scholarly journals Correlating Gastrointestinal Histopathologic Changes to Clinical Disease Activity in Dogs With Idiopathic Inflammatory Bowel Disease

2018 ◽  
Vol 56 (3) ◽  
pp. 435-443 ◽  
Author(s):  
Karin A. Allenspach ◽  
Jonathan P. Mochel ◽  
Yingzhou Du ◽  
Simon L. Priestnall ◽  
Frances Moore ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Scoring System ◽  
Activity Index ◽  
Clinical Disease ◽  
Clinical Activity ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel ◽  
Histopathologic Changes

Prior studies have failed to detect a convincing association between histologic lesions of inflammation and clinical activity in dogs with inflammatory bowel disease (IBD). We hypothesized that use of a simplified histopathologic scoring system would improve the consistency of interpretation among pathologists when describing histologic lesions of gastrointestinal inflammation. Our aim was to evaluate the correlation of histopathologic changes to clinical activity in dogs with IBD using this new system. Forty-two dogs with IBD and 19 healthy control dogs were enrolled in this retrospective study. Endoscopic biopsies from the stomach, duodenum, ileum, and colon were independently scored by 8 pathologists. Clinical disease activity was scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), depending on the individual study center. Summative histopathological scores and clinical activity were calculated for each tissue (stomach, duodenum, ileum, and colon) and each tissue histologic score (inflammatory/morphologic feature). The correlation between CCECAI/CIBDAI and summative histopathologic score was significant ( P < .05) for duodenum ( r = 0.42) and colon ( r = 0.33). In evaluating the relationship between histopathologic scores and clinical activity, significant ( P < .05) correlations were observed for crypt dilation ( r = 0.42), lamina propria (LP) lymphocytes ( r = 0.40), LP neutrophils ( r = 0.45), mucosal fibrosis ( r = 0.47), lacteal dilation ( r = 0.39), and villus stunting ( r = 0.43). Compared to earlier grading schemes, the simplified scoring system shows improved utility in correlating histopathologic features (both summative histology scores and select histologic scores) to IBD clinical activity.

scholarly journals P178 Variation in assessment of outcomes for inflammatory bowel disease in routine clinical practice: a mixed-methods study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S227-S227
Author(s):  
V Razanskaite ◽  
P Williamson ◽  
B Young ◽  
K Bodger
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Clinical Disease ◽  
Routine Practice ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel ◽  
Activity Indices

Abstract Background A number of global initiatives have sought to standardise the assessment of outcomes for inflammatory bowel disease (IBD), both for clinical trials (Core Outcome Sets1) and routine practice (ICHOM2). Our aim was to explore variability in the assessment and recording of clinical IBD outcomes during routine practice in England, evaluating the range of individual outcomes elicited and the extent of objective quantification of symptoms. Methods We performed ethnographic observations of 102 IBD clinic consultations conducted by 24 IBD clinicians (10 consultants, 10 IBD nurses and 4 trainees) in six acute hospitals in the North West region of England. We analysed 909 retrospective clinic records from outpatient IBD clinic visits recorded for observed patients in routine electronic patient records (EPRs). Audio-recordings of observed consultations and clinic records were analysed for pre-defined IBD outcomes, including those items required for Crohn’s Disease Activity Index (CDAI), Harvey–Bradshaw Index (HBI), Mayo Clinic Score (MCS) and Simple Clinical Colitis Activity Index (SCCAI). In addition, we performed 24 semi-structured interviews with IBD clinicians to explore the barriers and facilitators to capturing structured IBD outcomes in EPRs. Results The most commonly elicited and recorded outcomes were general well-being (95% consultations [C] and 61% clinic records [R]), stool frequency [SF] (87% C, 68% R), abdominal pain [AP] (79% C, 46% R), blood in stool [BS] (71% C, 57% R) and loose stool (64% C, 51% R). Clinical disease activity indices (HBI and SCCAI) were collected in only 15 (14.7%) observed consultations and recorded in 51 (5.6%) clinic letters. There was marked variation in the quantification of individual symptom items of MCS, SCCAI, CDAI and HBI in analysed consultations and records. Both PRO2 Crohn’s disease outcomes [AP and SF] were collected in 29/50 (58%) observed consultations and recorded in 169/484 (35%) records. Both PRO2 ulcerative colitis outcomes [SF and BS] were collected in 42/52 (81%) consultations and 253/425 (60%) records. Selected outcomes were recorded significantly more frequently by IBD nurses compared with doctors. Clinicians reported a range of IT barriers and issues with psychometric properties of currently available clinical disease activity indices in practice. Conclusion There is significant variability in the breadth, depth and quantification of IBD clinical outcomes during routine clinical assessments. Although most domains of clinical disease activity indices were elicited in consultations, formal scoring and assessment over fixed time periods was rare. There is an urgent need for practical alternatives to clinician reported disease activity indices in routine care.

Su1345 Patterns of Antibiotic Exposure and Clinical Disease Activity in Inflammatory Bowel Disease: A 4 Year Prospective Study

2014 ◽  
Vol 146 (5) ◽  
pp. S-442
Author(s):  
Jana G. Hashash ◽  
Claudia M. Ramos Rivers ◽  
Miguel Regueiro ◽  
Arthur Barrie ◽  
Marc Schwartz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Prospective Study ◽  
Disease Activity ◽  
Bowel Disease ◽  
Clinical Disease ◽  
Antibiotic Exposure ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel

Su1255 Fecal Calprotectin Is Elevated With Clinical Disease Activity During Pregnancy in Women With Inflammatory Bowel Disease

2015 ◽  
Vol 148 (4) ◽  
pp. S-452 ◽  
Author(s):  
Vivian Huang ◽  
Jasmin Bal ◽  
Rae R. Foshaug ◽  
Lindsy Ambrosio ◽  
Karen Kroeker ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel

Mo1830 - Sleep Fragmentation Measured by Wearable Device is an Indicator of Clinical Disease Activity in Inflammatory Bowel Disease

2018 ◽  
Vol 154 (6) ◽  
pp. S-817-S-818
Author(s):  
M. Anthony Sofia ◽  
Olivia Yvellez ◽  
Nada Zmeter ◽  
Katia El Jurdi ◽  
Jacob Ollech ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Sleep Fragmentation ◽  
Clinical Disease ◽  
Wearable Device ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel

scholarly journals P485 Switching infliximab biosimilar: No adverse impact on inflammatory bowel disease control or drug levels with the first or second switch

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S426-S427
Author(s):  
R Luber ◽  
R O’Neill ◽  
S Singh ◽  
Z Arkir ◽  
P Irving
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Disease Control ◽  
Bowel Disease ◽  
Trough Level ◽  
Clinical Disease ◽  
Drug Levels ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel ◽  
Activity Indices

Abstract Background Biological medicines account for a significant cost to healthcare systems. With the advent of anti-tumour necrosis factor biosimilars, switching from originator to biosimilar has enabled cost saving in inflammatory bowel disease (IBD) without compromising disease control. However, with more biosimilars entering the market, the effect on IBD activity and pharmacokinetics (PK) of a second switch to another biosimilar is uncertain. This study aims to assess the effect on disease activity and drug levels associated with switching from infliximab (IFX) biosimilar Remsima® (Celltrion, Hungary) to another biosimilar, Flixabi® (Samsung Bioepis, The Netherlands), and to compare those switching for the first and second time. Methods All IBD patients on IFX biosimilar Remsima® were prospectively followed during their switch to Flixabi® in a single centre. Baseline data including C-reactive protein (CRP), trough IFX level, and clinical disease activity indices were collected; Harvey Bradshaw Index for Crohn’s disease (CD) and Simple Clinical Colitis Activity Index for ulcerative colitis (UC). These indices were repeated after at least two infusions of Flixabi®. Results 221 patients (179 CD, 42 UC) on stable IFX treatment were included in the study. 174 (79%) were on a concomitant immunomodulator. 5 (2%) patients ceased IFX prior to follow-up due to sustained remission, and 3 (1%) patients discontinued due to factors not directly related to drug or disease. 112 patients had PK analysis performed pre and post switch. An increase in IFX trough level was observed after switching IFX biosimilars; baseline median (IQR) trough level of 4.5µg/ml (2.9–6.3) compared with post switch of 5.1µg/ml (3.4–7.0) (p = 0.02). There was no difference in clinical scores or CRP post switch, and no new anti-IFX antibodies were detected. 107 patients (48%) were switching IFX agent for the second time, of which 51 had PK analysis performed. A similar increase in median IFX trough level was observed post switch in those switching for the first (4.7 vs. 6.1 µg/ml, p = 0.03) and second (4.0 vs. 4.5µg/ml, p = 0.05) times (Figure 1). No change in clinical disease activity or CRP occurred in either group. Concomitant immunomodulator and disease classification had no impact on change in IFX level (p = 0.72 and 0.37, respectively, on univariate analysis). Conclusion In a cohort of IBD patients switching to a new IFX biosimilar either for the first or second time, an increase in IFX level was observed with no impact on clinical and biochemical disease activity indices. Switching IFX biosimilars in IBD appears safe in the short term with respect to maintaining drug pharmacokinetic profile and disease control whether switching for the first or second time.

scholarly journals Colonic mucosal and cytobrush sample cytokine mRNA expression in canine inflammatory bowel disease and their correlation with disease activity, endoscopic and histopathologic score

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245713
Author(s):  
Alexandros O. Konstantinidis ◽  
Katerina K. Adamama-Moraitou ◽  
Dimitra Pardali ◽  
Chrysostomos I. Dovas ◽  
Georgia D. Brellou ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Mrna Expression ◽  
Bowel Disease ◽  
Colonic Mucosa ◽  
Clinical Disease ◽  
Healthy Controls ◽  
Clinical Disease Activity ◽  
Inflammatory Bowel ◽  
Cytobrush Sample

Canine inflammatory bowel disease (IBD) is a group of chronic gastrointestinal disorders, the pathogenesis of which remains elusive, but it possibly involves the interaction of the intestinal immune system with luminal microbiota and food-derived antigens. Mucosal cytokines profiles in canine IBD have been investigated mainly in small intestinal disease, while data on cytokine profiles in large intestinal IBD are limited. The objective of this study was to measure colonic mucosal and cytobrush sample messenger (m)RNA expression of interleukin (IL)-1β, IL-2, IL-12p40, IL-23p19, tumor necrosis factor-alpha (TNF-α) and chemokine C‐C motif ligand (CCL28) in dogs with IBD and healthy controls using quantitative real-time polymerase chain reaction (PCR), and assess their correlation with clinical disease activity, endoscopic and histopathologic score. Dogs with IBD had a significantly increased mRNA expression of IL-1β, IL-23p19 and CCL28 in the colonic mucosa, compared to healthy controls. None of the selected cytokines had significantly different mRNA expression in the colonic cytobrush samples between the two groups or between the colonic mucosa and cytobrush samples of dogs with IBD. Finally, there was a statistically significant correlation of clinical disease activity with endoscopic activity score and fibrosis and atrophy of the colonic mucosa in dogs with large intestinal IBD. IL-1β, IL-23p19 and CCL28 could play a role in the pathogenesis of canine large intestinal IBD. Colonic cytokine expression does not correlate with clinical disease activity and/or endoscopic score. However, clinical signs reflect the severity of endoscopic lesions.

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