592 Histological Normalization Is Associated With Superior Relapse Free Survival Compared to Histological Activity and Histological Quiescence in Ulcerative Colitis

2015 ◽  
Vol 148 (4) ◽  
pp. S-115 ◽  
Author(s):  
Britt Christensen ◽  
Olufemi Kassim ◽  
Jonathan Erlich ◽  
Stephen B. Hanauer ◽  
David T. Rubin
Keyword(s):  
Ulcerative Colitis ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Histological Activity

scholarly journals Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative colitis compared to oral tacrolimus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiromichi Shimizu ◽  
Toshimitsu Fujii ◽  
Kenji Kinoshita ◽  
Ami Kawamoto ◽  
Shuji Hibiya ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Primary Outcome ◽  
Remission Rate ◽  
Survival Rates ◽  
Efficacy And Safety ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Severe Ulcerative Colitis ◽  
Intravenous Corticosteroid

Abstract Background Intravenous corticosteroid is the mainstay for managing acute severe ulcerative colitis, but one-third of patients do not respond to intravenous corticosteroid. Tacrolimus, a salvage therapy before colectomy, is usually orally administered, though its bioavailability is low compared intravenous administration. The efficacy of intravenous tacrolimus has not been widely studied. Aim To determine the efficacy and safety of intravenous tacrolimus for the treatment of acute severe ulcerative colitis. Methods Eighty-seven hospitalized acute severe ulcerative colitis patients were enrolled for a prospective cohort study between 2009 and 2017. Sixty-five patients received intravenous tacrolimus and 22 received oral tacrolimus. The primary outcome was the achievement of clinical remission within 2 weeks. Relapse and colectomy incidence and adverse events were assessed at 24 weeks. Results Response rates of both treatments exceeded 50% but were not significantly different. The remission rate was higher in intravenous tacrolimus compared with oral tacrolimus. At 24 weeks, oral and intravenous tacrolimus showed similar relapse-free survival rates; however, colectomy-free survival rates were higher in intravenous tacrolimus compared with oral tacrolimus. Conclusions Patients receiving intravenous tacrolimus achieved superior remission and colectomy-free survival rates compared with patients receiving oral tacrolimus. Safety was similar between the two treatments.

scholarly journals Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis

2020 ◽  
Vol 9 (6) ◽  
pp. 1771
Author(s):  
Keiichi Haga ◽  
Tomoyoshi Shibuya ◽  
Kei Nomura ◽  
Koki Okahara ◽  
Osamu Nomura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Renal Function ◽  
Medical Records ◽  
Careful Monitoring ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Effective Option ◽  
Term Administration ◽  
Potential Use

Background: Tacrolimus (TAC) is used for the management of ulcerative colitis (UC). However, there are few reports on the effectiveness of its long-term administration. TAC is also known to cause renal toxicity. The aim of this study was to evaluate long-term effectiveness and monitor changes in renal function during prolonged TAC use in patients with UC. Methods: Medical records of 50 UC patients treated with TAC were retrospectively reviewed. Clinical outcomes were assessed at 6, 12, 24, and 36 months after initiating TAC. We also monitored chronological changes in renal function. Results: Thirty-nine patients were treated with TAC for more than 3 months. Relapse-free survival among these patients at 6, 12, 24, and 36 months was 82%, 69%, 41%, and 23%, respectively. On the other hand, renal function was reduced in 35.9% of patients. We found that irreversible renal dysfunction was more likely to occur in cases in which the estimated glomerular-filtration rate (eGFR) was reduced by more than 30%. Conclusion: This study demonstrated the potential use of TAC as an effective option in the long-term medical management of UC, although it tended to increase the risk of nephrotoxicity. There is a need for the careful monitoring of renal function during TAC administration.

scholarly journals Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255620
Author(s):  
Akira Madarame ◽  
Masakatsu Fukuzawa ◽  
Yoshiya Yamauchi ◽  
Shin Kono ◽  
Akihiko Sugimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Dose Reduction ◽  
Clinical Relapse ◽  
Aminosalicylic Acid ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Significant Difference ◽  
History Of

Objectives Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for maintenance therapy of UC. Methods UC patients whose 5-ASA dose was reduced in clinical remission (partial Mayo score of ≤ 1) at our institution from 2012 to 2017 were analyzed. Various clinical variables of patients who relapsed after reducing the dose of oral 5-ASA were compared with those of patients who maintained remission. Risk factors for relapse were assessed by univariate and multivariate logistic regression analyses. Cumulative relapse-free survival rates were calculated using the Kaplan–Meier method. Results A total of 70 UC patients were included; 52 (74.3%) patients maintained remission and 18 (25.7%) patients relapsed during the follow-up period. Multivariate analysis indicated that a history of acute severe UC (ASUC) was an independent predictive factor for clinical relapse (p = 0.024, odds ratio: 21, 95% confidence interval: 1.50–293.2). Based on Kaplan–Meier survival analysis, the cumulative relapse-free survival rate within 52 weeks was 22.2% for patients with a history of ASUC, compared with 82.0% for those without. the log-rank test showed a significant difference in a history of ASUC (p < 0.001). Conclusions Dose reduction of 5-ASA should be performed carefully in patients who have a history of ASUC.

scholarly journals Segmental Histological Normalisation Occurs in Ulcerative Colitis but Does Not Improve Clinical Outcomes

2020 ◽  
Vol 14 (10) ◽  
pp. 1345-1353 ◽  
Author(s):  
Britt Christensen ◽  
Stephen B Hanauer ◽  
Peter R Gibson ◽  
Jerrold R Turner ◽  
John Hart ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Outcomes ◽  
Clinical Relapse ◽  
Relapse Free Survival ◽  
Disease Extent ◽  
Free Survival ◽  
Current Smoking ◽  
Younger Age ◽  
Age Of Diagnosis ◽  
Distal Direction

Abstract Background and Aims Complete histological normalisation and reduction of inflammation severity in patients with ulcerative colitis are associated with improved clinical outcomes, but the clinical significance of normalisation of only segments of previously affected bowel is not known. We examined the prevalence, pattern, predictors, and clinical outcomes associated with segmental histological normalisation in in patients with ulcerative colitis. Methods Medical records of patients with confirmed ulcerative colitis and more than one colonoscopy were sought. Segmental histological normalisation was defined as histological normalisation of a bowel segment [rectum, left-sided or right-sided colon] that had previous evidence of chronic histological injury. We assessed the variables influencing these findings and whether segmental normalisation was associated with improved clinical outcomes. Results Of 646 patients, 32% had segmental and 10% complete histological normalisaton when compared with their maximal disease extent. Most [88%] had segmental normalisation in a proximal-to-distal direction. Others had distal-to-proximal or patchy normalisation. On multivariate analysis, only current smoking [p = 0.040] and age of diagnosis ≤16 years [p = 0.028] predicted segmental histological normalisation. Of 310 who were in clinical remission at initial colonoscopy, 77 [25%] experienced clinical relapse after median 1.3 [range 0.06–7.52] years. Only complete histological normalisation of the bowel was associated with improved relapse-free survival (hazard ratio [HR] 0.23; 95% confidence interval [CI] 0.08–0.68; p = 0.008]. Conclusions Segmental histological normalisation occurs in 32% of patients with ulcerative colitis and is increased in those who smoke or were diagnosed at younger age. Unlike complete histological normalisation, segmental normalisation does not signal improved clinical outcomes.

Surgery and metastases of stomach cancer in liver

2020 ◽  
pp. 21-24
Author(s):  
F. M. Dzhuraev ◽  
S. L. Gutorov ◽  
E. I. Borisova ◽  
G. G. Khakimova
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Lymphovascular Invasion ◽  
Peritoneal Dissemination ◽  
Surgical Removal ◽  
Relapse Free Survival ◽  
Cancer Markers ◽  
Free Survival ◽  
The Poor ◽  
Isolated Liver

Liver metastases of gastric cancer determine the poor prognosis. Until now The expediency of their surgical removal has been controversial. However, according to a number of studies, the removal of potentially operable isolated liver metastases allows a significant increase of overall and relapse-free survival in some cases. The review is dedicated to the analysis of prognostic factors that allow selecting patients for surgical removal of liver metastases of gastric cancer. The main criteria are: effective perioperative chemotherapy; stage under T4, N0, absence of lymphovascular invasion, absence of peritoneal dissemination, number less than 3, size up to 4 cm, localization of metastases in one lobe, low level of cancer markers CA 19-9 and CEA.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

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