Sa1852 VEDOLIZUMAB DRUG LEVELS IN MATERNAL AND CORD BLOOD FOLLOWING TREATMENT OF INFLAMMATORY BOWEL DISEASE IN PREGNANCY: ONGOING MULTICENTRE PROSPECTIVE STUDY FROM THE CZECH REPUBLIC

2020 ◽  
Vol 158 (6) ◽  
pp. S-451 ◽  
Author(s):  
Barbora Pipek ◽  
Dana Duricova ◽  
Katarina Mitrova ◽  
Martin Bortlik ◽  
ondrej urban ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Czech Republic ◽  
Prospective Study ◽  
Cord Blood ◽  
Bowel Disease ◽  
The Czech Republic ◽  
Drug Levels ◽  
Inflammatory Bowel ◽  
Multicentre Prospective Study ◽  
In Pregnancy

Inflammatory bowel disease has a negative impact on patients reproductive behaviour: the first multicentre survey in the Czech Republic

2021 ◽  
Vol 75 (1) ◽  
pp. 12-19
Author(s):  
Dana Ďuricová ◽  
Zuzana Krátka ◽  
Martin Bortlík ◽  
Lenka Slabá ◽  
Kristýna Strnadová ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Czech Republic ◽  
General Population ◽  
Bowel Disease ◽  
Negative Impact ◽  
Fertility Rate ◽  
Sexual Life ◽  
The Czech Republic ◽  
Live Births ◽  
Inflammatory Bowel

Background: Several previous studies reported the negative impact of inflammatory bowel disease (IBD) on reproductive plans and fertility rate. The aim of our study was to investigate, for the first time, reproductive attitudes and fertility rate among Czech patients with IBD. Methods: Between March and August 2019, consecutive patients with IBD from 22 centres across the Czech Republic responded anonymously to a predefined questionnaire focused on the patients’ demographics, details of IBD and treatment, gynaecological/urological history, reproductive issues and patients’ knowledge on this topic. Results: The questionnaire was filled in by 798 patients (526 women; median age 34 years, 66% with Crohn’s disease). Of these, 58% of the females and 47.1% of the males already had ≥ 1 child (median 2 children). Women with IBD were significantly more worried about infertility (55.5% versus 22.4%), had more limitations in their sexual life (53.2% vs. 26.8%) and more frequently changed their earlier reproductive plans (27.6% versus 11.0%) than the males (p < 0.0001). The total fertility rate in female IBD patients was lower compared to the general population with 1.004 live births/IBD woman versus 1.69 live births/woman in the Czech population. The pattern of decreased fertility was observed in all age-specific categories. Of the childless patients, 14% of the women and 18.1% of the men were voluntarily childless. Approximately one-half of them indicated their IBD to be the primary cause. Conclusions: IBD seems to have a negative impact on patients’ reproductive plans and attitudes. The fertility rate in Czech IBD female patients was decreased compared to the general population in this study.

scholarly journals A Systematic Review and Meta-analysis of Paediatric Inflammatory Bowel Disease Incidence and Prevalence Across Europe

2020 ◽  
Vol 14 (8) ◽  
pp. 1119-1148 ◽  
Author(s):  
S E Roberts ◽  
K Thorne ◽  
N Thapar ◽  
I Broekaert ◽  
M A Benninga ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Czech Republic ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Grey Literature ◽  
Incidence Rates ◽  
Cochrane Library ◽  
The Czech Republic ◽  
Inflammatory Bowel

Abstract Background and Aims Inflammatory bowel disease [IBD] is often one of the most devastating and debilitating chronic gastrointestinal disorders in children and adolescents. The main objectives here were to systematically review the incidence and prevalence of paediatric IBD across all 51 European states. Methods We undertook a systematic review and meta-analysis based on PubMed, CINAHL, the Cochrane Library, searches of reference lists, grey literature and websites, covering the period from 1970 to 2018. Results Incidence rates for both paediatric Crohn’s disease [CD] and ulcerative colitis [UC] were higher in northern Europe than in other European regions. There have been large increases in the incidence of both paediatric CD and UC over the last 50 years, which appear widespread across Europe. The largest increases for CD have been reported from Sweden, Wales, England, the Czech Republic, Denmark and Hungary, and for UC from the Czech Republic, Ireland, Sweden and Hungary. Incidence rates for paediatric CD have increased up to 9 or 10 per 100 000 population in parts of Europe, including Scandinavia, while rates for paediatric UC are often slightly lower than for CD. Prevalence reported for CD ranged from 8.2 per 100 000 to approximately 60 and, for UC, from 8.3 to approximately 30. Conclusions The incidence of paediatric IBD continues to increase throughout Europe. There is stronger evidence of a north–south than an east–west gradient in incidence across Europe. Further prospective studies are needed, preferably multinational and based on IBD registries, using standardized definitions, methodology and timescales.

scholarly journals Differences in the placental pharmacokinetics of vedolizumab and ustekinumab during pregnancy in women with inflammatory bowel disease: a prospective multicentre study

2021 ◽  
Vol 14 ◽  
pp. 175628482110327
Author(s):  
Katarina Mitrova ◽  
Barbora Pipek ◽  
Martin Bortlik ◽  
Ludek Bouchner ◽  
Jan Brezina ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cord Blood ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Placental Transfer ◽  
Maternal Blood ◽  
Drug Levels ◽  
Lower Drug ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Background: Vedolizumab demonstrated different placental pharmacokinetics than other immunoglobulin G1 antibodies, leading to lower drug levels in cord blood in contrast to maternal blood at the time of delivery. The placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor agents. Current evidence on the placental pharmacokinetics of vedolizumab and ustekinumab is limited. We aimed to assess the placental transfer of ustekinumab and vedolizumab in pregnant patients with inflammatory bowel disease. Methods: Consecutive women from a prospective observational study who were exposed to ustekinumab or vedolizumab within 2 months prior to conception or during pregnancy were included. Ustekinumab and vedolizumab levels were measured in maternal and cord blood at the time of delivery. Results: Drug levels were available in 31 infant-mother pairs (15 exposed to ustekinumab and 16 to vedolizumab). The median maternal and newborn ustekinumab levels were 5.3 mg/l and 10.3 mg/l, respectively (the median infant-to-maternal ratio was 1.7), while the median maternal and cord vedolizumab levels were 7.3 mg/l and 4.5 mg/l (the median infant-to-maternal ratio was 0.66). The ustekinumab levels in cord blood positively correlated with the maternal levels at delivery (ρ = 0.751, p = 0.001). However, no correlation with the timing of the last drug administration was found. In contrast, the vedolizumab levels in cord blood demonstrated significant positive correlation with the maternal levels (ρ = 0.831, p < 0.001) along with the gestational week of the last infusion (ρ = 0.736, p = 0.001). Conclusion: Vedolizumab demonstrated different placental pharmacokinetics, leading to lower drug levels in cord blood compared to maternal blood at delivery; in contrast, the placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor (TNF) agents.

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