scholarly journals Effect of distance to specialist care for the diagnosis and disease outcome of inflammatory bowel disease in the Swiss inflammatory bowel disease cohort study

2020 ◽  
Vol 13 ◽  
pp. 175628481989521
Author(s):  
Lorenz Grob ◽  
Sena Bluemel ◽  
Luc Biedermann ◽  
Nicolas Fournier ◽  
Jean-Benoit Rossel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Bowel Disease ◽  
Disease Course ◽  
Specialist Care ◽  
Inflammatory Bowel ◽  
Group 3 ◽  
Group 2 ◽  
Zip Code ◽  
Group 1

Background: Inflammatory bowel disease (IBD) needs early interventions and an individual specialist–patient relationship. Distance from a tertiary IBD center might affect patient’s disease course and outcome. We investigated whether the patient-to-specialist distance has an impact on the disease course using the well-defined patient collective of the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). Methods: Patient’s home address at diagnosis (postal zip code) was extracted from the SIBDCS database. Distance between each zip code and the nearest located IBD specialist center was calculated and classified into the following three sections based on proximity: <10 km (group 1); 10–35 km (group 2); >35 km (group 3). Results: Our study included in total 408 IBD patients [234 Crohn’s disease (CD), 154 ulcerative colitis (UC), 20 IBD unclassified (IBDU)]. Median age was lowest in group 2 at diagnosis (G1: 28 years; G2: 21 years, G3: 26 years, p < 0.01). The diagnostic delay did not differ between groups. CD patients in group 1 were treated more often with anti-tumor necrosis factor (TNF) agents (72% versus 56%, p = 0.04) and 5-aminosalicylates (44% versus 28%, p = 0.04) than in group 3. UC/IBDU patients in group 1 were treated more often with corticosteroids than patients in group 3 (83% versus 58%, p < 0.01). The occurrence of IBD-related surgeries did not differ between groups. Conclusions: Patient-to-specialist distance might affect drug treatment. However, disease course and the need for IBD-related surgery does not seem to be associated with a longer distance to specialist care in Switzerland.

Multiple Switches From the Originator Infliximab to Biosimilars Is Effective and Safe in Inflammatory Bowel Disease: A Prospective Multicenter Cohort Study

2021 ◽  
Author(s):  
Jurij Hanzel ◽  
Jeroen M Jansen ◽  
Rinze W F ter Steege ◽  
Krisztina B Gecse ◽  
Geert R D’Haens
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Bowel Disease ◽  
Multicenter Cohort Study ◽  
Treatment Persistence ◽  
Multicenter Cohort ◽  
Inflammatory Bowel ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Though a single nonmedical switch from the originator infliximab (IFX) to a biosimilar is considered effective and safe for most patients with inflammatory bowel disease (IBD), very limited data are available on multiple successive switches. Methods We performed a prospective multicenter cohort study of adult IBD patients who underwent 2 switches from the originator IFX to CT-P13 to SB2 (group 1), 1 switch from CT-P13 to SB2 (group 2), and 1 switch from the originator IFX to CT-P13 (group 3). Patients were assessed at 4 and 12 months since the most recent switch for remission using clinical (physician’s assessment) and biochemical (C-reactive protein [CRP], and fecal calprotectin [FC]) measures. Patients discontinuing treatment for ineffectiveness or adverse events before month 12 were imputed as nonremitters. Results One hundred seventy-six patients (Crohn’s disease 71%, ulcerative colitis 27.8%, IBD unclassified 1.2%; group 1, 69; group 2, 80; group 3, 27) were included. At 12 months after the most recent switch 76.9% (40 of 52, group 1), 65.7% (46 of 70, group 2) and 76.9% (20 of 26, group 3) of patients were in clinical remission. Treatment persistence at 12 months was 85.0%, 87.0%, and 70.1%, respectively. There were no significant differences in the rate of clinical, CRP, FC remission, or treatment persistence at 12 months between the 3 groups. Infusion reactions occurred in 1.7% of patients (3/176), all in patients with antidrug antibodies from group 2. Conclusions Multiple successive switching and switching between biosimilars of IFX seemed to be effective and safe.

Long-Term Disease Course and Pregnancy Outcomes in Women with Inflammatory Bowel Disease: An Indian Cohort Study

2016 ◽  
Vol 62 (8) ◽  
pp. 2054-2062 ◽  
Author(s):  
Rajesh Kumar Padhan ◽  
Saurabh Kedia ◽  
Sushil Kumar Garg ◽  
Sawan Bopanna ◽  
V. Pratap Mouli ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Disease Course ◽  
Inflammatory Bowel

scholarly journals P559 Effect of vedolizumab and ustekinumab on articular manifestations in patients with inflammatory bowel disease refractory or intolerant to anti-TNF therapy: An observational prospective study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S472-S473
Author(s):  
O Britschu ◽  
A Meyer ◽  
J E Gottenberg ◽  
J M Reimund ◽  
B Caron
Keyword(s):  
Inflammatory Bowel Disease ◽  
Prospective Study ◽  
Bowel Disease ◽  
Interleukin 12 ◽  
Extraintestinal Manifestation ◽  
Observational Prospective Study ◽  
Inflammatory Bowel ◽  
Group 2 ◽  
Group 1

Abstract Background The effectiveness of vedolizumab (VDZ), a monoclonal antibody targeting the α4β7 integrin, and ustekinumab (UST), an anti-interleukin-12/anti-interleukin-23 antibody, for the treatment of patients with inflammatory bowel disease (IBD) has been demonstrated. Nearly 50% of patients with IBD have extraintestinal manifestation(s) (EIM). The most frequent are rheumatologic. In contrast to the data available for infliximab (IFX), only retrospective or small studies with contradictory results have been published regarding the effect of VDZ or UST on IBD-associated articular manifestations. The aim of our study was to evaluate the effect of VDZ and UST used in the treatment of Crohn’s disease or ulcerative colitis on associated articular manifestations, compared with patients receiving IFX. Methods We conducted a single-centre observational prospective study. All consecutive patients diagnosed with IBD and treated with IFX, VDZ or UST were included and classified into two groups: group 1, not presenting articular manifestations at the baseline, and group 2, having articular manifestations at the inclusion. We evaluated the occurrence of articular manifestations assessed by the BASDAI score in group 1 and the evolution of articular manifestations according to the BASDAI score in group 2. EIM activity was assessed at months 0, 3, 6, 9 and 12. Improvement or worsening of joint manifestations was considered significant if the BASDAI decreased or increased by 10 mm or 20 % in relative value between its initial value and its last available value (M12 or earlier for patients with shorter follow-up times). Results From September 2017 to April 2019, 54 patients were included. Twenty-nine patients were analysed in group 1: 9 treated with IFX, 8 with VDZ and 12 with UST. During the follow-up period, 12 (41.4 %) patients in group 1 without EIM at baseline developed articular manifestations: 44.4 %, 50 % and 33.3 % respectively under IFX, VDZ and UST. The mean time from treatment initiation to the development of articular symptoms was 3.3, 3.8 and 2.6 months, respectively on IFX, VDZ and UST. Twenty-five patients were analysed in group 2, 6 treated with IFX, 7 with VDZ and 12 with UST. A significant improvement of the BASDAI score was observed in 50 % of patients treated with IFX, 71.4 % with VDZ and 41.7 % with UST. BASDAI scores were 31.2, 51.8 and 27.9 at M0 and 31.0, 44.7 and 27.5 on average over the entire follow-up for the following treatments respectively: IFX, VDZ and UST. Conclusion This prospective study suggests a potential beneficial effect of VDZ and UST on articular manifestations associated with IBD compared with IFX. However, these results need to be confirmed by larger prospective trials.

scholarly journals Predicting disease course in ulcerative colitis using stool proteins identified through an aptamer-based screen

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sanam Soomro ◽  
Suresh Venkateswaran ◽  
Kamala Vanarsa ◽  
Marwa Kharboutli ◽  
Malavika Nidhi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Disease Monitoring ◽  
Disease Course ◽  
Lipocalin 2 ◽  
Time Points ◽  
Inflammatory Bowel ◽  
Stool Samples

AbstractIn the search for improved stool biomarkers for inflammatory bowel disease (IBD), an aptamer-based screen of 1129 stool proteins was conducted using stool samples from an IBD cohort. Here we report that of the 20 proteins subsequently validated by ELISA, stool Ferritin, Fibrinogen, Haptoglobin, Hemoglobin, Lipocalin-2, MMP-12, MMP-9, Myeloperoxidase, PGRP-S, Properdin, Resistin, Serpin A4, and TIMP-1 are significantly elevated in both ulcerative colitis (UC) and Crohn’s disease (CD) compared to controls. When tested in a longitudinal cohort of 50 UC patients at 4 time-points, fecal Fibrinogen, MMP-8, PGRP-S, and TIMP-2 show the strongest positive correlation with concurrent PUCAI and PGA scores and are superior to fecal calprotectin. Unlike fecal calprotectin, baseline stool Fibrinogen, MMP-12, PGRP-S, TIMP-1, and TIMP-2 can predict clinical remission at Week-4. Here we show that stool proteins identified using the comprehensive aptamer-based screen are superior to fecal calprotectin alone in disease monitoring and prediction in IBD.

scholarly journals The incidence and prevalence of inflammatory bowel disease in UK primary care: a retrospective cohort study of the IQVIA Medical Research Database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karoline Freeman ◽  
Ronan Ryan ◽  
Nicholas Parsons ◽  
Sian Taylor-Phillips ◽  
Brian H. Willis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Practice ◽  
Cohort Study ◽  
Medical Research ◽  
Bowel Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Research Database ◽  
Care Providers ◽  
Inflammatory Bowel

Abstract Background Our knowledge of the incidence and prevalence of inflammatory bowel disease (IBD) is uncertain. Recent studies reported an increase in prevalence. However, they excluded a high proportion of ambiguous cases from general practice. Estimates are needed to inform health care providers who plan the provision of services for IBD patients. We aimed to estimate the IBD incidence and prevalence in UK general practice. Methods We undertook a retrospective cohort study of routine electronic health records from the IQVIA Medical Research Database covering 14 million patients. Adult patients from 2006 to 2016 were included. IBD was defined as an IBD related Read code or record of IBD specific medication. Annual incidence and 12-month period prevalence were calculated. Results The prevalence of IBD increased between 2006 and 2016 from 106.2 (95% CI 105.2–107.3) to 142.1 (95% CI 140.7–143.5) IBD cases per 10,000 patients which is a 33.8% increase. Incidence varied across the years. The incidence across the full study period was 69.5 (95% CI 68.6–70.4) per 100,000 person years. Conclusions In this large study we found higher estimates of IBD incidence and prevalence than previously reported. Estimates are highly dependent on definitions of disease and previously may have been underestimated.

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