scholarly journals Paradoxical gastrointestinal effects of interleukin-17 blockers

2020 ◽  
Vol 79 (9) ◽  
pp. 1132-1138 ◽  
Author(s):  
Marine Fauny ◽  
David Moulin ◽  
Ferdinando D'Amico ◽  
Patrick Netter ◽  
Nadine Petitpain ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Monoclonal Antibody ◽  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Interleukin 17 ◽  
Disease Exacerbation ◽  
Disease Flare ◽  
Paradoxical Effects ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Secukinumab, ixekizumab and brodalumab are monoclonal antibody therapies that inhibit interleukin (IL)-17 activity and are widely used for the treatment of psoriasis, psoriatic arthritis and ankylosing spondylitis. The promising efficacy results in dermatology and rheumatology prompted the evaluation of these drugs in Crohn’s disease and ulcerative colitis, but the onset of paradoxical events (disease exacerbation after treatment with a theoretically curative drug) prevented their approval in patients with inflammatory bowel diseases (IBDs). To date, the pathophysiological mechanisms underlying these paradoxical effects are not well defined, and there are no clear guidelines for the management of patients with disease flare or new IBD onset after anti-IL-17 drug therapy. In this review, we summarise the literature on putative mechanisms, the clinical digestive effects after therapy with IL-17 inhibitors and provide guidance for the management of these paradoxical effects in clinical practice.

Features of the complex treatment of ulcerative colitis in clinical practice

2020 ◽  
pp. 6-11
Author(s):  
Svetlana Svetlana ◽  
Mikhail Klimentov ◽  
Olga Neganova ◽  
Alina Nazmieva ◽  
Anastasiya Kochurova
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Statistical Study ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Unknown Etiology ◽  
Number Of Patients ◽  
First Republic ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Nowadays there are certain difficulties in the early diagnosis of ulcerative colitis, proceeding with minimal intestinal symptoms. The etiology of the disease remains unclear to this day; there is no exact information about the prevalence of the disease due to the large number of latent forms and the low number of patients seeking medical help. This article presents the results of a retrospective analysis of the incidence of ulcerative colitis in the coloproctology department of the First Republic Clinical Hospital of Izhevsk. The study was conducted to assess the frequency of occurrence and determine the internal picture of ulcerative colitis. To achieve this goal, we selected 34 patients with ulcerative colitis. A statistical study was conducted on the following criteria: gender composition, age groups, forms of the disease, localization, complications, and main complaints. The length of hospital stay often was not more than 20 days. The literature on this pathology was also studied and presented in the form of a theoretical basis, which consisted of the determination and etiology of inflammatory bowel diseases. Due to the unknown etiology, insufficiently studied pathogenesis, difficult differential diagnosis with other intestinal diseases and insufficiently perfect treatment methods, there are a large number of unresolved problems in the field of ulcerative colitis. That is why, in this article we tried to reveal the problem of the features of the course and complex therapy of that disease in clinical practice.

Biosimilars monoclonal antibodies in the therapy of inflammatory bowel diseases An important milestone in the development of Crohn’s disease and ulcerative colitis therapy, or just a sophisticated generic?

2021 ◽  
Vol 75 (6) ◽  
pp. 550-555
Author(s):  
Milan Lukáš
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
Therapeutic Strategy ◽  
Active Drug ◽  
The Czech Republic ◽  
Innovative Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Summary: In 2013, EMA approved the fi rst biosimilar infl iximab CT-P13 for clinical practice in all indications of the original infl iximab. Since 2015, biosimilar infl iximab has been extensively used in patients with Crohn‘s disease and ulcerative colitis also in the Czech Republic. Biosimilar infl iximab is very similar to the original infl iximab in terms of its macromolecular structure, and its clinical eff ects, adverse events and immunogenicity are identical to those of the original infl iximab. Biosimilar biologics which have been introduced in clinical practice signifi cantly reduced therapeutic costs and improved access to an innovative therapy and facilitated a new therapeutic strategy, with pro-active drug monitoring and fl exibility in dosing. Biosimilars are associated with a signifi cant improvement in the therapeutic armamentarium, which makes them one of the important therapeutic milestones in the treatment of infl ammatory bowel disease. Key words: bio similars – bio logic therapy – Crohn’s disease – ulcerative colitis

scholarly journals Psoriasis and inflammatory bowel diseases: pathogenetic pathways and the choice of biologic therapy (a literature review)

2019 ◽  
Vol 47 (6) ◽  
pp. 568-578 ◽  
Author(s):  
L. S. Kruglova ◽  
A. N. Lvov ◽  
A. V. Kagramanova ◽  
O. V. Knyazev
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Psoriatic Arthritis ◽  
Crohn's Disease ◽  
Genetically Engineered ◽  
Evidence Level ◽  
Frequent Administration ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Effector Cytokines

Psoriasis and inflammatory bowel disease (IBD) are multifactorial chronic immuno-inflammatory potentially disabling disorders with similar genetic factors and immunological pathways, in particular, genetic polymorphisms of IL-23R, which determines the signal IL-12/23-mediated pathway of immunopathogenesis. The emergence of genetically engineered biological agents has changed the prognosis for both psoriasis and IBD. The intersection of the therapeutic spectrum in psoriasis and IBD is a very important point when choosing the management strategy for these patients. Infliximab and adalimumab are effective in the treatment of psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis (evidence level 1A). Ustekinumab demonstrates effectiveness in the treatment of psoriasis, psoriatic arthritis (evidence level 1A) and Crohn's disease (evidence level 1B). Etanercept and secukinumab have been shown to be effective against psoriasis, psoriatic arthritis (evidence level 1A) and ineffective and even associated with exacerbation risk in Crohn's disease and ulcerative colitis. Inhibition of regulatory cytokines IL-12/23 also has a number of advantages compared to the blockade of effector cytokines (TNF-α, IL-17) due to potentially long-term and stable treatment results and less frequent administration.

IL-23/IL-17 INHIBITORS IN IMMUNOINFLAMMATORY RHEUMATIC DISEASES: NEW HORIZONS

2019 ◽  
Vol 57 (4) ◽  
pp. 400-406 ◽  
Author(s):  
E. L. Nasonov ◽  
T. V. Korotaeva ◽  
T. V. Dubinina ◽  
A. M. Lila
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Small Molecules ◽  
Th17 Cells ◽  
Wide Spectrum ◽  
Interleukin 17 ◽  
New Horizons ◽  
Leading Role ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Recently, more attention has been given to Th17 cells, the pathological activation of which plays a leading role in the development of a wide spectrum of human immunoinflammatory diseases (IID), including rheumatoid arthritis, psoriasis, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel diseases, etc. This has served as an incentive to design new biological agents and small molecules, the main mechanism of action of which is based on blocking the pathological effects of interleukin-17 (IL-17), others are associated with the activation of Th17 cells cytokines or signaling pathways that regulate the effects of these cytokines. The review discusses current ideas about the mechanisms regulating the formation and functional activity of IL-17 family cytokines, as well as evidence for the importance of these cytokines in the pathogenesis of IID.

scholarly journals A Rare Case of New-Onset Ulcerative Colitis following Initiation of Secukinumab

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Ted George Achufusi ◽  
Prateek S. Harnee ◽  
Sekou Rawlins
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Monoclonal Antibody ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Adverse Effects ◽  
Rare Case ◽  
Young Male ◽  
Inflammatory Bowel ◽  
New Onset

Secukinumab is an IgG monoclonal antibody widely used for treatment of ankylosing spondylitis, psoriasis, and psoriatic arthritis. Recently, there has been increasing controversy regarding potential adverse effects of the drug especially in those with underlying inflammatory bowel disease. We present the case of a young male patient who developed severe new-onset ulcerative colitis following initiation of secukinumab for psoriasis, with excellent response and rapid resolution of symptoms with infliximab.

scholarly journals A Challenging Case of Severe Ulcerative Colitis following the Initiation of Secukinumab for Ankylosing Spondylitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Dean Ehrlich ◽  
Nimah Jamaluddin ◽  
Joseph Pisegna ◽  
David Padua
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Active Treatment ◽  
Biologic Agent ◽  
Interleukin 17 ◽  
Loading Dose ◽  
Severe Ulcerative Colitis ◽  
Inflammatory Bowel

Secukinumab is an interleukin-17 inhibitor used for the treatment of ankylosing spondylitis (AS), psoriasis, and psoriatic arthritis. The risk of exacerbating underlying inflammatory bowel disease (IBD) in patients being treated with secukinumab for other conditions is controversial. We document a patient with AS and previously undiagnosed IBD, found to be in a severe ulcerative colitis flare shortly after receiving the loading dose of secukinumab. There are no guidelines regarding biologic salvage therapy for IBD in the setting of active treatment with another biologic agent. After waiting one half-life of secukinumab, our patient had an excellent response to initiation of infliximab.

Transmural Response and Transmural Healing Defined by Intestinal Ultrasound - New Potential Therapeutic Targets?

2021 ◽  
Author(s):  
Ulf Helwig ◽  
Imma Fischer ◽  
Leonie Hammer ◽  
Stefanie Kolterer ◽  
Stefan Rath ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Medical Practice ◽  
Bowel Wall ◽  
Treatment Intensification ◽  
Post Hoc Analysis ◽  
Bowel Diseases ◽  
Routine Medical Practice ◽  
Inflammatory Bowel ◽  
Post Hoc

Abstract Background and Aims Intestinal ultrasound (IUS) is a useful modality to monitor patients with inflammatory bowel diseases (IBD). Little is known about the use of IUS and appropriate definitions for transmural response (TR) and healing (TH). We aimed to establish the use of IUS in monitoring TH as a potential target in routine medical practice. Methods Based on the prospective, non-interventional, multicentre studies TRUST and TRUST&UC, we conducted a post-hoc analysis of 351 IBD patients with increased bowel wall thickness (BWT). We analysed the rates of patients achieving TR and TH, comparing three definitions of TH. In 137 Crohn’s disease (CD) patients, the predictive value of TR and TH was investigated for the clinical and sonographic outcome at week 52. Results Within 12 weeks of treatment intensification, 65.6% (n = 118) of CD patients and 76.6% (n = 131) of ulcerative colitis (UC) patients showed a TR. Depending on the definition, 23.9%–37.2% (n=58/67/43) of CD patients and 45.0%–61.4% (n=90/105/77) of UC patients had TH at week 12. CD patients with TH were more likely to reach clinical remission at week 12 (OR 3.33 [1.09–10.2]; p = 0.044) and a favourable sonographic outcome (OR 5.59 [1.97–15.8]; p = 0.001) at week 52 compared with patients without TH. Conclusions IUS response and TH in a relevant proportion of patients suggests that IUS is a useful method to assess transmural inflammatory activity in daily clinical practice. TR and TH are predictive for the sonographic outcome at week 52.

scholarly journals Vedolizumab in the treatment of inflammatory bowel diseases: whom and how?

2018 ◽  
pp. 44-49
Author(s):  
A. O. Golovenko ◽  
O. V. Golovenko
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Inflammatory Bowel Diseases ◽  
Safety Profile ◽  
Actual Clinical Practice ◽  
Loss Of Response ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Available Information

The article is devoted to the use of vedolizumab, an α4β7 integrin antagonist, in the treatment of inflammatory bowel diseases (ulcerative colitis and Crohn’s disease). It presents the results of clinical trials of the drug and the experience of using vedolizumab in actual clinical practice. The latest available information about the drug’s safety profile is provided. The authors considered the practical aspects of therapy, such as determining the indications for treatment, tactics in loss of response, the need for a combination of vedolizumab with immunosuppressors, and the use of the drug in specific categories of patients.

scholarly journals Optimization of approaches to the treatment of mild to moderate ulcerative colitis

2021 ◽  
Author(s):  
С.С. Белоус ◽  
О.В. Князев
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Autoimmune Disease ◽  
Prolonged Release ◽  
Ph Values ◽  
Combined Use ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Ph Dependent ◽  
Systemic Drug

Язвенный колит – аутоиммунное заболевание толстой кишки, проявляющееся развитием неспецифического воспаления его слизистой оболочки с обязательным поражением прямой кишки. Наиболее часто в клинической практике встречается левосторонний язвенный колит, легкая или среднетяжелая атака. Оптимальным способом лечения таких пациентов являются месалазины, однако применение препарата с рН-зависимой оболочкой может быть ограничено в связи с большим разнообразием значений рН у пациентов с воспалительными заболеваниями кишечника. Препаратами выбора в таких ситуациях являются покрытые этилцеллюлозой микрогранулы месалазина с пролонгированным высвобождением, позволяющие достигнуть максимального терапевтического эффекта. Для улучшения результатов терапии месалазинами необходимо комбинированное применение местного и системного препарата. При неэффективности данного подхода в качестве альтернативы системным глюкокортикостероидам можно рассмотреть вопрос о назначении будесонида ММХ с новой мультиматриксной системой высвобождения месалазина (multimatrix system, ММХ). Ulcerative colitis is an autoimmune disease of the colon, manifested by the development of non-specific inflammation of its mucous membrane with a mandatory lesion of the rectum. The most common in clinical practice is left-sided ulcerative colitis, a mild or moderate attack. The optimal treatment for such patients is mesalazine, but the use of the drug with a pH-dependent shell may be limited due to the large variety of pH values in patients with inflammatory bowel diseases. The drugs of choice in such situations are ethylcellulose-coated mesalazine microgranules with prolonged release, which allow to achieve the maximum therapeutic effect. To improve the results of mesalazine therapy, the combined use of a local and systemic drug is necessary. If this approach is ineffective, the use of budesonide MMH may be considered as an alternative to systemic glucocorticosteroids. Keywords: mesalazine, treatment scheme, therapy, ulcerative colitis, proctitis, left-side colitis, budesonide, suppositoria, delivery system, MMX.

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