scholarly journals Worldwide Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: An International Survey

2020 ◽  
Author(s):  
Charles N Bernstein ◽  
Siew C Ng ◽  
Rupa Banerjee ◽  
Flavio Steinwurz ◽  
Bo Shen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Task Force ◽  
Health Care Systems ◽  
Underlying Disease ◽  
Virus Spread ◽  
The World ◽  
Management Guidance ◽  
Care Systems ◽  
Inflammatory Bowel

Abstract Background and Aims Persons with inflammatory bowel disease (IBD) may be particularly vulnerable to COVID-19 either because of their underlying disease or its management. Guidance has been presented on the management of persons with IBD in the time of this pandemic by different groups. We aimed to determine how gastroenterologists around the world were approaching the management of IBD. Methods Members of the World Gastroenterology Organization (WGO) IBD Task Force contacted colleagues in countries largely beyond North America and Europe, inviting them to review the WGO website for IBD and COVID-19 introduction, with links to guideline documents, and then to respond to 9 ancillary open-ended management questions. Results Fifty-two gastroenterologists from 33 countries across 6 continents completed the survey (April 14 to May 16, 2020). They were all adhering for the most part to published guidelines on IBD management in the COVID-19 era. Some differences and reductions in services related to access, and some related to approach within their communities in terms of limiting virus spread. In particular, most gastroenterologists reduced in-person clinics (43 of 52), limited steroid use (47 of 51), limited elective endoscopy (45 of 52), and limited elective surgeries (48 of 51). If a patient was diagnosed with COVID-19, immunomodulatory therapy was mostly held. Conclusions In most countries, the COVID-19 pandemic significantly altered the approach to persons with IBD. The few exceptions were mostly based on low burden of COVID-19 in individual communities. Regardless of resources or health care systems, gastroenterologists around the world took a similar approach to the management of IBD.

Faecal Microbiota Transplantation in Inflammatory Bowel Disease: Current Concepts and Future Challenges

2020 ◽  
Vol 21 (14) ◽  
pp. 1440-1447
Author(s):  
Hubert Zatorski ◽  
Radislav Nakov
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Health Care Systems ◽  
Point Of View ◽  
Study Cohort ◽  
Faecal Microbiota ◽  
Faecal Microbiota Transplantation ◽  
Care Systems ◽  
Inflammatory Bowel ◽  
Severity Of The Disease

Dysbiosis has been repeatedly observed in inflammatory bowel disease (IBD) and is now recognized as an essential factor in the gut inflammatory process. IBD is a significant burden to health-care systems, mainly due to treatment-related costs. Available treatments have several limitations: up to 30% of patients are primary non-responders, and between 10 and 20% lose response per year, requiring a dose-escalation or a switch to another biologic. Hence, the current IBD treatment is not sufficient, and there is an urgent need to introduce new therapies in the management of these patients. Recently, the correction of dysbiosis has become an attractive approach from a therapeutic point of view. Faecal microbiota transplantation (FMT) appears as a reliable and potentially beneficial therapy in IBD patients. There is developing data that FMT for mild-to-moderately active UC is a safe and efficient therapy for the induction of remission. However, the current studies have different designs and have a short follow up, which makes clinical interpretation significantly difficult. There is a need for RCTs with a well-defined study cohort using FMT for the therapy of CD patients. The location, behavior, and severity of the disease should be taken into account. The goal of this manuscript is to review the data currently available on FMT and IBD, to explain FMT principles and methodology in IBD patients and to discuss some unresolved issues.

scholarly journals P704 The biennial direct pharmaceutical costs per treatment with biologics for the inflammatory bowel disease in Greece: A comparative calculation study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S569-S571
Author(s):  
C Liatsos ◽  
A Papaefthymiou ◽  
N Kyriakos ◽  
M Giakoumis ◽  
M Tzouvala ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Health Care Systems ◽  
Cost Benefit ◽  
Cost Utility ◽  
Drug Prices ◽  
High Prevalence ◽  
Care Systems ◽  
Inflammatory Bowel ◽  
Pharmaceutical Costs

Abstract Background Inflammatory bowel disease (IBD), as a chronic disease with relatively high prevalence worldwide, has undoubtedly resulted in a notable economic burden on health care systems globally. The IBD treatment with biologics (IBD-BT) seems quite complex with various strategies to induce and maintain remission and balance against long-term complications. IBD-BT costs have never been estimated in detail so far in Greece, especially during such a severe 10-years financial crisis experience. Methods Direct pharmaceutical costs for one and two years, both for induction and maintenance, adult treatment diagnosed with Crohn’s disease (CD-BT) or Ulcerative colitis (UC-BT) were estimated. For intravenous agents, the hospital drug prices and one day admission costs were calculated, whereas for subcutaneous biologics the retail ones. It was taken for granted that all patients were fully responders and after the approved induction scheme continued with the standard maintenance strategy. Prototype and biosimilar drug prices were also assessed where available. More specifically, when considering biosimilars, the most affordable one was included to our analysis. Each drug price was estimated based on the data collected from the 2019 Greek official electronic national publication on drug therapy of the Greek national organisation for medicines. Results Table shows the costs in euros of each IBD-BT scheme. The biosimilar adalimumab was proved as the most affordable choice both for CD- and UC-BT. The second most affordable choice for CD revealed to be the prototype Adalimumab and respectively for UC the recently introduced tofacitinib, in the maintenance dose of 5 mg bid after week 8 (with a slight burden when the more intensive scheme with Tofacitinib 10 mg bid for 16 weeks is necessary). The most expensive strategies include Ustekinumab 90 mg (per 8 weeks for body weight—BW > 55 to ≤85 kg and >85 kg) and the prototype Infliximab 5 mg/kg (per 8 weeks for BW>81 kg), whereas Vedolizumab remains expensive regardless BW. It is worthwhile to mention that the hospitalisation expenditures (563€) raise the costs of intravenous agents when compared with the subcutaneous ones. Conclusion The biennial direct pharmaceutical costs for the approved IBD-BT schemes both for induction and maintenance phases in fully responders were estimated thoroughly for the first time in Greece. These results should motivate Governments and European Union policymakers in order to promote cost-benefit and cost-utility studies to offer the best patients’ benefit by evaluating and deciding the most suitable regimen with respect to biologic prices, adverse effects, hospitalisation expenditures, IBD complications and recurrences.

scholarly journals The Emerging Epidemic of Inflammatory Bowel Disease in Asia and Iran by 2035: A Modeling Study

2021 ◽  
Author(s):  
Meysam Olfatifar ◽  
Mohammad Reza Zali ◽  
Mohamad Amin Pourhoseingholi ◽  
Hedieh Balaii ◽  
Shaghayegh Baradaran Ghavami ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Health Care Systems ◽  
Fold Increase ◽  
Asia Pacific ◽  
The Public ◽  
The Future ◽  
Care Systems ◽  
Inflammatory Bowel ◽  
East Asia Region

Abstract Background: The projection studies are imperative to optimize the future need for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD). Methods: To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia regions and Iran separately from 2017 to 2035. We applied two deterministic and stochastic approaches. Results: For 2035 compared to 2020, we projected a 2.5-fold increase in prevalent cases for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increment for East Asia region with 4.5 million cases and a 1.6-fold increase in prevalence for High‐income Asia‐Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively. Conclusions: Our results showed an emerging epidemic for the prevalence of IBD in Asia regions or/and countries. Hence, we suggest the need for emergency action to control this increasing trend in Asia and Iran.

scholarly journals Issues of inflammatory bowel disease management in primary care.

2021 ◽  
Vol 2021 (1) ◽  
pp. 109-115
Author(s):  
M.S. Brynza ◽  
◽  
K.G. Uvarova ◽  
Keyword(s):  
Primary Care ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Primary Care Physicians ◽  
Health Care Systems ◽  
Bowel Diseases ◽  
Care Systems ◽  
Inflammatory Bowel ◽  
Clear Communication

Іnflammatory bowel diseases are among various chronic processes, which, in the case of inadequate diagnosis and irrational treatment, eventually lead to highly unfavorable consequences. Thus, the timely establishment of the diagnosis, as well as the prescription of effective therapy and the subsequent careful follow-up of patients with inflammatory bowel diseases is the key to prolongation of the patients’ wellbeing and prevention of the occurrence of severe complications. Due to the possible increase in the prevalence of these pathologies in the future, close and effective cooperation between specialists and primary care physicians is extremely important nowadays. Unfortunately, there are currently no tools that can be used by primary care physicians to improve the routing of patients with inflammatory bowel disease. However, close and clear communication between primary and secondary healthcare specialists should become an integral part of health care systems, including that in our country.

scholarly journals Best Practice Guidance for Adult Infusion Centres during the COVID-19 Pandemic: Report from the COVID-19 International Organization for the Study of IBD [IOIBD] Task Force

2020 ◽  
Vol 14 (Supplement_3) ◽  
pp. S785-S790
Author(s):  
Iris Dotan ◽  
Remo Panaccione ◽  
Gilaad G Kaplan ◽  
Colm O’Morain ◽  
James O Lindsay ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Best Practice ◽  
Online Survey ◽  
Task Force ◽  
International Organization ◽  
Care Givers ◽  
Global Guidance ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Infusion centres are a central part in the management of patients with inflammatory bowel disease [IBD] and could be a source of transmission of SARS-COV-2. Here we aimed to develop global guidance for best practices of infusion centres for IBD patients and to determine the impact of the COVID-19 pandemic on these centres. Under the auspices of the International Organization for the Study of Inflammatory Bowel Disease [IOIBD], a task force [TF] was formed, an online survey was developed to query infusion centre protocols during COVID-19, and recommendations were made, based on TF experience and opinion. Recommendations focus mainly on patients screening, infusion centres re-organization, personnel protection, and protocol modifications such as shortening infusion duration or replacing it with subcutaneous alternatives. Implementing these recommendations will hopefully reduce exposure of both IBD patients and care givers to SARS-COV-2 and improve the function and safety of infusion centres during the COVID-19 pandemic as well as potential future threats.

Bariatric Surgery and Its Complications in Inflammatory Bowel Disease Patients

2019 ◽  
Author(s):  
Amandeep Singh ◽  
Brian Koenen ◽  
Donald F Kirby
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Management Strategies ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Underlying Disease ◽  
Life Outcomes ◽  
High Prevalence ◽  
History Of ◽  
Inflammatory Bowel

Abstract Recent data have suggested that bariatric procedures, especially laparoscopic sleeve gastrectomy (SG), are safe and effective weight loss measures in patients with inflammatory bowel disease (IBD). But most of the studies have looked at short-term outcomes, and there is a general lack of awareness of underlying disease processes and baseline comorbidities in IBD patients undergoing bariatric procedures. Postbariatric issues in IBD patients including diarrhea from dumping syndrome, choleretic diarrhea, a high prevalence of small intestinal bacterial overgrowth, gastroesophageal reflux disease, Barrett’s esophagus, stomal ulcerations, stenosis, and renal and gallstones can complicate the natural history of IBD. This could lead to unnecessary hospitalizations, change of medical therapy, and poor surgical and quality of life outcomes. In this review, we will discuss major complications after common bariatric procedures (SG, Roux-en-Y gastric bypass, and gastric banding) and suggest possible management strategies.

Prevalence of Anemia and Iron Deficiency in Romanian Patients with Inflammatory Bowel Disease: a Prospective Multicenter Study

2015 ◽  
Vol 24 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Alexandru Lupu ◽  
Mircea Diculescu ◽  
Razvan Diaconescu ◽  
Marcel Tantau ◽  
Alina Tantau ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Bowel Disease ◽  
Activity Index ◽  
Vitamin B12 Deficiency ◽  
Underlying Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Multicenter Prospective Study ◽  
Prevalence Of Anemia

Background & Aims: Anemia is the most frequent systemic complication in inflammatory bowel diseases. It affects the quality of life and can interact with working capacity. Our objectives were to identify the prevalence of anemia, its main causes and its management in patients with inflammatory bowel disease from Romania.Methods: We conducted a multicenter prospective study from March 2013 to August 2014. We enrolled 291 patients from three referral centers: 115 (39.52%) with Crohn's disease (CD) and 176 (60.48%) with ulcerative colitis (UC). We defined anemia according to the WHO criteria.Results: Median age of the patients was 41 years and the median time period since diagnosis was 3 years (0.75-7). The median activity index for UC (UCAI) was 4 and the median CD activity index (CDAI) was 96. More patients with CD were on antiTNFα therapy (p < 0.01), corticosteroids (p =0.18) or azathioprine (p=0.05) and required surgery for their underlying disease at study enrollment (p < 0.01). Anemia was present in 31.27% of the patients, more often in those with CD (35.65%) than with UC (28.41%) (not statistically significant); 53.26% of the patients had iron deficiency while 4.12% had folic acid and 8.59% vitamin B12 deficiency; 9.62% of the patients had received anti-anemic therapy at inclusion in the study or in the last three months prior to study enrollment.Conclusions: About one in three Romanian patients with inflammatory bowel disease has anemia, which is frequently associated with iron deficiency. About 30% of the patients with anemia are under therapy and the most frequent route for iron supplementation is the oral one. This might contribute to the high prevalence of iron deficiency and the low level of compliance.

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