scholarly journals Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3275-3283 ◽  
Author(s):  
Anastasia Dupré ◽  
Michael Collins ◽  
Gaétane Nocturne ◽  
Franck Carbonnel ◽  
Xavier Mariette ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Bowel Diseases ◽  
History Of ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.

scholarly journals AN ADVANCED REVIEW ON DIAGNOSIS AND TREATMENT AND EXTRA-INTESTINAL MANIFESTATIONS ASSOCIATED WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 10 (1) ◽  
pp. 99-113
Author(s):  
Deep Sharma ◽  
Rekha Rana ◽  
Kiran Thakur ◽  
Priyanka
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Severe Disease ◽  
Clinical Pathology ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory Bowel Diseases are mainly a group of bowel disorders which are generally associated with chronic inflammation of the intestinal tract due to the reason of an imbalance in the presence of the intestinal microbiota. Inflammatory bowel disease can have two different types based on their clinical pathology which are mainly Crohn’s Disease and Ulcerative Colitis. Both of these clinical sub-types are most likely to be focussed among all of the inflammatory bowel diseases due to their increasing risk of incidence as well as associated difficulties in their treatment. However, the main cause of inflammatory bowel disease has not been cleared till the date but from last three decades, there is a hub of researchnes being going on to get a clear idea about the cause of disease. Among these studies most of researchers have found the role of Nucleotide Oligomerization Domain 2 genes in the pathophysiology of disease. For the treatment of ulcerative colitis, there are severalapproaches available, based on the severity of the disease. Aminosalicylates are used to treat mild disease, use of corticosteroids is the effective treatment in the moderate case whereas use of cyclosporine in severe disease. In Crohn’s disease, drug choices are dependent on both location and behavior ofthe disease. Nowadays, the advanced treatments have been included such as use of monoclonal antibodiesor fusion proteins including anti-TNF drugs as biological therapy of disease. Also the post treatment remission of this disease makes it more complicated to be cured.

scholarly journals AB0905 THE PREVALENCE AND RISK FACTORS OF OSTEOPOROSIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES: A TUNISIAN STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1755.1-1755
Author(s):  
L. Mnif ◽  
H. Gdoura ◽  
L. Chtourou ◽  
A. Amouri ◽  
M. Boudabbous ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Inflammatory Bowel Disease ◽  
Bone Mineral ◽  
Bone Densitometry ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Mineral Density ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background:Osteoporosis is as known a chronic complication of inflammatory bowel diseases (IBD). Its etiopathogenesis is often multifactorial.Objectives:The aim of our study was to describe the prevalence of reduced bone mineral density and to identify risk factors of osteoporosis in patients with inflammatory bowel diseases.Methods:This is a retrospective study over three years, collecting patients suffering from IBD and having benefited from a bone densitometry. We have specified for each patient the clinical data and the IBD characteristics. Bone mineral density (BMD, g/ cm) was assessed by dual X-ray absorptiometry. Osteoporosis was diagnosed when BMD was 2.5 standard deviations below the mean peak value in young adults (T score,22.5 SD). Patients with other pathology that may change the bone metabolism were excluded.Results:sixty-one patients were included with an average age of 38 ± 13 years [16-73]. The sex ratio M / F was 1.25. 69% of patients had ulcerative colitis. The bone density profile was normal in 49.2% of the cases. Osteoporosis and osteopenia were noted in 13.1% and 37.7% of patients, respectively. Osteoporosis was associated with advanced age (50.5 ± 16.5 years vs 36.26 ± 12.93 years; p = 0.007) and longer course disease (6.75 ± 7, 4 years vs 2.5 ± 4 years; p = 0.015). The cumulative dose of prednisone equivalent used in patients with osteoporosis was significantly higher than the other patients (2775 ± 3338 mg vs 706 ± 1449 mg; p = 0.003). Osteopenia was more frequently associated with crohn’s disease (58% vs 28.6% p = 0.0029). There was no significant difference between the group with osteoporosis or osteopenia and the group with normal bone densitometry for sex and body mass index.Conclusion:Osteoporosis during IBD is associated with advanced age, longer duration of illness and administration of high doses of corticosteroids. The high proportion of osteoporosis and osteopenia in our study underlines the importance of systematic BMD measurement in all IBD patients as a base for initiating the appropriate treatment.References:[1]The prevalence and risk factors for osteoporosis in patients with inflammatory bowel disease. Miznerova E et al. Bratisl Lek Listy. 2013;114(8):439-45.[2]Osteoporosis and inflammatory bowel disease: prevalence and risk factors in Tunisian patients. Boubaker J et al. Gastroenterol Clin Biol. 2003 Oct;27(10):901-7.Disclosure of Interests:None declared

scholarly journals Reações adversas no tratamento da doença inflamatória intestinal em um Ambulatório de Referência / Adverse reactions in inflammatory bowel disease treatment in a Reference Center

2020 ◽  
Vol 65 (1) ◽  
pp. 1
Author(s):  
Bruna Romano Correa ◽  
Mylena Scheneider Becale ◽  
Felipe Bertollo Ferreira ◽  
Fabiano Quarto Martins ◽  
Ana Paula Hamer Sousa Clara ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Adverse Reactions ◽  
Inflammatory Conditions ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Introdução: A Doença Inflamatória Intestinal que compreende, principalmente, a Doença de Crohn e a Retocolite Ulcerativa, consiste em um grupo de condições inflamatórias crônicas que afetam predominantemente o trato gastrointestinal de indivíduos suscetíveis expostos a fatores de risco ambientais. Estudos recentes demonstram que a incidência e a prevalência da doença vêm aumentando em diferentes regiões do mundo. Em paralelo, há crescimento na utilização de imunomoduladores e terapias biológicas, tornando necessária a análise de seus riscos e impactos. Devido às terapias de longa duração com medicamentos sujeitos a efeitos nocivos, pacientes em vigência de tratamento podem evoluir com reações adversas. Objetivos: Analisar a ocorrência de reações adversas a medicamento durante o tratamento farmacológico de pacientes do Ambulatório de Referência de Doenças Inflamatórias Intestinais do Hospital Santa Casa de Misericórdia em Vitória – ES. Métodos: Estudo observacional e analítico de pesquisa documental retrospectiva através da coleta de dados durante o mês de outubro de 2020, em registros de pacientes em acompanhamento clínico. Conclusão: O perfil de reações adversas a medicamentos do estudo concordou majoritariamente com dados da literatura. Por meio desses dados será possível desenvolver estratégias voltadas ao rastreio, prevenção e redução das reações adversas a medicamentos, contribuindo para a diminuição da morbimortalidade e dos custos inerentes ao tratamento.Palavras chave: Reações adversas relacionadas a medicamentos, Efeitos colaterais, Doença de Crohn, Colite ulcerativa, Doenças inflamatórias intestinais ABSTRACT Introduction: Inflammatory Bowel Disease, which mainly comprises Crohn’s Disease and Ulcerative Colitis, consists of a group of chronic inflammatory conditions that predominantly affect the gastrointestinal tract of susceptible individuals exposed to environmental risk factors. Recent studies show that the incidence and prevalence of the disease has been increasing in different regions of the world. In parallel, there is a growth in the use of immunomodulators and biological therapies, making it necessary to analyze their risks and impacts. Due to long-term therapies with drugs subject to harmful effects, patients undergoing treatment may evolve with adverse reactions. Objective: To analyze the occurrence of adverse reactions to drugs during the pharmacological treatment of patients at the Reference Clinic for Inflammatory Bowel Diseases at Hospital Santa Casa de Misericórdia in Vitória - ES (HSCMV). Methods: This is an observational and analytical study of retrospective documentary research was carried out through of data during the month of October 2020, in patient records under clinical follow-up. Conclusion: The adverse drug reactions (ADR) profile of the study mostly agreed with data from the literature. Through these data, it will be possible to develop strategies aimed at screening, preventing and reducing ADRs, contributing to the reduction of morbidity and mortality and costs inherent to treatment. Keywords: Drug-related adverse reactions, Side effects, Crohn’s disease, Ulcerative colitis, Inflammatory bowel diseases

scholarly journals Risk Factors of Urothelial Cancer in Inflammatory Bowel Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3257
Author(s):  
Gian Paolo Caviglia ◽  
Giorgio Martini ◽  
Angelo Armandi ◽  
Chiara Rosso ◽  
Marta Vernero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Urothelial Cancer ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
Number Of Publications

Extraintestinal cancers are important complications in patients with inflammatory bowel disease (IBD). A limited number of publications are available regarding the association between IBD and urothelial cancer. The primary outcome of our study was the comparison of the prevalence of urothelial cancer in patients with IBD with respect to the prevalence in the general population. Secondary outcomes were the assessment of risk factors for the onset of urothelial cancer in IBD. In a retrospective study we examined the medical records of all patients with a confirmed diagnosis of IBD followed in our clinic between 1978 and 2021. For each of the patients with identified urothelial cancer, more than ten patients without cancer were analyzed. Furthermore, 5739 patients with IBD were analyzed and 24 patients diagnosed with urothelial cancer were identified. The incidence of urothelial cancer, compared with the incidence in the general population, was not significantly different (0.42% vs. 0.42%; p = 0.98). Twenty-three cases were then compared (1 case was discarded due to lack of follow-up data) against 250 controls. During the multivariate analysis, smoking (odds ratio, OR = 8.15; 95% confidence interval, CI = 1.76–37.63; p = 0.007) and male sex (OR = 4.04; 95% CI = 1.29–12.66; p = 0.016) were found as risk factors. In conclusion, patients with IBD have a similar risk of developing urothelial cancer compared to the general population, but males with a history of smoking are at increased risk.

scholarly journals THU0382 ARTICULAR MANIFESTATIONS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES TREATED WITH ANTI-TNFΑ

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 425.1-425
Author(s):  
L. Cachen ◽  
G. Nocturne ◽  
M. Collins ◽  
A. Meyer ◽  
F. Carbonnel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Predictive Factor ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
De Novo ◽  
Tertiary Hospital ◽  
Factors Associated ◽  
Bowel Diseases ◽  
History Of ◽  
Inflammatory Bowel

Background:Articular manifestations are the most frequent extra-digestive manifestations of Inflammatory Bowel Disease (IBD). Anti-TNF have proved to be as effective on articular symptoms as on IBD’s ones, but have been suspected to induce paradoxical articular manifestations.Objectives:The aims of this study were to describe the frequency, the type and the management of all articular manifestations occurring in patients treated with anti-TNF for IBD and to look for factors associated with their occurrence.Methods:In this retrospective monocentric study, we included all patients who received an anti-TNF for an IBD in our tertiary hospital referent for inflammatory rheumatic and bowel diseases. We searched for all incident articular manifestations occurring during treatment with anti-TNF, including new or recurrent articular manifestations. Characteristics of patients with paradoxical articular manifestations (defined as inflammatory articular symptoms occurring while IBD was in remission, without immunization against anti-TNF) were compared to that of patients without articular manifestations to identify factors associated with their occurrence.Results:Through a systematic search of all IBD patients seen in our tertiary hospital between February 2013 and May 2017, we identified 442 patients (36.2±15 years, 50.5% men) who had ever received an anti-TNF for IBD: Crohn’s disease (n=277), ulcerative colitis (154) and undetermined colitis (n=11). 74 (16.7%) had already a history of inflammatory articular manifestations including 37 patients with a diagnosis of spondyloarthritis (SpA) made before anti-TNF’s beginning.Among them, 115 (26%) patients developed a new articular manifestation after a mean of 20 (±22) months of treatment: mechanical in 56 (12.6%) and inflammatory in 59 (13.3%). Within patients with new inflammatory articular manifestations: 39% were paradoxical, 27% were concomitant of an IBD flare, 27% were associated to an immunization against anti-TNF, 3% were induced lupus, 2% were chondrocalcinosis and 2% were polymyalgia rheumatic. Articular manifestations associated to an immunization were linked to a loss of efficiency of the treatment for 62%, with (42%) or without (20%) associated digestive symptoms and 38% were due to delayed hypersensitivity reaction. Among paradoxical articular manifestations, 83% were new articular symptoms, including 35% of SpA de novo, and 17% were recurrence of known articular manifestations. The only predictive factor of paradoxical articular manifestation was a previous diagnosis of SpA (21.7% vs 6.8%; p=0.02). Paradoxical manifestations improved in 17 patients despite continuation of anti-TNF, methotrexate was added in 2 and anti-TNF was discontinued in only 4 patients.Conclusion:Inflammatory articular manifestations occurred in about 13% of patients treated with anti-TNF for IBD. More than a quarter were linked to an immunization against anti-TNF, which has to be searched in this situation. Less than half of them (39%) were paradoxical. In most of cases, they were transitory and did not require anti-TNF’s discontinuation. The only predictive factor of paradoxical articular manifestations was having a history of SpA.References:[1]Thiebault H, et al. Paradoxical articular manifestations in patients with inflammatory bowel diseases treated with infliximab. Eur J Gastroenterol Hepatol, 2016.[2]Fiorino G et al. Paradoxical immune-mediated inflammation in inflammatory bowel disease patients receiving anti-TNF-α agents. Autoimmun Rev, 2014.Disclosure of Interests:Laurie Cachen: None declared, Gaetane Nocturne: None declared, Michael Collins Consultant of: Abbvie, Takeda, MSD, Celgene, Antoine Meyer: None declared, Franck Carbonnel Consultant of: Msd Abbvie Amgen, Xavier Mariette Consultant of: BMS, Gilead, Medimmune, Novartis, Pfizer, Servier, UCB, Raphaèle Seror Consultant of: BMS UCB Pfizer Roche

scholarly journals Different renal manifestations associated with very early onset pediatric inflammatory bowel disease: case report and review of literature

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
A. Angeletti ◽  
S. Arrigo ◽  
A. Madeo ◽  
M. Molteni ◽  
E. Vietti ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Interstitial Nephritis ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Early Onset ◽  
Renal Involvement ◽  
Granulomatous Interstitial Nephritis ◽  
Disease Case ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel diseases are characterized by chronic inflammation of the gastrointestinal tract. In particular, Crohn disease and ulcerative colitis represent the two most common types of clinical manifestations. Extraintestinal manifestations of inflammatory bowel diseases represent a common complications, probably reflecting the systemic inflammation. Renal involvement is reported in 4–23% of cases. However, available data are limited to few case series and retrospective analysis, therefore the real impact of renal involvement is not well defined. Case presentation We report the case of a 10-years old male affected by very early onset unclassified-Inflammatory bowel diseases since he was 1-year old, presenting with a flare of inflammatory bowel diseases associated with acute kidney injury due to granulomatous interstitial nephritis. Of interest, at 7-year-old, he was treated for IgA nephropathy. To our knowledge, no previous reports have described a relapse of renal manifestation in inflammatory bowel diseases, characterized by two different clinical and histological phenotypes. Conclusions The link between the onset of kidney injuries with flares of intestinal inflammation suggest that nephritis maybe considered an extra-intestinal manifestation correlated with active inflammatory bowel disease. However, if granulomatous interstitial nephritis represents a cell-mediated hypersensitivity reaction than a true extraintestinal manifestation of inflammatory bowel diseases is still not clarified. We suggest as these renal manifestations here described may be interpreted as extraintestinal disorder and also considered as systemic signal of under treatment of the intestinal disease.

Mo1375 Prevalence of Family History of Inflammatory Bowel Disease Among Ulcerative Colitis Patients

2013 ◽  
Vol 144 (5) ◽  
pp. S-649-S-650
Author(s):  
Ryan E. Childers ◽  
Swathi Eluri ◽  
Christine Vazquez ◽  
Theodore M. Bayless ◽  
Susan Hutfless
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Family History ◽  
Bowel Disease ◽  
History Of ◽  
Inflammatory Bowel

The SPOSIB SB2 Sicilian Cohort: Safety and Effectiveness of Infliximab Biosimilar SB2 in Inflammatory Bowel Diseases, Including Multiple Switches

2020 ◽  
Author(s):  
Fabio Salvatore Macaluso ◽  
Walter Fries ◽  
Anna Viola ◽  
Andrea Centritto ◽  
Maria Cappello ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Tumor Necrosis ◽  
Prospective Observational Study ◽  
Cumulative Number ◽  
Serious Adverse Events ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background No data on the recently introduced infliximab (IFX) biosimilar SB2 in inflammatory bowel disease (IBD) are available. Methods The Sicilian Prospective Observational Study of Patients With IBD Treated With Infliximab Biosimilar SB2 is a multicenter, observational, prospective study performed among the cohort of the Sicilian Network for Inflammatory Bowel Disease. All consecutive IBD patients starting the IFX biosimilar SB2 from its introduction in Sicily (March 2018) to September 2019 (18 months) were enrolled. Results Two hundred seventy-six patients (Crohn disease: 49.3%, ulcerative colitis: 50.7%) were included: 127 (46.0%) were naïve to IFX and naïve to anti-tumor necrosis factor medications (anti-TNFs), 65 (23.5%) were naïve to IFX and previously exposed to anti-TNFs, 17 (6.2%) were switched from an IFX originator to SB2, 43 (15.6%) were switched from the biosimilar CT-P13 to SB2, and 24 (8.7%) were multiply switched (from IFX originator to CT-P13 to SB2). The cumulative number of infusions of SB2 was 1798, and the total follow-up time was 182.7 patient-years. Sixty-seven serious adverse events occurred in 57 patients (20.7%; incidence rate: 36.7 per 100 patient-year), and 31 of these events caused the withdrawal of the drug. The effectiveness after 8 weeks of treatment was evaluated in patients naïve to IFX (n = 192): 110 patients (57.3%) had steroid-free remission, while 56 patients had no response (29.2%). At the end of follow-up, 72 patients (26.1%) interrupted the treatment, without significant differences in treatment persistency estimations between the five groups (log-rank P = 0.15). Conclusions The safety and effectiveness of SB2 seem to be overall similar to those reported for the IFX originator and CT-P13.

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