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https://www.readbyqxmd.com/read/29775790/clinical-course-of-nodular-regenerative-hyperplasia-in-thiopurine-treated-inflammatory-bowel-disease-patients
#1
Melek Simsek, Berrie Meijer, Dewkoemar Ramsoekh, Gerd Bouma, Egbert-Jan van der Wouden, Bert den Hartog, Annemarie C de Vries, Frank Hoentjen, Gerard Dijkstra, Sybrand Y de Boer, Jeroen M Jansen, Andrea E van der Meulen, Ruud Beukers, Menno A Brink, Toos Steinhauser, Bas Oldenburg, Lennard P Gilissen, Ton H Naber, Marc A Verhagen, Nanne K H de Boer, Chris J J Mulder
No abstract text is available yet for this article.
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29766398/hepatosplenic-t-cell-lymphoma-a-unifying-entity-in-a-patient-with-hemolytic-anemia-massive-splenomegaly-and-liver-dysfunction
#2
Marianna Mavilia, Agnes McAuliffe, Safina Hafeez, Haleh Vaziri
Hepatosplenic T cell lymphoma (HSTCL) is a rare subtype of peripheral non-Hodgkin lymphoma, of which 20% of cases are associated with chronic immunosuppression. It often occurs in patients with inflammatory bowel disease treated with immunomodulating medications such a thiopurines or TNF-alpha inhibitors. Cytopenias are commonly seen but autoimmune hemolytic anemia (AIHA) is rare. Here we present a young male with longstanding ulcerative colitis on chronic azathioprine, exhibiting several rare features of HSTCL...
May 15, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29760546/thiopurines-are-negatively-associated-with-anthropometric-parameters-in-pediatric-crohn-s-disease
#3
Neera Gupta, Robert H Lustig, Cewin Chao, Eric Vittinghoff, Howard Andrews, Cheng-Shiun Leu
AIM: To determine the distribution of anthropometric parameter (AP)- z -scores and characterize associations between medications/serum biomarkers and AP- z -scores in pediatric Crohn's disease (CD). METHODS: CD patients [< chronological age (CA) 21 years] were enrolled in a cross-sectional study. Descriptive statistics were generated for participants' demographic characteristics and key variables of interest. Paired t -tests were used to compare AP- z -scores calculated based on CA (CA z -scores) and bone age (BA) (BA z -scores) for interpretation of AP's...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29754190/allergic-and-immunologic-perspectives-of-inflammatory-bowel-disease
#4
REVIEW
Kofi Clarke, Jayakrishna Chintanaboina
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory condition primarily involving the gastrointestinal tract. It includes Crohn's disease (CD), ulcerative colitis (UC), and a less common phenotype-indeterminate colitis. It is thought to result from a complex interplay of environmental, microbial, and host factors including genetic factors, although the exact mechanism is not known. Dietary factors have been shown to play a role in the pathogenesis of IBD and can potentially alter the intestinal microbiota as well as disrupt the immune function in the gut...
May 12, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29752633/clinical-pharmacokinetic-and-pharmacodynamic-considerations-in-the-treatment-of-ulcerative-colitis
#5
REVIEW
Sophie E Berends, Anne S Strik, Mark Löwenberg, Geert R D'Haens, Ron A A Mathôt
Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) of unknown etiology, probably caused by a combination of genetic and environmental factors. The treatment of patients with active UC depends on the severity, localization and history of IBD medication. According to the classic step-up approach, treatment with 5-aminosalicylic acid compounds is the first step in the treatment of mild to moderately active UC. Corticosteroids, such as prednisolone are used in UC patients with moderate to severe disease activity, but only for remission induction therapy because of side effects associated with long-term use...
May 12, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29745777/current-experimental-and-future-treatments-in-inflammatory-bowel-disease-a-clinical-review
#6
Christian L Hvas, Mia Bendix, Anders Dige, Jens F Dahlerup, Jørgen Agnholt
Inflammatory bowel diseases (IBDs) may result from dysregulated mucosal immune responses directed toward the resident intestinal microbiota. This review describes the hallmark immunobiology of Crohn's disease and ulcerative colitis as well as therapeutic targets and mechanisms of action for current, experimental, and future treatments in IBD. Conventional therapies include 5-aminosalicylic acid, glucocorticosteroids, thiopurines, and methotrexate. Since 1997, monoclonal antibodies have gained widespread use...
May 10, 2018: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/29743834/characteristics-and-management-of-patients-with-inflammatory-bowel-disease-between-a-secondary-and-tertiary-hospitals-a-propensity-score-analysis
#7
Ki Hwan Song, Eun Soo Kim, Yoo Jin Lee, Byung Ik Jang, Kyeong Ok Kim, Sang Gyu Kwak, Hyun Seok Lee
Background/Aims: This study aimed to compare the clinical characteristics and management patterns of inflammatory bowel disease (IBD) patients in a secondary hospital (SH) with those in tertiary referral centers (TRC). Methods: Data from IBD patients in SH and 2 TRCs were retrospectively reviewed. The cumulative thiopurine use rate was compared between hospitals after controlling for different baseline characteristics using propensity score matching. Results: Among the total of 447 patients with IBD, 178 Crohn's disease (CD) and 269 ulcerative colitis (UC) patients were included...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29742281/analyzing-the-clinical-actionability-of-germline-pharmacogenomic-findings-in-oncology
#8
Rebecca Wellmann, Brittany A Borden, Keith Danahey, Rita Nanda, Blase N Polite, Walter M Stadler, Mark J Ratain, Peter H O'Donnell
BACKGROUND: Germline and tumor pharmacogenomics impact drug responses, but germline markers less commonly guide oncology prescribing. The authors hypothesized that a critical number of clinically actionable germline pharmacogenomic associations exist, representing clinical implementation opportunities. METHODS: In total, 125 oncology drugs were analyzed for positive germline pharmacogenomic associations in journals with impact factors ≥5. Studies were assessed for design and genotyping quality, clinically relevant outcomes, statistical rigor, and evidence of drug-gene effects...
May 9, 2018: Cancer
https://www.readbyqxmd.com/read/29723116/high-inter-individual-variability-of-serum-xanthine-oxidoreductase-activity-in-ibd-patients
#9
Berrie Meijer, Margien L Seinen, Tessa Hosman, Ronald K Linskens, Jan-Kees Kneppelhout, Godefridus J Peters, Chris Jj Mulder, Adriaan A van Bodegraven, Nanne Kh de Boer
OBJECTIVES: Thiopurines play an essential role in the management of inflammatory bowel diseases (IBD, i.e. Crohn's disease and ulcerative colitis). Over the past decade, several strategies to optimize treatment with thiopurines have been evaluated, including co-administration of allopurinol, a xanthine-oxidoreductase (XO) inhibitor, to low-dose thiopurine therapy. We aimed to assess the inter-individual variability of XO-activity between IBD-patients. METHODS: We assessed XO activity in serum of IBD-patients of two medical centers in The Netherlands using the Amplex® Red Xanthine/Xanthine Oxidase Assay Kit, which measures the superoxide formation in a coupled reaction to the red-fluorescent oxidation product, resofurine...
May 3, 2018: Nucleosides, Nucleotides & Nucleic Acids
https://www.readbyqxmd.com/read/29720911/association-between-thiopurine-s-methyltransferase-tpmt-genetic-variants-and-infection-in-pediatric-heart-transplant-recipients-treated-with-azathioprine-a-multi-institutional-analysis
#10
Dionna J Green, Son Q Duong, Gilbert J Burckart, Tristan Sissung, Douglas K Price, William D Figg, Maria M Brooks, Richard Chinnock, Charles Canter, Linda Addonizio, Daniel Bernstein, David C Naftel, Adriana Zeevi, James K Kirklin, Steven A Webber, Brian Feingold
OBJECTIVES: Bone marrow suppression is a common adverse effect of the immunosuppressive drug azathioprine. Polymorphisms in the gene encoding thiopurine S -methyltransferase (TPMT) can alter the metabolism of azathioprine, resulting in marrow toxicity and life-threatening infection. In a multicenter cohort of pediatric heart transplant (HT) recipients, we determined the frequency of TPMT genetic variation and assessed whether azathioprine-treated recipients with TPMT variants were at increased risk of infection...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29707074/hepatobiliary-manifestations-and-complications-in-inflammatory-bowel-disease-a-review
#11
REVIEW
Fotios S Fousekis, Vasileios I Theopistos, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou
Liver and biliary track diseases are common extraintestinal manifestations of inflammatory bowel disease (IBD), reported both in Crohn's disease and ulcerative colitis, and may occur at any time during the natural course of the disease. Their etiology is mainly related to pathophysiological changes induced by IBD, and secondary, due to drugs used in IBD. Fatty liver is considered as the most frequent hepatobiliary manifestation in IBD, while primary sclerosing cholangitis (PSC) is the most correlated hepatobiliary disorder and is more prevalent in patients with ulcerative colitis...
April 2018: Gastroenterology Research
https://www.readbyqxmd.com/read/29704867/azathioprine-induced-alopecia-and-leukopenia-associated-with-nudt15-polymorphisms
#12
H Nomura, Y Kurihara, M Saito, A Fukushima, Y Shintani, R Shiiyama, S Toshima, A Kamata, J Yamagami, T Funakoshi, K Kameyama, M Amagai, A Kubo, N Umegaki-Arao
Azathioprine (AZA), a widely used immunosuppressant, can induce cytotoxic effects including myelosuppression and alopecia.1 Recent studies revealed that polymorphisms of NUDT15 are associated with thiopurine-induced alopecia and leukopenia.2-5 The frequency of NUDT15 polymorphisms in East and South Asians is high (22.6% and 13.6%, respectively).5 Thus, adverse event management during AZA treatment is essential for Asian populations with these polymorphisms. This article is protected by copyright. All rights reserved...
April 28, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29688409/methotrexate-for-the-treatment-of-pediatric-crohn-s-disease-a-systematic-review-and-meta-analysis
#13
Ruben J Colman, Rachel C Lawton, Marla C Dubinsky, David T Rubin
Background: Methotrexate (MTX) is an immunomodulator used for the treatment of pediatric inflammatory bowel disease (IBD). There are currently no RCTs that assess the treatment efficacy of methotrexate within the pediatric IBD patient population. This systematic review and meta-analysis assesses the efficacy of MTX therapy among the existing pediatric literature. Methods: A systematic literature search was performed using MEDLINE and the Cochrane library from inception until March 2016...
April 23, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29688401/anal-fistulas-in-severe-perineal-crohn-s-disease-mri-assessment-in-the-determination-of-long-term-healing-rates
#14
Charlène Brochard, Amandine Landemaine, Alexandre Merlini L'Heritier, Marie Provost Dewitte, Belinda Tchoundjeu, Tanguy Rohou, Aurélien Garros, Guillaume Bouguen, Laurent Siproudhis
Background & Aims: The European Crohn's and Colitis Organization recommends magnetic resonance imaging (MRI) of anal fistulas to decide on the drug/surgery strategy. No evidence is available on the long-term impact of MRI features on fistula healing. The aim of this study was to evaluate the benefit of combined drug/surgery strategies for the treatment of perianal Crohn's fistulas based on MRI factors at referral. Methods: The clinical event (anal abscess, new fistula tract, cellulitis), therapeutic intervention (introduction/optimization of immunosuppressant/biologics, anal surgery, intestinal resection, stoma), and MRI data were prospectively recorded for patients with Crohn's disease (CD) and anal fistulas...
April 20, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29683944/slco1b1-polymorphisms-are-associated-with-drug-intolerance-in-childhood-leukemia-maintenance-therapy
#15
İrem Eldem, Duygu Yavuz, Özge Cumaoğullari, Talia İleri, Elif Ünal İnce, Mehmet Ertem, Beyza Doğanay Erdoğan, Recep Bindak, Hilal Özdağ, N Lale Şatiroğlu-Tufan, L Zümrüt Uysal
BACKGROUND: Therapy discontinuations and toxicities occur because of significant interindividual variations in 6-mercaptopurine (6-MP) and methotrexate (MTX) response during maintenance therapy of childhood acute lymphoblastic leukemia (ALL). 6-MP/MTX intolerance in some of the patients cannot be explained by thiopurine S-methyl transferase (TPMT) gene variants. In this study, we aimed to investigate candidate pharmacogenetic determinants of 6-MP and MTX intolerance in Turkish ALL children...
April 20, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29669052/cancer-associated-chemotherapy-induces-less-ibd-exacerbations-and-a-reduction-of-ibd-medication-afterwards
#16
Özgür M Koc, Roel J W van Kampen, Adriaan A van Bodegraven
Background: The prevalence of inflammatory bowel disease (IBD) is increasing and, consequently, more IBD patients will develop cancer with need for cancer-associated chemotherapy. Physicians are therefore confronted with whether they should continue, stop, or restart IBD medication in relation with chemotherapy. The current strategy in our hospital is to discontinue immunomodulating IBD medication, comprising corticosteroids, anti-tumour necrosis factor (anti-TNF), and other immunosuppressives, before starting chemotherapy...
April 13, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29668998/methotrexate-and-thioguanine-rescue-therapy-for-conventional-thiopurine-failing-ulcerative-colitis-patients-a-multi-center-database-study-on-tolerability-and-effectiveness
#17
Berrie Meijer, Chris J J Mulder, Gerd Bouma, Cyriel Y Ponsioen, C Janneke van der Woude, Andrea E van der Meulen, Dion S J Wintjens, Gerard Dijkstra, Frank Hoentjen, Bas Oldenburg, Adriaan A van Bodegraven, Nanne K H de Boer
Background: Patients with active ulcerative colitis (UC) failing conventional therapies are in need of rescue strategies. Due to the fact that accepted step-up therapy with biologicals is expensive and sometimes unavailable, alternative therapies are warranted. Methotrexate (MTX) and thioguanine (TG) have both been suggested as alternative maintenance strategies in conventional thiopurine failing UC patients. In this multicenter database study, we compared safety and effectiveness (drug-survival) of MTX and TG in UC patients...
April 13, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29659353/-genetic-polymorphisms-of-thiopurine-methyltransferase-and-incidence-of-adverse-events-in-patients-with-medical-indication-of-azathioprine
#18
Manuel A Buhl, Graciela Gómez, María Victoria Collado, Elisabet M Oddo, Marina Khoury, Pablo J Azurmendi, Judith Sarano
Azathioprine is a thiopurine which has a narrow therapeutic index and marked hematological and hepatic toxicity. Thiopurine s-methyltransferase is an enzyme involved in the metabolism of thiopurines. Mutations in the gene that encodes the enzyme may augment the risk of adverse events. For that reason, pharmacogenetic determinations prior to the initiation of therapy can provide useful information for the future therapeutic strategy. Nevertheless, its utility in the local environment is not completely established...
2018: Medicina
https://www.readbyqxmd.com/read/29658768/idiopathic-portal-hypertension-with-regard-to-thiopurine-treatment
#19
Salvador Machlab, Mireia Miquel, Mercedes Vergara
Idiopathic portal hypertension (IPH) is an infrequent adverse reaction to the use of thiopurines that tends to be overlooked. Herein, we present a patient with ileocolic Crohn's disease treated with azathioprine who presented ascites, esophageal varices and splenomegaly without any signs of liver cirrhosis. A portal hemodynamics study revealed a normal portosystemic gradient compatible with presinusoidal portal hypertension. Finally, IPH was diagnosed after a liver biopsy. IPH secondary to thiopurines is due to a 6-thioguanine nucleotide (6-TGN)-dependent reaction and occurs predominantly between three months and three years after the start of treatment...
April 16, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29655835/risk-of-serious-and-opportunistic-infections-associated-with-treatment-of-inflammatory-bowel-diseases
#20
Julien Kirchgesner, Magali Lemaitre, Fabrice Carrat, Mahmoud Zureik, Md Franck Carbonnel, Rosemary Dray-Spira
BACKGROUND & AIMS: The risk of infection associated with tumor necrosis factor antagonists (anti-TNF) and thiopurines (combination therapy) is uncertain. We assessed the risk of serious and opportunistic infections in patients with IBD treated with thiopurine monotherapy, anti-TNF monotherapy, or combination therapy in a large cohort of patients in France. METHODS: We performed a nationwide population-based study of patients (18 years or older) with a diagnosis of IBD in the French national health insurance database; we collected data from January 1, 2009 until December 31, 2014...
April 12, 2018: Gastroenterology
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