scholarly journals QuantiFERON-TB Gold Test Conversion Is Associated with Active Tuberculosis Development in Inflammatory Bowel Disease Patients Treated with Biological Agents: An Experience of a Medical Center in Taiwan

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Hsiang-Chun Lai ◽  
Chia-Hsi Chang ◽  
Ken-Sheng Cheng ◽  
Tsung-Wei Chen ◽  
Yuan-Yao Tsai ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Medical Center ◽  
Biological Agents ◽  
Baseline Serum ◽  
Tertiary Referral Center ◽  
Western Countries ◽  
Before And After ◽  
Inflammatory Bowel

Taiwan has a lower prevalence of inflammatory bowel disease (IBD) and a higher prevalence of tuberculosis (TB) infection than Western countries. The aim of this study was to investigate the prevalence of latent TB (LTB) and active TB infection in IBD patients treated with biological agents. From January 2000 to September 2018, we retrospectively collected data from IBD patients treated with biological agents at a tertiary referral center. Patients underwent a QuantiFERON-TB Gold test (QFT) to screen for TB infection before and after biological treatment courses. The diagnostic age, sex, body mass index, hepatitis B virus infection, biochemistry profile, treatment regimens, and the results of the QFT were analyzed. Overall, 130 IBD patients who received biological treatment were enrolled. The results of the QFT before biological treatment were determined in 120 patients (92%); of these, 10 were positive (8%), 110 were negative (85%), and 10 were indeterminate (9%). Six patients demonstrated seroconversion after biological treatment, as determined by the QFT. Three patients (2.4%) developed active pulmonary TB after biological treatment. In subgroup analysis, the positive QFT patients had a trend of lower baseline serum C-reactive protein and erythrocyte sedimentation rate levels than the negative QFT group. The present study demonstrates that the prevalence of LTB before and after biological treatment is higher in Taiwan than in most Western countries and similar to other Asian countries. Therefore, screening and monitoring of TB infection are necessary for IBD patients before and during biological treatments in Taiwan.

scholarly journals Efficacy of biological treatment in inflammatory bowel disease – a single-center experience

2019 ◽  
Vol 129 (3) ◽  
pp. 105-109
Author(s):  
Agata Michalak ◽  
Beata Kasztelan-Szczerbinska ◽  
Katarzyna Laskowska ◽  
Piotr Radwan ◽  
Marek Cybulski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Biological Agents ◽  
Diagnostic Tools ◽  
Laboratory Parameters ◽  
Single Center Experience ◽  
Mayo Score ◽  
Inflammatory Bowel ◽  
Endoscopic Picture

Abstract Introduction. Efficacy of biological treatment (BT) is a key issue among inflammatory bowel disease (IBD) patients. Laboratory markers and endoscopic procedures are basic diagnostic tools in the assessment of response to biological agents in the course of Crohn’s disease (CD) and ulcerative colitis (UC). Aim. The aim of our investigation was to assess the correlation between laboratory parameters and endoscopic picture in the course of BT in patients with IBD – CD and UC–treated with biological agents. Material and methods. The total number of 71 patients were enrolled in the study, 25 with CD and 46 with UC. When it comes to 15 patients with CD, they were treated with infliximab (IFX) and 10 patients with adalimumab (ADA) – one year of therapy. Patients with UC were administered IFX – induction therapy. Laboratory tests (C-reactive protein (CRP) and platelet (PLT) count) and colonoscopy were performed in all patients before and during BT. Results. BT improved endoscopic picture (SES-CD, MAYO) in all patients. BT lowered CRP (p<0.05) and PLT count (p<0.05) in CD group. CRP level and PLT count decreased in UC group, too (p<0.05). A positive correlation between PLT count and SESCD score prior to the first dose was noticed in ADA group. CRP level correlated positively with PLT count in CD patients treated with IFX before the introduction of BT. Moreover, CRP level correlated positively with both MAYO score and MAYO endoscopic subscore after the second dose of IFX and after finished induction regimen in UC group. Discussion. BT revolutionized a natural history of IBD and its efficacy was approved worldwide. Nevertheless, biological agents do not lead to a full remission of the disease in all patients. Because of this reason, laboratory parameters and endoscopic picture must be carefully monitored during BT to achieve the best outcome in IBD patients. Conclusion. Full clinical and endoscopic remission of IBD was not achieved, although BT lowered CRP level, PLT count and improved endoscopic picture of patients enrolled into our study.

Biosimilars of Adalimumab in Inflammatory Bowel Disease: Are we Ready for that?

2019 ◽  
Vol 25 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Marjorie Argollo ◽  
Gionata Fiorino ◽  
Daniela Gilardi ◽  
Federica Furfaro ◽  
Giulia Roda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Care Providers ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Reference Product ◽  
European Medicines Agency ◽  
Care Providers ◽  
Inflammatory Bowel ◽  
To Receive ◽  
The Ideal

Introduction: Biosimilars present a considerable potential to reduce costs related to clinical management allowing health-care providers to reinvest this money, leading to a wider access to an effective biological treatment with monoclonal antibodies (mAb). Infliximab biosimilars have already been incorporated in daily clinical practice and are currently used in all indications for which the reference product (RP) was approved. Areas covered: In the next few years, also adalimumab biosimilars will become available for the treatment of inflammatory bowel disease (IBD). In fact, several of them (ABP501, BI 695501, GP2017, and SB5) have been approved by the European Medicines Agency (EMA) with the same indications of the reference product (Humira ®). Initial preclinical data proved a strong similarity between all biosimilars and the RP. Moreover, phase 3 studies in rheumatoid arthritis and psoriasis showed no differences in terms of efficacy, safety, and immunogenicity. Data on IBD patients are urgently needed. Expert opinion: Biosimilars of adalimumab showed equivalent clinical efficacy to the RP in other immunemediated diseases. However, defining the ideal patient’s profile to receive or to be switched to a biosimilar, choosing one biosimilar vs. another, or cross-switching among biosimilars, will become the next challenge in IBD.

Sa489 DEPRESSION BEFORE AND AFTER THE DIAGNOSIS OF INFLAMMATORY BOWEL DISEASE: A NATIONWIDE POPULATION STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-519
Author(s):  
Sara Ghoneim ◽  
Abdul Mohammed ◽  
Simcha Weissman ◽  
Erin Walsh ◽  
Nisheet Waghray
Keyword(s):  
Inflammatory Bowel Disease ◽  
Population Study ◽  
Bowel Disease ◽  
Before And After ◽  
Inflammatory Bowel

scholarly journals Impact of COVID-19 on the Healthcare of Patients With Inflammatory Bowel Disease: A Comparison Between Epicenter vs. Non-epicenter Areas

2020 ◽  
Vol 7 ◽  
Author(s):  
Yun Qiu ◽  
Ying-Fan Zhang ◽  
Liang-Ru Zhu ◽  
Jin-Shen He ◽  
Jin-Yu Tan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Elective Surgery ◽  
Guangdong Province ◽  
Hubei Province ◽  
Survey Study ◽  
Real World Setting ◽  
Before And After ◽  
Inflammatory Bowel ◽  
The Impact

Background and Aims: The COVID-19 pandemic poses a great challenge to healthcare. We aimed to investigate the impact of COVID-19 on the healthcare of patients with inflammatory bowel disease (IBD) in epicenter and non-epicenter areas.Methods: Patients with IBD from Hubei province (the epicenter of COVID-19) and Guangdong province (a non-epicenter area), China were surveyed during the pandemic. The questionnaire included change of medications (steroids, immunomodulators, and biologics), procedures (lab tests, endoscopy, and elective surgery), and healthcare mode (standard healthcare vs. telemedicine) during 1 month before and after the outbreak of COVID-19.Results: In total, 324 IBD patients from Guangdong province (non-epicenter) and 149 from Hubei province (epicenter) completed the questionnaire with comparable demographic characteristics. Compared to patients in Guangdong province (non-epicenter), significantly more patients in Hubei (epicenter) had delayed lab tests/endoscopy procedures [61.1% (91/149) vs. 25.3% (82/324), p &lt; 0.001], drug withdrawal [28.6% (43/149) vs. 9.3% (30/324), p &lt; 0.001], delayed biologics infusions [60.4% (90/149) vs. 19.1% (62/324), p &lt; 0.001], and postponed elective surgery [16.1% (24/149) vs. 3.7% (12/324), p &lt; 0.001]. There was an increased use of telemedicine after the outbreak compared to before the outbreak in Hubei province [38.9% (58/149) vs. 15.4% (23/149), p &lt; 0.001], while such a significant increase was not observed in Guangdong province [21.9% (71/324) vs. 18.8% (61/324), p = 0.38]. Approximately two-thirds of IBD patients from both sites agreed that telemedicine should be increasingly used in future medical care.Conclusions: Our patient-based survey study in a real-world setting showed that COVID-19 resulted in a great impact on the healthcare of patients with IBD, and such an impact was more obvious in the epicenter compared to the non-epicenter area of COVID-19. Telemedicine offers a good solution to counteract the challenges in an unprecedented situation such as COVID-19.

scholarly journals Development of Machine Learning Model to Predict the 5-Year Risk of Starting Biologic Agents in Patients with Inflammatory Bowel Disease (IBD): K-CDM Network Study

2020 ◽  
Vol 9 (11) ◽  
pp. 3427 ◽  
Author(s):  
Youn I Choi ◽  
Sung Jin Park ◽  
Jun-Won Chung ◽  
Kyoung Oh Kim ◽  
Jae Hee Cho ◽  
...  
Keyword(s):  
Machine Learning ◽  
Inflammatory Bowel Disease ◽  
Validation Study ◽  
Bowel Disease ◽  
Medical Center ◽  
External Validation ◽  
Biologic Agents ◽  
Risk Level ◽  
Common Data Model ◽  
Inflammatory Bowel

Background: The incidence and global burden of inflammatory bowel disease (IBD) have steadily increased in the past few decades. Improved methods to stratify risk and predict disease-related outcomes are required for IBD. Aim: The aim of this study was to develop and validate a machine learning (ML) model to predict the 5-year risk of starting biologic agents in IBD patients. Method: We applied an ML method to the database of the Korean common data model (K-CDM) network, a data sharing consortium of tertiary centers in Korea, to develop a model to predict the 5-year risk of starting biologic agents in IBD patients. The records analyzed were those of patients diagnosed with IBD between January 2006 and June 2017 at Gil Medical Center (GMC; n = 1299) or present in the K-CDM network (n = 3286). The ML algorithm was developed to predict 5- year risk of starting biologic agents in IBD patients using data from GMC and externally validated with the K-CDM network database. Result: The ML model for prediction of IBD-related outcomes at 5 years after diagnosis yielded an area under the curve (AUC) of 0.86 (95% CI: 0.82–0.92), in an internal validation study carried out at GMC. The model performed consistently across a range of other datasets, including that of the K-CDM network (AUC = 0.81; 95% CI: 0.80–0.85), in an external validation study. Conclusion: The ML-based prediction model can be used to identify IBD-related outcomes in patients at risk, enabling physicians to perform close follow-up based on the patient’s risk level, estimated through the ML algorithm.

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