scholarly journals Intralesional Injection of Adalimumab for Anal Stricture in Pediatric Crohn’s Disease: A Therapeutic Option?

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Camacho- Gomez A
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Option ◽  
Intralesional Injection ◽  
Anal Stricture

scholarly journals Crohn’s disease patients effectively mobilize peripheral blood stem cells to perform autologous haematopoietic stem cell transplantation

2018 ◽  
Author(s):  
Milton Artur Ruiz ◽  
Roberto Luiz Kaiser ◽  
Lilian Piron – Ruiz ◽  
Tatiana Peña-Arciniegas ◽  
Lilian Castiglioni ◽  
...  
Keyword(s):  
Stem Cell ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Therapeutic Option ◽  
Haematopoietic Stem Cell ◽  
Peripheral Blood Stem Cells ◽  
Haematopoietic Progenitor Cell

AbstractBackgroundTreatment with high doses chemotherapy followed by autologous haematopoietic stem cell transplantation is promising for refractory Crohn’s disease patients with no therapeutic option and at imminent risk of further surgeries.ObjectivesTo evaluate the feasibility and efficacy of haematopoietic progenitor cell mobilization in a group of Crohn’s disease patients preparing for autologous unselected haematopoietic stem cell transplantation in a single institution. This is the first study to evaluate mobilization for Crohn’s disease.MethodsPatients were selected according to criteria of the European Bone Marrow Transplant Society.ResultsAll patients mobilized with the mean number of haematopoietic progenitor cells obtained and infused being 16.17 × 106/CD34+/kg. Most patients required only one leukapheresis session to reach the ideal number of cells. Grafting occurred around ten days after cells infusion. Complications and adverse events during the mobilization period were rare with only one patient presenting sepsis as a relevant event in the period.Most patients 20 (70%) had anaemia from the beginning of the mobilization but only 11 (37.9%) received packed red blood cell transfusions.ConclusionMobilization in patients with Crohn’s disease is effective and it seems they are good mobilizers.

scholarly journals Postoperative Morbidity After Iterative Ileocolonic Resection for Crohn’s Disease: Should we be Worried? A Prospective Multicentric Cohort Study of the GETAID Chirurgie

2019 ◽  
Vol 13 (12) ◽  
pp. 1510-1517 ◽  
Author(s):  
Solafah Abdalla ◽  
Antoine Brouquet ◽  
Léon Maggiori ◽  
Philippe Zerbib ◽  
Quentin Denost ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Morbidity ◽  
Multivariate Analyses ◽  
Therapeutic Option ◽  
Anastomotic Complications ◽  
Conversion Rates ◽  
Significant Difference ◽  
Ileocolonic Resection

Abstract Background and Aims To compare perioperative characteristics and outcomes between primary ileocolonic resection [PICR] and iterative ileocolic resection [IICR] for Crohn’s disease [CD]. Methods From 2013 to 2015, 567 patients undergoing ileocolonic resection were prospectively included in 19 centres of the GETAID chirurgie group. Perioperative characteristics and postoperative results of both groups [431 PICR, 136 IICR] were compared. Uni- and multivariate analyses of the risk factors of overall 30-day postoperative morbidity was carried out in the IICR group. Results IICR patients were less likely to be malnourished [27.2% vs 39.9%, p = 0.007], and had more stricturing forms [69.1% vs 54.3%, p = 0.002] and less perforating disease [19.9% vs 39.2%, p < 0.001]. Laparoscopy was less commonly used in IICR [45.6% vs 84.5%, p < 0.01] and was associated with increased conversion rates [27.4% vs 14.6%, p = 0.012]. Overall postoperative morbidity was 36.8% in the IICR group and 26.7% in the PICR group [p = 0.024]. There was no significant difference between IICR and PICR regarding septic intra-abdominal complications, anastomotic leakage [8.8% vs 8.4%] or temporary stoma requirement. IICR patients were more likely to present with non-infectious complications and ileus [11.8% vs 3.7%, p < 0.001]. Uni- and multivariate analyses did not identify specific risk factors of overall postoperative morbidity in the IICR group. Conclusions Surgery for recurrent CD is associated with a slight increase of non-infectious morbidity [postoperative ileus] that mainly reflects the technical difficulties of these procedures. However, IICR remains a safe therapeutic option in patients with recurrent CD because severe morbidity including anastomotic complications is similar to patients undergoing primary resection. Podcast This article has an associated podcast which can be accessed at https://academic.oup.com/ecco-jcc/pages/podcast

scholarly journals Cyclosporine and inflammatory bowel disease: buying time

1998 ◽  
Vol 7 (3) ◽  
pp. 145-147 ◽  
Author(s):  
M. A. C. Meijssen
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Therapeutic Option ◽  
Short Term ◽  
Disease Remission ◽  
Acute Exacerbations ◽  
Inflammatory Bowel

Cyclosporine is an effective drug in acute exacerbations of corticosteroid resistant ulcerative colitis, but its efficacy to maintain disease remission is not clear. Cyclosporine may not be as effective in Crohn's disease. However, being a rapidly acting immunosuppressant, cyclosporine may be a valuable therapeutic option in the short-term to treat corticosteroid resistant Crohn's disease and ulcerative colitis.

scholarly journals Recurrent granulomatous cheilitis associated with Crohn’s disease successfully treated with ustekinumab: case report and literature review

2020 ◽  
Vol 13 ◽  
pp. 175628482093432
Author(s):  
Carlos Taxonera ◽  
Cristina Alba ◽  
Michel Colmenares ◽  
David Olivares ◽  
Enrique Rey
Keyword(s):  
Monoclonal Antibody ◽  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Literature Review ◽  
Clinical Case ◽  
Therapeutic Option ◽  
Therapeutic Challenge ◽  
Persistent Inflammation ◽  
Granulomatous Cheilitis

Granulomatous cheilitis, characterized by persistent inflammation of the lips and a granulomatous histology, is sometimes associated with Crohn’s disease and is a therapeutic challenge. Reported evidence indicates treatment with an anti-TNF agent (mainly infliximab) is the most recommended therapeutic option after failure of conventional treatments. The clinical case reported the effectiveness of ustekinumab, a monoclonal antibody against interleukins 12/23, to induce the remission of severe and recurrent granulomatous cheilitis in a patient with Crohn’s disease.

scholarly journals Su1038 INTRALESIONAL INJECTION OF ADALIMUMAB IN INTESTINAL STRICTURES OF PATIENTS WITH CROHN’S DISEASE: A RANDOMIZED, MULTICENTER, PROSPECTIVE CLINICAL TRIAL

2020 ◽  
Vol 91 (6) ◽  
pp. AB277
Author(s):  
Begoña Gonzalez Suarez ◽  
Antonio Giordano ◽  
Cristina Romero Mascarell ◽  
Sam Khorrami ◽  
Ana Gutiérrez ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Prospective Clinical Trial ◽  
Intralesional Injection

Are Immunosuppressants Becoming Obsolete?

2016 ◽  
Vol 34 (Suppl. 1) ◽  
pp. 56-60 ◽  
Author(s):  
Donata Lissner ◽  
Britta Siegmund
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Option ◽  
Significant Drop ◽  
Current Role ◽  
Early Introduction ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission ◽  
Therapy Of Crohn's Disease

Historically, in the 1950s, the introduction of simple, old-fashioned steroids resulted in a significant drop in mortality and hence offered for the first time a real therapeutic option for patients with inflammatory bowel disease. However, as we are all aware of, steroids are no option for maintenance of remission. This review will provide an overview of the available data on the current role of azathioprine in the therapy of Crohn's disease. Based on several controlled trials, the place of azathioprine for maintenance of remission is indisputable. Data from a pediatric cohort suggested that early introduction of azathioprine is beneficial for the disease course. Two recent studies aimed at reproducing these data in adult populations and failed. Hence indicating that azathioprine should only be introduced for maintenance of remission in a step-up-wise approach. An additional role for azathioprine in combo therapy with TNF antibodies has been indicated by several trials revealing a substantial benefit on response. This is partly attributed to the gain in the therapeutic effect by azathioprine itself and possibly through reduction of anti-drug antibody development. In summary, the current role of azathioprine in the therapy of Crohn's disease is manifold and still has an impact in times of targeted therapy.

scholarly journals Autophagy: A Primer for the Gastroenterologist/Hepatologist

2011 ◽  
Vol 25 (12) ◽  
pp. 667-674 ◽  
Author(s):  
Christiane Sokollik ◽  
Michelle Ang ◽  
Nicola L Jones
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Present Article ◽  
Clinical Significance ◽  
Gastrointestinal Disease ◽  
Therapeutic Option ◽  
Eukaryotic Cells ◽  
Diverse Range ◽  
Cellular Pathway ◽  
Autophagy Pathway

Autophagy is a conserved cellular pathway that maintains intracellular homeostasis by degrading proteins and cytosolic contents of eukaryotic cells. Autophagy clears misfolded and long-lived proteins, damaged organelles and invading microorganisms from cells, and provides nutrients and energy in response to exposure to cell stressors such as starvation. Defective autophagy has recently been linked to a diverse range of disease processes of relevance to gastroenterologists and hepatologists including Crohn’s disease, pancreatitis, hepatitis and cancer. The present article provides an overview of the autophagy pathway and discusses gastrointestinal disease processes in which alterations in autophagy have been implicated. The clinical significance of autophagy as a potential therapeutic option is also discussed.

scholarly journals Long-Term Clinical Remission in Biologically Naïve Crohn’s Disease Patients with Adalimumab Therapy, Including Analyses of Switch from Adalimumab to Infliximab

2016 ◽  
Vol 10 (2) ◽  
pp. 283-291 ◽  
Author(s):  
Tsutomu Mizoshita ◽  
Satoshi Tanida ◽  
Keiji Ozeki ◽  
Takahito Katano ◽  
Takaya Shimura ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Dose Escalation ◽  
Clinical Remission ◽  
Therapeutic Option ◽  
Serious Adverse Events ◽  
Adalimumab Therapy ◽  
Treatment Naïve ◽  
Trough Levels

There is little evidence regarding the maintenance of long-term clinical remission by adalimumab (ADA) therapy in Crohn’s disease (CD) patients naïve to anti-tumor necrosis factor treatment (naïve CD patients), since most CD patients are treated with ADA after infliximab (IFX) therapy. The long-term clinical response to ADA was retrospectively analyzed in 17 naïve CD patients for at least 24 months, and the serum trough IFX levels were evaluated in patients switching from ADA to IFX. Of the 17 naïve CD patients, 14 (82.4%) maintained long-term clinical remission with ADA therapy for at least 24 months, without serious adverse events. The clinical condition of 7 patients was observed for more than 36 months, and 3, 1, 1, and 2 cases maintained remission at months 42, 48, 54, and 60 after ADA therapy, respectively. Three patients (17.6%) switched from ADA to IFX less than 24 months after the start of ADA therapy, and they had remission, retaining trough levels of IFX higher than 1 μg/ml, occasionally by dose escalation. In conclusion, maintenance ADA therapy achieves long-term clinical remission in naïve CD patients. Switching from ADA to IFX is an important therapeutic option in CD patients showing loss of response to ADA, occasionally with dose escalation, based on the analysis of serum IFX trough levels.

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