W1262 Prospective, Open Pilot Study for Evaluating the Clinical Efficacy and Mucosal Healing Rate of Infliximab in Steroid-Dependent Ulcerative Colitis

Abstract Background Granulocyte and monocyte adsorptive apheresis (GMA) has been used for therapy of steroid-dependent/refractory ulcerative colitis (UC). The aim of this study was to investigate the effectiveness of GMA in UC patients not receiving steroids. Methods We conducted a single-arm, open-label, and multicenter prospective clinical trial. UC patients who had insufficient responses to 5-aminosalicylic acid received GMA twice a week for 5 weeks. Results The response rate of all patients was 58.2% (39/67). Of the 39 patients who achieved a response, 74.4% achieved endoscopically confirmed mucosal healing. Conclusions GMA shows effectiveness in inducing remission in UC patients not receiving steroid.

Download Full-text

Sa1886 Bilberry Ingestion Improves Disease Activity in Mild to Moderate Ulcerative Colitis - an Open Pilot Study

Gastroenterology ◽

10.1016/s0016-5085(12)61321-3 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-350-SS-350 ◽

Cited By ~ 2

Author(s):

Luc Biedermann ◽

Jessica Mwinyi ◽

Michael Scharl ◽

Pascal Frei ◽

Jonas Zeitz ◽

...

Keyword(s):

Ulcerative Colitis ◽

Pilot Study ◽

Disease Activity ◽

Open Pilot

Download Full-text

Beyond white light: optical enhancement in conjunction with magnification colonoscopy for the assessment of mucosal healing in ulcerative colitis

Endoscopy ◽

10.1055/s-0042-124363 ◽

2017 ◽

Vol 49 (06) ◽

pp. 553-559 ◽

Cited By ~ 16

Author(s):

Marietta Iacucci ◽

Ralf Kiesslich ◽

Xianyong Gui ◽

Remo Panaccione ◽

Joan Heatherington ◽

...

Keyword(s):

Ulcerative Colitis ◽

Pilot Study ◽

Diagnostic Accuracy ◽

Mucosal Healing ◽

Mucosal Inflammation ◽

Vascular Changes ◽

Virtual Chromoendoscopy ◽

Acute Changes ◽

Inflammatory Changes ◽

Targeted Biopsies

Abstract Background and study aim The I-SCAN optical enhancement (OE) system with magnification is a recently introduced combination of optical and digital electronic virtual chromoendoscopy, which enhances mucosal and vascular details. The aim of this pilot study was to investigate the use of I-SCAN OE in the assessment of inflammatory changes in ulcerative colitis (UC). Patients and methods A total of 41 consecutive patients with UC and 9 control patients were examined by I-SCAN OE (Pentax Medical, Tokyo, Japan). Targeted biopsies of the imaged areas were obtained. A new optical enhancement score focusing on mucosal and vascular changes was developed. The diagnostic accuracy of I-SCAN OE was calculated against histology using two UC histological scores – Robarts Histopathology Index (RHI) and ECAP (Extent, Chronicity, Activity, Plus additional findings). Results The overall I-SCAN OE score correlated with ECAP (r = 0.70; P < 0.001). The accuracy of the overall I-SCAN OE score to detect abnormalities by ECAP was 80 % (sensitivity 78 %, specificity 100 %). I-SCAN OE vascular and mucosal scores correlated with ECAP (r = 0.65 and 0.71, respectively; P < 0.001). The correlation between overall I-SCAN OE score and RHI was r = 0.61 (P < 0.01), and the accuracy to detect abnormalities by RHI was 68 % (sensitivity 78 %, specificity 50 %). The majority of patients with Mayo 0 had abnormalities on I-SCAN OE. Conclusion In UC, the new I-SCAN OE technology accurately identified mucosal inflammation, and correlated well with histological scores of chronic and acute changes.

Download Full-text

Su1561 Endoscopic Ultrasound of the Colon for Evaluation of Mucosal Healing/Early Therapy Response of Anti-TNF-α Therapy in Patients With Ulcerative Colitis - First Results of a Pilot Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.1214 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB368

Author(s):

Mark Ellrichmann ◽

Johannes Bethge ◽

Susanna Nikolaus ◽

Alexander Arlt ◽

Stefan Schreiber ◽

...

Keyword(s):

Ulcerative Colitis ◽

Pilot Study ◽

Endoscopic Ultrasound ◽

Therapy Response ◽

Mucosal Healing ◽

Early Therapy ◽

Tnf Α ◽

First Results

Download Full-text

Intensified Infliximab Induction is Associated with Improved Response and Decreased Colectomy in Steroid-Refractory Paediatric Ulcerative Colitis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz019 ◽

2019 ◽

Vol 13 (8) ◽

pp. 982-989 ◽

Cited By ~ 6

Author(s):

Peter C Church ◽

Shaun Ho ◽

Ajay Sharma ◽

Diane Tomalty ◽

Karen Frost ◽

...

Keyword(s):

Ulcerative Colitis ◽

Activity Index ◽

Mucosal Healing ◽

Therapeutic Drug ◽

Physician Global Assessment ◽

Rates Of Return ◽

Steroid Dependent ◽

Dosing Regimens ◽

Steroid Refractory

Abstract Background Infliximab pharmacokinetics in steroid-refractory [SR] ulcerative colitis [UC] suggest a need for higher dosing, but data concerning efficacy of intensification in this setting are lacking in children and inconsistent overall. Methods Paediatric patients [N = 125] treated with infliximab for SR or steroid-dependent UC were retrospectively reviewed. Outcomes [clinical response and remission, colectomy, mucosal healing, safety] with standard vs intensified induction [mean induction dose ≥7 mg/kg or interval ≤5 weeks between doses 1 and 3] were compared. Results Among 125 patients [median age 14 years, median UC duration 0.7 years, 74 SR], 73 [58%] received standard induction and 52 [42%] received intensified induction. Overall, 73 [58%] achieved remission (judged by physician global assessment [PGA] and paediatric UC activity index [PUCAI]≤10]. Among patients in remission, 7 [10%] experienced secondary loss of response by a median of 0.7 [IQR 0.4–1.0] years. Of the 74 SR patients, 17 [23%] underwent colectomy, and of the 51 steroid-dependent patients, 12 [24%] underwent colectomy. Intensified induction in SR patients was associated with a higher chance of remission (hazard ratio [HR] 3.2, p = 0.02) and a lower chance of colectomy [HR 0.4, p = 0.05], but did not improve outcomes in steroid-dependent patients. During follow-up, 46/73 [63%] patients in remission had regimen individualization, with similar rates of return to standard dosing after 1 year between those with initial intensified or standard induction. Follow-up endoscopy, performed in 35/73 patients in remission, demonstrated mucosal healing for 66%. Adverse events were rare, despite use of intensified regimens. Conclusions These data suggest a benefit from intensified infliximab induction specifically among children with steroid-refractory UC. Prospective studies comparing dosing regimens and incorporating therapeutic drug monitoring should be undertaken.

Download Full-text