scholarly journals P635 Carriage of the HLA-DQA1*05 allele is associated with a high risk of loss of response to infliximab in patients with inflammatory bowel disease

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S435-S436
Author(s):  
J Guardiola ◽  
L Rodriguez Alonso ◽  
E Santacana ◽  
A Padró ◽  
K Serra ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
High Risk ◽  
Bowel Disease ◽  
Loss Of Response ◽  
Inflammatory Bowel ◽  
Hla Dqa1

P053 VARIATIONS IN HEALTHCARE UTILIZATION PATTERNS AMONG HIGH RISK INFLAMMATORY BOWEL DISEASE PATIENTS ENROLLED IN HIGH DEDUCTIBLE HEALTH PLANS

2020 ◽  
Vol 158 (3) ◽  
pp. S110-S111
Author(s):  
Jeffrey Berinstein ◽  
Shirley Cohen-Mekelburg ◽  
Calen Steiner ◽  
Megan Mcleod ◽  
Mohamed Noureldin ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
High Risk ◽  
Healthcare Utilization ◽  
Bowel Disease ◽  
Health Plans ◽  
Utilization Patterns ◽  
Inflammatory Bowel

What Should Be Done in Inflammatory Bowel Disease Patients with Prior Malignancy?

2017 ◽  
Vol 35 (1-2) ◽  
pp. 50-55 ◽  
Author(s):  
Jacques Cosnes
Keyword(s):  
Inflammatory Bowel Disease ◽  
Urinary Tract ◽  
High Risk ◽  
Bowel Disease ◽  
Immunosuppressive Treatment ◽  
Intestinal Resection ◽  
Immunosuppressive Drugs ◽  
Inflammatory Bowel ◽  
Risk Of Cancer ◽  
Prior Malignancy

Background: Treatment of inflammatory bowel disease (IBD) in patients with prior malignancy is challenging because therapeutic immunosuppression required for controlling IBD activity may increase the risk of cancer recurrence. Key Messages: Contrary to the observations in the post-transplant population, retrospective observational studies of IBD patients with prior malignancy have not demonstrated that immunosuppressive drugs increased significantly the risk of new or recurrent cancer. However, these studies are highly biased and do not permit the use of these drugs. Factors like the time since treatment completion, severity, and subtype of prior cancer should be weighed along with the current IBD activity before choosing the best therapeutic strategy. In practice, most cases of prior cancer require a delay of at least 2 years before starting or resuming immunosuppressants, including anti-TNF agents. This delay should be extended to 5 years in cancer with a high risk of recurrence including cancer of the urinary tract, gastrointestinal cancer, leukemias, and multiple myeloma. A special attention should be paid to cancers with a high risk of late metastasis (breast, melanoma, renal cell carcinoma). Enteral nutrition, Budesonide, mesalamine, and limited intestinal resection should be considered following the completion of cancer treatment and prior to the safe initiation of immunosuppressive treatment for IBD. Thiopurines should be avoided in case of prior Epstein-Barr virus-related lymphoma, HPV-related carcinomas, and cancer of the urinary tract. Methotrexate and anti-TNF agents seem to be safe except for the risk of recurrent melanoma for the latter. Conclusion: IBD patients with prior malignancy should benefit from individual decisions made on a case-by-case basis.

New Methylation Biomarker Panel for Early Diagnosis of Dysplasia or Cancer in High-Risk Inflammatory Bowel Disease Patients

2018 ◽  
Author(s):  
Daniel Azuara ◽  
Susanna Aussó ◽  
Francisco Rodriguez-Moranta ◽  
Jordi Guardiola ◽  
Xavier Sanjuan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
High Risk ◽  
Early Diagnosis ◽  
Bowel Disease ◽  
Biomarker Panel ◽  
Inflammatory Bowel

scholarly journals P605 Eight-year efficacy and safety of azathioprine treatment in the maintenance of steroid-free remission in inflammatory bowel disease patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S505-S505
Author(s):  
C Cassieri ◽  
R Pica ◽  
E V Avallone ◽  
G Brandimarte ◽  
M Zippi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Bowel Disease ◽  
Efficacy And Safety ◽  
Loss Of Response ◽  
Steroid Dependent ◽  
Azathioprine Treatment ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission

Abstract Background Azathioprine (AZA) and thiopurine are widely used for induction and maintenance of remission in steroid-dependent patients with inflammatory bowel disease (IBD). The aim of this study has been to investigate its efficacy and safety in maintaining steroid-free remission in steroid-dependent IBD patients eight years after the institution of treatment. Methods Data from consecutive IBD outpatients referred in our Institution, between 1985–2017, were reviewed and all patients treated with AZA were included in this retrospective study. AZA was administered at the recommended dose of 2–2.5 mg/kg. Results Out of 2992 consecutive IBD outpatients visited in the index period, AZA was prescribed to 446 patients, 245 (54.9%) were affected by Crohn’s disease (CD) and 201 (45.1%) by ulcerative colitis (UC). One hundred and ninety-six patients with a follow-up < 96 months were excluded from the study. Two hundred and fifty patients were evaluated, 140 (56%) with CD and 110 (44%) with UC. One hundred and thirty-eight (55.2%) were male and 112 (44.8%) female (average age of 35.48 ± 14.26 SD years, range 14–74 years). Eight year after the institution of treatment, 123 (49.2%) patients still were in steroid-free remission (82 CD vs. 41 UC, 58.6% and 37.3%, respectively, p = 0.0009), 71 (28.4%) had a relapse requiring retreatment with steroids (29 CD vs. 42 UC, 20.7% and 38.2%, respectively, p = 0.0030), 56 (22.4%) discontinued the treatment due to side effects (29 CD vs. 27 UC, 20.7% and 24.5%, respectively). The loss of response from first to eighth year of follow-up was low, about 21%. Conclusion Eight years after the onset of treatment about 50% of patients did not require further steroid courses. After the first-year loss of response was low in seven subsequent years. In the present series, the maintenance of steroid-free remission was significantly higher in CD than in UC patients. The occurrence of side effects leading to the withdrawal of AZA treatment has been low.

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