scholarly journals Impact of Adalimumab Patient Support Program’s Care Coach Calls on Clinical Outcomes in Patients with Crohn’s Disease in Canada: An Observational Retrospective Cohort Study

2018 ◽  
Vol 1 (4) ◽  
pp. 191-198
Author(s):  
Neeraj Narula ◽  
Brad Millson ◽  
Katia Charland ◽  
Krishna Donepudi ◽  
Tania Gaetano ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Patient Support

scholarly journals Influence of Vitamin D3 Supplementation on Infliximab Effectiveness in Chinese Patients With Crohn's Disease: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sheng-long Xia ◽  
Quan-jia Min ◽  
Xiao-xiao Shao ◽  
Dao-po Lin ◽  
Guo-long Ma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Vitamin D3 ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Remission Rate ◽  
Serum Cytokine ◽  
Cytokine Profiles ◽  
Tnf Α

Background: It remains uncertain whether vitamin D3 (vitD3) supplementation is beneficial for remission of Crohn's disease (CD). The influence of vitD3 supplementation on Infliximab (IFX) effectiveness was analyzed in Chinese CD patients.Methods: In this retrospective cohort study, moderate-to-severe CD patients, who were bio-naïve and prescribed with IFX treatment for at least 54 weeks, were recorded from January 2014 to December 2019. VitD3 supplementation was defined as patients additionally took oral vitD3 (125 IU/d) within 3 days after the first infusion and persisted in the whole follow-up period. Disease activity was assessed using Harvey-Bradshaw Index (HBI). Serum cytokine profiles (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were quantitatively analyzed in a subset of all patients at baseline and 54-week after intervention.Results: Among 73 enrolled patients, 37 took vitD3 regularly (D3-patients), the others (non-D3-patients) did not. At 54-week, the mean 25-hydroxyvitaminD level increased in D3-patients (20.33 vs. 15.07 ng/mL, P < 0.001). The clinical remission rate was higher in D3-patients compared to non-D3-patients (83.8 vs. 61.6%, P = 0.030). The decrease of HBI from baseline to 54-week was more in D3-patients than non-D3-patients (7.41 ± 3.0 vs. 6.28 ± 2.75, P = 0.023). Furthermore, vitD3 supplementation was independently related to the increase of remission rate at 54-week in D3-patients (β = −1.667, P = 0.015). The benefit of vitD3 supplementation was significant only in patients with deficient vitD3 (all P < 0.05), but not in non-deficient vitD3. A total of nine patients (four non-D3-patients and five D3-patients) were selected to determine serum cytokine profiles after 54-week IFX treatment. In non-D3-patients, the decreases of TNF-α and IL-6 at 54-week were more obvious than at baseline (P = 0.032, 0.022, respectively). In D3-patients, however, only IL-10 increased at 54-week compared with its baseline value (P = 0.037).Conclusions: VitD3 supplementation could improve IFX effectiveness in CD patients, especially for patients with vitD3 deficiency. This beneficial effect of vitD3 supplementation probably arose from the up-regulation of IL-10.Trial Registration: NCT04606017.

Short-Term Outcomes of Adalimumab for Patients with Crohn's Disease and Associated Prognostic Factors: A Multicenter Retrospective Cohort Study

2017 ◽  
Vol 152 (5) ◽  
pp. S408
Author(s):  
Masanao Nasuno ◽  
Hiroki Tanaka ◽  
Maki Miyakawa ◽  
Satoshi Motoya ◽  
Manabu Ishii ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Prognostic Factors ◽  
Crohn's Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Short Term

scholarly journals S3201 The Obesity Paradox in Crohn’s Disease: A Retrospective Cohort Study

2020 ◽  
Vol 115 (1) ◽  
pp. S1679-S1679
Author(s):  
Subash Ghimire ◽  
Amlish Gondal ◽  
Chandrakala Dadeboyina ◽  
Kriti Suwal ◽  
Swapna Talluri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Obesity Paradox

scholarly journals Ustekinumab is effective for perianal fistulising Crohn's disease: a real-world experience and systematic review with meta-analysis

2021 ◽  
Vol 8 (1) ◽  
pp. e000702
Author(s):  
Gala M Godoy Brewer ◽  
George Salem ◽  
Muhammad A Afzal ◽  
Berkeley N Limketkai ◽  
Zadid Haq ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Response ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Symptomatic Improvement ◽  
Symptomatic Remission

BackgroundPerianal Crohn’s disease (pCD) is a debilitating complication affecting up to 30% of Crohn’s disease (CD) population, leading to increased morbidity, mortality and decreased quality of life. Despite the growing armamentarium of medications for luminal CD, their efficacy in pCD remains poorly studied.AimTo determine the efficacy of ustekinumab, a biologic approved for luminal CD, in pCD through a retrospective cohort study and systematic review.MethodsA retrospective cohort study on patients with CD with active perianal fistulae treated with ustekinumab from September 2013 to August 2019 was performed to determine perianal fistula response and remission at 6 and 12 months after ustekinumab induction. A systematic review was performed to further establish rates of fistula response and remission with ustekinumab.ResultsAt 6 months, 48.1% (13/27) patients achieved fistula response with none achieving fistula remission on provider exam, and 59.3% (16/27) achieved patient-reported symptomatic improvement with 3.7% (1/27) achieving symptomatic remission. At 1 year, on provider exam, 55.6% (5/9) had fistula response with none achieving fistula remission, and 100% (9/9) had symptomatic improvement with 22.2% (2/9) achieving symptomatic remission. There were no major safety signals during 1-year follow-up. The systematic review of 25 studies found 44% (92/209) of patients with active perianal fistulas had a clinical response within 6 months of follow-up, and 53.9% (85/152) of patients with 12 months of follow-up achieved clinical response.ConclusionUstekinumab presents a safe and effective therapy for treatment of pCD. Prospective, randomised trials are needed to further elucidate long-term efficacy of ustekinumab for pCD.

scholarly journals Combined therapy with early initiation of infliximab following drainage of perianal fistulising Crohn’s disease: a retrospective cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ping Zhu ◽  
Jin-fang Sun ◽  
Yun-fei Gu ◽  
Hong-jin Chen ◽  
Min-min Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Maintenance Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Early Initiation ◽  
Infliximab Infusion ◽  
Induction Group ◽  
Fistula Healing

Abstract Background Recent studies have confirmed that combined surgery and anti-TNF therapy could improve outcomes in patients with perianal fistulising Crohn’s disease (PFCD). However, the optimal timing for infliximab infusion after surgical intervention is uncertain. We aimed to determine the long-term efficacy of early initiation of infliximab following surgery among PFCD patients. Methods We performed a retrospective cohort study of PFCD patients who received combined infliximab and surgical treatment between 2010 and 2018 at a tertiary referral hospital. Patients were grouped according to the time interval between surgery and infliximab infusion, with < 6 weeks into early infliximab induction group and > 6 weeks into delayed infliximab induction group. The primary outcome was to compare surgical re-intervention between early and delayed infliximab induction groups. The secondary outcomes were fistula healing and predictors associated with these outcomes of early infliximab induction approach. Results One hundred and seventeen patients were included (73 in early infliximab induction, 44 in delayed infliximab induction). The median interval between surgery and infliximab initiation was 9.0 (IQR 5.5–17.0) days in early infliximab induction group and 188.0 (IQR 102.25–455.75) days in delayed infliximab induction group. After followed-up for a median of 36 months, 61.6% of patients in early infliximab induction group and 65.9% in delayed infliximab induction group attained fistula healing (p = 0.643). The cumulative re-intervention rate was 23%, 32%, 34% in early infliximab induction group and 16%, 25%, 25% in delayed infliximab induction group, at 1, 2, and 3 years respectively (p = 0.235). Presence of abscess at baseline (HR = 5.283; 95% CI, 1.61–17.335; p = 0.006) and infliximab maintenance therapy > 3 infusions (HR = 3.691; 95% CI, 1.233–11.051; p = 0.02) were associated with re-intervention in early infliximab induction group. Presence of abscess at baseline also negatively influenced fistula healing (HR = 3.429, 95% CI, 1.216–9.668; p = 0.02). Conclusion Although no clear benefit was shown compared with delayed infliximab induction group, early initiation of infliximab after surgery could achieve promising results for PFCD patients. Before infliximab infusion, durable drainage is required for patients with concomitant abscess or prolonged infliximab maintenance therapy.

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