scholarly journals Prospective evaluation of intestinal decompression in treatment of acute bowel obstruction from Crohn’s disease

2019 ◽  
Vol 7 (4) ◽  
pp. 263-271
Author(s):  
Rui-Qing Liu ◽  
Shuai-Hua Qiao ◽  
Ke-Hao Wang ◽  
Zhen Guo ◽  
Yi Li ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Obstruction ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Intestinal Decompression ◽  
Decompression Tube ◽  
Endoscopic Placement ◽  
Emergent Surgery

Abstract Background Conservative therapy for Crohn’s disease (CD)-related acute bowel obstruction is essential to avoid emergent surgery. The present study aimed to evaluate the efficacy of using a long intestinal decompression tube (LT) in treatment of CD with acute intestinal obstruction. Methods This is a prospective observational study. Comparative analysis was performed in CD patients treated with LT (the LT group) and nasogastric tube (the GT group). The primary outcome was the avoidance of emergent surgery. Additionally, predictive factors for failure of decompression and subsequent surgery were investigated. Results There were 27 and 42 CD patients treated with LT and GT, respectively, in emergent situations. Twelve (44.4%) patients using LT were managed conservatively without laparotomy, while only nine (21.4%) patients in the GT group were spared from emergent surgery (P < 0.05). Both in surgery-free and in surgery patients, the time to alleviation of symptoms was significantly shorter in the LT groups than in the GT groups (both P < 0.01). C-reactive protein decrease after intubation and 48-hour drainage volume >500 mL were predictors of unavoidable surgery (both P < 0.05). The rate of temporary stoma and incidence of incision infection in the LT surgery group were significantly lower than those in the GT group (both P < 0.05). No significant differences were observed in the frequency of medical and surgical recurrences between the LT and GT groups (all P > 0.05). Conclusions Endoscopic placement of LT could improve the emergent status in CD patients with acute bowel obstruction. The drainage output and changes in C-reactive protein after intubation could serve as practical predictive indices for subsequent surgery. Compared to traditional GT decompression, LT decompression was associated with fewer short-term complications and did not appear to affect long-term recurrence.

scholarly journals P473 Long-term follow-up of switching from original adalimumab to adalimumab biosimilar: real-world data in IBD

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S416-S416 ◽  
Author(s):  
C Padilla Suarez ◽  
K Webb ◽  
N Persad ◽  
J Sercombe ◽  
E Tyler ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
C Reactive Protein ◽  
Drug Levels ◽  
Reactive Protein ◽  
Loss Of Response ◽  
Mayo Score

Abstract Background Studies have reported good efficacy outcomes for patients with inflammatory bowel disease (IBD) treated with biosimilars. There are limited long-term data. We assessed the long-term efficacy data and safety after switching from adalimumab to adalimumab biosimilars in patients with IBD. Methods A prospective single-centre observational study involving patients with Crohn’s disease or ulcerative colitis switched from adalimumab to adalimumab biosimilar and reviewed up to 12months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. Blood tests including C-reactive protein, adalimumab drug levels and anti-drug antibodies were monitored. We have recorded side effects and possible serious adverse effects. The plan is to continue the study for 24 months. Results 109 patients with IBD have completed at least 6 months of treatment with adalimumab biosimilar, 12 of which have ulcerative colitis and 97 Crohn’s disease. Most of them (88%) continued on biosimilar after 6 months. Patients discontinued the therapy due to loss of response or development of antibodies in one case. Two patients were switched to a different biosimilar due to the presence of side effects which were however not serious. Of those who remained on the treatment, 74.5% were in clinical remission at 6 months and 71.4% at 9 months. HB index, partial Mayo score, C-reactive protein and adalimumab drug levels did not show significant changes. We have not reported any serious adverse events. We hope than by February, at least 60% of these patients will have been on Adalimumab for 12 months and further amended date would be added. Conclusion Most of the patients switching from original adalimumab were maintained on biosimilar at 6 and 12months of follow-up with similar efficacy and safety as the original drug.

1103 Predictive Value of C-Reactive Protein Level Changes On the Long Term Outcome of Infliximab in Crohn's Disease

2009 ◽  
Vol 136 (5) ◽  
pp. A-171
Author(s):  
Matthias Jürgens ◽  
Fabian Schnitzler ◽  
Kristel Van Steen ◽  
Jestinah Mahachie ◽  
Vera Ballet ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Protein Level ◽  
Predictive Value ◽  
C Reactive Protein ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Reactive Protein

Sa2038 Early Normalization of C-Reactive Protein (CRP) by Infliximab is a Predictive Factor of Sustained Long-Term Clinical Efficacy in Crohn's Disease

2012 ◽  
Vol 142 (5) ◽  
pp. S-386
Author(s):  
Kayoko Kimura ◽  
Katsuyoshi Matsuoka ◽  
Takanori Kanai ◽  
Susumu Okamoto ◽  
Tadakazu Hisamatsu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Efficacy ◽  
Predictive Factor ◽  
C Reactive Protein ◽  
Reactive Protein

Combined evaluation of fecal calprotectin and C-reactive protein as a therapeutic target in the management of patients with Crohn's disease

2021 ◽  
Vol 44 (2) ◽  
pp. 87-95
Author(s):  
Francisco Guilherme Cancela Penna ◽  
Rodrigo Macedo Rosa ◽  
Fernando H. Pereira ◽  
Pedro Ferrari Sales Cunha ◽  
Stella Cristina S. Sousa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Target ◽  
Fecal Calprotectin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Combined Evaluation

Correlation between levels of C-reactive protein and clinical activity in Crohn's disease

2007 ◽  
Vol 39 (11) ◽  
pp. 1006-1010 ◽  
Author(s):  
S. Karoui ◽  
S. Ouerdiane ◽  
M. Serghini ◽  
T. Jomni ◽  
L. Kallel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Activity ◽  
C Reactive Protein ◽  
Reactive Protein

Plasma Arachidonic Acid-Rich Phospholipids in Crohn's Disease: Response to Treatment

1996 ◽  
Vol 91 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Stephen P. Pereira ◽  
Theresa B. Cassell ◽  
Jeffrey L Engelman ◽  
Gordon E. Sladen ◽  
Gerard M. Murphy ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Polyunsaturated Fatty Acids ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Polyunsaturated Phosphatidylcholine

1. Increased concentrations of plasma polyunsaturated fatty acids have been implicated in the pathogenesis of Crohn's disease. However, it is not known whether there are corresponding changes in circulating phospholipids - the major source of fatty acids in the plasma. 2. Fasting plasma samples were obtained from 17 control subjects and 13 patients with active Crohn's disease [Simple Index of Crohn's Disease Activity (SICDA) >6] before, and 2 and 8 weeks after, treatment with either a peptide diet or oral prednisolone. 3. Before treatment, the Crohn's disease patients had mildly active disease (SICDA 9.9 ± 0.8, erythrocyte sedimentation rate 26.4 ± 6.5 mm/h, serum C-reactive protein 2.8 ± 0.4 mg/l). The proportions of the polyunsaturated phosphatidylcholine species, 16:0–20:4 (10.0 ± 0.7%) and 16:0–22:6 (7.1 ± 0.8%), were both significantly higher than those in healthy controls (7.6 ± 0.5%, P < 0.01 and 5.3 ± 0.5%, P < 0.05 respectively). 4. After 2 weeks treatment, the SICDA in the Crohn's disease patients decreased to 3.2 ± 0.6 (P < 0.0001 compared with the pretreatment value), and there were corresponding falls in the erythrocyte sedimentation rate (to 12.6 ± 2.7 mm/h, P < 0.05) and C-reactive protein concentration (to 1.7 ± 0.3 mg/l, P < 0.05)—these improvements being maintained at 8 weeks. There was also a fall to normal values in 16:0–20:4 (to 7.7 ± 0.6%, P < 0.01 compared with the pretreatment value) and in 16:0–22:6 (to 5.7 ± 0.5%, P not significant), by week 8. 5. The proportions of polyunsaturated phosphatidylcholine molecular species were increased in the plasma of patients with active Crohn's disease, but fell to normal levels during disease remission. These observations are consistent with the theory that, in active Crohn's disease, the mucosal phospholipids containing polyunsaturated fatty acids are increased, contribute to eicosanoid synthesis and ‘spill’ into the plasma.

Sign in / Sign up

Export Citation Format

Share Document