942 – Shifts in Use of Colectomy in Patients with Crohn's Disease Throughout the Past Decade

The past decade has brought great change to the treatment of pediatric Crohn's disease. The majority of affected patients now receive therapy directed at the underlying immune dysregulation that is associated with this chronic disease. The monoclonal antibodies directed against tumor necrosis factor alpha play an increasing role in such therapy. Infliximab is the prototype of this class of biologic based therapy. This review covers the basic pharmacokinetics of infliximab while reviewing the data on its efficacy in pediatric Crohn's disease patients. Current issues related to infliximab dosing and safety are also reviewed.

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Improvements in the Long-Term Outcome of Crohn’s Disease Over the Past Two Decades and the Relation to Changes in Medical Management: Results from the Population-Based IBDSL Cohort

The American Journal of Gastroenterology ◽

10.1038/ajg.2016.524 ◽

2017 ◽

Vol 112 (2) ◽

pp. 325-336 ◽

Cited By ~ 49

Author(s):

Steven F G Jeuring ◽

Tim R A van den Heuvel ◽

Limmie Y L Liu ◽

Maurice P Zeegers ◽

Wim H Hameeteman ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Medical Management ◽

Population Based ◽

Term Outcome ◽

Long Term Outcome ◽

The Past

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The effect of early immunosuppressive therapy on the rate of resections performed in patients with Chron’s disease, in Veszprém county, Hungary, a population-based cohort study

Orvosi Hetilap ◽

10.1556/oh.2012.29331 ◽

2012 ◽

Vol 153 (14) ◽

pp. 541-552 ◽

Cited By ~ 2

Author(s):

Petra Anna Golovics ◽

Péter László Lakatos ◽

Gyula Dávid ◽

Tünde Pandur ◽

Zsuzsanna Erdélyi ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Medical Therapy ◽

Propensity Scores ◽

Age At Onset ◽

Population Based ◽

Systemic Steroid ◽

Azathioprine Therapy ◽

The Past ◽

Cox Analysis

Medical therapy for Crohn’s disease has changed significantly over the past 20 years with the increasing use of immunosuppressants. In contrast, surgery rates are still high and evidence about the the changes in the outcome of Crohn’s disease over the past decades is scarce. Aims: The objective of this study was to analyze the evolution of the surgical rates and medical therapy in the population-based Veszprém county database. Methods: Data of 506 Crohn’s disease patients were analyzed (age at diagnosis: 31.5 years, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. The study population was divided into three groups based on the year of diagnosis (cohort A: 1977–1989, cohort B: 1990–1998 and cohort C: 1999–2008). Results: Overall azathioprine, systemic steroid, and biological (only available after 1998) exposure was 45.8, 68.6, and 9.5%, respectively. The 1 and 5-year probabilities of azathioprine use were 3.2 and 6.2% in cohort A, 11.4 and 29.9% in cohort B, and 34.8 and 46.2% in cohort C. In multivariate analysis, decade of diagnosis (P<0.001), age at onset (P = 0.008), disease behavior at diagnosis (P<0.001), and need for systemic steroids (P<0.001) were significantly associated with the time to initiation of azathioprine therapy. Early azathioprine use was significantly associated with the time to intestinal surgery in Crohn’s disease patients; in a multivariate Cox analysis (HR: 0.43, 95% confidence interval (CI): 0.28–0.65) and after matching on propensity scores for azathioprine use (HR: 0.42,95% CI:0.26–0.67). Conclusions: This population-based inception cohort showed that reduction in surgical rates was independently associated with increased and earlier azathioprine use. Orv. Hetil., 2012, 153, 541–552.

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P060 THE TREND OF DIAGNOSTIC COMPETENCY OF CROHN'S DISEASE IN THAI POPULATION FOR THE PAST TWO DECADES

Gastroenterology ◽

10.1053/j.gastro.2019.11.089 ◽

2020 ◽

Vol 158 (3) ◽

pp. S24-S25

Author(s):

Natapat Chaisidhivej ◽

Satimai Aniwan ◽

Nonthalee Pausawasdi ◽

Julajak Limsrivilai

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Thai Population ◽

The Past

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Multicentric Cutaneous Crohn's Disease: A Case Report and Review of Literature

Canadian Journal of Gastroenterology ◽

10.1155/1990/480817 ◽

1990 ◽

Vol 4 (2) ◽

pp. 59-63 ◽

Cited By ~ 2

Author(s):

Robert Prokopetz ◽

J Barrie Ross ◽

Peter Smith ◽

Joseph J Sidorov

Keyword(s):

Crohn’S Disease ◽

Case Report ◽

Crohn's Disease ◽

Erythema Nodosum ◽

Skin Lesions ◽

Review Of Literature ◽

Histological Features ◽

The Past ◽

Common Skin ◽

Skin Conditions

A patient presented with skin lesions at sites not contiguous with Crohn's disease of the bowel and with specific histological features of Crohn's disease occurring two weeks from the onset of bowel symptoms. Currently a number of nonspecific skin conditions such as erythema nodosum, pyoderma gangrenosum and erythema multiforme are accepted as being the most common skin manifestations of Crohn's disease. It is likely, however, that specific lesions of Crohn's disease in the skin have been underdiagnosed either because of lack of biopsy or misinterpretation of the histology. Twenty-three cases with specific Crohn's disease in the skin have been recorded in the past 25 years, since the condition has been recognized. Sarcoidosis has been a common misdiagnosis. The literature relating to multicentric Crohn's disease is reviewed and attention drawn to its protean and masquerading features. An argument is made for the use of the term 'multicentric' rather than 'metastatic' in relation to cutaneous Crohn's disease.

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Is Resection of Crohn’s Disease a Procedure of the Past?

World Journal of Surgery ◽

10.1007/s00268-010-0791-y ◽

2010 ◽

Vol 34 (12) ◽

pp. 2803-2804

Author(s):

Fabrizio Michelassi

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

The Past

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Colon Adenocarcinoma Metastasis Through Ileocolic Fistula to Small Bowel in the Setting of Crohn’s Disease

10.21203/rs.3.rs-522870/v1 ◽

2021 ◽

Author(s):

Michael Tseng ◽

Taseen Ahmed Syed ◽

Patricija Zot ◽

Ravi Vachhani

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Unusual Case ◽

Colon Adenocarcinoma ◽

Fistula Tract ◽

Gastrointestinal Fistula ◽

The Past ◽

Pathology Reports

Abstract Purpose: Patients with Crohn’s disease (CD) are at higher risk of developing colorectal cancer (CRC) and gastrointestinal fistula. We report an unusual case of sigmoid colon adenocarcinoma in a CD patient that metastasized to the small bowel through an ileocolic fistula tract.Methods: This case report was written after patient was seen in the clinic and reviewing overall hospitalization including clinically relevant data including imaging and pathology reports associated to our focus and presentation. Prior cases of metastatic CRC via fistula tract were reviewed and compared as well. Results: We described an unprecedented case of a sigmoid adenocarcinoma metastasized to ileum via ileal-sigmoid fistula. Patient received surgical treatment and systemic chemotherapy and currently in remission. Conclusion: CD is associated with a higher risk of fistula development. Few cases in the past described CRC metastasized within the gastrointestinal tract through a fistula. Intriguingly in our case, sigmoid adenocarcinoma developed and further metastasized to the ileum via the ileal-sigmoid fistula in the setting of CD. In addition to presenting a unique pathological phenomenon in these patients, this case raises awareness of the importance of regular follow-up and early initiation of IBD therapies.

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25 years of anti-TNF treatment for inflammatory bowel disease: lessons from the past and a look to the future

Gut ◽

10.1136/gutjnl-2019-320022 ◽

2021 ◽

pp. gutjnl-2019-320022

Author(s):

Geert R D'Haens ◽

Sander van Deventer

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Clinical Development ◽

Good Time ◽

The Past ◽

Clinical Observations ◽

Open Questions ◽

Inflammatory Bowel ◽

Maintenance Schedules ◽

Necrosis Factor

Anti-tumour necrosis factor (TNF) antibodies have been widely used for approximately 25 years now. The first clinical observations in patients with refractory Crohn’s disease rapidly responding to infliximab prompted accelerated clinical development and approval for this indication. However, many questions remained unanswered when this treatment came to market related to maintenance schedules, pharmacokinetics, toxicity and positioning. Many of these open questions were addressed by investigators and sponsors during more than two decades of clinical use. The authors were among the first to use infliximab in Crohn’s disease and felt that now is a good time to look back and draw lessons from the remarkable anti-TNF story. Even today, new insights continue to appear. But more importantly, what was learnt in the past 25 years has created a platform for future development of even stronger and safer therapies. We should not forget to learn from the past.

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Association ofNOD1,CXCL16,STAT6andTLR4gene polymorphisms with Malaysian patients with Crohn’s disease

PeerJ ◽

10.7717/peerj.1843 ◽

2016 ◽

Vol 4 ◽

pp. e1843 ◽

Cited By ~ 9

Author(s):

Kek Heng Chua ◽

Jin Guan Ng ◽

Ching Ching Ng ◽

Ida Hilmi ◽

Khean Lee Goh ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Healthy Controls ◽

The Past ◽

Weak Association ◽

Pcr Rflp ◽

Prevention And Treatment ◽

Inflammatory Bowel ◽

Stratified Analysis ◽

Shed Light

Crohn’s disease (CD) is a prominent type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract. CD is known to have higher prevalence in the Western countries, but the number of cases has been increasing in the past decades in Asia, including Malaysia. Therefore, there is a need to investigate the underlining causes of CD that may shed light on its prevention and treatment. In this study, genetic polymorphisms inNOD1(rs2075820),CXCL16(rs2277680),STAT6(rs324015) andTLR4(rs4986791) genes were examined in a total of 335 individuals (85 CD patients and 250 healthy controls) with PCR-RFLP approach. There was no significant association observed betweenNOD1rs2075820 andSTAT6rs324015 with the onset of CD in the studied cohort. However, the G allele ofCXCL16rs2277680 was found to have a weak association with CD patients (P= 0.0482;OR= 1.4310). TheTLR4rs4986791 was also significantly associated to CD. Both the homozygous C genotype (P= 0.0029;OR= 0.3611) and C allele (P= 0.0069;OR= 0.4369) were observed to confer protection against CD. On the other hand, the heterozygous C/T genotype was a risk genotype (P= 0.0015;OR= 3.1392). Further ethnic-stratified analysis showed that the significant associations inCXCL16rs2277680 andTLR4rs4986791 were accounted by the Malay cohort. In conclusion, the present study reported two CD-predisposing loci in the Malay CD patients. However, these loci were not associated to the onset of CD in Chinese and Indian patients.

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Anomalous asthma and chronic obstructive pulmonary disease Google Trends patterns during the COVID-19 pandemic

Clinical and Translational Allergy ◽

10.1186/s13601-020-00352-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Bernardo Sousa-Pinto ◽

Enrico Heffler ◽

Aram Antó ◽

Wienczyslawa Czarlewski ◽

Anna Bedbrook ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Pulmonary Disease ◽

Media Coverage ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

The Past ◽

Search Patterns ◽

Online Searches

Abstract Background An increase in online searches on health topics may either mirror epidemiological changes or reflect media coverage. In the context of COVID-19, this is particularly relevant, as COVID-19 symptoms may be mistaken for those of respiratory disease exacerbations. Therefore, we aimed to assess Internet search patterns on asthma and chronic obstructive pulmonary disease (COPD) in the context of COVID-19, as compared to searches on other chronic diseases. Methods We retrieved Google Trends (GTs) data on two respiratory (asthma and COPD) and three non-respiratory (diabetes, hypertension, and Crohn’s disease) chronic diseases over the past 5 years (up to May 31, 2020). For 54 countries, and for each disease, we built autoregressive integrated moving average (ARIMA) models to predict GTs for 2020 based on 2015–2019 search patterns. In addition, we estimated the proportion of searches in which COVID-19-related terms were used. To assess the potential impact of media coverage on online searches, we assessed whether weekly “asthma” GTs correlated with the number of Google News items on asthma. Results Over the past 5 years, worldwide search volumes for asthma and COPD reached their maximum values in March 2020. Such was not observed for diabetes, hypertension and Crohn’s disease. In 38 (70%) countries, GTs on asthma were higher in March 2020 than the respective maximum predicted values. This compares to 19 countries for COPD, 23 for hypertension, 11 for Crohn’s disease, and 9 for diabetes. Queries with COVID-19-related terms represented up to 47.8% of the monthly searches on asthma, and up to 21.3% of COPD searches. In most of the assessed countries, moderate-strong correlations were observed between “asthma” GTs and the number of news items on asthma. Conclusions During March 2020, there was a peak in searches on asthma and COPD, which was probably mostly driven by media coverage, as suggested by their simultaneity in several countries with different epidemiological situations.

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