scholarly journals Pharmacotherapy of inflammatory bowel diseases: efficacy performance and safety management

2021 ◽  
Vol 93 (8) ◽  
pp. 841-852
Author(s):  
Igor G. Bakulin ◽  
Maria I. Skalinskaya ◽  
Igor V. Maev ◽  
Ekaterina V. Skazyvaeva ◽  
Mariia S. Zhuravleva ◽  
...  

Treatment of inflammatory bowel diseases IBD (Crohns disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

2014 ◽  
Vol 18 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Filiz Topaloǧlu Demir ◽  
Emek Kocatürk ◽  
Elif Yorulmaz ◽  
Gupse Adali ◽  
Mukaddes Kavala

Background: Mucocutaneous manifestations of inflammatory bowel diseases are relatively common; the mean incidence is around 10% at the time of diagnosis. However, during follow-up, an increased variety of skin lesions, granulomatous cutaneous disease, reactive skin eruptions, nutritional defiencies, and other associated conditions may develop. Objective: The objective of this study was to evaluate the prevalence of the mucocutaneous manifestations and their association with gender, duration of disease, arthritis, location of the bowel disease, and disease activity. Methods: Fifty-six patients with ulcerative colitis (UC) and 36 patients with Crohn disease (CD) who were in follow-up in the Istanbul Medeniyet University Göztepe Training and Research Hospital Department of Gastroenterology were included in the study. Whole-body dermatologic examinations were performed for all patients, and patient files were evaluated for mucocutaneous manifestations. Results: Of the 92 patients, 49 (53.26%) presented with at least one mucocutaneous manifestation (58.9% of patients with UC and 44.4% of patients with CD). Of these, 38 (41.3%) had at least one reactive skin eruption. Aphthous stomatitis was noted in 33 patients (35.86%) and became the most common mucocutaneous manifestation. Granulomatous cutaneous diseases were detected in 18 patients (19.57%), and none of the patients had a nutritional deficiency–associated skin condition. Only 3 patients (3.26%) had erythema nodosum and 2 patients (2.17%) had pyoderma gangrenosum. Conclusions: We found that mucocutaneous manifestations of inflammatory bowel diseases are more common than thought and are more common in UC than in CD. No association was detected between mucocutaneous manifestions and gender, duration of disease, arthritis, location of the bowel disease, and activity of the disease.


2021 ◽  
Vol 92 (10) ◽  
pp. 831-834
Author(s):  
Omer Tehori ◽  
Benjamin Koslowsky ◽  
Daniel Gabbai ◽  
Shachar Shapira ◽  
Oded Ben-Ari

INTRODUCTION: Military aviators are likely to be first diagnosed with inflammatory bowel diseases (IBD) during military service. Current recommendations support continuing flying with restrictions, but risks may be significant. The aim of the study was to document the long-term results of aviators newly diagnosed with IBD. METHODS: A prospective observational study over a 23-yr period included all Israeli Air Force (IAF) aviators with IBD. Primary end point was the qualification and safety to continue operational flying following IBD diagnosis. RESULTS: Subjects were 16 male aviators with an average follow-up of 130 mo. Average age was 27 (2045) and average time from symptoms onset to final diagnosis was 7.3 mo. Eight (50%) patients had Crohns disease (CD), and the other eight had ulcerative colitis (UC). Eight (50%) were high performance platform aviators. Two patients received biologic treatment, two were treated with repeated corticosteroid courses, and four with immunosuppressive therapy. Two patients underwent surgery and four needed different lengths of hospitalizations. Eight (50%) aviators (3 CD, 5 UC) were grounded for a mean of 177 d (5590). Altogether grounding for IBD aviators was 46/2087 mo (2.2%). Most grounding periods were short term and reversible. All aviators continued flying under annual monitoring or as needed and no compromise of their abilities was documented. CONCLUSIONS: All aviators were able to continue flying and no events of sudden incapacitation or severe disabling flares have been seen among patients. Our study findings support the current recommendation to continue flying when IBD is in stable remission. Tehori O, Koslowsky B, Gabbai D, Shapira S, Ben-Ari O. Military aviators with inflammatory bowel diseases continued flying. Aerosp Med Hum Perform. 2021; 92(10):831834.


2020 ◽  
Vol 22 (4) ◽  
pp. 148-155
Author(s):  
D. S. Purgina ◽  
M. V. Solovyev ◽  
L. V. Lyalina ◽  
V. V. Rassokhin

Epidemiological features and clinical variants of inflammatory bowel diseases in St. Petersburg in conditions of outpatient practice are considered. It was established that among patients suffering from ulcerative colitis in the Vyborg and Frunze regions, women predominate in a ratio of 1:2. At the same time, more than 50% of cases of ulcerative colitis and Crohns disease come from the age of 2049 years. The vast majority of patients examined with ulcerative colitis experienced a moderate attack. In more than half of cases, left-sided localization was noted with endoscopic activity of 23 points on the Schroeder scale, rectal lesion was observed in 22% of cases, total colitis was detected in only 14%. In general, the incidence and prevalence of ulcerative colitis in the Vyborg and Frunze regions is higher than Crohns disease. However, more extensive and lengthy studies of the problem are needed, but there are some difficulties associated with the lack of a unified registration base for patients suffering from inflammatory bowel diseases. Given that the incidence of ulcerative colitis and Crohns disease is higher among women and more than 50% of patients are of the most able-bodied age (2049 years), inflammatory bowel disease is a group of highly relevant and socially significant diseases. Lower figures for the incidence and prevalence of inflammatory bowel diseases compared with those of developed countries indicate insufficient detection, diagnostic and clinical features of these diseases, as well as the need to optimize specialized medical care in places of residence of patients suffering from inflammatory bowel diseases. Nevertheless, currently in St. Petersburg and the Leningrad Region a fairly effective system of early detection and dynamic observation of patients suffering from ulcerative colitis has been created, which includes the activities of therapists and gastroenterologists of polyclinics, endoscopists and specialists of centers for the treatment of inflammatory bowel diseases of academic and university clinics.


2021 ◽  
Vol 12 (4) ◽  
pp. 443-445
Author(s):  
Gian Paolo Caviglia ◽  
Davide Giuseppe Ribaldone ◽  
Aurora Nicolosi ◽  
Rinaldo Pellicano

Inflammatory bowel diseases (IBD) are chronic inflammatory disorders, including Crohns’ disease (CD) and ulcerative colitis (UC), both characterized by a clinical relapsing course and an immune-mediated pathogenesis [...]


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