Tu1131 The Effect of Ulcerative Colitis Remission Status on the Ability to Maintain or Achieve Clinical and Endoscopic Remission After 12-Month Maintenance Treatment With MMx®* Mesalamine

2013 ◽  
Vol 144 (5) ◽  
pp. S-770
Author(s):  
David T. Rubin ◽  
Susi Inglis ◽  
Elizabeth Magee ◽  
Paul Streck ◽  
Dory M. Solomon ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Maintenance Treatment ◽  
Remission Status ◽  
Endoscopic Remission

scholarly journals Thiopurine Treatment in Ulcerative Colitis: A Critical Review of the Evidence for Current Clinical Practice

2017 ◽  
Vol 24 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Sara van Gennep ◽  
Nanne K de Boer ◽  
Geert R D’Haens ◽  
Mark Löwenberg
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Critical Review ◽  
Maintenance Treatment ◽  
Randomized Trials ◽  
Current Clinical Practice ◽  
Sufficient Power ◽  
Significant Difference ◽  
Endoscopic Remission ◽  
Remission Rates

Abstract Background Due to toxicity problems and controversial evidence, thiopurine use in ulcerative colitis (UC) has faced a lot of criticism. We present a critical review of the literature on efficacy of thiopurines in UC. Methods Studies evaluating therapeutic efficacy of thiopurine remission induction and/or maintenance treatment in UC were identified using the Cochrane Library, MEDLINE, and EMBASE. Results Out of 5 randomized trials on thiopurine induction treatment, 3 demonstrated a significant effect of thiopurine treatment vs mesalamine or placebo in steroid-dependent UC patients: (1) lower endoscopic activity scores, (2) higher clinical remission rates, and (3) more patients who discontinued steroids. Two found no significant difference in clinical and endoscopic remission of azathioprine compared with sulfasalazine or placebo in patients with active UC. Out of 7 randomized trials on thiopurine maintenance treatment, 4 demonstrated significant higher clinical and endoscopic remission rates in thiopurine-treated patients compared with placebo or mesalamine. Three found no significant difference in clinical and endoscopic remission of thiopurine maintenance treatment compared with sulfasalazine or placebo. Conclusions All studies that investigated thiopurine treatment in UC had shortcomings, such as lack of sufficient power, no use of blinding, allowed concomitant treatment with steroids, and no endoscopy to confirm active disease at study entry or to evaluate therapeutic efficacy. Hence, current clinical practice of thiopurine treatment in UC is based on minimal and controversial evidence. This underscores the need for clinical studies with sufficient power and objective end points in order to determine efficacy of thiopurines in UC. 10.1093/ibd/izx025_video1 izx025.video1 5732762967001

scholarly journals Prevalence and risk factors of bowel symptoms in Korean patients with ulcerative colitis in endoscopic remission: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kwangwoo Nam ◽  
Sang Hyoung Park ◽  
Jun Ho Oh ◽  
Ho-Su Lee ◽  
Soomin Noh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Patient Reported Outcomes ◽  
Significant Risk ◽  
Disease Extent ◽  
Korean Patients ◽  
Female Sex ◽  
Bowel Symptoms ◽  
Patient Reported ◽  
Endoscopic Remission

Abstract Background Many patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB). However, studies on these patient-reported outcomes in patients with inactive UC are limited, especially in Korea. Therefore, we investigated the prevalence and risk factors of bowel symptoms in Korean patients with inactive UC. Methods We investigated the prevalence of bowel symptoms in patients with endoscopically quiescent UC between June 1989 and December 2016 using a well-characterized referral center-based cohort. The Mayo clinic score (MCS) was used to evaluate bowel symptoms at the most recent visit near the date of endoscopy. Clinical characteristics of the patients were compared based on the presence or absence of bowel symptoms. Results Overall, 741 patients with endoscopically quiescent UC were identified, of whom 222 (30%) and 48 (6.5%) had an SF and RB subscore of ≥ 1, respectively. Patients with bowel symptoms (SF + RB ≥ 1; n = 244 [32.9%]) had higher rates of left-sided colitis (E2) or extensive colitis (E3) than patients without bowel symptoms (SF + RB = 0; n = 497 [67.1%]; P = 0.002). Multivariate analysis revealed that female sex (odds ratio [OR]: 1.568; 95% confidence interval [CI]: 1.023–2.402; P = 0.039) and E2 or E3 (OR 1.411; 95% CI 1.020–1.951; P = 0.038) were the significant risk factors for increased SF. Conclusions This study revealed that one-third of patients with endoscopically quiescent UC reported increased SF. Female sex and disease extent may be associated with bowel symptoms.

scholarly journals A15 EFFICACY AND SAFETY OF FILGOTINIB AS INDUCTION THERAPY FOR PATIENTS WITH MODERATELY TO SEVERELY ACTIVE ULCERATIVE COLITIS: RESULTS FROM THE PHASE 2B/3 SELECTION STUDY

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 18-20
Author(s):  
B G Feagan ◽  
E V Loftus ◽  
S Danese ◽  
S Vermeire ◽  
W J Sandborn ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Induction Therapy ◽  
Clinical Remission ◽  
Active Ulcerative Colitis ◽  
Treatment Groups ◽  
Disease Characteristics ◽  
Serious Infections ◽  
Endoscopic Remission ◽  
Induction Study ◽  
Secondary Endpoints

Abstract Aims The SELECTION (NCT02914522) Induction Studies evaluated the efficacy/safety of filgotinib (FIL), a preferential JAK1 inhibitor, as induction therapy for patients (pts) with moderately to severely active ulcerative colitis (UC) who were biologic-naïve but failed conventional therapy (Induction Study A) or failed prior biologics (Induction Study B). Methods Pts were randomized 2:2:1 to once–daily FIL 200mg, FIL 100mg or placebo (PBO). The primary (clinical remission), key secondary (Mayo Clinic Score [MCS] remission, endoscopic remission, and histologic remission), and exploratory endpoints (MCS response and endoscopic improvement) were assessed at Week 10. Results In both studies, baseline demographics and disease characteristics were similar across treatment groups. In Study A, 659 pts were randomized and treated. Baseline mean MCS was 8.6 and 56% had a Mayo endoscopic subscore (ES)=3. A significantly higher proportion of biologic-naïve pts on FIL 200mg achieved clinical remission vs PBO and all key secondary endpoints (Table). In Study B, 689 pts were randomized and treated. Baseline mean MCS was 9.3 and 78% had ES=3. Prior treatment failures were: anti-TNF (86%), vedolizumab (52%) and both (dual-refractory; 43%). A significantly higher proportion of biologic-experienced pts on FIL 200mg achieved clinical remission vs PBO. In Studies A and B, a greater proportion of pts on FIL 200 mg achieved an MCS response and endoscopic improvement vs PBO. The rates of AEs, serious AEs and discontinuations due to AEs were similar across FIL and PBO groups during induction. In the PBO, FIL 100mg and FIL 200mg groups, serious infections occurred in 0.7%, 0.7% and 0.4% pts in Study A and 1.4%, 1.4% and 0.8% pts in Study B; H Zoster occurred in <1% in both groups for both cohorts. Conclusions SELECTION included a high proportion of dual-refractory pts, and pts with severe endoscopic disease. Both doses of FIL were well tolerated. Filgotinib 200mg was effective induction therapy for both biologic-naïve/-experienced pts with moderately to severely active UC. Funding Agencies None

scholarly journals Middle-term prognosis in patients with ulcerative colitis who achieved clinical and endoscopic remission by budesonide rectal foam

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220413
Author(s):  
Makoto Naganuma ◽  
Fumihito Hirai ◽  
Kiyonori Kobayashi ◽  
Kenji Watanabe ◽  
Ken Takeuchi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Middle Term ◽  
Endoscopic Remission ◽  
Rectal Foam

scholarly journals Four-Year Maintenance Treatment With Adalimumab in Patients with Moderately to Severely Active Ulcerative Colitis: Data from ULTRA 1, 2, and 3

2014 ◽  
Vol 109 (11) ◽  
pp. 1771-1780 ◽  
Author(s):  
Jean-Frederic Colombel ◽  
William J Sandborn ◽  
Subrata Ghosh ◽  
Douglas C Wolf ◽  
Remo Panaccione ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Maintenance Treatment ◽  
Active Ulcerative Colitis

Ménétrier’s disease in a patient with refractory ulcerative colitis: a clinical challenge and review of the literature

2021 ◽  
Vol 14 (10) ◽  
pp. e246137
Author(s):  
Sofia Rao ◽  
Anna Viola ◽  
Omar Ksissa ◽  
Walter Fries
Keyword(s):  
Ulcerative Colitis ◽  
Rare Disease ◽  
Treatment Options ◽  
Review Of The Literature ◽  
Protein Loss ◽  
Menetrier’S Disease ◽  
Clinical Challenge ◽  
Endoscopic Remission ◽  
Ménétrier's Disease ◽  
Menetrier's Disease

Ménétrier’s disease (MD) is a rare disease of the stomach, characterised by hypertrophic gastric folds leading to protein loss. The association with ulcerative colitis (UC) is rare but has been reported in the literature. We report a case of a 29-year-old male affected by UC with an additional diagnosis of MD 3 years after UC diagnosis. UC was refractory to several treatment lines (thiopurines, infliximab, vedolizumab and ustekinumab), and the patient underwent colectomy. Octreotide was administered for MD normalising blood biochemistry, but it was not effective in inducing endoscopic remission of the stomach. Treatment options in patients with MD and UC are discussed.

Histologic Evaluation Using the Robarts Histopathology Index in Patients With Ulcerative Colitis in Deep Remission and the Association of Histologic Remission With Risk of Relapse

2022 ◽  
Author(s):  
Jin Park ◽  
Soo Jin Kang ◽  
Hyuk Yoon ◽  
Jihye Park ◽  
Hyeon Jeong Oh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Proportional Hazards Model ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Fecal Calprotectin ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Clinical Relapse ◽  
Endoscopic Remission ◽  
Risk Of Relapse

Abstract Background This study prospectively evaluated the risk of relapse according to the status of histologic activity in patients with ulcerative colitis (UC) who achieved deep remission. Methods Patients with UC in clinical remission (partial Mayo score ≤1) and endoscopic remission (ulcerative colitis endoscopic index of severity ≤1) were enrolled. Rectal biopsies were performed in patients, and histologic remission was defined as a Robarts histopathology index of ≤3. Receiver-operating characteristic curve analysis was conducted to determine fecal calprotectin cutoff values for histologic remission. The cumulative risk of relapse was evaluated using the Cox proportional hazards model. Results Among the 187 patients enrolled, 82 (43.9%) achieved histologic remission. The best cutoff value of fecal calprotectin for predicting histologic remission was 80 mg/kg (area under the curve of 0.646, sensitivity of 74%, and specificity of 61%). Among 142 patients who were followed up for >3 months, 56 (39.4%) showed clinical relapse during a median of 42 weeks. The risk of relapse was lower in patients with histologic remission than in those with histologic activity (P = .026). In multivariable analysis, histologic remission (hazard ratio [HR], 0.551; 95% confidence interval [CI], 0.316-0.958; P = .035), elevated C-reactive protein levels (HR, 3.652; 95% CI, 1.400-9.526; P = .008), and history of steroid use (HR, 2.398; 95% CI, 1.196-4.808; P = .014) were significantly associated with clinical relapse. Conclusions In patients with UC who achieved clinical and endoscopic remission, histologic remission was independently associated with a lower risk of clinical relapse.

scholarly journals A Comparison of Short- and Long-Term Therapeutic Outcomes of Infliximab- versus Tacrolimus-Based Strategies for Steroid-Refractory Ulcerative Colitis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Katsuya Endo ◽  
Motoyuki Onodera ◽  
Hisashi Shiga ◽  
Masatake Kuroha ◽  
Tomoya Kimura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Therapeutic Efficacy ◽  
Maintenance Treatment ◽  
Remission Rate ◽  
Rank Test ◽  
Clinical Response Rate ◽  
Therapeutic Outcomes ◽  
Significant Difference ◽  
Steroid Refractory

Background/Aims. Antitumor necrosis factor antibodies and calcineurin inhibitors have shown good therapeutic efficacy for steroid-refractory ulcerative colitis (UC). Although some studies have compared the efficacy of infliximab (IFX) and cyclosporin A, there are no published studies comparing IFX and tacrolimus (Tac). This study aimed to compare therapeutic efficacies between IFX- and Tac-based strategies for steroid-refractory UC.Methods. Between July 2009 and August 2013, 95 patients with steroid-refractory UC received either IFX(n=48)or Tac(n=47)in our hospital. In the IFX group, the patients continued to receive maintenance treatment with IFX. In the Tac group, patients discontinued Tac treatment up to 3 months and subsequently received thiopurine. We retrospectively compared the therapeutic outcomes between the groups.Results. There was no significant difference in the colectomy-free rate, clinical remission rate, and clinical response rate at 2 months between the groups. However, relapse-free survival was significantly higher in the IFX group than in the Tac group (p<0.001; log-rank test). The proportions of serious adverse events did not differ between the groups.Conclusion.The findings of our study showed that IFX and Tac have similar short-term therapeutic efficacy for steroid-refractory UC. Maintenance treatment with IFX, however, yields better long-term outcomes than Tac-thiopurine bridging treatment.

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