scholarly journals Optimization of approaches to the treatment of mild to moderate ulcerative colitis

2021 ◽  
Author(s):  
С.С. Белоус ◽  
О.В. Князев
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Autoimmune Disease ◽  
Prolonged Release ◽  
Ph Values ◽  
Combined Use ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Ph Dependent ◽  
Systemic Drug

Язвенный колит – аутоиммунное заболевание толстой кишки, проявляющееся развитием неспецифического воспаления его слизистой оболочки с обязательным поражением прямой кишки. Наиболее часто в клинической практике встречается левосторонний язвенный колит, легкая или среднетяжелая атака. Оптимальным способом лечения таких пациентов являются месалазины, однако применение препарата с рН-зависимой оболочкой может быть ограничено в связи с большим разнообразием значений рН у пациентов с воспалительными заболеваниями кишечника. Препаратами выбора в таких ситуациях являются покрытые этилцеллюлозой микрогранулы месалазина с пролонгированным высвобождением, позволяющие достигнуть максимального терапевтического эффекта. Для улучшения результатов терапии месалазинами необходимо комбинированное применение местного и системного препарата. При неэффективности данного подхода в качестве альтернативы системным глюкокортикостероидам можно рассмотреть вопрос о назначении будесонида ММХ с новой мультиматриксной системой высвобождения месалазина (multimatrix system, ММХ). Ulcerative colitis is an autoimmune disease of the colon, manifested by the development of non-specific inflammation of its mucous membrane with a mandatory lesion of the rectum. The most common in clinical practice is left-sided ulcerative colitis, a mild or moderate attack. The optimal treatment for such patients is mesalazine, but the use of the drug with a pH-dependent shell may be limited due to the large variety of pH values in patients with inflammatory bowel diseases. The drugs of choice in such situations are ethylcellulose-coated mesalazine microgranules with prolonged release, which allow to achieve the maximum therapeutic effect. To improve the results of mesalazine therapy, the combined use of a local and systemic drug is necessary. If this approach is ineffective, the use of budesonide MMH may be considered as an alternative to systemic glucocorticosteroids. Keywords: mesalazine, treatment scheme, therapy, ulcerative colitis, proctitis, left-side colitis, budesonide, suppositoria, delivery system, MMX.

Features of the complex treatment of ulcerative colitis in clinical practice

2020 ◽  
pp. 6-11
Author(s):  
Svetlana Svetlana ◽  
Mikhail Klimentov ◽  
Olga Neganova ◽  
Alina Nazmieva ◽  
Anastasiya Kochurova
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Statistical Study ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Unknown Etiology ◽  
Number Of Patients ◽  
First Republic ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Nowadays there are certain difficulties in the early diagnosis of ulcerative colitis, proceeding with minimal intestinal symptoms. The etiology of the disease remains unclear to this day; there is no exact information about the prevalence of the disease due to the large number of latent forms and the low number of patients seeking medical help. This article presents the results of a retrospective analysis of the incidence of ulcerative colitis in the coloproctology department of the First Republic Clinical Hospital of Izhevsk. The study was conducted to assess the frequency of occurrence and determine the internal picture of ulcerative colitis. To achieve this goal, we selected 34 patients with ulcerative colitis. A statistical study was conducted on the following criteria: gender composition, age groups, forms of the disease, localization, complications, and main complaints. The length of hospital stay often was not more than 20 days. The literature on this pathology was also studied and presented in the form of a theoretical basis, which consisted of the determination and etiology of inflammatory bowel diseases. Due to the unknown etiology, insufficiently studied pathogenesis, difficult differential diagnosis with other intestinal diseases and insufficiently perfect treatment methods, there are a large number of unresolved problems in the field of ulcerative colitis. That is why, in this article we tried to reveal the problem of the features of the course and complex therapy of that disease in clinical practice.

Biosimilars monoclonal antibodies in the therapy of inflammatory bowel diseases An important milestone in the development of Crohn’s disease and ulcerative colitis therapy, or just a sophisticated generic?

2021 ◽  
Vol 75 (6) ◽  
pp. 550-555
Author(s):  
Milan Lukáš
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
Therapeutic Strategy ◽  
Active Drug ◽  
The Czech Republic ◽  
Innovative Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Summary: In 2013, EMA approved the fi rst biosimilar infl iximab CT-P13 for clinical practice in all indications of the original infl iximab. Since 2015, biosimilar infl iximab has been extensively used in patients with Crohn‘s disease and ulcerative colitis also in the Czech Republic. Biosimilar infl iximab is very similar to the original infl iximab in terms of its macromolecular structure, and its clinical eff ects, adverse events and immunogenicity are identical to those of the original infl iximab. Biosimilar biologics which have been introduced in clinical practice signifi cantly reduced therapeutic costs and improved access to an innovative therapy and facilitated a new therapeutic strategy, with pro-active drug monitoring and fl exibility in dosing. Biosimilars are associated with a signifi cant improvement in the therapeutic armamentarium, which makes them one of the important therapeutic milestones in the treatment of infl ammatory bowel disease. Key words: bio similars – bio logic therapy – Crohn’s disease – ulcerative colitis

scholarly journals Paradoxical gastrointestinal effects of interleukin-17 blockers

2020 ◽  
Vol 79 (9) ◽  
pp. 1132-1138 ◽  
Author(s):  
Marine Fauny ◽  
David Moulin ◽  
Ferdinando D'Amico ◽  
Patrick Netter ◽  
Nadine Petitpain ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Monoclonal Antibody ◽  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Interleukin 17 ◽  
Disease Exacerbation ◽  
Disease Flare ◽  
Paradoxical Effects ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Secukinumab, ixekizumab and brodalumab are monoclonal antibody therapies that inhibit interleukin (IL)-17 activity and are widely used for the treatment of psoriasis, psoriatic arthritis and ankylosing spondylitis. The promising efficacy results in dermatology and rheumatology prompted the evaluation of these drugs in Crohn’s disease and ulcerative colitis, but the onset of paradoxical events (disease exacerbation after treatment with a theoretically curative drug) prevented their approval in patients with inflammatory bowel diseases (IBDs). To date, the pathophysiological mechanisms underlying these paradoxical effects are not well defined, and there are no clear guidelines for the management of patients with disease flare or new IBD onset after anti-IL-17 drug therapy. In this review, we summarise the literature on putative mechanisms, the clinical digestive effects after therapy with IL-17 inhibitors and provide guidance for the management of these paradoxical effects in clinical practice.

Transmural Response and Transmural Healing Defined by Intestinal Ultrasound - New Potential Therapeutic Targets?

2021 ◽  
Author(s):  
Ulf Helwig ◽  
Imma Fischer ◽  
Leonie Hammer ◽  
Stefanie Kolterer ◽  
Stefan Rath ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Medical Practice ◽  
Bowel Wall ◽  
Treatment Intensification ◽  
Post Hoc Analysis ◽  
Bowel Diseases ◽  
Routine Medical Practice ◽  
Inflammatory Bowel ◽  
Post Hoc

Abstract Background and Aims Intestinal ultrasound (IUS) is a useful modality to monitor patients with inflammatory bowel diseases (IBD). Little is known about the use of IUS and appropriate definitions for transmural response (TR) and healing (TH). We aimed to establish the use of IUS in monitoring TH as a potential target in routine medical practice. Methods Based on the prospective, non-interventional, multicentre studies TRUST and TRUST&UC, we conducted a post-hoc analysis of 351 IBD patients with increased bowel wall thickness (BWT). We analysed the rates of patients achieving TR and TH, comparing three definitions of TH. In 137 Crohn’s disease (CD) patients, the predictive value of TR and TH was investigated for the clinical and sonographic outcome at week 52. Results Within 12 weeks of treatment intensification, 65.6% (n = 118) of CD patients and 76.6% (n = 131) of ulcerative colitis (UC) patients showed a TR. Depending on the definition, 23.9%–37.2% (n=58/67/43) of CD patients and 45.0%–61.4% (n=90/105/77) of UC patients had TH at week 12. CD patients with TH were more likely to reach clinical remission at week 12 (OR 3.33 [1.09–10.2]; p = 0.044) and a favourable sonographic outcome (OR 5.59 [1.97–15.8]; p = 0.001) at week 52 compared with patients without TH. Conclusions IUS response and TH in a relevant proportion of patients suggests that IUS is a useful method to assess transmural inflammatory activity in daily clinical practice. TR and TH are predictive for the sonographic outcome at week 52.

scholarly journals Vedolizumab in the treatment of inflammatory bowel diseases: whom and how?

2018 ◽  
pp. 44-49
Author(s):  
A. O. Golovenko ◽  
O. V. Golovenko
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Inflammatory Bowel Diseases ◽  
Safety Profile ◽  
Actual Clinical Practice ◽  
Loss Of Response ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Available Information

The article is devoted to the use of vedolizumab, an α4β7 integrin antagonist, in the treatment of inflammatory bowel diseases (ulcerative colitis and Crohn’s disease). It presents the results of clinical trials of the drug and the experience of using vedolizumab in actual clinical practice. The latest available information about the drug’s safety profile is provided. The authors considered the practical aspects of therapy, such as determining the indications for treatment, tactics in loss of response, the need for a combination of vedolizumab with immunosuppressors, and the use of the drug in specific categories of patients.

Curative Ayurvedic approach to Ulcerative colitis - A Case Report

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Dr. Sumedh Wasnik ◽  
Anita Ghodke ◽  
Vaibhav Sulakhe
Keyword(s):  
Ulcerative Colitis ◽  
Weight Loss ◽  
Immune Suppression ◽  
Inflammatory Bowel Diseases ◽  
Life Style ◽  
Intravenous Fluids ◽  
Genetic Origin ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Difficult Issue

Westernization and today’s changing life style is resulting in various health problems like Inflammatory Bowel diseases, which is a common entity encountered in surgical practise. Ulcerative colitis is the most common among them. Though it is believed to have auto immune and genetic origin, today’s life style, environment, diet and stress plays an important role in aetiology. The disease is prevalent in middle aged western and northern people characterised by abdominal pain with bloody diarrhoea, weight loss, anaemia and general debility. This condition has remissions and exacerbations. One should always keep in mind that inflammatory bowel diseases can have anorectal manifestations. Diagnosis is made on the basis of symptoms, stool exam. and endoscopy. Management is symptomatic i.e. antibiotics, anti-inflammatory, anti-spasmodic, multivitamins, immune suppression and if required admission, intravenous fluids. if no response colectomy. As such there is no satisfactory treatment till date, so it remains the difficult issue. Here we need to have an alternative, safe, convenient treatment. Ayurveda has an answer for such cases.

scholarly journals Recurrent myocarditis in a patient with active ulcerative colitis: a case report and review of the literature

2021 ◽  
Vol 8 (1) ◽  
pp. e000587
Author(s):  
Giacomo Caio ◽  
Lisa Lungaro ◽  
Fabio Caputo ◽  
Maria Muccinelli ◽  
Maria Caterina Marcello ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Case Report ◽  
Inflammatory Bowel Diseases ◽  
Drug Toxicity ◽  
Active Ulcerative Colitis ◽  
Extraintestinal Manifestations ◽  
Review Of The Literature ◽  
Extraintestinal Manifestation ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.

scholarly journals Targeted 1H NMR metabolomics and immunological phenotyping of human fresh blood and serum samples discriminate between healthy individuals and inflammatory bowel disease patients treated with anti-TNF

2021 ◽  
Author(s):  
Sara Notararigo ◽  
Manuel Martín-Pastor ◽  
Juan E. Viñuela Roldán ◽  
Adriano Quiroga ◽  
J. Enrique Dominguez-Munoz ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
T Lymphocyte ◽  
Fresh Blood ◽  
Serum Samples ◽  
Nmr Metabolomics ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease is a multifactorial etiology, associated with environmental factors that can trigger both debut and relapses. A high level of tumor necrosis factor-α in the gut is the main consequence of immune system imbalance. The aim of treatment is to restore gut homeostasis. In this study, fresh blood and serum samples were used to identify biomarkers and to discriminate between Crohn’s disease and ulcerative colitis patients under remission treated with anti-TNF. Metabolomics based on Nuclear Magnetic Resonance spectroscopy (NMR) was used to detect unique biomarkers for each class of patients. Blood T lymphocyte repertories were characterized, as well as cytokine and transcription factor profiling, to complement the metabolomics data. Higher levels of homoserine-methionine and isobutyrate were identified as biomarkers of Crohn’s disease with ileocolic localization. For ulcerative colitis, lower levels of creatine-creatinine, proline, and tryptophan were found that reflect a deficit in the absorption of essential amino acids in the gut. T lymphocyte phenotyping and its functional profiling revealed that the overall inflammation was lower in Crohn’s disease patients than in those with ulcerative colitis. These results demonstrated that NMR metabolomics could be introduced as a high-throughput evaluation method in routine clinical practice to stratify both types of patients related to their pathology. Key messages NMR metabolomics is a non-invasive tool that could be implemented in the normal clinical practice for IBD to assess beneficial effect of the treatment. NMR metabolomics is a useful tool for precision medicine, in order to sew a specific treatment to a specific group of patients. Finding predictors of response to IFX would be desirable to select patients affected by IBD. Immunological status of inflammations correlates with NMR metabolomics biomarkers.

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