scholarly journals Joint lesions in inflammatory bowel diseases: the analysis of the Moscow regional patient registry and a clinical case

2020 ◽  
Vol 48 (6) ◽  
pp. 395-402
Author(s):  
O. V. Taratina ◽  
E. A. Belousova
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Clinical Case ◽  
Moscow Region ◽  
Tnf Α ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Mean ◽  
The Given ◽  
Necrosis Factor

Rationale: Extraintestinal manifestations (EIM) of an inflammatory bowel disease (IBD) are a sign of its more severe course. Joint lesions are most common among IBD EIM.Aim: To evaluate the prevalence and types of joint lesions in the population of IBD patients of the Moscow region.Materials and methods: We performed a  retrospective analysis of medical files of the patients who were admitted to the Moscow Region Inflammatory Bowel Disease Center (MONIKI) for examination and treatment from August 1, 2019, to March 1, 2020. The study included 70 patients with confirmed diagnoses of IBD and confirmed or suspected involvement of the joints.Results: Thirty six of 70 patients with IBD and EIM (51.43%) had been diagnosed with Crohn's disease (CD), and 34 (48.57%) with ulcerative colitis (UC). The CD group included more men (n=21, 58.33%), whereas their proportion in the UC group was 47.02% (n=16). The mean age at CD diagnosis in the UC and CD groups was comparable: 38.3±13.7  years in men with CD and 40.5±12.8 years in men with UC, 37.7±11.1 years in women with CD and 35.7±14.0 in women with UC. The most prevalent among all IBD patients were X-ray negative peripheral arthralgias. Among joint lesions confirmed by radiological diagnostics, sacroileitis was most prevalent both in all IBD patients (24.3%), as well as in the UC group (17.6%), whereas in the CD patients its frequency was the same as that of ankylosing spondyloarthritis (AS) (30.6% of the cases). AS ranked second in the prevalence of joint lesions in the UC group (8.8%) and all IBD (20%). Psoriatic arthritis was diagnosed only in the CD patients (2 / 36). We describe a clinical case of CD with AS, complicated with psoriatic rash, treated with a  monoclonal antibody to tumor necrosis factor alfa (anti-TNF-α).Conclusion: Peripheral arthropathias were most prevalent among all joint lesions in the group studied. EIM mirror a more aggressive phenotype of the disease and higher glucocorticosteroids requirements. Administration of anti-TNF-α agents allows for the control of both intestinal IBD manifestations and of the joint syndrome. However, drug-associated skin adverse event can occur during treatment with this drug class. In such a case, it is possible to switch the biological therapy to another class of drugs that we have demonstrated with the given clinical example.

The SPOSIB SB2 Sicilian Cohort: Safety and Effectiveness of Infliximab Biosimilar SB2 in Inflammatory Bowel Diseases, Including Multiple Switches

2020 ◽  
Author(s):  
Fabio Salvatore Macaluso ◽  
Walter Fries ◽  
Anna Viola ◽  
Andrea Centritto ◽  
Maria Cappello ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Tumor Necrosis ◽  
Prospective Observational Study ◽  
Cumulative Number ◽  
Serious Adverse Events ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background No data on the recently introduced infliximab (IFX) biosimilar SB2 in inflammatory bowel disease (IBD) are available. Methods The Sicilian Prospective Observational Study of Patients With IBD Treated With Infliximab Biosimilar SB2 is a multicenter, observational, prospective study performed among the cohort of the Sicilian Network for Inflammatory Bowel Disease. All consecutive IBD patients starting the IFX biosimilar SB2 from its introduction in Sicily (March 2018) to September 2019 (18 months) were enrolled. Results Two hundred seventy-six patients (Crohn disease: 49.3%, ulcerative colitis: 50.7%) were included: 127 (46.0%) were naïve to IFX and naïve to anti-tumor necrosis factor medications (anti-TNFs), 65 (23.5%) were naïve to IFX and previously exposed to anti-TNFs, 17 (6.2%) were switched from an IFX originator to SB2, 43 (15.6%) were switched from the biosimilar CT-P13 to SB2, and 24 (8.7%) were multiply switched (from IFX originator to CT-P13 to SB2). The cumulative number of infusions of SB2 was 1798, and the total follow-up time was 182.7 patient-years. Sixty-seven serious adverse events occurred in 57 patients (20.7%; incidence rate: 36.7 per 100 patient-year), and 31 of these events caused the withdrawal of the drug. The effectiveness after 8 weeks of treatment was evaluated in patients naïve to IFX (n = 192): 110 patients (57.3%) had steroid-free remission, while 56 patients had no response (29.2%). At the end of follow-up, 72 patients (26.1%) interrupted the treatment, without significant differences in treatment persistency estimations between the five groups (log-rank P = 0.15). Conclusions The safety and effectiveness of SB2 seem to be overall similar to those reported for the IFX originator and CT-P13.

scholarly journals P415 Paradoxical onset of Takayasu’s arteritis in patients with inflammatory bowel disease treated with anti-tumour necrosis factor-α agents

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S422-S422
Author(s):  
Y Matsune ◽  
J Kouyama ◽  
Y Tsuru ◽  
K Shimizu ◽  
S Asami ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Features ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Rare Complication ◽  
Tumour Necrosis Factor Α ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background Takayasu’s arteritis (TA) is a rare complication associated with inflammatory bowel disease (IBD). TA is a granulomatous systemic vasculitis of uncertain aetiology affecting large arteries, predominantly the aorta and its main branches, leading to stenotic and expansible lesions. The estimated prevalence of coexisting of TA in patients with ulcerative colitis (UC) is 0.3%, and that in patients with Crohn’s disease (CD) is 0.1%. Anti-tumour necrosis factor-α (TNF-α) agents are used to treat both TA and IBD, although some patients with IBD paradoxically develop TA during treatment with anti-TNF-α agents. However, data regarding the incidence and clinical features of TA in such cases are lacking. This study was performed to clarify the prevalence, risk factors, and clinical features of TA that develops paradoxically during treatment with anti-TNF-α agents in patients with IBD. Methods Consecutive patients with IBD who were regularly seen at our centre, a tertiary IBD centre in Japan, from 2000 to 2019 were included in this retrospective single-centre study. We evaluated the prevalence of TA according to the presence or absence of treatment with anti-TNF-α agents and the patients’ clinical manifestations. Results Of 1846 patients with UC and 1249 patients with CD, 7 (0.23%) patients with UC developed TA. The prevalence of TA in patients treated with anti-TNF-α agents was significantly higher (4/254, 1.6%) than that in patients without anti-TNF-α agent treatment (3/1592, 0.19%) (p=0.0087, Fisher’s exact test). Among four patients with UC who paradoxically developed TA during treatment with anti-TNF-α agents, three (75%) received infliximab, one (25%) received adalimumab, and one (25%) received golimumab. One was male and three (75%) were female. The median interval from starting treatment with anti-TNF-α agents to diagnosis of TA was 49.0 (34–63) months. All patients had pancolitis as well as persistent active colitis resistant to anti-TNF-α antibody treatment. The treatments for TA administered after anti-TNF-α therapy were as follows: Two (50%) patients discontinued anti-TNF-α agent therapy, three (75%) were treated with prednisolone, and one (25%) received tocilizumab. No patient required an operation for TA. Conclusion To our knowledge, this is the first study to show the prevalence and clinical features of TA in patients with IBD following administration of anti-TNF-α agent therapy. Although TA is a rare complication, our results suggest that it can develop as paradoxical reaction following administration of anti-TNF-α agents.

scholarly journals Characterization of the Serum Levels of Meteorin-like in Patients with Inflammatory Bowel Disease and its Association with Inflammatory Cytokines 

2020 ◽  
Author(s):  
Afsane Gholamrezayi ◽  
Maryam Mohamadinarab ◽  
Pegah Rahbarinejad ◽  
Soudabeh Fallah ◽  
Shekufe Rezghi Barez ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Serum Levels ◽  
Pathological Examination ◽  
Tnf Α ◽  
Healthy Control ◽  
Patient Groups ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background: Meteorin-like (Metrnl) is an adipokine with insulin sensitizing and anti-inflammatory properties that has been discovered recently. The relation among Metrnl, Inflammatory Bowel Disease (IBD), and obesity has been unexplored yet. Methods: The present study was conducted on 54 healthy control, 42 Ulcerative Colitis (UC), and 43 Crohn's disease (CD) patients who were diagnosed by pathological examination. In all participants, serum levels of adiponectin, Metrnl, interleukin (IL)-6, and Tumor necrosis factor (TNF-α) were measured using ELISA kits.Results: Metrnl concentration was considerably lower in both UC (85.25±36.55 pg/mL) and CD (76.93±27.92 pg/mL) patients in comparison to control (107.52 ± 35.33 pg/mL). In addition, it was seen that both patient groups have a decreased level of adiponectin compared to the controls. Besides that, the level of IL-6 and TNF-α were significantly greater in the patient groups. Moreover, the result showed that the level of Metrnl is inversely correlated with body mass index (BMI) in the controls and the patients. Metrnl levels are also inversely associated with IL-6, and TNF-α in both of the patient groups.Conclusions: The current study is the first one reporting the decreased levels of Metrnl in serum among patients with IBD, which is inversely related with BMI, TNF-α, and IL-6. These results suggested a possible relation of Metrnl with the pathogenesis of IBD, particularly through inflammatory process, although further studies are warranted to dissect the possible mechanism.

Antitumor Necrosis Factor-α Therapy Associated with Inflammatory Bowel Disease: Three Cases and a Systematic Literature Review

2017 ◽  
Vol 44 (7) ◽  
pp. 1088-1095 ◽  
Author(s):  
Amir Bieber ◽  
Abdallah Fawaz ◽  
Irina Novofastovski ◽  
Reuven Mader
Keyword(s):  
Inflammatory Bowel Disease ◽  
Literature Review ◽  
Bowel Disease ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Patient Specific ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Factor Α ◽  
Necrosis Factor

Objective.Antitumor necrosis factor-α (anti-TNF-α) therapy is the most prescribed biologic agent therapy in rheumatology and gastroenterology. However, a number of serious side effects have been reported with these drugs. Only a handful of cases of new-onset inflammatory bowel disease (IBD), mostly in children diagnosed with juvenile idiopathic arthritis (JIA), have been reported during anti-TNF-α therapy. We present 3 cases of adult IBD following anti-TNF-α therapy and a literature review on this topic.Methods.We searched PubMed MESH for all relevant terms, papers were reviewed, and patient-specific data were extracted. Relevant clinical data were calculated and presented.Results.The PubMed search resulted in 137 articles, of which 11 articles and 4 cited publications were included in our analysis. We found 53 cases of IBD after anti-TNF-α therapy reported in the literature; most of them were case series collected retrospectively from national databases or studies. Almost all the patients developed IBD after the introduction of etanercept (ETN); 2 patients with rheumatoid arthritis were also included. The average age at IBD onset was 17.3 years and the average time from ETN introduction to IBD onset was 27 months (± 24). Gastrointestinal symptoms have been reported as improving or subsiding in most of the patients after discontinuing ETN.Conclusion.Although this manifestation is not common, it should be taken into consideration as an adverse effect of ETN. Rheumatologists, and in particular rheumatologists treating adult patients, should be aware of this possible complication. Further investigation about the pathogenic process underlying this phenomenon is warranted.

Real-world biologic treatment and associated cost in patients with inflammatory bowel disease

2019 ◽  
Vol 57 (07) ◽  
pp. 843-851 ◽  
Author(s):  
Alina Brandes ◽  
Antje Groth ◽  
Fraence Gottschalk ◽  
Thomas Wilke ◽  
Boris A. Ratsch ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Biologic Therapy ◽  
Health Care Cost ◽  
Maintenance Phase ◽  
Biologic Treatment ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Objectives This study aimed to describe biologic treatment of German inflammatory bowel disease (IBD) patients, including biologics’ dosage, health care resource use, and treatment-associated cost. Methods In this retrospective claims data analysis, all continuously insured adult IBD patients (Crohnʼs disease [CD] or ulcerative colitis [UC]) who started a new therapy with an anti-tumor necrosis factor alpha (anti-TNF-α) or vedolizumab (VDZ) were included. Observation started with the date of the first prescription of index biologic therapy and lasted 12 months. Results In the database, 1248 out of 57 296 IBD patients started a biologic treatment of interest (1020 anti-TNF-α, 228 VDZ), and 837 patients were bio-naïve (773 anti-TNF-α, 64 VDZ). The mean age of bio-naïve/bio-experienced anti-TNF-α patients was 39.2/38.1 years (54.9 %/56.7 % female) and 42.6/37.8 years for VDZ patients (56.3 %/54.9 % female). The proportion of patients receiving a maintenance dosage > 150 % compared to SmPC was 15.1 % for Adalimumab, 5.2–39.0 % for Golimumab, 14.7–34.5 % for Infliximab, and 19.7 % for VDZ patients. During the maintenance phase, up to 58.8 % of patients received at least 1 prescription of any CS, and 41.7 %/47.1 % (anti-TNF-α/VDZ) were treated in a hospital due to IBD. The mean IBD-related direct health care cost per patient year was € 30 246 (anti-TNF-α)/ € 28 227 (VDZ) for bio-naïve patients (p = 0.288) and € 34 136 (anti-TNF-α)/ € 32 112 (VDZ) for bio-experienced patients (p = 0.011). Conclusions A substantial percentage of patients receive a high biologic dosage in the maintenance phase. Despite biologic therapy, 30–40 % receive a CS therapy and/or experience at least 1 IBD-associated hospitalization within a year, possibly indicating a remaining disease activity.

scholarly journals AB0513 THE RELATIONSHIP OF PERIARTICULAR TISSUES LESIONS AND JOINTS DEGENERATIVE CHANGES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1283.3-1284
Author(s):  
G. Gainullina ◽  
E. Kirillova ◽  
D. Abdulganieva ◽  
E. Belousova ◽  
A. Odincova
Keyword(s):  
Inflammatory Bowel Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Power Doppler ◽  
Degenerative Changes ◽  
Joint Involvement ◽  
Ultrasound Study ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Mean

Background:Inflammatory bowel diseases (IBD) are associated with a variety of extra-intestinal manifestations. The most frequent of these is joint involvement, which affects 16–33 % of IBD patients, whereas 5–10 % are affected by enthesitis [1, 2]. Recent studies have shown the superiority of ultrasound over clinical findings in the evaluation of joints and periarticular tissues [3].Objectives:To assess of joint and entheseal involvement in patients with Crohn’s disease (CD) and ulcerative colitis (UC) using ultrasound with Power Doppler.Methods:We prospectively included 70 IBD patients into the study. Peripheral joints and entheses were imaged by ultrasound, using Samsung Accuvix A30 5-13 MHz linear array transducer. Ultrasound examination of 14 peripheral joints (hip, knee, ankle, shoulder, acromioclavicular, elbow, wrist) and 35 entheses was performed. Vascularization was assessed with Power Doppler (PD). Statistical analysis was done by Mann-Whitney test by “Statistica” software.Results:In 70 patients UC was in 40 (57%), CD - in 30 (43%). The mean age of patients was 32 (27; 36) years. The mean duration of the disease was 48 (12; 84) months. The majority of patients had highly active disease: moderate and severe activity was observed in 47 (67%).Osteophytes were found in 32 (46%) IBD pts, in 10 pts (14%) - osteophytes were found in three or more joints. We divided pts into two groups. In first group we included pts without degenerative changes in the joints, in the second - with identified osteophytes.Osteophytes were found more often in the acromioclavicular joints - 13 pts (41%) and in the hip joints - 10 pts (31%). With the same frequency (9 pts), osteophytes were detected in the wrist, knee and ankle joints. The mean age of pts and mean duration of IBD were significantly higher in the second group patients (p = 0.00002 and p = 0.019).Enthesitis (echogenicity reduction and thickening) without vascularization were detected in 26 patients of the first group (68%) and 29 patients of the second group (91%) (p = 0.009). The rate of vascularized enthesitis in the two groups was the same: enthesitis with vascularization were observed in 14 pts of the first group (37%) and 14 of the second group (44%) (p = 0.822). Structure damage (erosions and enthesophytis) was more frequent in the second group (p = 0.025 and p = 0.001). There were no significant differences in the incidence of tendinitis and tenosynovitis between two groups.Conclusion:Joint and periarticular tissues damage in IBD patients increases with age and duration of the disease. The presence of degenerative changes in the joints is associated with more frequent detection of enthesitis and enthesopathies.References:[1]The First European Evidence-based Consensus on Extra-Intestinal Manifestations in IBD. JCC. 2016; 10 (3): 239-254.[2]Rovisco J, Duarte C, Batticcioto A et al. Hidden musculoskeletal involvement in inflammatory bowel disease: a multicenter ultrasound study. BMC Musculoskelet Disord. 2016; 17: 84.[3]Yu-Fen Hsiao, Shu-Chen Wei, Cheng-Hsun Lu et al. Patients with Inflammatory Bowel Disease have Higher Sonographic Enthesitis Scores than Normal Individuals: Pilot Study in Taiwan. Journal of Medical Ultrasound. 2014 Dec; 22(4): 194-199.Disclosure of Interests:None declared.

scholarly journals Characterization of the Serum Levels of Meteorin-like in Patients with Inflammatory Bowel Disease and its Association with Inflammatory Cytokines

2020 ◽  
Author(s):  
Afsane Gholamrezayi ◽  
Maryam Mohamadinarab ◽  
Pegah Rahbarinejad ◽  
Soudabeh Fallah ◽  
Shekufe Rezghi Barez ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Serum Levels ◽  
Pathological Examination ◽  
Tnf Α ◽  
Healthy Control ◽  
Patient Groups ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background: Meteorin-like (Metrnl) is an adipokine with insulin sensitizing and anti-inflammatory properties that has been discovered recently. The relation among Metrnl, Inflammatory Bowel Disease (IBD), and obesity has been unexplored yet. Methods: The present study was conducted on 54 healthy control, 42 Ulcerative Colitis (UC), and 43 Crohn's disease (CD) patients who were diagnosed by pathological examination. In all participants, serum levels of adiponectin, Metrnl, interleukin (IL)-6, and Tumor necrosis factor (TNF-α) were measured using ELISA kits.Results: Metrnl concentration was considerably lower in both UC (85.25±36.55 pg/mL) and CD (76.93±27.92 pg/mL) patients in comparison to control (107.52 ± 35.33 pg/mL). In addition, it was seen that both patient groups have a decreased level of adiponectin compared to the controls. Besides that, the level of IL-6 and TNF-α were significantly greater in the patient groups. Moreover, the result showed that the level of Metrnl is inversely correlated with body mass index (BMI) in the controls and the patients. Metrnl levels are also inversely associated with IL-6, and TNF-α in both of the patient groups.Conclusions: The current study is the first one reporting the decreased levels of Metrnl in serum among patients with IBD, which is inversely related with BMI, TNF-α, and IL-6. These results suggested a possible relation of Metrnl with the pathogenesis of IBD, particularly through inflammatory process, although further studies are warranted to dissect the possible mechanism.

scholarly journals 1728. A Retrospective Analysis of 49 Cases of Histoplasmosis in Inflammatory Bowel Disease Patients on Tumor Necrosis Factor-α Antagonists

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S633-S634
Author(s):  
Courtney Harris ◽  
Claire Jansson-Knodell ◽  
Edward Loftus ◽  
Randall Walker ◽  
Mark Enzler ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Tumor Necrosis Factor ◽  
Bowel Disease ◽  
Initial Treatment ◽  
Tumor Necrosis ◽  
Boxed Warning ◽  
Antagonist Therapy ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background Tumor necrosis factor (TNF)-α antagonist therapy has revolutionized the practice of management of inflammatory bowel disease (IBD); however, these medications carry a boxed warning from the Food and Drug Administration for risk of serious infection. We aimed to study the invasive fungal infection, histoplasmosis, in the setting of TNF-α antagonist therapy. Methods We performed a retrospective review of patients with IBD receiving TNF-α antagonist therapy who developed histoplasmosis during the time period January 2001–May 2018 at the Mayo Clinic, Rochester, MN. The medical records of patients were reviewed for demographics, medications, symptoms, diagnosis, treatment, and outcomes including mortality. IBD was diagnosed by biopsy, radiographic, or endoscopic evidence of disease. Results We identified 49 patients (age range 19–74; median 44 years) with a confirmed diagnosis of histoplasmosis while receiving a TNF-α antagonist. 73.5% of cases were classified as disseminated. Median time from starting TNF-α antagonist to histoplasmosis diagnosis was 2.1 years. Liposomal amphotericin B was given in 17 cases as the initial treatment. Itraconazole was given to all 49 patients. Initial treatment was split evenly between inpatient (49%) and outpatient (51%) locations with 6 patients (12%) requiring ICU-level care. Median length of stay was 9.5 days. The total length of treatment for all antifungals was 38.4 weeks, with 20.4% of patients developing documented antifungal side effects. TNF-α antagonist was continued in 9 patients (18.4%) and another 10 patients resumed TNF-α antagonist. Half of those who resumed TNF-α antagonists were on antifungal therapy. There was one histoplasmosis recurrence while off TNF-α antagonist, and three deaths (6%). Conclusion Histoplasmosis outcomes in IBD patients on TNF-α antagonists were mostly favorable; however, approximately half required hospitalization. Many patients were young with few co-morbidities, and over one-third were able to continue or resume TNF-α antagonists without documented recurrence of histoplasmosis. Practitioners should be vigilant for histoplasmosis infections in this patient population who reside in histoplasma-endemic regions. Disclosures All authors: No reported disclosures.

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