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Clinical trials in ibd

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https://www.readbyqxmd.com/read/28644565/long-term-risk-of-infection-in-patients-with-crohn-s-disease-on-anti-tnf-treatment-a-prospective-single-center-cohort-study-in-china
#1
Yue Li, Hui Jun Shu, Hong Lu, Hong Yang, Ji Li, Bei Tan, Jiaming Qian
BACKGROUND: Anti-TNF agents have demonstrated to greatly improve management strategies for inflammatory bowel disease (IBD). Clinical trials and registry studies in Western countries have shown that infections and malignancy are the most concerned complications of anti-TNF treatment. However, data derived from clinical practice in China are limited. The aim of this study is to explore the long-term infection risk of infliximab (IFX) in treating patients with Crohn's disease (CD) from a tertiary IBD center in China...
June 23, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28644183/more-dose-dependent-side-effects-with-mercaptopurine-over-azathioprine-in-ibd-treatment-due-to-relatively-higher-dosing
#2
Mark M T J Broekman, Marieke J H Coenen, Corine J van Marrewijk, Geert J A Wanten, Dennis R Wong, Andre L M Verbeek, Olaf H Klungel, Piet M Hooymans, Henk-Jan Guchelaar, Hans Scheffer, Luc J J Derijks, Dirk J de Jong
BACKGROUND: There are substantial global differences in the preference for mercaptopurine (MP) or its prodrug azathioprine (AZA) as first-choice thiopurine to treat inflammatory bowel diseases. Studies comparing both agents are scarce. Our aim was to compare AZA and MP in thiopurine-naive patients with inflammatory bowel disease for the frequency of side effects and efficacy. METHODS: Post hoc analysis of the "Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory bowel disease Clinics" (TOPIC) trial, in which thiopurine-naive patients with inflammatory bowel disease with an indication for a thiopurine were randomized for a genotype-based dose versus standard of care...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28643285/skin-manifestations-of-inflammatory-bowel-disease
#3
REVIEW
Thomas Greuter, Alexander Navarini, Stephan R Vavricka
Inflammatory bowel disease (IBD) with its two main subtypes Crohn's disease and ulcerative colitis is not restricted to the gastrointestinal tract. Indeed, so-called extraintestinal manifestations (EIMs) are frequent and considerably affect morbidity and mortality. The prevalence of EIMs ranges from 6 to 47%. In up to one quarter of the patients, EIMs can present even before an IBD diagnosis is established. The pathophysiology of EIMs remains elusive, although data from clinical trials demonstrating anti-tumor necrosis factor (TNF) efficacy suggest a common pathogenic link between intestinal and extraintestinal disease activity...
June 23, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28636960/mechanisms-and-therapeutic-relevance-of-neuro-immune-communication
#4
REVIEW
Sangeeta S Chavan, Valentin A Pavlov, Kevin J Tracey
Active research at the frontiers of immunology and neuroscience has identified multiple points of interaction and communication between the immune system and the nervous system. Immune cell activation stimulates neuronal circuits that regulate innate and adaptive immunity. Molecular mechanistic insights into the inflammatory reflex and other neuro-immune interactions have greatly advanced our understanding of immunity and identified new therapeutic possibilities in inflammatory and autoimmune diseases. Recent successful clinical trials using bioelectronic devices that modulate the inflammatory reflex to significantly ameliorate rheumatoid arthritis and inflammatory bowel disease provide a path for using electrons as a therapeutic modality for targeting molecular mechanisms of immunity...
June 20, 2017: Immunity
https://www.readbyqxmd.com/read/28620682/infectious-bursal-disease-outbreak-investigation-molecular-characterization-and-vaccine-immunogenicity-trial-in-ethiopia
#5
Aregitu Mekuriaw, Molalegne Bitew, Esyas Gelaye, Bedaso Mamo, Gelagay Ayelet
The study was conducted with the objective of isolation and molecular characterization of infectious bursal disease virus (IBDV) circulating in Ethiopia and to assess the immunogenicity of different commercially available live attenuated IBD vaccines and finally to select the appropriate vaccine strain for the existing IBDV. Outbreak samples collected from different poultry farms with IBD infection between 2013 and 2015 were used for the virus isolation and molecular characterization. IBD vaccine immunogenicity test was conducted using four different commercially available live attenuated IBD vaccine strains: namely D78, B2K, LC75, and EXTREM...
June 15, 2017: Tropical Animal Health and Production
https://www.readbyqxmd.com/read/28618865/streptococcus-thermophilus-ncimb-41856-ameliorates-signs-of-colitis-in-an-animal-model-of-inflammatory-bowel-disease
#6
J R Bailey, V Vince, N A Williams, T A Cogan
Treatment of inflammatory bowel disease (IBD) is mainly based on suppression of symptoms, often with numerous side effects. Trials of probiotics in IBD have frequently produced disappointing results. The majority of probiotics are unusual, since they do not require iron for growth, unlike many bacteria resident in the intestine. The IBD intestine is iron-rich due to bleeding and use of oral iron supplements; conventional probiotics would be rapidly outcompeted. We have evaluated an iron-responsive Streptococcus thermophilus strain for its potential to reduce signs of colitis...
June 16, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28617319/pde4-inhibition-and-inflammatory-bowel-disease-a-novel-therapeutic-avenue
#7
REVIEW
Marco Spadaccini, Silvia D'Alessio, Laurent Peyrin-Biroulet, Silvio Danese
BACKGROUND: In the last few decades, a better knowledge of the inflammatory pathways involved in the pathogenesis of Inflammatory Bowel Disease (IBD) has promoted biological therapy as an important tool to treat IBD patients. However, in spite of a wider spectrum of biological drugs, a significant proportion of patients is unaffected by or lose their response to these compounds, along with increased risks of infections and malignancies. For these reasons there is an urgent need to look for new pharmacological targets...
June 15, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28616406/new-endoscopic-approach-of-anti-fibrotic-therapy-for-inflammatory-bowel-disease
#8
REVIEW
Kenji Suzuki, Hiroyuki Yoneyama
Fibrosis continues to be paid a great attention in not only basic research but also clinical practice, especially for the development of novel therapeutics in various fibrotic diseases. However, there remain several obstacles to translation in developing anti-fibrosis therapy. The present review documents our translational practice from target discovery to first-in-patient studies in the development of anti-fibrosis therapy for inflammatory bowel disease (IBD). First topic is a target selection. We have focused on the target that has an ability to regulate multifactorial cascades of fibrosis...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28612637/treatment-options-for-children-and-adolescents-with-inflammatory-bowel-disease-is-granulomonocytapheresis-an-effective-alternative-to-drug-therapy
#9
Tomotaka Tanaka, Takayuki Yamamoto, Koji Sawada, Rodolfo Sacco
Patients with inflammatory bowel diseases (IBD) require life-long medications, which even if effective have the potential to cause adverse effects as additional morbidity factors. In pediatric patients, drug therapy has more serious limitations, including impaired physical and mental development. A non-drug therapeutic option is believed to be depletion of elevated and activated granulocytes and monocytes known to release inflammatory cytokines, like the CD14+CD16+ monocyte phenotype known to release tumor necrosis factor-α...
June 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28601837/development-of-a-core-outcome-set-for-clinical-trials-in-inflammatory-bowel-disease-study-protocol-for-a-systematic-review-of-the-literature-and-identification-of-a-core-outcome-set-using-a-delphi-survey
#10
Christopher Ma, Remo Panaccione, Richard N Fedorak, Claire E Parker, Reena Khanna, Barrett G Levesque, William J Sandborn, Brian G Feagan, Vipul Jairath
INTRODUCTION: Crohn's disease (CD) and ulcerative colitis (UC), the main forms of inflammatory bowel disease (IBD), are chronic, progressive and disabling disorders of the gastrointestinal tract. Although data from randomised controlled trials (RCTs) provide the foundation of evidence that validates medical therapy for IBD, considerable heterogeneity exists in the measured outcomes used in these studies. Furthermore, in recent years, there has been a paradigm shift in IBD treatment targets, moving from symptom-based scoring to improvement or normalisation of objective measures of inflammation such as endoscopic appearance, inflammatory biomarkers and histological and radiographic end points...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28555281/disease-activity-and-mucosal-healing-in-inflammatory-bowel-disease-a-new-role-for-histopathology
#11
Rish K Pai, Karel Geboes
Histologic evaluation of disease activity in the setting of inflammatory bowel disease is gaining interest within the gastroenterology community. Recent data suggests that histologic measurements of inflammation in ulcerative colitis are more sensitive at detecting disease activity and perform better than endoscopic measurements in predicting clinical outcomes. Histologic measurements are also increasingly used in ulcerative colitis clinical trials to assess response to new therapies. Histologic measurements of disease activity are less well studied in Crohn's disease, but are gaining attention...
May 30, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28555037/evidence-of-the-anti-inflammatory-effects-of-probiotics-and-synbiotics-in-intestinal-chronic-diseases
#12
REVIEW
Julio Plaza-Díaz, Francisco Javier Ruiz-Ojeda, Laura Maria Vilchez-Padial, Angel Gil
Probiotics and synbiotics are used to treat chronic diseases, principally due to their role in immune system modulation and the anti-inflammatory response. The present study reviewed the effects of probiotics and synbiotics on intestinal chronic diseases in in vitro, animal, and human studies, particularly in randomized clinical trials. The selected probiotics exhibit in vitro anti-inflammatory properties. Probiotic strains and cell-free supernatants reduced the expression of pro-inflammatory cytokines via action that is principally mediated by toll-like receptors...
May 28, 2017: Nutrients
https://www.readbyqxmd.com/read/28554892/extrapolation-in-the-development-of-paediatric-medicines-examples-from-approvals-for-biological-treatments-for-paediatric-chronic-immune-mediated-inflammatory-diseases
#13
REVIEW
Anna M Stefanska, Dorota Distlerová, Joachim Musaus, Thorsten M Olski, Kristina Dunder, Tomas Salmonson, Dirk Mentzer, Jan Müller-Berghaus, Robert Hemmings, Richard Veselý
The European Union (EU) Paediatric Regulation requires that all new medicinal products applying for a marketing authorisation (MA) in the EU provide a paediatric investigation plan (PIP) covering a clinical and non-clinical trial programme relating to the use in the paediatric population, unless a waiver applies. Conducting trials in children is challenging on many levels, including ethical and practical issues, which may affect the availability of the clinical evidence. In scientifically justified cases, extrapolation of data from other populations can be an option to gather evidence supporting the benefit-risk assessment of the medicinal product for paediatric use...
May 29, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28546791/fecal-microbiota-transplantation-from-clostridium-difficile-to-inflammatory-bowel-disease
#14
Robert J Gianotti, Alan C Moss
Fecal microbiota transplantation (FMT) has evolved from a case report in the medical literature to the basis of major innovations in the treatment of Clostridium difficile infection (CDI) and, potentially, inflammatory bowel disease (IBD). In the clinical setting, FMT was noted to significantly lower the risk of recurrent CDI, likely by increasing microbial diversity and altering the metabolic environment in the intestinal tract of recipients. In parallel, advances in the ability to quantify and characterize microbial communities in fecal samples led to the association of IBD with a state of intestinal dysbiosis...
April 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28542712/histologic-scoring-indices-for-evaluation-of-disease-activity-in-ulcerative-colitis
#15
REVIEW
Mahmoud H Mosli, Claire E Parker, Sigrid A Nelson, Kenneth A Baker, John K MacDonald, G Y Zou, Brian G Feagan, Reena Khanna, Barrett G Levesque, Vipul Jairath
BACKGROUND: Disease activity can be determined using clinical, endoscopic or histologic criteria in patients with ulcerative colitis (UC). Persistent disease activity is associated with poor outcomes. Histologic disease activity has been shown to be associated with relapse, colectomy and colorectal cancer. The ability to objectively evaluate microscopic disease activity using histology is important for both clinical practice and clinical trials. However, the operating properties of the currently available histologic indices remain unclear...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28540291/evaluation-of-two-dry-commercial-therapeutic-diets-for-the-management-of-feline-chronic-gastroenteropathy
#16
Sally C Perea, Stanley L Marks, Leighann Daristotle, Patricia E Koochaki, Richard Haydock
Management of feline chronic gastroenteropathies has included intervention with both veterinary therapeutic formulas designed to manage non-specific gastrointestinal disorders and those designed with limited novel or hydrolyzed ingredients for management of food-responsive enteropathies and steroid-responsive enteropathies (inflammatory bowel disease). There have been few studies evaluating the use of dietary intervention for the management of feline chronic gastroenteropathy. This prospective, multi-center study evaluated the use of two commercially available feline veterinary therapeutic dry diets designed to manage non-specific gastrointestinal disorders in 28 cats with a history of chronic vomiting and/or diarrhea...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28536562/use-of-wild-type-or-recombinant-lactic-acid-bacteria-as-an-alternative-treatment-for-gastrointestinal-inflammatory-diseases-a-focus-on-inflammatory-bowel-diseases-and-mucositis
#17
REVIEW
Rodrigo D De Oliveira Carvalho, Fillipe L R do Carmo, Alberto de Oliveira Junior, Philippe Langella, Jean-Marc Chatel, Luis G Bermúdez-Humarán, Vasco Azevedo, Marcela S de Azevedo
The human gastrointestinal tract (GIT) is highly colonized by bacterial communities, which live in a symbiotic relationship with the host in normal conditions. It has been shown that a dysfunctional interaction between the intestinal microbiota and the host immune system, known as dysbiosis, is a very important factor responsible for the development of different inflammatory conditions of the GIT, such as the idiopathic inflammatory bowel diseases (IBD), a complex and multifactorial disorder of the GIT. Dysbiosis has also been implicated in the pathogenesis of other GIT inflammatory diseases such as mucositis usually caused as an adverse effect of chemotherapy...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28533919/combination-therapy-for-inflammatory-bowel-disease
#18
REVIEW
Keith S Sultan, Joshua C Berkowitz, Sundas Khan
Biologic therapies such as infliximab and adalimumab have become mainstays of treatment for inflammatory bowel disease. Early studies suggested that combination therapy (CT) with infliximab and an immunomodulator drug such as azathioprine may help optimize biologic pharmacokinetics, minimize immunogenicity, and improve outcomes. The landmark SONIC trial in Crohn's disease and the UC SUCCESS trial in ulcerative colitis demonstrated CT with infliximab and azathioprine to be superior to monotherapy with either agent alone at inducing clinical remission in treatment naïve patients with moderate to severe disease...
May 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28531908/methods-and-reporting-studies-assessing-fecal-microbiota-transplantation-a-systematic-review
#19
Aïda Bafeta, Amelie Yavchitz, Carolina Riveros, Rui Batista, Philippe Ravaud
Background: Fecal microbiota transplantation (FMT) could be a novel treatment option for several chronic diseases associated with altered gut microbiota. Purpose: To examine the conduct and reporting of studies assessing FMT. Data Sources: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and Web of Science from inception to 31 January 2017. Study Selection: Two reviewers independently examined titles and abstracts to identify all English-language reports of human clinical studies assessing the safety or efficacy of FMT...
May 23, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28529069/cholinergic-modulation-of-the-immune-system-presents-new-approaches-for-treating-inflammation
#20
REVIEW
Donald B Hoover
The nervous system and immune system have broad and overlapping distributions in the body, and interactions of these ubiquitous systems are central to the field of neuroimmunology. Over the past two decades, there has been explosive growth in our understanding of neuroanatomical, cellular, and molecular mechanisms that mediate central modulation of immune functions through the autonomic nervous system. A major catalyst for growth in this field was the discovery that vagal nerve stimulation (VNS) caused a prominent attenuation of the systemic inflammatory response evoked by endotoxin in experimental animals...
May 18, 2017: Pharmacology & Therapeutics
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