (MRE) is a leading radiological modality in Crohn's disease (CD) and is used together with laboratory findings and endoscopic examinations for the evaluation of patients during initial diagnosis and follow up. Over the years, there has been great progress in the understanding of CD and there is a continuous strive to achieve better monitoring of patients and to develop new modalities which will predict disease course and thus help in clinical decisions making. An objective evaluation of CD using a quantification score is not a new concept and there are different clinical, endoscopies, radiological and combined indices which are used in clinical practice...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29662538/the-accuracy-of-intestinal-ultrasound-compared-with-small-bowel-capsule-endoscopy-in-assessment-of-suspected-crohn-s-disease-in-patients-with-negative-ileocolonoscopy
#8
Dan Carter, Lior H Katz, Eytan Bardan, Eti Salomon, Shulamit Goldstein, Shomron Ben Horin, Uri Kopylov, Rami Eliakim
Background: Small bowel involvement in Crohn's disease (CD) is frequently proximal to the ileocecal valve and inaccessible by conventional ileocolonoscopy (IC). Small bowel capsule endoscopy (SBCE) is among the prime modalities for assessment of small bowel disease in these patients. Intestinal ultrasound (IUS) is an accurate bedside fast and low-cost diagnostic modality utilized in CD for both diagnosis and monitoring. The aim of this study was to examine the accuracy of IUS in patients with suspected CD after a negative IC, and to evaluate the correlation of IUS with SBCE, inflammatory biomarkers and other cross-sectional imaging techniques...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29623105/subtherapeutic-concentrations-of-infliximab-and-adalimumab-are-associated-with-increased-disease-activity-in-crohn-s-disease
#9
Arne Carlsen, Roald Omdal, Kristian Øgreid Leitao, Kjetil Isaksen, Anne Kristine Hetta, Lars Normann Karlsen, Lars Aabakken, Nils Bolstad, David Warren, Knut E A Lundin, Tore Grimstad
Background: Low anti-tumor necrosis factor α (TNFα) serum concentrations may result in lack of treatment response in patients with inflammatory bowel disease. We determined the anti-TNFα drug concentrations in patients with inflammatory bowel disease and investigated whether or not subtherapeutic drug concentrations were associated with increased levels of disease activity. Methods: In a single-center cross-sectional study, we included patients with ulcerative colitis or Crohn's disease who were receiving infliximab or adalimumab maintenance therapy...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29619090/host-targeting-therapies-for-hepatitis-c-virus-infection-current-developments-and-future-applications
#10
REVIEW
Emilie Crouchet, Florian Wrensch, Catherine Schuster, Mirjam B Zeisel, Thomas F Baumert
Chronic hepatitis C virus (HCV) infection is a leading cause of chronic liver diseases and hepatocellular carcinoma (HCC) worldwide. In the past few years, anti-HCV therapies have undergone a revolution with the approval of multiple direct-acting antivirals (DAAs), which enable interferon-free treatments with considerable improvement of sustained virologic response in patients. Today, DAAs have become the standard of care for HCV therapy. However, several limitations remain, which include access to therapy, treatment failure in a subset of patients and persistent risk of HCC development following cure in patients with advanced fibrosis...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29535793/clinical-outcomes-of-endoscopic-ultrasound-guided-ethanol-ablation-for-pancreatic-cystic-lesions-compared-with-the-natural-course-a-propensity-score-matching-analysis
#11
Jin Ho Choi, Sang Hyub Lee, Young Hoon Choi, Jinwoo Kang, Woo Hyun Paik, Dong-Won Ahn, Ji Kon Ryu, Yong-Tae Kim
Background: Endoscopic ultrasound-guided ethanol ablation (EUS-EA) is a recently introduced treatment for pancreatic cystic lesions (PCLs). However, clinical benefits such as survival gain and maintenance of quality of life (QOL) have not been fully established. The aim of this study was to evaluate the clinical benefits of EUS-EA compared with the natural course (NC) of PCLs. Methods: This retrospective comparative study of patients with PCLs investigated an EUS-EA group ( n = 118) and an NC group ( n = 428)...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29531578/video-capsule-endoscopy-in-pediatric-patients-with-crohn-s-disease-a-single-center-experience-of-180-procedures
#12
Artur Nemeth, Daniel Agardh, Gabriele Wurm Johansson, Henrik Thorlacius, Ervin Toth
Background: Video capsule endoscopy (VCE) is a noninvasive method enabling excellent visualization of the small bowel (SB) mucosa. The aim of this study was to examine the impact and safety of VCE performed in children and adolescents with suspected or established Crohn's disease (CD). Methods: A total of 180 VCE examinations in 169 consecutive patients conducted in 2003-14 in a single center were retrospectively analyzed. The median age was 13 years (range 3-17 years) and indications for VCE were suspected (125 cases, 69%) and established (55 cases, 31%) CD...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29487628/low-serum-zinc-levels-predict-presence-of-depression-symptoms-but-not-overall-disease-outcome-regardless-of-atg16l1-genotype-in-crohn-s-disease-patients
#13
Thomas Greuter, Yannick Franc, Matthias Kaelin, Alain M Schoepfer, Philipp Schreiner, Jonas Zeitz, Michael Scharl, Benjamin Misselwitz, Alex Straumann, Stephan R Vavricka, Gerhard Rogler, Roland von Känel, Luc Biedermann
Background: Zinc deficiency (ZD) in Crohn's disease (CD) is considered a frequent finding and may exacerbate CD activity. ZD is associated with depression in non-CD patients. We aimed to assess the prevalence of ZD in CD patients in clinical remission, its association with mood disturbances and to analyze a potential impact on future disease course. Methods: Zinc levels from CD patients in clinical remission at baseline and an uncomplicated disease course within the next 3 years ( n = 47) were compared with those from patients developing complications ( n = 50)...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29487627/the-role-of-early-colonoscopy-in-patients-presenting-with-acute-lower-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis
#14
Ira Roshan Afshar, Mo Seyed Sadr, Lisa L Strate, Myriam Martel, Charles Menard, Alan N Barkun
Objective: The use of early colonoscopy in the management of acute lower gastrointestinal bleeding (LGIB) is controversial, with disparate evidence. We aim to formally characterize the utility of early colonoscopy (within 24 h) in managing acute LGIB. Design: A systematic literature search to August 2016 identified fully published and abstracts of randomized controlled trials (RCTs) and observational studies assessing early colonoscopy in acute LGIB. Single-arm studies were also included to define incidence...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29479375/efficacy-and-safety-of-pasireotide-lar-for-the-treatment-of-refractory-bleeding-due-to-gastrointestinal-angiodysplasias-results-of-the-angiopas-multicenter-phase-ii-noncomparative-prospective-double-blinded-randomized-study
#15
Robert Benamouzig, Mourad Benallaoua, Jean-Christophe Saurin, Marouane Boubaya, Christophe Cellier, René Laugier, Magalie Vincent, Christian Boustière, Rodica Gincul, Elia Samaha, Philippe Grandval, Thomas Aparicio, Gheorghe Airinei, Bakhtiar Bejou, Cyriaque Bon, Jean-Jacques Raynaud, Vincent Levy, Denis Sautereau
Background: Gastrointestinal angiodysplasias (GIADs) could be responsible for recurrent bleeding and severe anemia. Somatostatin analogs could reduce transfusion requirements in these patients but no randomized controlled study is available. The main objective of the ANGIOPAS phase II double-blinded randomized, noncomparative study was to assess the effectiveness of pasireotide-LAR in reducing transfusion requirements in patients with refractory GIADs bleeding. Methods: A total of 22 patients with transfusion requirements ⩾6 units of packed red blood cells (pRBCs) during the 6 months prior to inclusion were randomized to receive pasireotide-LAR 60 mg ( n = 10) or placebo ( n = 12) every 28 days for 6 months...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29467827/advanced-imaging-techniques-for-small-bowel-crohn-s-disease-what-does-the-future-hold
#16
REVIEW
Inês Pita, Fernando Magro
Treatment of Crohn's disease (CD) is intrinsically reliant on imaging techniques, due to the preponderance of small bowel disease and its transmural pattern of inflammation. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are the most widely employed imaging methods and have excellent diagnostic accuracy in most instances. Some limitations persist, perhaps the most clinically relevant being the distinction between inflammatory and fibrotic strictures. In this regard, several methodologies have recently been tested in animal models and human patients, namely US strain elastography, shear wave elastography, contrast-enhanced US, magnetization transfer MRI and contrast dynamics in standard MRI...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29399042/the-lewis-score-or-the-capsule-endoscopy-crohn-s-disease-activity-index-which-one-is-better-for-the-assessment-of-small-bowel-inflammation-in-established-crohn-s-disease
#17
Doron Yablecovitch, Adi Lahat, Sandra Neuman, Nina Levhar, Benjamin Avidan, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
Background: Small-bowel capsule endoscopy (CE) is a prime modality for evaluation of the small bowel. The Lewis score (LS) and the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are validated endoscopic indices for quantification of small-bowel inflammation on CE. It is unclear whether these indexes are interchangeable for the evaluation of mucosal inflammation in established Crohn's disease (CD). The aim of this study was to compare the quantitative evaluation of small- bowel inflammation by LS and CECDAI...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29399041/insights-into-the-management-of-gastric-antral-vascular-ectasia-watermelon-stomach
#18
REVIEW
Wen-Hung Hsu, Yao-Kuang Wang, Meng-Shu Hsieh, Fu-Chen Kuo, Meng-Chieh Wu, Hsiang-Yao Shih, I-Chen Wu, Fang-Jung Yu, Huang-Ming Hu, Yu-Chung Su, Deng-Chyang Wu
Gastric antral vascular ectasia (GAVE) is an uncommon but important cause of chronic gastrointestinal bleeding. It is often associated with systemic diseases such as autoimmune diseases, liver cirrhosis, chronic renal insufficiency and cardiovascular disease. The etiology of GAVE has not been fully explored and remains controversial. Diagnosis is mainly based on endoscopic presentation with flat or raised erythematous stripes radiating from the pylorus to the antrum and resembles a watermelon. Clinical presentation may range from iron-deficiency anemia secondary to occult blood loss, melena to hematemesis...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29399040/clinical-outcome-of-patients-with-obscure-gastrointestinal-bleeding-during-antithrombotic-drug-therapy
#19
Yoshiyasu Kono, Seiji Kawano, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Hiroyuki Sakae, Makoto Abe, Tatsuhiro Gotoda, Toshihiro Inokuchi, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Hiroyuki Okada
Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29399039/food-consumption-and-dietary-intakes-in-36-448-adults-and-their-association-with-irritable-bowel-syndrome-nutrinet-sant%C3%A3-study
#20
Marion J Torres, Jean-Marc Sabate, Michel Bouchoucha, Camille Buscail, Serge Hercberg, Chantal Julia
Introduction: Diet plays an important role for patients with irritable bowel syndrome (IBS). The aim of this study was to compare the diets in terms of food consumption and nutrient intake between subjects with IBS and controls in a large French population. Methods: This study included 36,448 subjects from the Nutrinet-Santé cohort study, who completed a questionnaire pertaining to functional bowel disorders based on the Rome III criteria. Dietary data were obtained from at least three self-administered 24 h records via the internet...
2018: Therapeutic Advances in Gastroenterology
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