scholarly journals IMPORTANCE OF MEASURING LEVELS OF INFLIXIMAB IN PATIENTS TREATING INFLAMMATORY BOWEL DISEASE IN A BRAZILIAN COHORT

2017 ◽  
Vol 54 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Katia Cristina KAMPA ◽  
Daphne Benatti Gonçalves MORSOLETTO ◽  
Marcela Rocha LOURES ◽  
Alcindo PISSAIA JUNIOR ◽  
Rodrigo Bremer NONES ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Clinical Symptoms ◽  
Serum Levels ◽  
Induction Phase ◽  
Tnf Α ◽  
Measurement Results ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Necrosis Factor ◽  
Chronic Inflammatory Bowel

ABSTRACT BACKGROUND: Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases. In such pathologies, there is an increased production of alpha tumor necrosis factor (TNF-α). Patients, in whom the conventional immunosuppressant treatment fails, require the use of immunobiological therapy, such as anti-TNF-α, a monoclonal antibody. Infliximab is an anti-TNF-α drug, a chimerical immunoglobulin, with a murine component, which is responsible for the generation of immunogenicity against the drug and formation of anti-TNF-α antibodies. The presence of anti-drug antibodies may be responsible for adverse events and reduction of the drug’s effectiveness. Patients with inflammatory bowel diseases undergoing therapy with biological medication, such as infliximab, can relapse overtime and this may not be translated into clinical symptoms. Thus, there is a need for a method to evaluate the efficacy of the drug, through the measurement of serum infliximab levels, as well as antibodies research. OBJECTIVE: This study aimed to measure serum infliximab levels and anti-infliximab antibodies in patients with inflammatory bowel diseases post-induction phase and during maintenance therapy, and describe the therapeutic modifications that took place based on the serum levels results. METHODS: It was a retrospective study, that included forty-five patients, with a total of 63 samples of infliximab measurement. RESULTS: Twenty-one patients had an adequate infliximab serum level, 31 had subtherapeutic levels and 11 had supratherapeutic levels. Seven patients had their medication suspended due to therapeutic failure or high levels of antibodies to infliximab. CONCLUSION: In conclusion, only a third of the patients had adequate infliximab levels and 36% presented with subtherapeutic levels at the end of the induction phase. Therapy optimization occurred based in about 46% of the samples results, demonstrating the importance of having this tool to help the clinical handling of patients with inflammatory bowel diseases ongoing biologic therapy.

scholarly journals Sources of Bias in Common Diagnosis of Chronic Inflammatory Bowel Diseases

2020 ◽  
Vol 30 (5) ◽  
pp. 26-29
Author(s):  
O. A. Svatkova ◽  
A. A. Sheptulin
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Clinical Symptoms ◽  
Late Diagnosis ◽  
Chronic Inflammatory Bowel Diseases ◽  
Common Diagnosis ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

Aim. Causal analysis of a late diagnosis of chronic inflammatory bowel diseases (CIBD) in general medical practice.Materials and methods. We continuously sampled 80 CIBD histories (44 of ulcerative colitis, UC, and 36 of Crohn’s disease, CD) to estimate the time and nature of first complaints, primary diagnosis, time lapse between the first physician visit and diagnosis and reasons for a late diagnosis.Results. Only 63.6 % of patients with UC and 38.9 % with Crohn’s disease were correctly diagnosed during the first visit and subsequent examination. Abdominal pain in debut of CIBD was registered in 40.9 % of the UC and 75.0 % of CD patients (p < 0.01). Diarrhoea as a CIBD manifestation was significantly more common in the UC than in CD patients (88.6 and 55.5 % of cases, respectively; p < 0.01). Hematochesia was observed in 68.2 % of the UC and 22.2 % of CD cases (p < 0.01). Among the CD patients with primary symptoms, a correct follow-up diagnosis was less frequent compared to the UC patients (38.9 % of cases, p < 0.01). Only 30 patients with UC (68.2 %) and 18 patients with CD (50.0 %) had colonoscopy at a first outpatient visit. The main cause of late diagnoses in CIBD is a delayed ileocolonoscopy.Conclusions. Ileocolonoscopy should be mandatory in all patients suspected for CIBD with clinical symptoms.

scholarly journals Optimization of antenatal monitoring approaches of women with chronic inflammatory bowel diseases

2021 ◽  
pp. 84-92
Author(s):  
O.V. Bulavenko Bulavenko ◽  
D.G. Konkov ◽  
N.V. Kuzminova ◽  
T.V. Lobastova ◽  
I.V. Oleksienko
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Inflammatory Bowel Diseases ◽  
Clinical Guidelines ◽  
Cochrane Library ◽  
Chronic Inflammatory Bowel Diseases ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

Chronic inflammatory bowel diseases (CIBD) affect patients at their peak of reproductive age. Clinical presentation of CIBD in pregnancy is associated with an increased risk of adverse effects in mother and fetus, including prematurity, low birth weight, increased indications for caesarean section. Thus optimizing of the CIBD diagnosis and treatment before and during pregnancy is essential to improve maternal and fetal outcomes.Research aim: to analyze the effectiveness of the CIBD clinical management at the stage of preconception and during pregnancy.Materials and methods. It was searched the Cochrane Library, WHO platform, clinical guidelines, and research reference database Medline. All potential studies have evaluated the clinical practice guidelines in women with CIBD for conception, pregnancy and breastfeeding. Recommendations related to the necessary laboratory and instrumental examination methods, therapeutic strategy, the safety of drugs for mother and fetus, the features of multidisciplinary antenatal observation, the timing and method of delivery of pregnant women with CIBD. Results. Treatment in the planning phase and pregnancy should be multidisciplinary, involving a gastroenterologist, obstetrician-gynecologist, primary care physician, pediatrician and a colorectal surgeon if necessary, as well as stakeholders from the association of patients with CIBD. Communication between these professionals is critical to avoid ambivalent or even conflicting counseling, which is an additional source of anxiety for patients, and also potentially dangerous for suboptimal prevention of clinical CIBD manifestation. Obtained results of the analysis will prevent laboratory and therapeutic polypharmacy and significantly improve the pregnancy outcome.Conclusions. Most women with CIBD had a physiological pregnancy and healthy children. However, some studies have linked CIBD to an increased risk of preterm birth and low birth weight infants. The development of national clinical guidelines will optimize and improve the quality of perinatal care to women with CIBD in the Ukraine, and will lead to a decrease in obstetric, fetal and neonatal complications.

Anti-tumour necrosis factor-α antibodies and B cell homeostasis in human inflammatory bowel diseases

2018 ◽  
Vol 54 ◽  
pp. 329-335 ◽  
Author(s):  
Caterina Defendenti ◽  
Fabiola Atzeni ◽  
Sergio Malandrin ◽  
Sandro Ardizzone ◽  
Piero Luigi Almasio ◽  
...  
Keyword(s):  
B Cell ◽  
Tumour Necrosis Factor ◽  
Inflammatory Bowel Diseases ◽  
Tumour Necrosis ◽  
Tumour Necrosis Factor Α ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
B Cell Homeostasis ◽  
Factor Α ◽  
Necrosis Factor

Anti-TNF-α agents and serum lipids in inflammatory bowel diseases

2016 ◽  
Vol 40 (4) ◽  
pp. e46-e47
Author(s):  
Çağdaş Kalkan ◽  
Fatih Karakaya ◽  
Murat Törüner ◽  
Hülya Çetinkaya ◽  
Irfan Soykan
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Serum Lipids ◽  
Tnf Α ◽  
Bowel Diseases ◽  
Inflammatory Bowel
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