Treatment of perianal fistulas in Crohn's disease by local injection of antibody to TNF-α accounts for a favourable clinical response in selected cases: A pilot study

2006 ◽  
Vol 41 (9) ◽  
pp. 1064-1072 ◽  
Author(s):  
Corrado R. Asteria ◽  
Ferdinado Ficari ◽  
Siro Bagnoli ◽  
Monica Milla ◽  
Francesco Tonelli
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Clinical Response ◽  
Local Injection ◽  
Perianal Fistulas ◽  
Tnf Α

Ustekinumab serum concentrations are associated with clinical outcomes in Crohn’s disease – a regional multi-center pilot study

2020 ◽  
Vol 58 (05) ◽  
pp. 439-444 ◽  
Author(s):  
Anne Kerstin Thomann ◽  
Lucas-Alexander Schulte ◽  
Anna-Maria Globig ◽  
Peter Hoffmann ◽  
Thomas Klag ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Clinical Response ◽  
Roc Curve ◽  
Response To Therapy ◽  
Therapeutic Drug ◽  
Serum Concentrations ◽  
Serum Samples ◽  
Area Under Roc Curve

Abstract Background and aim The role of therapeutic drug monitoring (TDM) in ustekinumab (UST) therapy for Crohn’s disease (CD) has not been established, as only few studies have analyzed the relationship between UST serum concentrations and clinical outcome. In this pilot study, we retrospectively examined the potential of UST-concentrations (cUST) 8 weeks after induction (cUSTw8) to predict clinical response at week 16. Methods Serum samples and clinical data from patients (n = 72) with moderate to severely active CD who received intravenous induction with UST were retrospectively analyzed. cUST were quantitated using liquid chromatography-tandem mass spectrometry (LC-MSMS). A receiver-operating characteristic (ROC) curve and area under ROC curve (AUROC) was computed to analyze the predictive potential of cUSTw8 for clinical response at week 16 and to determine the minimal therapeutic UST trough concentration. Results Forty-four patients (61 %) achieved clinical response to UST therapy at week 16. cUSTw8 was moderately effective to predict clinical response with a minimal therapeutic cUSTw8 of 2.0 mg/l (AUC 0.72, p = 0.001). Conclusion Trough concentrations of UST 8 weeks after induction predict clinical response to therapy in week 16 with moderate sensitivity and specificity. TDM using LC-MSMS could prove beneficial in personalized UST therapy of patients with CD by identifying individuals with subtherapeutic concentrations who might benefit from dose escalation.

FiLaC® and Crohn’s disease perianal fistulas: a pilot study of 20 consecutive patients

2019 ◽  
Vol 24 (1) ◽  
pp. 75-78 ◽  
Author(s):  
A. Alam ◽  
F. Lin ◽  
N. Fathallah ◽  
E. Pommaret ◽  
M. Aubert ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Perianal Fistulas

Endoscopic Activity and Serum TNF-α Level at Baseline Are Associated With Clinical Response to Ustekinumab in Crohn’s Disease Patients

2020 ◽  
Vol 26 (11) ◽  
pp. 1669-1681
Author(s):  
Kentaro Murate ◽  
Keiko Maeda ◽  
Masanao Nakamura ◽  
Daisuke Sugiyama ◽  
Hirotaka Wada ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Response ◽  
High Serum ◽  
Real World Data ◽  
Patient Demographics ◽  
Disease Characteristics ◽  
Tnf Α ◽  
Appropriate Therapy ◽  
Α Level

Abstract Background and Aims The therapeutic efficacy and safety of ustekinumab for Crohn’s disease (CD) have been reported from randomized controlled trials and real-world data. However, there are few studies describing the identification of patients most suitable for ustekinumab therapy. The aim of this study was to prospectively evaluate the patients receiving ustekinumab and identify predictors of the treatment efficacy. Methods Patients with moderate to severe active CD scheduled to receive ustekinumab were enrolled. The responders and nonresponders were compared at weeks 0, 8, 24, and 48 by evaluating patient demographics, simple endoscopic scores (SES-CD), ustekinumab and cytokine concentrations, and cellular fractions. Results The clinical response and clinical remission rates in the 22 enrolled patients were 59.1% and 31. 8% at week 8, 68.2% and 45.5% at week 24, and 54.4% and 40.9% at week 48, respectively. There were no significant differences in patients’ demographic and disease characteristics at baseline between responders and nonresponders. A combination of low SES-CD and high serum TNF-α concentration at baseline showed a good correlation with the clinical response. Serum TNF-α concentration was decreased because of the therapy. The ratio of CD4+TNF-α cells at baseline was significantly higher in responders than in nonresponders; however, the ratios of CD45+CD11b+TNF-α and CD45+CD11c+TNF-α cells were not different. The ratio of CD4+ TNF-α cells decreased with the treatment in the responders but not in the nonresponders. Conclusions The combination of 2 factors, namely higher serum TNF-α concentration and lower SES-CD at baseline, may assist clinicians in selecting the appropriate therapy for patients with moderate to severe CD.

411 PLATELET-RICH STROMA INJECTION (PRS) AS A NOVEL SURGICAL TREATMENT FOR TREATMENT-REFRACTORY COMPLEX PERIANAL FISTULAS IN CROHN'S DISEASE: A PILOT STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-82-S-83
Author(s):  
Jeanine Hubertina Catharina Arkenbosch ◽  
Oddeke van Ruler ◽  
Roy S. Dwarkasing ◽  
Gwenny Fuhler ◽  
W.R. Schouten ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Perianal Fistulas ◽  
Treatment Refractory

scholarly journals Treatment of Crohn’s disease-related high perianal fistulas combining the mucosa advancement flap with platelet-rich plasma: a pilot study

2015 ◽  
Vol 19 (8) ◽  
pp. 455-459 ◽  
Author(s):  
K. W. A. Göttgens ◽  
R. R. Smeets ◽  
L. P. S. Stassen ◽  
G. L. Beets ◽  
M. Pierik ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Platelet Rich Plasma ◽  
Advancement Flap ◽  
Perianal Fistulas

scholarly journals P383 The level of intestinal inflammation and fibrosis in resection specimens after preoperative anti-tumour necrosis factor-α treatment in patients with Crohn’s disease: a comparative pilot study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S357-S358
Author(s):  
J Torle ◽  
P Dabir ◽  
U Korsgaard ◽  
J J Christiansen ◽  
N Qvist ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Inflammatory Cytokines ◽  
Intestinal Inflammation ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Extracellular Proteins ◽  
Fibrosis Score ◽  
Tnf Α

Abstract Background Strictures are a common complication in Crohn’s disease (CD), which are found in more than 50% of the patients. They are characterised by excessive deposition of extracellular proteins in the tissue as a result of the chronic inflammatory process. The effect of anti- TNF-α therapy on the development of fibrosis is not yet fully understood. The aim of the study was to investigate whether the degree of intestinal inflammation and fibrosis correlates with pre-operative anti-TNF-α therapy in patients with Crohn’s disease undergoing bowel resection. Methods This is an unblinded, prospective, multicentre cohort pilot study. All adult patients with Crohn’s disease, who underwent elective, laparoscopic or open intestinal resection were included. Pre-operative blood investigations included measurement of TNF- α concentration and specific drug antibodies in addition to the concentration of selected inflammatory cytokines. Three pathologists examined the specimens independently and assessed the degree of inflammation and fibrosis. Results Histopathological specimens from 10 patients with CD who underwent ileocecal or ileocolic resections were retrieved. Four of those patients were on anti-TNF-α treatment pre-operatively. The last dose of anti-TNF-α agents was administered within 1–9 weeks prior to bowel resection. Patients on anti-TNF-α treatment had higher fibrosis score than the controls (p = 0.01). Anti-TNF-α treatment was not associated with an increase in either CD68 or CD163-positive macrophages. There was no significant relationship between time from last anti-TNF-α dose to surgery, and fibrosis score. No significant association between the concentration of major inflammatory cytokines including TNF-α and fibrosis score or degree of inflammation was found. Conclusion Patients on anti-TNF-α treatment had higher fibrosis score than the controls.

scholarly journals P249 What’s the role of anti-TNF α in correcting anemia in Crohn’s disease?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S289-S290
Author(s):  
A Hassine ◽  
A Hammami ◽  
H Jaziri ◽  
N Elleuch ◽  
M Ksiaa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Clinical Response ◽  
Therapeutic Efficacy ◽  
Hypochromic Anemia ◽  
Mucosal Healing ◽  
Erythroid Progenitors ◽  
Tnf Α ◽  
The Mean

Abstract Background Anemia is the most common extra intestinal complication in Inflamatory Bowel Diseases (IBD) affecting the quality of life of patients. Iron deficiency and inflammation are the two most common mechanisms. It has been suggested that controlling disease activity is sufficient to correct well-tolerated anemia. Anti-TNF α by their powerful anti-inflammatory action and their role in increasing the growth of erythroid progenitors can lead to correction of anemia. The aim of this work was to determine the effect of anti-TNFα on the course of anemia in Crohn’s disease (CD). Methods This is a single-center retrospective study including patients followed for CD, between 2011 and 2017, on anti-TNF. Anemia was tested in these patients before the initiation of anti-TNF. After six months of treatment, a correlation between the achievement of therapeutic efficacy and the correction of the anemia was sought. The judgment criteria adopted were: clinical response (CDAI score <150 points), mucosal healing at endoscopy (absence of ulcerations), and normalization of the C-reactive protein (CRP <5mg / l). Results 120 patients were included, 60% of whom are female. The mean age at diagnosis was 29.8 years [12–56 years]. The mean duration of the disease was 7.42 ± 4.8 years. The disease phenotype was penetrating in 55% of cases and structuring in 45% of patients. Anoperineal manifestations (PAD) were noted in 20% of patients. 50% of patients were on Adalimumab, 50% on Infliximab and 45% of cases were on combination therapy. The indications for Biotherapy were: the presence of anoperineal manifestations (20%), failure of immunosuppressants (25%), postoperative recurrence (20%), intolerance to immunosuppressants (20%), and extradigestive manifestations in particular articular (15%). Pre-therapy, anemia was noted in 84 patients (70%), most of whom had chronic microcytic hypochromic anemia. The presence of anemia was well correlated with disease activity (p = 0.038). During the control, correction of anemia was obtained in 72 patients (60%), with a statistically significant association with the therapeutic efficacy criteria (clinical response: p <10–3, mucosal healing: p = 0.009, normalization of CRP: p <10–3). Conclusion Our study showed the effectiveness of anti-TNF alpha agents in correcting anemia in Crohn’s disease. Larger scale studies are needed to confirm our results.

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