scholarly journals Management of Musculoskeletal Manifestations in Inflammatory Bowel Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Tejas Sheth ◽  
C. S. Pitchumoni ◽  
Kiron M. Das
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Multidisciplinary Approach ◽  
Physical Therapist ◽  
Cost Savings ◽  
The Past ◽  
The Us ◽  
Bowel Diseases ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel ◽  
Near Future

Musculoskeletal manifestations are the most common extraintestinal manifestations in inflammatory bowel diseases. Some appendicular manifestations are independent of gut inflammation and are treated with standard anti-inflammatory strategies. On the other hand, axial involvement is linked to gut inflammatory activity; hence, there is a considerable amount of treatment overlap. Biological therapies have revolutionized management of inflammatory bowel diseases as well as of associated articular manifestations. Newer mechanisms driving gut associated arthropathy have surfaced in the past decade and have enhanced our interests in novel treatment targets. Introduction of biosimilar molecules is expected in the US market in the near future and will provide an opportunity for considerable cost savings on healthcare. A multidisciplinary approach involving a gastroenterologist, rheumatologist, and physical therapist is ideal for these patients.

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.

Efficacy, Safety and Immunogenicity of Biosimilars in Inflammatory Bowel Diseases: A Systematic Review

2019 ◽  
Vol 26 (2) ◽  
pp. 270-279 ◽  
Author(s):  
Laura Martelli ◽  
Laurent Peyrin-Biroulet
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Patent Protection ◽  
Real Life ◽  
Cost Savings ◽  
High Price ◽  
Real World Evidence ◽  
Real Life Setting ◽  
Bowel Diseases ◽  
Post Marketing ◽  
Inflammatory Bowel

Background: Anti-tumor necrosis factor (anti-TNF) monoclonal antibodies have revolutionized the treatment of inflammatory bowel diseases (IBD). However, because of their complexity, their production is expensive contributing to their high price. As the patent protection of these therapies has expired in several countries, biosimilars have been developed to reduce the healthcare costs. The aim of this article is to review the literature on the safety, efficacy and immunogenicity of biosimilars in IBD. </P><P> Methods: A PubMed literature search was performed using the following terms until May 2016: ‘biosimilars’, ‘CT-P13’, ‘infliximab’, ‘Crohn’s disease’, ‘ulcerative colitis’, ‘inflammatory bowel diseases’, ‘efficacy’, ‘safety’, ‘immunogenicity’. Additionally, abstracts from international meetings were also reviewed. </P><P> Results: A total of eleven studies in IBD patients provided real-world evidence on the efficacy, safety and immunogenicity profile of biosimilars in IBD patients. Based on the available evidence, CT-P13 is efficacious and well tolerated in IBD patients in a real-life setting. The vast majority of studies only included IBD patients who had never received biological therapies. Information regarding the interchangeability between CT-P13 and its originator is currently being investigated in the NOR-SWITCH trial. Otherwise, the immunogenicity profile of CT-P13 seems to be similar to the originator. </P><P> Conclusion: The infliximab biosimilar seems to be efficacious, safe and with a similar immunogenicity profile as the originator in IBD. Large prospective post-marketing studies are needed to assess the long-term safety profile of CT-P13. The use of infliximab biosimilars may lead to major healthcare cost savings.

scholarly journals Musculoskeletal clinical and imaging manifestations in inflammatory bowel diseases

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Mihaela Ionela Sarbu ◽  
Nicolae Sarbu
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Metabolic Disorders ◽  
Imaging Techniques ◽  
Preclinical Phase ◽  
Bowel Diseases ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel ◽  
Work Up ◽  
Impaired Quality

AbstractRheumatic musculoskeletal manifestations are increasingly recognized as a major cause of morbidity and impaired quality of life in patients with inflammatory bowel diseases (IBDs). IBDs are associated with a variety of musculoskeletal pathologies, from peripheral arthritis to axial involvement, and from localized or regional pathologies to diffuse metabolic disorders. Recent advances, especially in imaging techniques, allow a better understanding of these pathologies, and assist their recognition even in the preclinical phase. This review aims to describe the musculoskeletal clinical and imaging manifestations in IBD with special emphasis on the current concepts and the updated radiological work-up.

scholarly journals Methotrexate for Inflammatory Bowel Diseases - New Developments

2016 ◽  
Vol 34 (1-2) ◽  
pp. 140-146 ◽  
Author(s):  
Hans H. Herfarth
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Inflammatory Bowel Diseases ◽  
Antibody Formation ◽  
Clinical Effectiveness ◽  
New Developments ◽  
The Past ◽  
Steroid Dependent ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Methotrexate (MTX) is an established therapy for patients with steroid-dependent Crohn's disease (CD). MTX is also frequently used in combination with anti-TNF agents to suppress anti-drug antibody formation. It has been suggested in the past that MTX lacks any clinical effectiveness in patients with ulcerative colitis (UC); however, newer data at least partially contradict this assumption. The following review will discuss recent data for the use of MTX in CD, UC and in combination with anti-TNF agents.

scholarly journals Epidemiology and diagnosis of inflammatory bowel diseases

2021 ◽  
Vol 64 (9) ◽  
pp. 579-587
Author(s):  
Kang-Moon Lee
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Public Awareness ◽  
Intestinal Tuberculosis ◽  
Diagnostic Delay ◽  
Perianal Fistula ◽  
Diagnostic Tools ◽  
Male Predominance ◽  
The Past ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background: Over the past three decades, inflammatory bowel diseases (IBD) have been rapidly increasing in the African, South American, and Asian countries, including Korea. However, in Korea, the public awareness of IBD remains low, and diagnostic delay is not uncommon due to the physicians' lack of clinical experience. It is essential to understand the trends and regional differences in the epidemiology of IBD for proper diagnosis and treatment.Current Concepts: Although lower than those of the West, the prevalence and incidence of IBD in Korea rank among the highest in Asia and are steadily increasing. In the past 10 years, the prevalence of IBD has almost doubled, while its incidence has decreased gradually. As compared to Western IBD patients, Korean patients have higher proportion of proctitis in ulcerative colitis, male predominance, more ileocolonic involvement, and higher incidence of perianal fistula in Crohn disease. There is no single gold standard for the diagnosis of IBD. Thus, diagnosis can be made by clinical evaluation, including a detailed history taking, physical examination, and a combination of endoscopic, radiologic, laboratory, and histologic findings.Discussion and Conclusion: Population-based studies have revealed the current trends and characteristics of the epidemiology of IBD in Korea. Continued education and development of diagnostic tools will help clinicians to diagnose IBD accurately and differentiate it from other diseases such as intestinal tuberculosis.

scholarly journals Systemic manifestations of inflammatory bowel diseases

2020 ◽  
Vol 92 (2) ◽  
pp. 4-11
Author(s):  
A. I. Parfenov ◽  
A. V. Kagramanova ◽  
O. V. Knyazev
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Multidisciplinary Approach ◽  
Current Data ◽  
Extraintestinal Manifestations ◽  
Bowel Diseases ◽  
Close Cooperation ◽  
Inflammatory Bowel ◽  
Systemic Manifestations ◽  
Shared Genetic

The article is devoted to the current data regarding the pathogenesis, classification and frequency of extraintestinal manifestations (EIMs) in inflammatory bowel diseases. We discuss two distinct theories of EIMs pathogenesis. First, EIMs arise from an extension of antigen-specific immune responses from the intestine to non-intestinal sites. Second, EIMs are independent inflammatory events initiated or perpetuated by the presence of IBD or by shared genetic or environmental risk factors in the host. These mechanisms are not mutually exclusive and may contribute to varying degrees in different EIMs. Early diagnosis of EIMs contributes to prevention disability and enhancement of quality of life of IBD patients. It is concluded that treatment of extraintestinal manifestations should be carried out taking into account the course of the IBD and the multidisciplinary approach, which requires close cooperation of doctors of various specialties. Assessment of prognostic markers and predictors for EIM in IBD will be part of a future investigation.

scholarly journals Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

2021 ◽  
Vol 12 (3) ◽  
pp. 293-301
Author(s):  
Richard H. Parrish
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Treatment Strategies ◽  
Biologic Agent ◽  
Nocebo Effect ◽  
Treatment Access ◽  
Research Directions ◽  
The Us ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Time Courses

This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic mechanisms for inflammatory bowel diseases (IBD) in adult and pediatric patients. Since they are not identical to the originator or reference biologic agent, all biosimilars are not generically equivalent. However, in the US and other countries, they are considered therapeutically interchangeable if the manufacturer has demonstrated no clinically meaningful differences from the reference product. Comparisons of different clinical initiation and switching scenarios are discussed with reference to interchangeability, immunogenicity, nocebo effect, cost effectiveness, and time courses for discontinuation rates.

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