Biological Therapy of Crohn’s Disease: Natalizumab, Vedolizumab, and Anti-MadCAM

Abstract Purpose Despite primary conservative therapy for Crohn’s disease, a considerable proportion of patients ultimately needs to undergo surgery. Presumably, due to the increased use of biologics, the number of surgeries might have decreased. This study aimed to delineate current case numbers and trends in surgery in the era of biological therapy for Crohn’s disease. Methods Nationwide standardized hospital discharge data (diagnosis-related groups statistics) from 2010 to 2017 were used. All patients who were admitted as inpatient Crohn’s disease cases in Germany were included. Time-related development of admission numbers, rate of surgery, morbidity, and mortality of inpatient Crohn’s disease cases were analyzed. Results A total number of 201,165 Crohn’s disease cases were included. Within the analyzed time period, the total number of hospital admissions increased by 10.6% (n = 23,301 vs. 26,069). While gender and age distribution remained comparable, patients with comorbidities such as stenosis formation (2010: 10.1%, 2017: 13.4%) or malnutrition (2010: 0.8%, 2017: 3.2%) were increasingly admitted. The total number of all analyzed operations for Crohn’s disease increased by 7.5% (2010: n = 1567; 2017: n = 1694). On average, 6.8 ± 0.2% of all inpatient patients received ileocolonic resections. Procedures have increasingly been performed minimally invasive (2010: n = 353; 2017: n = 687). The number of postoperative complications remained low. Conclusion Despite the development of novel immunotherapeutics, the number of patients requiring surgery for Crohn’s disease remains stable. Interestingly, patients have been increasingly hospitalized with stenosis and malnutrition. The trend towards more minimally invasive operations has not relevantly changed the rate of overall complications.

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Predicting the Durability of Biological Therapy in Pediatric Crohn’s Disease: Do the Immunomodulators Matter?

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2015.06.007 ◽

2015 ◽

Vol 13 (10) ◽

pp. 1757-1759

Author(s):

Marina Aloi ◽

Salvatore Cucchiara

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Biological Therapy

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P025 MAINTENANCE Q8 THERAPY OF CROHN'S DISEASE WITH INFLIXIMAB IS ASSOCIATED WITH ENDOSCOPIC MUCOSAL HEALING IN THE LONG-TERM

Journal of Crohn s and Colitis Supplements ◽

10.1016/s1873-9954(08)70036-3 ◽

2008 ◽

Vol 2 (1) ◽

pp. 13

Author(s):

F. Schnitzler ◽

H. Fidder ◽

M. Ferrante ◽

M. Noman ◽

G. Van Assche ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Mucosal Healing ◽

Therapy Of Crohn's Disease

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PATIENTS WITH INFLAMMATORY BOWEL DISEASE PERSPECTIVE ON COVID-19 AND HEALTH CARE SERVICE DURING THE PANDEMIC

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.120 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S50-S51

Author(s):

Randi Opheim ◽

Kristian Moum ◽

Bjørn Moum

Keyword(s):

Ulcerative Colitis ◽

Health Care ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Medical Treatment ◽

Biological Therapy ◽

Care Service ◽

Health Care Service ◽

Inflammatory Bowel

Abstract Background Patients with inflammatory bowel diseases (IBD) have experienced changes to the routine management of their conditions during the coronavirus disease (COVID-19) pandemic. The disease as well IBD treatment frequently require immunosuppressant medications, which could increase their risk of infection. The aim of this study was to determine patients’ experience of the health care service, including the restrictions of hospitals visits made in Norway from Mars 12th 2020. Method From June 18 to September 18 2020, all patients at the IBD outpatient clinic at Oslo University Hospital in Norway on biological therapy or other immunosuppressant’s were included. A questionnaire including patients concerns regarding their disease, medical therapy and COVID-19, as well as their health care service needs in follow-up during the COVID-19 pandemic. Results Altogether 506 IBD patients answered a paper-based questionnaire. The mean age was 40.78 (SD 14.71), 289/506 (57%) men, ulcerative colitis 199/506 (39%), Crohn’s disease 307/506 (61%). Sixty-three patients (12.5%) used biological therapy in combination with azathioprine or steroids. Ninety-one (18.2%) were in obligated quarantine with negative test. Five patients (4.9%) tested positive to SARS- CoV-2 of the 98 patients tested, (1.0% of the total sample). One third of the IBD patients perceived they had increased risk for being infected by SARS- CoV-2 because of the immunosuppressive drugs they used. Nonetheless, 496/506 (98.6%) of the patients adhered to continuing their medication. One-hundred and sixty-one (32.3%) voluntarily isolated, and 21/506 (4.2%) was in sick leave being afraid of being infected. Furthermore, 20/506 (4.0%) cancelled their consultation because they were afraid of being infected from SARS- CoV-2 at the hospital. The hospital changed physical consultation to telephone consultation for 75/506 (15.0%) of the patients. Thirty-eight patients (7.6%) reported that they were afraid of going to the hospital because of restrictions due to the COVID-19 pandemic, and 18/506 (3.6%) did not feel safe when at hospital. Approximately half of the IBD patients (219/506) were satisfied with the information provided by physician about medical treatment for IBD and Covid-19 while 398/506 (77.3%) were satisfied with the information from health-care providers about restrictions due to COVID-19. There were no statistical differences between Crohn’s disease and ulcerative colitis. Conclusion IBD patients on biological treatment and immunosuppressives took precautions because of fear of being infected with SARS- CoV-2. At the same time, they adhere to medical treatment regimens and follow-up at the hospital. Most patients were satisfied with the information they received from physicians and other health-care workers. One percent tested positive to SARS-CoV-2.

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