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Crohn Disease: HELP
Articles by Daniela Gilardi
Based on 4 articles published since 2008

Between 2008 and 2019, Daniela Gilardi wrote the following 4 articles about Crohn Disease.
+ Citations + Abstracts
1 Review PF-00547659 for the treatment of Crohn's disease and ulcerative colitis. 2018

Allocca, Mariangela / Gilardi, Daniela / Fiorino, Gionata / Furfaro, Federica / Argollo, Marjorie / Peyrin-Biroulet, Laurent / Danese, Silvio. ·a IBD Centre, Humanitas Clinical and Research Centre , Milan , Italy. · b Gastroenterology and Inserm U954, University Hospital of Nancy , Nancy , France. · c Department of Biomedical Sciences , Humanitas University , Milan , Italy. ·Expert Opin Investig Drugs · Pubmed #29985060.

ABSTRACT: INTRODUCTION: Gut-specific homing is mainly mediated by the expression of MAdCAM-1 on endothelial cells. An increase in MAdCAM-1 expression has been shown in patients with inflammatory bowel disease (IBD). Areas covered: PF-00547659 is a fully human monoclonal antibody (mAb) toward MAdCAM-1 on endothelial cells, blocking its binding with the α4β7 integrin on leukocytes. This review discusses the available data on effectiveness and safety of PF-00547659 in IBD. Expert opinion: A phase II study in moderate-to-severe ulcerative colitis (UC) patients, both naïve and previously exposed to anti-tumor necrosis factors, showed that PF-00547659 was superior to placebo for induction of remission, response, and mucosal healing at week 12. In contrast, preliminary results in a similar study in Crohn's disease (CD) did not show a superiority of PF-00547659, suggesting that PF-00547659 may have limited impact over CD outcomes. However, the time frame needed to evaluate clinical effectiveness of PF-00547659 may be longer in CD patients, given its transmural characteristic. In addition, it should be taken into consideration the possibility of incorporating new tools and more objective parameters in disease assessment that are proven to better correlate with inflammation. Future randomized-controlled trials are needed to confirm the efficacy of PF-00547659 in CD.

2 Review IL-23 Blockade for Crohn s disease: next generation of anti-cytokine therapy. 2017

Furfaro, Federica / Gilardi, Daniela / Allocca, Mariangela / Cicerone, Clelia / Correale, Carmen / Fiorino, Gionata / Danese, Silvio. ·a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy. · b Department of Internal Medicine and Medical Specialties , Sapienza University , Rome , Italy. · c Department of Biomedical Sciences , Humanitas University , Rozzano , Milan , Italy. ·Expert Rev Clin Immunol · Pubmed #28067059.

ABSTRACT: INTRODUCTION: Adaptive immunity in intestinal inflammation may play a key role in the pathogenesis of Crohn's disease. In particular, interleukin (IL)-23 may be a key mediator in chronic intestinal inflammation by inducing the differentiation of naïve CD4 + T cells into Th17, with the production of several pro-inflammatory cytokines. Furthermore, IL-23 induces interferon-γ (IFN- γ) production from activated T cells, a critical cytokine in innate and adaptive immunity against infections. Areas covered: We aim to review the available data from literature regarding the role of IL-23, with a more specific focus on the recent progresses in the therapeutic modulation of this cytokine. Expert commentary: Increased knowledge regarding the role of IL-23 has allowed for the development of effective therapeutic progresses by blocking the IL-23 mediated pathways. Primary or secondary loss of response to anti-TNF therapies in Crohn's disease patients during the first year is widely described in literature: the development of new drugs, with alternative mechanisms of action, is thus a key point to consider for the optimal management of these subjects. Drugs blocking the IL-12/23 pathway showed a good efficacy and safety profile in immune-mediated diseases Further studies are necessary regarding the role of the single blockade of IL-23.

3 Review Emerging therapeutic targets and strategies in Crohn's disease. 2016

Furfaro, Federica / Fiorino, Gionata / Allocca, Mariangela / Gilardi, Daniela / Danese, Silvio. ·a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy. · b Department of Gastroenterology , University Study of Milan , Milan , Italy. ·Expert Rev Gastroenterol Hepatol · Pubmed #26766496.

ABSTRACT: Crohn's disease (CD) is an immune-mediated inflammatory bowel disease, in which inflammation is driven by a complex interaction between the microbiota, immune cells, genes and mediators. New mechanisms of action and several cytokines have been identified as factors involved in the inflammatory process in CD, and many new molecules have been developed to treat this complex disease. New agents have been developed that target leukocyte trafficking, block or adhesion molecules for example, as well as the development of antibodies against classic inflammatory cytokines or therapies directed against IL-12/23 and Janus kinases. The development of selective mechanisms of action and targeting of different cytokines or inflammatory mediators for each patient presents the biggest challenge for the future in CD therapy. Such agents are currently at different phases of development. We aim to review the current literature data on a targeted approach in CD, which could be promising alternative approach for CD patients in the near future.

4 Article Comparative Accuracy of Bowel Ultrasound Versus Magnetic Resonance Enterography in Combination With Colonoscopy in Assessing Crohn's Disease and Guiding Clinical Decision-making. 2018

Allocca, Mariangela / Fiorino, Gionata / Bonifacio, Cristiana / Furfaro, Federica / Gilardi, Daniela / Argollo, Marjorie / Peyrin-Biroulet, Laurent / Danese, Silvio. ·IBD Centre, Humanitas Clinical and Research Centre, Rozzano, Milan, Italy. · Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy. · Radiology, IRCCS Humanitas, Rozzano, Milano, Italy. · Department of Gastroenterology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil. · Department of Gastroenterology and Inserm U954, University Hospital of Nancy, Lorraine University, Nancy, France. ·J Crohns Colitis · Pubmed #29982361.

ABSTRACT: Background: The comparative accuracy of bowel ultrasound [US] versus magnetic resonance enterography [MRE] in combination with colonoscopy [CS] in assessing Crohn's disease [CD] and influencing the decision-making process is unknown. Methods: Consecutive ileo-colonic CD patients seen in a tertiary referral centre were prospectively assessed by MRE, CS, and bowel US, within 1 week. Sensitivity, specificity, accuracy, positive predictive value [PPV], and negative predictive value [NPV] of bowel US in assessing localisation, enhancement [presence of vascularisation at Power Doppler], active disease [presence of ulcers at colonoscopy], strictures, fistulas, and abscesses were calculated using CS + MRE findings together as a reference standard. Two blinded inflammatory bowel disease [IBD] specialists reviewed MRE and bowel US findings and were asked to decide the therapeutic strategy [continue versus change therapy]. Kappa agreement with clinical decision was calculated. Results: Sixty CD patients [36 with endoscopic disease activity, 28 with complications] were enrolled. For localisation, sensitivity, specificity, accuracy, PPV, and NPV of bowel US were 88%, 96%, 91%, 96%, and 85%, respectively; for enhancement, 87%, 92%, 89%, 93%, and 86%; for activity, 92%, 100%, 96%, 100%, and 94%; for strictures, 75%, 86%, 81%, 78%, and 83%; for fistulas, 100%, 98%, 98%, 66%, and 100%; for abscesses, 100%, 96%, 96%, 33%, and 100%. The concordance of management of CD patients based on bowel US or MRE findings, alone, compared with clinical decision, was 0.768 and 0.767, respectively [p <0.001]. The concordance between bowel US and MRE on management of CD patients was 0.800 [p <0.001]. Conclusions: Bowel US is very accurate in assessing CD and is a non-invasive, easy-to-use tool to manage CD patients in clinical practice.