scholarly journals Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter?

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Ashish Malhotra ◽  
Parkpoom Phatharacharukul ◽  
Charat Thongprayoon
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Post Discharge ◽  
Inflammatory Bowel

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.

scholarly journals Are Steroids Still Useful in Immunosuppressed Patients With Inflammatory Bowel Disease? A Retrospective, Population-Based Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Beatriz Sicilia ◽  
Lara Arias ◽  
Gadea Hontoria ◽  
Nieves García ◽  
Ester Badia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Significant Risk ◽  
Steroid Treatment ◽  
Oral Steroid ◽  
Immunosuppressed Patients ◽  
Inflammatory Bowel

Background: Effectiveness of corticosteroids in immunosuppressed patients with inflammatory bowel disease (IBD) has not been completely elucidated.Aims: To assess the effectiveness and examine the long-term follow-up of systemic or low-bioavailability oral steroid treatment for moderate flare-ups in patients treated with immunosuppressive drugs.Methods: Immunosuppressed patients with inflammatory bowel disease (IBD) from our population-data registry were analyzed. For statistical analysis, the chi-square test, Mann-Whitney U test, and Kaplan-Meier survival analysis were used as appropriate.Results: A total of 392 patients with IBD and a median of 82 (range, 6–271) months of immunosuppressive (IMM) treatment were identified. The mean follow-up was 87 months (range, 6–239 months). A total of 89 patients (23%) needed at least one steroid course during their follow-up. Average time from IMM to steroid treatment was 26 (range, 6–207) months. In patients with CD, fibrostenotic (B2) and fistulizing (B3) behaviors [p = 0.005; odds ratio (OR): 2.284] were risk factors for using steroids after IMM treatment. In patients with UC, no statistically significant variables were identified. Of the 89 patients who received one first steroid course, 49 (55%) stepped up to biological treatment or surgery after a median of 13 months (range, 0–178), 19 (21%) were treated with repeated steroid courses, and 31 (35%) required no further treatment. Patients with CD had a higher risk (p = 0.007; OR: 3.529) of receiving biological treatment or surgery than patients with UC. The longer the patients with UC (more months) spent using steroids, the greater the risk of requiring treatment with biological drugs or surgery (p = 0.009).Conclusion: A total of 23% of the immunosuppressed patients with IBD received at least one course of steroid treatment. In patients under immunosuppression treated with at least a course of steroids, CD patients were more likely stepped up to biologics and/or surgery than UC patients. In patients with CD, B2/B3 behavior pattern were significant risk factors. After one course of steroids only 35% of immunosuppressed IBD patients remained in remission without needing treatment scalation.

Incidence, Risk Factors and Evaluation of Osteoporosis in Patients With Inflammatory Bowel Disease: A Danish Population-Based Inception Cohort With 10 Years of Follow-Up

2020 ◽  
Vol 14 (7) ◽  
pp. 904-914 ◽  
Author(s):  
Bobby Lo ◽  
Jakob Præst Holm ◽  
Marianne Kajbæk Vester-Andersen ◽  
Flemming Bendtsen ◽  
Ida Vind ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Bowel Disease ◽  
Population Based ◽  
Control Population ◽  
Inception Cohort ◽  
Mineral Density ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease [IBD] including Crohn’s disease [CD] and ulcerative colitis [UC] are at risk of developing metabolic bone disease. The aims here were to investigate the screening strategy, incidence and risk factors of osteoporosis in a prospective population-based inception cohort. Method Between 2003 and 2004 all incident patients diagnosed with CD and UC in a well-defined Copenhagen area were included and followed until 2015. Data were compared with a control population [at a ratio of 1:20]. Regression models were performed with several covariates. The sensitivity of the Danish registries for osteoporosis was also assessed. Results A total of 513 patients were included [213 CD, 300 UC]. Overall, 338 (66%, CD: 164 [77%], UC: 174 [58%], p < 0.001] patients received ≥ 500 mg corticosteroid within a year, resulting in 781 patient-years at risk of osteoporosis. Of those, only 83 [10.6%] patient-years were followed by a dual-energy X-ray absorptiometry scan within the same or the following 2 years. Overall, 73 [14.2%] IBD patients (CD: 31 [14.6%], UC: 42 [14%]) and 680 [6.6%, p < 0.001] controls were diagnosed with osteoporosis during follow-up. The risk of osteoporosis was increased compared to the control population (odds ratio: CD: 2.9 [95% confidence interval: 2.0–4.1], UC: 2.8 [2.1–3.9]). Conclusion In this population-based inception cohort, the incidence of osteoporosis was significantly higher compared to a control population. Measurement of bone mineral density is infrequent, especially in patients at high risk of developing osteoporosis. These results demonstrate the need of further awareness of the risk of osteoporosis among IBD patients, and prospective population-based studies are warranted.

scholarly journals Increased Risk of High-grade Cervical Neoplasia in Women with Inflammatory Bowel Disease: A Case-controlled Cohort Study

2021 ◽  
Author(s):  
R L Goetgebuer ◽  
J E Kreijne ◽  
C A Aitken ◽  
G Dijkstra ◽  
F Hoentjen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Multivariable Analysis ◽  
High Grade ◽  
Matched Cohort ◽  
Detection Rates ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background and Aims Women with inflammatory bowel disease [IBD] may be at higher risk for cervical intraepithelial neoplasia [CIN]. However, data are conflicting. The aim of this study was to assess the risk of high-grade dysplasia and cancer [CIN2+] in IBD women and identify risk factors. Methods Clinical data from adult IBD women in a multicentre Dutch IBD prospective cohort [PSI] from 2007 onwards were linked to cervical cytology and histology records from the Dutch nationwide cytology and pathology database [PALGA], from 2000 to 2016. Patients were frequency-matched 1:4 to a general population cohort. Standardised detection rates [SDR] were calculated for CIN2+. Longitudinal data were assessed to calculate CIN2+ risk during follow-up using incidence rate ratios [IRR] and risk factors were identified in multivariable analysis. Results Cervical records were available from 2098 IBD women [77%] and 8379 in the matched cohort; median follow-up was 13 years. CIN2+ detection rate was higher in the IBD cohort than in the matched cohort (SDR 1.27, 95% confidence interval [CI] 1.05–1.52). Women with IBD had an increased risk of CIN2+ [IRR 1.66, 95% CI 1.21–2.25] and persistent or recurrent CIN during follow-up (odds ratio [OR] 1.89, 95% CI 1.06–3.38). Risk factors for CIN2+ in IBD women were smoking and disease location (ileocolonic [L3] or upper gastrointestinal [GI] [L4]). CIN2+ risk was not associated with exposure to immunosuppressants. Conclusions Women with IBD are at increased risk for CIN2+ lesions. These results underline the importance of human papillomavirus [HPV] vaccination and adherence to cervical cancer screening guidelines in IBD women, regardless of exposure to immunosuppressants.

scholarly journals 2375. Association Between Clostridium difficile Colonization and Inflammatory Bowel Disease Activity

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S819-S819
Author(s):  
Oscar Morado-Aramburo ◽  
Eric Ochoa-Hein ◽  
Miriam Bobadilla-Del-Valle ◽  
Jesus K Yamamoto-Furusho ◽  
Alfredo Ponce de Leon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Disease Activity ◽  
Mexico City ◽  
Bowel Disease ◽  
The State ◽  
Factors Associated ◽  
Inflammatory Bowel

Abstract Background Clostridium difficile (CD) is a frequent cause of nosocomial infectious diarrhea. Despite no clear evidence has linked CD colonization (CDC) or CD infection (CDI) with inflammatory bowel disease activity (IBDA), data in our setting has suggested the contrary. Methods Prospective cohort study in a tertiary care hospital in Mexico City. Patients aged ≥18 years with IBD in clinical remission were included between April 2017 and April 2019. Demographic, clinical and laboratory variables, as well as three fecal samples, were collected at inclusion and during follow-up. CDC was defined as a positive GDH test without diarrhea. CDI was defined as diarrhea (as per IDSA criteria) plus positive GDH and PCR tests. IBDA was defined as bloody diarrhea plus a negative GDH test. The primary outcome was the association between CDC and IBDA. Secondary outcomes were incidence rates of CDC and CDI, including risk factors associated with CDC. Univariate and multivariable analyses were performed considering P < 0.05 as statistically significant. Results Out of 250 IBD patients, 101 cases met inclusion criteria and 85 completed follow-up (median = 420 days, IQR = 243–511 days). Twenty-three cases (27%) had IBDA during follow-up, eight cases had new CDC (incidence of 8.2/100 person-years), and one case developed CDI (incidence of 1.0/100 person-years). Figure 1 shows the cumulative percentage of cases without CDC during follow-up. In univariate analysis, the following were associated with CDC: decreasing age, decreasing age when IBD was diagnosed, residence in Mexico City or the State of Mexico, and hospitalization during follow-up. In Cox regression analysis, a decreasing age when IBD was diagnosed (HR = 0.92, CI95% = 0.87–0.98, p = 0.009) and residence in the State of Mexico (HR = 5.88, CI 95% = 1.21–28.60, p = 0.028) remained significantly associated with CDC. However, we did not find a statistically significant association between new CDC events and IBDA during a median follow-up period extending beyond 1 year. Conclusion We found no association between CDC and IBDA. Risk factors associated with CDC were residence in the State of Mexico and a decreasing age when IBD was diagnosed. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors of Urothelial Cancer in Inflammatory Bowel Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3257
Author(s):  
Gian Paolo Caviglia ◽  
Giorgio Martini ◽  
Angelo Armandi ◽  
Chiara Rosso ◽  
Marta Vernero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Urothelial Cancer ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
Number Of Publications

Extraintestinal cancers are important complications in patients with inflammatory bowel disease (IBD). A limited number of publications are available regarding the association between IBD and urothelial cancer. The primary outcome of our study was the comparison of the prevalence of urothelial cancer in patients with IBD with respect to the prevalence in the general population. Secondary outcomes were the assessment of risk factors for the onset of urothelial cancer in IBD. In a retrospective study we examined the medical records of all patients with a confirmed diagnosis of IBD followed in our clinic between 1978 and 2021. For each of the patients with identified urothelial cancer, more than ten patients without cancer were analyzed. Furthermore, 5739 patients with IBD were analyzed and 24 patients diagnosed with urothelial cancer were identified. The incidence of urothelial cancer, compared with the incidence in the general population, was not significantly different (0.42% vs. 0.42%; p = 0.98). Twenty-three cases were then compared (1 case was discarded due to lack of follow-up data) against 250 controls. During the multivariate analysis, smoking (odds ratio, OR = 8.15; 95% confidence interval, CI = 1.76–37.63; p = 0.007) and male sex (OR = 4.04; 95% CI = 1.29–12.66; p = 0.016) were found as risk factors. In conclusion, patients with IBD have a similar risk of developing urothelial cancer compared to the general population, but males with a history of smoking are at increased risk.

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