Recombinant human GH in paediatric inflammatory bowel disease: short term effects on bone biomarkers and long term effects on bone and lean mass

Abstract Background Increases of lipid levels associated with inflammatory bowel disease (IBD) medication have been previously reported. However, it is unknown whether this effect is similar for all IBD drug classes. Methods We performed a systematic literature search of randomized controlled trials and observational cohort studies of IBD treatment with corticosteroids, anti TNFα agents and tofacitinib that assessed total cholesterol (TC) before and after short-term (≤8 week) and long-term (≥12 week) treatment. Data of 11 studies (1,663 IBD patients) were pooled using a random effect model with as primary outcome TC levels. Lipid changes were reported as mean difference on the log2-scale (MDlog2) with 95% CI. The effect of patient and disease characteristics on TC changes were analyzed in 6 studies with individual patient data of 1,211 patients. Results A significant increase in TC was observed after treatment with corticosteroids, anti TNFα agents and tofacitinib (short-term +0.370, +0.197 and +0.190; long-term: +0.452, +0.068 and +0.162, respectively). (Figure 1) After correcting for age, sex, BMI and CRP, increases of TC levels after start of corticosteroids and tofacitinib treatment were higher (short-term: +0.293 and +0.161; long-term: +0.090 and +0.127, respectively) as compared to anti TNFα agents (short-term: -0.059, long-term: +0.041). (Figure 2) Conclusion Changes in lipid levels differ between IBD drug classes. TC levels increase was strongest for corticosteroids followed by tofacitinib but not observed for anti TNFα agents. Whether TC change associated with IBD treatment has effect on CVD risk requires further study.

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Diagnostic evaluation and short-term outcome as indicators of long-term prognosis in horses with findings suggestive of inflammatory bowel disease treated with corticosteroids and anthelmintics

Acta Veterinaria Scandinavica ◽

10.1186/1751-0147-56-35 ◽

2014 ◽

Vol 56 (1) ◽

pp. 35 ◽

Cited By ~ 14

Author(s):

Ritva Kaikkonen ◽

Kati Niinistö ◽

Benjamin Sykes ◽

Marjukka Anttila ◽

Satu Sankari ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Diagnostic Evaluation ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Inflammatory Bowel ◽

Long Term Prognosis

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COMPARISON AND EVALUATION OF TACROLIMUS VS STEROID THERAPY IN THE TREATMENT OF INFLAMMATORY BOWEL DISEASE IN ACTIVE PHASE

International Journal of Advanced Research ◽

10.21474/ijar01/12492 ◽

2021 ◽

Vol 9 (02) ◽

pp. 644-654

Author(s):

Zeba Samreen ◽

◽

Minhaj Sultana ◽

Mohd Shanawazuddin ◽

Tahoora Zainab ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Remission Rate ◽

Active Phase ◽

Initial Therapy ◽

Efficacy And Safety ◽

Short Term ◽

Inflammatory Bowel

Background:-The aim of the study is to compare and evaluate the efficacy and safety of short-term outcomes of tacrolimus in inflammatory bowel disease (IBD) patients who were not concomitantly receiving other immunosuppressive therapies by carrying out an observational prospective study of tacrolimus (TAC) v/s corticosteroid (CS) therapy in the treatment of IBD in active phase, to prevent patient from long term use of CS by reducing the incidence rate of flare. To use TAC as a step-up approach in IBD by early induction of remission and maintain it for longer period which reduces re-hospitalization and surgery rate hence improving quality of life. Method And Material:-The study was conducted in gastroenterology department, Princess Esra hospital, Hyd. 50 patients were enrolled based on our inclusion and exclusion criteria, allocated in 2 groups receiving CS and TAC respectively for 10 days. Follow-ups were done and at the end of 2 months, again a colonoscopy was performed to assess the effectiveness of the treatment. Results:-At an initial therapy of 2 months, clinical remissions were observed in most of the patients of both the groups. After six months of treatment, TAC showed 100% remission rate while 20% patients on CS have shown flare. Conclusion:- prolongs period of remission, and prevents the long-term use of CS thereby preventing its complications proving step-up to be a better approach towards the management of IBD. This study concludes that the efficacy and safety profile of TAC was overall favorable, and the doses were well tolerated by most of the patients.

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Faculty Opinions recommendation of Long term efficacy and safety of allopurinol and azathioprine or 6-mercaptopurine in patients with inflammatory bowel disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1165801.628867 ◽

2009 ◽

Author(s):

Ian Beales

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Efficacy And Safety ◽

Term Efficacy ◽

Inflammatory Bowel

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Novel Targets For Therapeutic Intervention in Inflammatory Bowel Disease. What is the Best Way to Assess the Safety Profile of a Drug?

Current Pharmaceutical Design ◽

10.2174/1381612825666190308102021 ◽

2019 ◽

Vol 25 (1) ◽

pp. 57-63 ◽

Cited By ~ 2

Author(s):

Clara Yzet ◽

Stacy S. Tse ◽

Maia Kayal ◽

Robert Hirten ◽

Jean-Frédéric Colombel

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Evaluation Process ◽

Population Based ◽

Stage Of Development ◽

Remission Rates ◽

Safety Parameters ◽

Post Marketing ◽

Inflammatory Bowel

The emergence of biologic therapies has revolutionized the management of inflammatory bowel disease (IBD) by halting disease progression, increasing remission rates and improving long-term clinical outcomes. Despite these well-described benefits, many patients are reluctant to commence therapy due to drug safety concerns. Adverse events can be detected at each stage of drug development and during the post-marketing period. In this article, we review how to best assess the safety parameters of new IBD medications, from the earliest stage of development to population-based registries, with a focus on the special populations often excluded from the evaluation process.

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