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https://www.readbyqxmd.com/read/28509816/variations-in-health-insurance-policies-regarding-biologic-therapy-use-in-inflammatory-bowel-disease
#1
Abhijeet Yadav, Joshua Foromera, Ilana Feuerstein, Kenneth R Falchuk, Joseph D Feuerstein
BACKGROUND: The American Gastroenterological Association (AGA) has developed guidelines for the management of ulcerative colitis and Crohn's disease (CD) recommending anti-TNF therapy in moderate-severe disease. However, which drug is used is often dictated by insurance company policies. We sought to determine the insurance policy requirements prior to approval of biologic therapies. METHODS: Using the National Association of Insurance Commissioners report of the top 125 insurance companies by market share in 2014, we reviewed the first 50 that had online policies regarding anti-TNF and vedolizumab available...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28509767/variations-in-health-insurance-policies-regarding-biologic-therapy-use-in-inflammatory-bowel-disease
#2
Abhijeet Yadav, Joshua Foromera, Ilana Feuerstein, Kenneth R Falchuk, Joseph D Feuerstein
BACKGROUND: The American Gastroenterological Association (AGA) has developed guidelines for the management of ulcerative colitis and Crohn's disease (CD) recommending anti-TNF therapy in moderate-severe disease. However, which drug is used is often dictated by insurance company policies. We sought to determine the insurance policy requirements prior to approval of biologic therapies. METHODS: Using the National Association of Insurance Commissioners report of the top 125 insurance companies by market share in 2014, we reviewed the first 50 that had online policies regarding anti-TNF and vedolizumab available...
May 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#3
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28425825/reviewing-treatments-and-outcomes-in-the-evolving-landscape-of-ulcerative-colitis
#4
Marla C Dubinsky
Ulcerative colitis (UC) is a chronic inflammatory disease extending proximally from the rectum to varying lengths of the colon that is characterized by alternating cycles of relapse and remission. Therapeutic goals for patients with active UC include induction and maintenance of remission and improvement in quality of life, as well as mucosal healing, a clinical outcome recently recognized in treatment guidance as being equally important. Mucosal healing is associated with favorable long-term patient outcomes related to remission, surgery, hospitalization, and quality of life...
May 2, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28399515/healthcare-professionals-views-of-the-use-and-administration-of-two-salvage-therapy-drugs-for-acute-ulcerative-colitis-a-nested-qualitative-study-within-the-construct-trial
#5
Clare Clement, Frances Rapport, Anne Seagrove, Laith Alrubaiy, John Williams
OBJECTIVES: Insight into healthcare professionals' views and experiences of the use of ciclosporin and infliximab as salvage therapies for acute ulcerative colitis (UC) and how this may affect participation in a comparison trial is lacking. The study aimed to capture views and opinions of healthcare professionals about the two drugs within the CONSTRUCT trial. DESIGN: An interview-based qualitative study using Framework Analysis embedded within an open-label, pragmatic randomised trial...
February 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28345207/autoinflammatory-syndromes-associated-with-hidradenitis-suppurativa-and-or-acne
#6
REVIEW
Caroline Vinkel, Simon F Thomsen
Autoinflammatory syndromes associated with hidradenitis suppurativa (HS) and/or acne are rare but potentially debilitating disorders if not diagnosed and treated correctly. They share a common pathogenesis involving a dysregulated innate immune system with abnormal interleukin (IL)-1 signaling leading to sterile neutrophilic inflammation. The clinical features are recurrent episodes of fever, painful arthritis, and skin lesions consistent with HS, acne, and pyoderma gangrenosum (PG) accompanied by elevated systemic inflammatory markers in blood...
March 27, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28296817/communication-between-physicians-and-patients-with-ulcerative-colitis-reflections-and-insights-from-a-qualitative-study-of-in-office-patient-physician-visits
#7
David T Rubin, Marla C Dubinsky, Steve Martino, Kathleen A Hewett, Julian Panés
BACKGROUND: We analyzed in-office communication between patients with ulcerative colitis (UC) and their gastroenterologists. METHODS: Participating gastroenterologists (United States N = 15; Europe N = 8) identified eligible patients with scheduled clinic visits. Patients (United States N = 40; Europe N = 28; ≥18 yr old; physician-defined moderately-to-severely active ulcerative colitis for approximately ≥1 yr; ≥1 flare in preceding year; prior or current therapy with 5-aminosalicylates and/or corticosteroids) consented to have their visit recorded...
April 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28274254/the-use-of-randomisation-based-efficacy-estimators-in-non-inferiority-trials
#8
David Gillespie, Daniel Farewell, Peter Barrett-Lee, Angela Casbard, Anthony Barney Hawthorne, Chris Hurt, Nick Murray, Chris Probert, Rachel Stenson, Kerenza Hood
BACKGROUND: In a non-inferiority (NI) trial, analysis based on the intention-to-treat (ITT) principle is anti-conservative, so current guidelines recommend analysing on a per-protocol (PP) population in addition. However, PP analysis relies on the often implausible assumption of no confounders. Randomisation-based efficacy estimators (RBEEs) allow for treatment non-adherence while maintaining a comparison of randomised groups. Fischer et al. have developed an approach for estimating RBEEs in randomised trials with two active treatments, a common feature of NI trials...
March 9, 2017: Trials
https://www.readbyqxmd.com/read/28254463/use-of-corticosteroids-and-immunosuppressive-drugs-in-inflammatory-bowel-disease-clinical-practice-guidelines-of-the-italian-group-for-the-study-of-inflammatory-bowel-disease
#9
Paolo Gionchetti, Fernando Rizzello, Vito Annese, Alessandro Armuzzi, Livia Biancone, Fabiana Castiglione, Michele Comberlato, Mario Cottone, Silvio Danese, Marco Daperno, Renata D'Incà, Walter Fries, Anna Kohn, Ambrogio Orlando, Claudio Papi, Maurizio Vecchi, Sandro Ardizzone
The two main forms of intestinal bowel disease, namely ulcerative colitis and Crohn's disease, are not curable but can be controlled by various medical therapies. The Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) has prepared clinical practice guidelines to help physicians prescribe corticosteroids and immunosuppressive drugs for these patients. The guidelines consider therapies that induce remission in patients with active disease as well as treatment regimens that maintain remission. These guidelines complement already existing guidelines from IG-IBD on the use of biological drugs in patients with inflammatory bowel diseases...
January 25, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28239313/second-korean-guidelines-for-the-management-of-ulcerative-colitis
#10
REVIEW
Chang Hwan Choi, Won Moon, You Sun Kim, Eun Soo Kim, Bo-In Lee, Yunho Jung, Yong Sik Yoon, Heeyoung Lee, Dong Il Park, Dong Soo Han
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by a relapsing and remitting course. The direct and indirect costs of the treatment of UC are high, and the quality of life of patients is reduced, especially during exacerbation of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies, including biologics, are currently used for the management of UC...
January 2017: Intestinal Research
https://www.readbyqxmd.com/read/28210080/il23r-single-nucleotide-polymorphisms-could-be-either-beneficial-or-harmful-in-ulcerative-colitis
#11
Sarah Fischer, Erzsébet Kövesdi, Lili Magyari, Veronika Csöngei, Kinga Hadzsiev, Béla Melegh, Péter Hegyi, Patrícia Sarlós
AIM: To investigate the association of seven single nucleotide polymorphisms (SNPs) of the IL23R gene with the clinical picture of ulcerative colitis (UC). METHODS: Genomic DNA samples of 131 patients (66 males, 65 females, mean age 55.4 ± 15.8 years) with Caucasian origin, diagnosed with UC were investigated. The diagnosis of UC was based on the established clinical, endoscopic, radiological, and histopathological guidelines. DNA was extracted from peripheral blood leukocytes by routine salting out method...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28161290/safety-of-treatments-for-inflammatory-bowel-disease-clinical-practice-guidelines-of-the-italian-group-for-the-study-of-inflammatory-bowel-disease-ig-ibd
#12
Livia Biancone, Vito Annese, Sandro Ardizzone, Alessandro Armuzzi, Emma Calabrese, Flavio Caprioli, Fabiana Castiglione, Michele Comberlato, Mario Cottone, Silvio Danese, Marco Daperno, Renata D'Incà, Giuseppe Frieri, Walter Fries, Paolo Gionchetti, Anna Kohn, Giovanni Latella, Monica Milla, Ambrogio Orlando, Claudio Papi, Carmelina Petruzziello, Gabriele Riegler, Fernando Rizzello, Simone Saibeni, Maria Lia Scribano, Maurizio Vecchi, Piero Vernia, Gianmichele Meucci, Massimo Rugge
Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs...
April 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28150131/inflammatory-bowel-disease-unclassified-in-children-diagnosis-and-pharmacological-management
#13
REVIEW
Giulia D'Arcangelo, Marina Aloi
Inflammatory bowel diseases are chronic disorders of the gastrointestinal tract that include Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease-unclassified (IBDU). The latter defines a subgroup of patients with clinical and endoscopic evidence of chronic colitis, without specific features of either CD or UC. These patients will possibly be re-classified as having UC or CD during the follow-up, although a significant percentage of them will keep the diagnosis of IBDU. IBDU is the rarest subtype of IBD, both in children and in adults, although it is twice as common among the pediatric population, especially in the younger ages...
April 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28135789/-second-korean-guideline-for-the-management-of-ulcerative-colitis
#14
REVIEW
Chang Hwan Choi, Won Moon, You Sun Kim, Eun Soo Kim, Bo In Lee, Yunho Jung, Yong Sik Yoon, Heeyoung Lee, Dong Il Park, Dong Soo Han
Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by a relapsing and remitting course. The direct and indirect costs of the treatment of UC are high, and the quality of life of patients is reduced, especially during exacerbation of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies, including biologics, are currently used for the management of UC...
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28131521/espen-guideline-clinical-nutrition-in-inflammatory-bowel-disease
#15
Alastair Forbes, Johanna Escher, Xavier Hébuterne, Stanisław Kłęk, Zeljko Krznaric, Stéphane Schneider, Raanan Shamir, Kalina Stardelova, Nicolette Wierdsma, Anthony E Wiskin, Stephan C Bischoff
INTRODUCTION: The ESPEN guideline presents a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). METHODOLOGY: The guideline is based on extensive systematic review of the literature, but relies on expert opinion when objective data were lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required...
April 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28128675/clinicians-adherence-to-international-guidelines-in-the-clinical-care-of-adults-with-inflammatory-bowel-disease
#16
Belinda D Jackson, Danny Con, Danny Liew, Peter De Cruz
BACKGROUND: Although evidence-based guidelines have been developed for inflammatory bowel disease (IBD), the extent to which they are followed is unclear. The objective of this study was to review clinicians' adherence to international IBD guidelines. METHODS: Retrospective data collection of patients attending a tertiary Australian hospital IBD clinic over a 12-month period. Management practices were audited and compared to ECCO (European Crohn's and Colitis Organization) guidelines...
January 27, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28068895/can-surgery-for-inflammatory-bowel-disease-be-personalized
#17
Antonino Spinelli, Alessandra Marano, Claudio Bacchelli, Nicolò Maria Mariani, Marco Montorsi, Paulo Gustavo Kotze
In the treatment of Inflammatory Bowel Diseases (IBD) despite advances in medical therapies, surgery has maintained a leading role in the management of complications of the disease, as well as in cases of failure of medical therapy. Surgery has become more and more minimally invasive, struggling for a difficult balance between guidelines and personalized treatment tailored on the single patient's need. In the present paper, the authors discuss the possible role for a personalization in debated fields of surgical treatment of Crohn&s disease and ulcerative colitis...
January 5, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28066941/surveillance-for-dysplasia-in-patients-with-ulcerative-colitis-discrepancy-between-guidelines-and-practice
#18
Masaru Shinozaki, Kiyonori Kobayashi, Reiko Kunisaki, Tadakazu Hisamatsu, Makoto Naganuma, Ken-Ichi Takahashi, Yasushi Iwao, Yasuo Suzuki, Mamoru Watanabe, Michio Itabashi, Akira Torii, Masakazu Takazoe, Akira Sugita
BACKGROUND AND AIM: The risk of developing colorectal cancer is higher in patients with ulcerative colitis (UC) than in the general population. Guidelines recommend surveillance colonoscopy (SCS) to reduce mortality; however, few studies have assessed physicians' adherence to guidelines. This study was aimed to clarify the current status of SCS and adherence to guidelines through the characteristics of cancer/dysplasia surveillance for UC patients in Japan. METHODS: A questionnaire was mailed to 541 physicians who attended meetings on inflammatory bowel disease...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28009685/there-is-significant-practice-pattern-variability-in-the-management-of-the-hospitalized-ulcerative-colitis-patient-at-a-tertiary-care-and-ibd-referral-center
#19
Shailja C Shah, Steven Naymagon, Benjamin L Cohen, Bruce E Sands, Marla C Dubinsky
BACKGROUND AND GOALS: Despite published clinical guidelines, substantive data underlying the approach to the management of hospitalized ulcerative colitis (UC) patients failing outpatient therapy are lacking. Variability in practice is therefore not uncommon and may impact clinical outcomes. The degree of variability, however, is not well-studied. Our aim was to evaluate variability in management of the hospitalized UC patient to inform future efforts targeting care optimization for this high-risk population...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27951611/clinical-implications-of-low-grade-dysplasia-found-during-inflammatory-bowel-disease-surveillance-a-retrospective-study-comparing-chromoendoscopy-and-white-light-endoscopy
#20
Joren R Ten Hove, Erik Mooiweer, Andrea E van der Meulen de Jong, Evelien Dekker, Cyriel Y Ponsioen, Peter D Siersema, Bas Oldenburg
Background and study aims Current guidelines recommend the use of pancolonic chromoendoscopy for surveillance of patients with inflammatory bowel disease (IBD). It is currently unknown whether low grade dysplasia (LGD) found using chromoendoscopy carries a similar risk of high grade dysplasia (HGD) or colorectal cancer (CRC) compared with LGD detected using white-light endoscopy (WLE). The aim of this study was to compare the risk of advanced neoplasia, a combined endpoint of HGD and CRC, during follow-up after detection of lesions containing LGD identified with either chromoendoscopy or WLE...
February 2017: Endoscopy
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