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Crohn Disease: HELP
Articles by Alexandra Feathers
Based on 6 articles published since 2010
(Why 6 articles?)
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Between 2010 and 2020, A. Feathers wrote the following 6 articles about Crohn Disease.
 
+ Citations + Abstracts
1 Review Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. 2017

Swaminath, A / Feathers, A / Ananthakrishnan, A N / Falzon, L / Li Ferry, S. ·Division of Gastroenterology, Lenox Hill Hospital, Northwell Health, New York, NY, USA. · Division of Gastroenterology, Massachusetts General Hospital, Cambridge, MA, USA. · Columbia University Medical Center, New York, NY, USA. · Teachers College, Columbia University, New York, NY, USA. ·Aliment Pharmacol Ther · Pubmed #28815649.

ABSTRACT: BACKGROUND: Despite potential adverse-events in a paediatric population, corticosteroids are used to induce remission in paediatric Crohn's disease. Exclusive enteral nutrition also induces remission, but is infrequently used in the USA because corticosteroids are considered the superior therapy. New data have become available since the publication of the most recent meta-analysis in 2007. AIM: To see if current literature supports the use of EEN versus CS in paediatric populations. METHODS: All studies with comparator arms of exclusive enteral nutrition and an exclusive corticosteroids, with remission clearly defined were identified by searching eight online databases. RESULTS: Of 2795 identified sources, nine studies met our inclusion criteria. Eight of these (n = 451), had data that could be abstracted into our meta-analysis. Exclusive enteral nutrition was as effective as corticosteroids in inducing remission (OR = 1.26 [95% CI 0.77, 2.05]) in paediatric Crohn's disease. There was no difference between Exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's (OR = 1.61 [95% CI .87, 2.98]) or relapsed (OR = 0.76 [95% CI .29-1.98]). Intestinal healing was significantly more likely among patients receiving Exclusive enteral nutrition compared to corticosteroids (OR = 4.5 [95% CI 1.64, 12.32]). There was no difference in the frequency of biomarker normalisation including CRP (OR = 0.85 [95% CI .44, 1.67]) and faecal calprotectin (OR 2.79 [95% CI .79-10.90]). CONCLUSIONS: There is no difference in efficacy between exclusive enteral nutrition and corticosteroids in induction of remission in Crohn's disease in a paediatric population. Exploratory analyses suggest that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing.

2 Article Mortality Risk of Inflammatory Bowel Disease: A Case-Control Study of New York State Death Records. 2019

Nocerino, Angelica / Feathers, Alexandra / Ivanina, Elena / Durbin, Laura / Swaminath, Arun. ·Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th St., 2nd Floor, New York, NY, 10075, USA. · Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th St., 2nd Floor, New York, NY, 10075, USA. aswaminath@northwell.edu. ·Dig Dis Sci · Pubmed #30604370.

ABSTRACT: BACKGROUND: Studies examining the mortality risk of inflammatory bowel disease (IBD) have yielded conflicting results, and most do not account for recent advancements made in the treatment of Crohn's disease (CD) and ulcerative colitis (UC). We aim to assess the overall, premature, and cause-specific mortality in IBD patients over a 17-year time period and to evaluate any differences since the introduction of biologic therapy. METHODS: A death record case-control study was performed to explore the odds of premature death (before age 65) and all-cause mortality among those with IBD. Cases consisted of IBD patients (1,129 with CD and 841 with UC) who died in New York State (NYS) from 1993 to 2010. Controls (n = 7880) were matched 4:1 on the basis of sex and zip code from those who died in NYS in the same time frame, without an IBD diagnosis. RESULTS: Compared with matched controls, those with CD (OR 1.56, CI 95% 1.34-1.82), but not UC (OR 0.72, CI 95% 0.59-0.89), were more likely to die prematurely. Both those with UC and CD were more likely to die from a gastrointestinal cause (CD OR 15.28, 95% CI 12.11-19.27; UC OR 14.02, 95% CI 10.76-18.26). There was no difference in the cause or age of death before and after the introduction of anti-TNF agents in those with IBD. CONCLUSIONS: Both CD and UC cases were more likely to die of a gastrointestinal etiology, and CD patients were more likely to die prematurely. There was no significant difference in the premature death, average age of death, and cause of death in this IBD population after the availability of anti-TNF therapy.

3 Article Escalation of Immunosuppressive Therapy for Inflammatory Bowel Disease Is Not Associated With Adverse Outcomes After Infection With Clostridium difficile. 2019

Lukin, Dana J / Lawlor, Garrett / Hudesman, David P / Durbin, Laura / Axelrad, Jordan E / Passi, Monica / Cavaliere, Kimberly / Coburn, Elliot / Loftus, Michelle / Jen, Henry / Feathers, Alexandra / Rosen, Melissa H / Malter, Lisa B / Swaminath, Arun / Anonymous60965. ·Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. · Division of Digestive and Liver Diseases, New York Presbyterian Hospital-Columbia University Medical Center, New York, New York. · Division of Gastroenterology, New York University Medical Center, New York, New York. · Division of Gastroenterology, Northwell Health, New York, New York. ·Inflamm Bowel Dis · Pubmed #30312400.

ABSTRACT: BACKGROUND: Clostridium difficile infection (CDI) is common in patients with inflammatory bowel disease (IBD), often leading to diagnostic confusion and delays in IBD therapy escalation. This study sought to assess outcomes after CDI in IBD patients exposed to new or escalated immunosuppressive therapy. METHODS: This multicenter retrospective cohort study included IBD patients with documented CDI at 4 academic medical centers. Data were abstracted from clinical databases at each institution. Outcomes at 30 and 90 days were compared between patients undergoing new or intensified immunosuppressive therapy and those without therapy escalation. Continuous variables were compared using t tests, and proportions using chi-square tests. Multivariable logistic regression was used to determine the association of individual variables with severe outcomes (including death, sepsis, and/or colectomy) within 90 days. Secondary outcomes included CDI recurrence, rehospitalization, worsening of IBD, and severe outcomes within 30 days. RESULTS: A total of 207 adult patients with IBD and CDI were included, of whom 62 underwent escalation to biologic or corticosteroid therapy (median time to escalation, 13 days). Severe outcomes within 90 days occurred in 21 (15.6%) nonescalated and 1 (1.8%) therapy-escalated patients. Serum albumin <2.5 mg/dL, lactate >2.2 mg/dL, intensive care unit admission, hypotension, and comorbid disease were associated with severe outcomes. Likelihood of severe outcomes was decreased in patients undergoing escalation of IBD therapy after CDI (adjusted odds ratio [aOR], 0.12) and increased among patients aged >65 years (aOR, 4.55). CONCLUSIONS: Therapy escalation for IBD within 90 days of CDI was not associated with worse clinical outcomes. Initiation of immunosuppression for active IBD may therefore be appropriate in carefully selected patients after treatment of CDI.

4 Article Internet Searches About Therapies Do Not Impact Willingness to Accept Prescribed Therapy in Inflammatory Bowel Disease Patients. 2016

Feathers, Alexandra / Yen, Tommy / Yun, Laura / Strizich, Garrett / Swaminath, Arun. ·Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th St., 2nd Floor, New York, NY, 10075, USA. · Sharp Rees-Stealy Medical Group, San Diego, CA, USA. · Division of Gastroenterology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. · Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. · Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th St., 2nd Floor, New York, NY, 10075, USA. aswaminath@nshs.edu. ·Dig Dis Sci · Pubmed #26660681.

ABSTRACT: BACKGROUND: A significant majority of patients with inflammatory bowel disease (IBD) search the Internet for information about their disease. While patients who search the Internet for disease or treatment information are believed to be more resistant to accepting medical therapy, no studies have tested this hypothesis. METHODS: All IBD patients over a 3-month period across three gastroenterology practices were surveyed about their disease, treatments, websites visited, attitudes toward medications, and their willingness to accept prescribed therapies after disease-related Internet searches. RESULTS: Of 142 total patients, 91 % of respondents searched the Internet for IBD information. The vast majority (82 %) reported taking medication upon their doctor's recommendation and cited the desire to acquire additional information about their disease and prescribed therapies as their most important search motivator (77 %). Internet usage did not affect the willingness of 52 % of our cohort to accept prescribed medication. CONCLUSION: The majority of IBD patients who searched the Internet for disease and treatment-related information were not affected in their willingness to accept prescribed medical therapy.

5 Minor Letter: reproducible evidence shows that exclusive enteral nutrition significantly reduces faecal calprotectin concentrations in children with active Crohn's disease-Authors' reply. 2017

Feathers, A / Swaminath, A / Ananthakrishnan, A N / Falzon, L / Li Ferry, S. ·Division of Gastroenterology, Lenox Hill Hospital, Northwell Health, New York, NY, USA. · Division of Gastroenterology, Massachusetts General Hospital, Cambridge, MA, USA. · Columbia University Medical Center, New York, NY, USA. · Teachers College, Columbia University, New York, NY, USA. ·Aliment Pharmacol Ther · Pubmed #29105134.

ABSTRACT: -- No abstract --

6 Minor Letter: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease-Authors' reply. 2017

Feathers, A / Swaminath, A / Ananthakrishnan, A N / Falzon, L / Li Ferry, S. ·Division of Gastroenterology, Lenox Hill Hospital, Northwell Health, New York, NY, USA. · Division of Gastroenterology, Massachusetts General Hospital, New York, NY, USA. · Columbia University Medical Center, New York, NY, USA. · Teachers College, Columbia University, New York, NY, USA. ·Aliment Pharmacol Ther · Pubmed #29052855.

ABSTRACT: -- No abstract --