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Crohn Disease: HELP
Articles by Britta Siegmund
Based on 38 articles published since 2010
(Why 38 articles?)
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Between 2010 and 2020, B. Siegmund wrote the following 38 articles about Crohn Disease.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline [Updated German clinical practice guideline on "Diagnosis and treatment of Crohn's disease" 2014]. 2014

Preiß, J C / Bokemeyer, B / Buhr, H J / Dignaß, A / Häuser, W / Hartmann, F / Herrlinger, K R / Kaltz, B / Kienle, P / Kruis, W / Kucharzik, T / Langhorst, J / Schreiber, S / Siegmund, B / Stallmach, A / Stange, E F / Stein, J / Hoffmann, J C / Anonymous2240814. ·Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin. · Gastroenterologische Gemeinschaftspraxis Minden. · Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Berlin. · Medizinische Klinik I, Agaplesion Markus-Krankenhaus, Frankfurt/Main. · Klinik Innere Medizin I, Klinikum Saarbrücken. · Agaplesion MVZ, Frankfurt/Main. · Innere Medizin I, Asklepios Klinik Nord, Hamburg. · Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e. V., Berlin. · Chirurgische Klinik, Universitätsmedizin Mannheim. · Abteilung für Innere Medizin, Evangelisches Krankenhaus Kalk, Köln. · Klinik für Allgemeine Innere Medizin & Gastroenterologie, Klinikum Lüneburg. · Integrative Gastroenterologie, Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte. · Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Kiel. · Klinik für Innere Medizin IV, Universitätsklinikum Jena. · Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart. · Abteilung Gastroenterologie/Ernährungsmedizin, DGD Kliniken Frankfurt Sachsenhausen, Frankfurt/Main. · Medizinische Klinik I, St. Marien- und St. Annastiftskrankenhaus, Ludwigshafen. ·Z Gastroenterol · Pubmed #25474283.

ABSTRACT: -- No abstract --

2 Review [Cancer Surveillance in Inflammatory Bowel Diseases]. 2019

Lissner, Donata / Siegmund, Britta. ·Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin. ·Dtsch Med Wochenschr · Pubmed #31163475.

ABSTRACT: Patients with ulcerative colitis and Crohn's colitis, especially in the presence of primary sclerosing cholangitis, have an increased risk of developing colorectal cancer due to the longstanding colonic inflammation. Therefore, anti-inflammatory drugs reduce this elevated risk.On the other hand, immunosuppressive medication can have direct mutagen effects or can lead to compromised tumor surveillance, therefore increasing the risk of extra-intestinal tumors. This article reviews recommendations concerning cancer surveillance strategies in patients with inflammatory bowel diseases.

3 Review Adipokines and Their Role in Intestinal Inflammation. 2018

Weidinger, Carl / Ziegler, Jörn F / Letizia, Marilena / Schmidt, Franziska / Siegmund, Britta. ·Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany. · Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany. ·Front Immunol · Pubmed #30369924.

ABSTRACT: Fat tissue was initially described for its endocrine and metabolic function. Over the last two decades increasing evidence indicated a close interaction with the immune system. Partly responsible for this immune modulatory function are soluble factors released by the fat tissue, most prominently the so-called adipokines. These discoveries led to the question how adipokines influence inflammatory diseases. Linking inflammation and adipose tissue, Crohn's disease, a chronic inflammatory bowel disease, is of particular interest for studying the immune modulatory properties of adipokines since it is characterized by a hyperplasia of the mesenteric fat that subsequently is creeping around the inflamed segments of the small intestine. Thus, the role of several adipokines in the creeping fat as well as in intestinal inflammation was recently explored. The present review selected the four adipokines adiponectin, apelin, chemerin, and leptin and provides a working model based on the available literature how these factors participate in the maintenance of intestinal immune homeostasis.

4 Review [Ustekinumab - Current position]. 2018

Siegmund, Britta / Högenauer, Christoph / Novacek, Gottfried / Petritsch, Wolfgang / Reinisch, Walter / Schoepfer, Alain / Schreiber, Stefan / Vavricka, Stephan / Bokemeyer, Bernd / Anonymous990958. ·Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany. · Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Österreich. · Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Wien, Österreich/Austria. · Centre hospitalier universitaire vaudois, Service de gastro-énterologie et d'hépatologie, Lausanne, Schweiz. · Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel. · Zentrum für Gastroenterologie und Hepatologie, Zürich, Schweiz. · Gastroenterologische Gemeinschaftspraxis Minden. ·Z Gastroenterol · Pubmed #30103222.

ABSTRACT: The present review by the IBD-Dach group provides a comprehensive summary of the mode of action, clinical development, approval, efficacy and safety aspects of the novel anti-p40 antibody Ustekinumab. The review provides current data, including the large clinical trials as well as smaller case series and work outside the field of inflammatory bowel diseases for shedding more light into special situations. Together, the data indicate that Ustekinumab shows clinical efficacy as well as a good safety profile for the treatment of Crohn's disease.

5 Review [Inflammatory bowel disease: cardinal signs and their diagnostics]. 2018

Lissner, Donata / Sonnenberg, Elena / Siegmund, Britta. · ·Dtsch Med Wochenschr · Pubmed #29972837.

ABSTRACT: Inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, often occur early in life. Therefore, they affect our patient's individual path of life, their ability to work and the quality of life tremendously, which calls for close and comprehensive medical care. This article features 5 cardinal signs and their diagnostics.

6 Review The role of adipose tissue in inflammatory bowel diseases. 2018

Weidinger, Carl / Hegazy, Ahmed N / Siegmund, Britta. ·Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie. · Berlin Institute of Health, Berlin, Germany. · Deutsches Rheumaforschungszentrum Berlin (DRFZ), An Institute of the Leibniz Association. ·Curr Opin Gastroenterol · Pubmed #29846262.

ABSTRACT: PURPOSE OF REVIEW: The occurrence of creeping fat wrapping segments of inflamed gut represents a characteristic yet incompletely understood hallmark of Crohn's disease. Over the last decade, numerous studies have provided a limited understanding of this feature. Still, deciphering the detailed mechanisms and the pathophysiologic relevance of the interplay between creeping fat, barrier function and intestinal inflammation will be the aim of future studies. RECENT FINDINGS: The last 18 months have substantially contributed to this field, starting with an elegant three-dimensional study revealing B cell aggregates around lymphatic vessels embedded in the mesenteric fat, thus bringing back the idea that Crohn's disease might represent a 'lymphatic disease'. Furthermore, studies on a cellular level elucidated the interplay of mesenteric adipocytes, immune cells and intestinal epithelial cells. Last, imaging studies provide evidence indicating that changes depicted by computed tomography within the mesenteric fat compartment rather than of the bowel wall are predictive for the presence of endoscopic lesions. This underlines the impact of mesenteric changes on Crohn's disease activity. SUMMARY: The findings of the last 18 months further contribute to solving the puzzle that will ultimately reveal the role of the mesenteric fat tissue in the control of intestinal immunity and inflammation.

7 Review Anti-Adhesion Therapies in Inflammatory Bowel Disease-Molecular and Clinical Aspects. 2017

Zundler, Sebastian / Becker, Emily / Weidinger, Carl / Siegmund, Britta. ·Department of Medicine 1, University of Erlangen-Nuremberg, Translational Research Center, Erlangen, Germany. · Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité-University Medicine, Berlin, Germany. · Berlin Institute of Health, Berlin, Germany. ·Front Immunol · Pubmed #28804488.

ABSTRACT: The number of biologicals for the therapy of immunologically mediated diseases is constantly growing. In contrast to other agents that were previously introduced in rheumatologic or dermatologic diseases and only later adopted for the treatment of inflammatory bowel diseases (IBDs), the field of IBD was ground breaking for the concept of anti-adhesion blockade. Anti-adhesion antibodies selectively target integrins controlling cell homing to the intestine, which leads to reduction of inflammatory infiltration to the gut in chronic intestinal inflammation. Currently, the anti-α4β7-antibody vedolizumab is successfully used for both Crohn's disease and ulcerative colitis worldwide. In this mini-review, we will summarize the fundamental basis of intestinal T cell homing and explain the molecular groundwork underlying current and potential future anti-adhesion therapies. Finally, we will comment on noteworthy clinical aspects of anti-adhesion therapy and give an outlook to the future of anti-integrin antibodies and inhibitors.

8 Review Mend Your Fences: The Epithelial Barrier and its Relationship With Mucosal Immunity in Inflammatory Bowel Disease. 2017

Martini, Eva / Krug, Susanne M / Siegmund, Britta / Neurath, Markus F / Becker, Christoph. ·Medical Clinic 1, Friedrich-Alexander-University, Erlangen, Germany. · Institute of Clinical Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany. · Department of Gastroenterology, Rheumatology and Infectious Diseases, Charité-Universitätsmedizin Berlin, Berlin, Germany. ·Cell Mol Gastroenterol Hepatol · Pubmed #28560287.

ABSTRACT: The intestinal epithelium can be easily disrupted during gut inflammation as seen in inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease. For a long time, research into the pathophysiology of IBD has been focused on immune cell-mediated mechanisms. Recent evidence, however, suggests that the intestinal epithelium might play a major role in the development and perpetuation of IBD. It is now clear that IBD can be triggered by disturbances in epithelial barrier integrity via dysfunctions in intestinal epithelial cell-intrinsic molecular circuits that control the homeostasis, renewal, and repair of intestinal epithelial cells. The intestinal epithelium in the healthy individual represents a semi-permeable physical barrier shielding the interior of the body from invasions of pathogens on the one hand and allowing selective passage of nutrients on the other hand. However, the intestinal epithelium must be considered much more than a simple physical barrier. Instead, the epithelium is a highly dynamic tissue that responds to a plenitude of signals including the intestinal microbiota and signals from the immune system. This epithelial response to these signals regulates barrier function, the composition of the microbiota, and mucosal immune homeostasis within the lamina propria. The epithelium can thus be regarded as a translator between the microbiota and the immune system and aberrant signal transduction between the epithelium and adjacent immune cells might promote immune dysregulation in IBD. This review summarizes the important cellular and molecular barrier components of the intestinal epithelium and emphasizes the mechanisms leading to barrier dysfunction during intestinal inflammation.

9 Review Role of visceral fat in colonic inflammation: from Crohn's disease to diverticulitis. 2017

Paeschke, Anna / Erben, Ulrike / Kredel, Lea I / Kühl, Anja A / Siegmund, Britta. ·aDepartment of Gastroenterology, Infectious Diseases and RheumatologybResearch Center ImmunoSciences, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany. ·Curr Opin Gastroenterol · Pubmed #27798440.

ABSTRACT: PURPOSE OF REVIEW: The composition of activated adipose tissue with adipocytes secreting a broad spectrum of immune-modulatory adipokines next to adipose tissue-derived stromal cells and professional immune effector cells in the visceral fat creates a complex network of inflammatory processes shaping local immune responses in the adjacent inflamed intestinal mucosa. RECENT FINDINGS: In Crohn's disease a particular phenomenon called 'creeping fat' can be observed. Here the hyperplastic mesenteric fat tissue not only grows around inflamed small intestinal segments but also furthermore affects the regulation of the mucosal immune system. Diverticular disease is highly prevalent in the western world but the knowledge about its immunopathology remains incomplete. Interestingly, adipose tissue also frequently covers the basolateral site of inflamed diverticula, hence locally reflecting the phenomenon seen in Crohn's disease. SUMMARY: This review aims to summarize the current knowledge in which measures this intraabdominal fat participates in the regulation of intestinal inflammation with a particular focus on differences and possible parallels in Crohn's disease and diverticulitis. The available data allow for suggesting that each inflamed diverticula mechanistically reflects Crohn's disease on a miniature scale.

10 Review Are Immunosuppressants Becoming Obsolete? 2016

Lissner, Donata / Siegmund, Britta. ·Medizinische Klinik für Gastroenterologie; Infektiologie, Rheumatologie, Charité Universitätsmedizin Berlin, Berlin, Germany. ·Dig Dis · Pubmed #27548499.

ABSTRACT: 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.

11 Review Medical Therapy of Fibrostenotic Crohn's Disease. 2015

Siegmund, Britta. ·Medical Department (Gastroenterology, Infectious Diseases, Rheumatology), Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany. ·Viszeralmedizin · Pubmed #26557834.

ABSTRACT: INTRODUCTION: The present review serves to provide a concise overview of the current knowledge on therapeutic strategies with regard to fibrostenotic lesions in Crohn's disease. METHODS: A literature search was performed focusing on the last 5 years, and current concepts of pathophysiology, epidemiology, and treatment have been summarized. RESULTS: Fibrostenotic lesions in Crohn's disease are currently considered to be a consequence of the chronic inflammatory nature of the disease. Hence, therapeutic strategies are limited to the concept that early treatment of the inflammatory lesions can prevent structural changes, and to various endoscopic and surgical approaches. Direct targeting of the fibrostenotic lesion itself has not been the focus until now. This review will provide an overview of the pathophysiology and epidemiology of fibrostenotic lesions including current therapeutic approaches. Since research with regard to other organ systems and fibrosis is far more advanced, current strategies from available studies in these areas will be discussed. The results and the potential impact for Crohn's disease will be considered. CONCLUSION: The vision of these approaches is to reverse structural changes and restore normal function.

12 Review Intestinal Microbiota and the Innate Immune System - A Crosstalk in Crohn's Disease Pathogenesis. 2015

Haag, Lea-Maxie / Siegmund, Britta. ·Division of Gastroenterology, Infectious Diseases and Rheumatology, Medical Department 1, Charité - Universitätsmedizin Berlin , Berlin , Germany. ·Front Immunol · Pubmed #26441993.

ABSTRACT: Crohn's disease (CD) is a chronic, relapsing inflammatory disorder that can occur anywhere along the gastrointestinal tract. The precise etiology of CD is still unclear but it is widely accepted that a complex series of interactions between susceptibility genes, the immune system and environmental factors are implicated in the onset and perpetuation of the disease. Increasing evidence from experimental and clinical studies implies the intestinal microbiota in disease pathogenesis, thereby supporting the hypothesis that chronic intestinal inflammation arises from an abnormal immune response against the microorganisms of the intestinal flora in genetically susceptible individuals. Given that CD patients display changes in their gut microbiota composition, collectively termed "dysbiosis," the question raises whether the altered microbiota composition is a cause of disease or rather a consequence of the inflammatory state of the intestinal environment. This review will focus on the crosstalk between the gut microbiota and the innate immune system during intestinal inflammation, thereby unraveling the role of the microbiota in CD pathogenesis.

13 Review [Current position on Vedolizumab for ulcerative colitis and Crohn's disease]. 2015

Schreiber, S / Dignass, A U / Hartmann, H / Kruis, W / Rogler, G / Siegmund, B / Stallmach, A / Witte, C / Bokemeyer, B. ·Clinic for Internal Medicine I, Kiel, Germany. · Medizinische Klinik I, Markus-Krankenhaus Frankfurter Diakonie-Kliniken, Frankfurt/Main, Germany. · Gastroenterologische Gemeinschaftspraxis, Herne, Germany. · Evangelisches Krankenhaus Kalk, Köln, Germany. · Zürich Center for Integrative Human Physiology (ZIHP), Zürich, Switzerland. · Charité, Berlin, Germany. · Universitätsklinikum Jena, Germany. · DCCV, Berlin, Germany. · Gastroenterologische Gemeinschaftspraxis Minden, Germany. ·Z Gastroenterol · Pubmed #26016456.

ABSTRACT: Vedolizumab, the first drug in the class of anti-integrin molecules, is newly approved for ulcerative colitis and Crohn's disease and can be prescribed in Germany since mid-2014. By a specific receptor binding a relatively gut-selective mode of action was achieved without the known side effects of the systemic immunosuppression of the anti-TNF-alpha antibodies. According to the present data the safety profile of Vedolizumab appears to be more favorable than that of the anti-TNF- alpha therapy. Vedolizumab is suitable for induction therapy in patients with ulcerative colitis and Crohn's disease, however the kinetic of response compared with the anti-TNF-alpha antibodies seems to be slower. For maintenance therapy the Vedolizumab data show a deep and sustained remission in patients initially responding to induction therapy with a lower loss of efficacy in the long-term treatment known from the anti-TNF-alpha therapy. On the basis of currently available data the efficacy of Vedolizumab in ulcerative colitis appears to be slightly better than in Crohn's disease.

14 Review [Azathioprine in Crohn's disease therapy--guidance against the background of recent studies]. 2014

Schmidt, C / Herrlinger, K / Siegmund, B / Bokemeyer, B / Schreiber, S / Stallmach, A / Anonymous2230814. ·Klinik für Innere Medizin IV, Universitätsklinikum Jena. · Innere Medizin I, Asklepios Klinik Nord, Hamburg. · Medizinische Klinik m. S. Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin. · Gastroenterologische Gemeinschaftspraxis Minden. · Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Kiel. ·Z Gastroenterol · Pubmed #25474282.

ABSTRACT: Thiopurines (azathioprine and 6-mercaptopurine) are the most frequently used drugs in the treatment of patients with Crohn's disease. In current guidelines published by the German Society of Gastroenterology, Nutritional and Metabolic Diseases (DGVS) in 2014 and by the European Crohn´s and Colitis Organisation (ECCO) in 2010 different indications have been suggested. However, efficacy of azathioprine has been substantially questioned by recent publications in adults as well as in children examining the efficacy of early initiation of this treatment. These articles were published after release of the aforementioned guidelines. Therefore, in this survey recently published data are discussed on the background of our knowledge on the efficacy of azathioprine and 6-mercaptopurine developed in many years, and suggestions for the future use of these substances in the treatment of patients with Crohn's disease will be provided.

15 Review Adipose-tissue and intestinal inflammation - visceral obesity and creeping fat. 2014

Kredel, Lea I / Siegmund, Britta. ·Gastroenterology, Rheumatology, Infectious Diseases, Medical Department I, Charité - Universitätsmedizin Berlin , Berlin , Germany. ·Front Immunol · Pubmed #25309544.

ABSTRACT: Obesity has become one of the main threats to health worldwide and therefore gained increasing clinical and economic significance as well as scientific attention. General adipose-tissue accumulation in obesity is associated with systemically increased pro-inflammatory mediators and humoral and cellular changes within this compartment. These adipose-tissue changes and their systemic consequences led to the concept of obesity as a chronic inflammatory state. A pathognomonic feature of Crohn's disease (CD) is creeping fat (CF), a locally restricted hyperplasia of the mesenteric fat adjacent to the inflamed segments of the intestine. The precise role of this adipose-tissue and its mediators remains controversial, and ongoing work will have to define whether this compartment is protecting from or contributing to disease activity. This review aims to outline specific cellular changes within the adipose-tissue, occurring in either obesity or CF. Hence the potential impact of adipocytes and resident immune cells from the innate and adaptive immune system will be discussed for both diseases. The second part focuses on the impact of generalized adipose-tissue accumulation in obesity, respectively on the locally restricted form in CD, on intestinal inflammation and on the closely related integrity of the mucosal barrier.

16 Review Exploring & exploiting our 'other self' - does the microbiota hold the key to the future therapy in Crohn's? 2014

Haag, Lea-Maxie / Siegmund, Britta. ·Medical Department (Gastroenterology/Rheumatology/Infectious Diseases), Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, DE - 12200 Berlin, Germany. Electronic address: lea-maxie.haag@charite.de. · Medical Department (Gastroenterology/Rheumatology/Infectious Diseases), Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, DE - 12200 Berlin, Germany. Electronic address: britta.siegmund@charite.de. ·Best Pract Res Clin Gastroenterol · Pubmed #24913380.

ABSTRACT: Inflammatory bowel diseases (IBD) with its two major forms Crohn's disease (CD) and ulcerative colitis (UC) are chronic relapsing disorders leading to inflammation of the gastrointestinal tract. Although the precise aetiology of IBD remains unclear, several factors are believed to contribute to disease pathogenesis. Among these, the role of the intestinal microbiota has become more and more appreciated. Evidence from experimental and clinical studies strongly suggests that chronic intestinal inflammation results from a dysregulated immune response towards components of the microbiota in genetically susceptible hosts. The growing perception of the microbiota as a major driver of disease pathogenesis raises the question, if the intestinal microbiota can be used as a therapeutic target in CD. Based on what we know about host microbiota interactions in health and disease, the objective of this review is to address the question if the microbiota holds the key to the future therapy in CD.

17 Review Therapy of complicated Crohn's disease during pregnancy--an interdisciplinary challenge. 2014

Seifarth, C / Ritz, J P / Pohlen, U / Kroesen, A J / Siegmund, B / Frericks, B / Buhr, H J. ·Department of General, Visceral and Vascular Surgery, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany, claudia.seifarth@charite.de. ·Int J Colorectal Dis · Pubmed #24793212.

ABSTRACT: BACKGROUND: Severe courses of Crohn's disease (CD) during pregnancy are rare. However, if occurring, the risk of miscarriage and low birth weight is increased. At present, only limited data is available on the treatment of CD during pregnancy. In particular, there are no standard guidelines for surgical therapy. Nevertheless, surgery is often unavoidable if complications during the course of the disease arise. PURPOSE: This study provides a critical overview of conventional and interventional treatment options for CD complications during pregnancy and analyses the surgical experience gained thus far. For illustrative purposes, clinical cases of three young women with a severe clinical course during pregnancy are presented. METHODS: After treatment-refractory for conservative and interventional measures, surgery remained as the only treatment option. In all cases, a split stoma was created after resection to avoid anastomotic leaks that would endanger the lives of mother and child. The postoperative course of all three patients was uneventful, and pregnancy remained intact until delivery. No further CD specific medication was required before birth. CONCLUSIONS: The management of CD patients during pregnancy requires close interdisciplinary co-operation between gastroenterologists, obstetricians, anaesthetists and visceral surgeons. For the protection of mother and child treatment should thus be delivered in a specialised centre. This article demonstrates the advantages of surgical therapy by focusing on alleviating CD complaints and preventing postoperative complications.

18 Review Bacterial translocation - impact on the adipocyte compartment. 2014

Kruis, Tassilo / Batra, Arvind / Siegmund, Britta. ·Department of Medicine I (Gastroenterology, Rheumatology, Infectious Diseases), Charité - Universitätsmedizin Berlin , Berlin , Germany. ·Front Immunol · Pubmed #24432024.

ABSTRACT: Over the last decade it became broadly recognized that adipokines and thus the fat tissue compartment exert a regulatory function on the immune system. Our own group described the pro-inflammatory function of the adipokine leptin within intestinal inflammation in a variety of animal models. Following-up on this initial work, the aim was to reveal stimuli and mechanisms involved in the activation of the fat tissue compartment and the subsequent release of adipokines and other mediators paralleled by the infiltration of immune cells. This review will summarize the current literature on the possible role of the mesenteric fat tissue in intestinal inflammation with a focus on Crohn's disease (CD). CD is of particular interest in this context since the transmural intestinal inflammation has been associated with a characteristic hypertrophy of the mesenteric fat, a phenomenon called "creeping fat." The review will address three consecutive questions: (i) What is inducing adipocyte activation, (ii) which factors are released after activation and what are the consequences for the local fat tissue compartment and infiltrating cells; (iii) do the answers generated before allow for an explanation of the role of the mesenteric fat tissue within intestinal inflammation? With this review we will provide a working model indicating a close interaction in between bacterial translocation, activation of the adipocytes, and subsequent direction of the infiltrating immune cells. In summary, the models system mesenteric fat indicates a unique way how adipocytes can directly interact with the immune system.

19 Review [Chronic inflammatory bowel diseases. Clinical aspects and new therapy approaches]. 2012

Siegmund, B. ·Medizinische Klinik mit Schwerpunkt Gastroenterologie/Infektiologie/Rheumatologie und Arbeitsbereich Ernährungsmedizin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin. britta.siegmund@charite.de ·Pathologe · Pubmed #23052341.

ABSTRACT: There is a continuously increasing incidence in inflammatory bowel diseases affecting mostly young people who are in a vulnerable phase of life. Thus, early diagnosis and initiation of an effective therapeutic regimen is critical in order to maintain a good quality of life. In Germany, the standard therapeutic strategy is an accelerated step up approach, including the introduction of early immunosuppressive therapy if required. Although novel therapeutic strategies have found their way into clinical use there is still a substantial subgroup of patients where effective therapy is lacking. The future introduction of anti-adhesion molecule antibodies might provide a realistic option for this subgroup. Equally important is the availability of predictive markers allowing stratification of patients into subgroups at the time of diagnosis. Assuming that the CD8(+) T cell transcriptome approach will be confirmed in prospective trials, personalized therapy in patients with inflammatory bowel disease will be the next step.

20 Review [What has been confirmed in the treatment of inflammatory bowel disease?]. 2010

Siegmund, B / Preiss, J C / Zeitz, M. ·Medizinische Klinik I, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany. britta.siegmund@charite.de ·Internist (Berl) · Pubmed #21069274.

ABSTRACT: The therapy of inflammatory bowel diseases is currently guided by clinical variables. An escalation of immunosuppressive therapy is required in case of treatment failure. However, clinical remission does not necessarily imply mucosal healing. In parallel to the treatment of rheumatoid arthritis a novel concept is emerging suggesting that an early anti-inflammatory treatment can reduce structural changes in inflammatory bowel diseases. The studies supporting this novel therapeutic strategy that mucosal healing might build the future therapeutic goal will be discussed. In order to adjust the therapy, risk factors indicating a complicated disease course will be identified, resulting in the development of an individual disease course. The benefit of these strategies will be discussed together with therapy-associated complications.

21 Article Leptin induces TNFα-dependent inflammation in acquired generalized lipodystrophy and combined Crohn's disease. 2019

Ziegler, Jörn F / Böttcher, Chotima / Letizia, Marilena / Yerinde, Cansu / Wu, Hao / Freise, Inka / Rodriguez-Sillke, Yasmina / Stoyanova, Ani K / Kreis, Martin E / Asbach, Patrick / Kunkel, Desiree / Priller, Josef / Anagnostopoulos, Ioannis / Kühl, Anja A / Miehle, Konstanze / Stumvoll, Michael / Tran, Florian / Fredrich, Broder / Forster, Michael / Franke, Andre / Bojarski, Christian / Glauben, Rainer / Löscher, Britt-Sabina / Siegmund, Britta / Weidinger, Carl. ·Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. · Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany. · Laboratory of Molecular Psychiatry and Department of Neuropsychiatry, Berlin, Germany. · Department of Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany. · Department of Radiology, Campus Benjamin Franklin, Berlin, Germany. · BIH Cytometry Core, Berlin Institute of Health, 10178, Berlin, Germany. · BIH Berlin, DZNE Berlin and University of Edinburgh and UK DRI, Edinburgh, UK. · Department of Pathology, Campus Charité Mitte, Berlin, Germany. · iPATH.Berlin-Immunopathology for Experimental Models, Core Facility of the Charité, Berlin, Germany. · Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany. · Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany. · Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. britta.siegmund@charite.de. · Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany. britta.siegmund@charite.de. · Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. carl.weidinger@charite.de. · Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany. carl.weidinger@charite.de. · Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany. carl.weidinger@charite.de. ·Nat Commun · Pubmed #31822667.

ABSTRACT: Leptin has been shown to modulate intestinal inflammation in mice. However, clinical evidence regarding its immune-stimulatory potential in human Crohn's disease remains sparse. We here describe a patient with the unique combination of acquired generalized lipodystrophy and Crohn's disease (AGLCD) featuring a lack of adipose tissue, leptin deficiency and intestinal inflammation. Using mass and flow cytometry, immunohistochemistry and functional metabolic analyses, the AGLCD patient was compared to healthy individuals and Crohn's disease patients regarding immune cell composition, function and metabolism and the effects of recombinant N-methionylleptin (rLeptin) were evaluated. We provide evidence that rLeptin exerts diverse pro-inflammatory effects on immune cell differentiation and function, including the metabolic reprogramming of immune cells and the induction of TNFα, ultimately aggravating Crohn's disease in the AGLCD patient, which can be reversed by anti-TNFα therapy. Our results indicate that leptin is required for human immune homeostasis and contributes to autoimmunity in a TNFα-dependent manner.

22 Article Perceived distress, personality characteristics, coping strategies and psychosocial impairments in a national German multicenter cohort of patients with Crohn's disease and ulcerative colitis. 2019

Petruo, Vanessa A / Krauss, Ekaterina / Kleist, Anika / Hardt, Juliane / Hake, Karsten / Peirano, Julia / Krause, Thomas / Ehehalt, Robert / von Arnauld de la Perriére, Philipp / Büning, Jürgen / Treml, Oliver / Krauss, Norbert / Albrecht, Heinz / Felten, Gisela / Hermannspahn, Uta / Burkhardt, Ulrike / Eisold, Marc / Teich, Nils / Siegmund, Britta / Maaser, Christian / Bokemeyer, Bernd / Baumgart, Daniel C / Neurath, Markus F / Mudter, Jonas / Anonymous1890986. ·Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany. · Department of Medicine II, Justus-Liebig University Giessen, Germany. · Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany. · Berlin Institute of Health (BIH), Clinical Research Unit (CRU) - Biostatistics, Berlin, Germany. · Institute of Biometry and Clinical Epidemiology (iBikE), Charité - Universitätsmedizin Berlin AND Berlin Institute of Health (BIH), Berlin, Germany. · Institute for Social Medicine and Epidemiology, University of Lübeck, Germany. · University of Rostock, Clinic for Psychosomatics and Psychotherapic Medicine, Rostock, Germany. · Psychotherapy practice with focus on IBD, Hamburg, Germany. · Gastroenterological practice, Kassel, Germany. · Gastroenterological practice, Heidelberg, Germany. · Gastroenterological practice, Lüneburg, Germany. · Department of Gastroenterology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany and Gastroenterological Practice, Lübeck, Germany. · Specialized Medical Center, Hagen, Germany. · Center of Visceral Medicine, Gastroenterology, Endoscopy and Surgery, Justus-Liebig University Giessen, Giessen, Germany. · Gastroenterological Practice, Herne, Germany. · Municipal Clinic of Landau i.d. Pfalz, Germany. · Gastroenterological Practice, Plauen, Germany. · Gastroenterological Practice, Moessingen, Germany. · Gastroenterological Practice, Leipzig, Germany. · Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Medical Clinic I, Berlin, Germany. · Outpatient's Department of Gastroenterology, University Teaching Hospital Lüneburg, Lüneburg, Germany. · Gastroenterological practice, Minden. · University Hospital of Schleswig-Holstein, Campus Kiel, Medical Clinic I, Kiel, Germany. · Department of Gastroenterology and Hepatology. Charité Medical School, Humboldt-University, Berlin, Germany. · Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada. · Department of Gastroenterology and Infectiology, Helios Clinic, Schwerin, Germany. ·Z Gastroenterol · Pubmed #30965377.

ABSTRACT: BACKGROUND AND AIMS:  This study examined differences in personality, psychological distress, and stress coping in inflammatory bowel disease (IBD) depending on type of disease and disease activity. We compared patients suffering from Crohn's disease (CD) and ulcerative colitis (UC) with controls. While the literature is replete with distinctive features of the pathogenesis of IBD, the specific differences in psychological impairments are not well studied. METHODS:  In this German national multicenter study, participants were recruited from 32 centers. Two hundred ninety-seven questionnaires were included, delivering vast information on disease status and psychological well-being based on validated instruments with a total of 285 variables. RESULTS:  CD patients were more affected by psychological impairments than patients suffering from UC or controls. Importantly, patients with active CD scored higher in neuroticism (p < 0.01), psychological distress (p < 0.001) and maladaptive stress coping (escape, p = 0.03; rumination, p < 0.03), but less need for social support (p = 0.001) than controls. In contrast, patients suffering from active UC showed psychological distress (p < 0.04) and maladaptive coping (avoidance, p < 0.03; escape, p = 0.01). Patients in remission seemed to be less affected. In particular, patients with UC in remission were not inflicted by psychological impairments. The group of CD patients in remission however, showed insecurity (p < 0.01) and paranoid ideation (p = 0.04). CONCLUSIONS:  We identified specific aspects of psychological impairment in IBD depending on disease and disease activity. Our results underscore the need for psychological support and treatment particularly in active CD.

23 Article Accuracy of diagnostic tests and a new algorithm for diagnosing cytomegalovirus colitis in inflammatory bowel diseases: a diagnostic study. 2019

Kredel, Lea I / Mundt, Pamela / van Riesen, Linda / Jöhrens, Korinna / Hofmann, Jörg / Loddenkemper, Christoph / Siegmund, Britta / Preiß, Jan C. ·Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany. · Praxis Jessen + Kollegen, Akademische Lehrpraxis der Charité - Universitätsmedizin Berlin, Berlin, Germany. · Klinik für Innere Medizin - Schwerpunkt Gastroenterologie, DRK Kliniken Westend, Berlin, Germany. · Institut für Pathologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. · Institut für Virologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. · Pathotres Gemeinschaftspraxis für Pathologie, Berlin, Germany. · Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany. jan.preiss@charite.de. · Klinik für Innere Medizin - Gastroenterologie, Diabetologie und Hepatologie, Vivantes Klinikum Neukölln, Berlin, Germany. jan.preiss@charite.de. ·Int J Colorectal Dis · Pubmed #30276706.

ABSTRACT: PURPOSE: The optimal method for detecting CMV colitis in patients with inflammatory bowel disease (IBD) has not been established. We wanted to investigate which diagnostic test would be most accurate when defining CMV colitis rather by the further clinical course than by using another diagnostic modality. METHODS: All consecutive patients with moderately or severely active IBD who had been tested for CMV by PCR, histology, or antigenemia assay at the two campuses CBF and CCM of the Charité - Universitätsmedizin Berlin between September 2006 and September 2009 were included in this retrospective study. During that time, in patients with a positive CMV test, immunosuppressive treatment of any kind was immediately reduced and antiviral treatment was started. This allowed identifying patients who responded to antiviral treatment and those who only responded to later escalation of immunosuppressive therapy. RESULTS: One hundred and nine patients were identified, out of whom nine were considered to have clinically relevant CMV colitis. Sensitivity and specificity were 1 and 0.94 for CMV PCR and 0.5 and 1 for pp65 antigen immunofluorescence assay from peripheral blood, 0.67 and 0.98 for immunohistochemistry, and 0.17 and 0.98 for hematoxylin-eosin staining. When using absence of leukocytosis, splenomegaly, and steroid refractory disease as clinical parameters to test for CMV colitis, blood CMV PCR and immunohistochemistry were able to exclude CMV colitis in negative patients with a 75% likelihood of positive patients to have clinically relevant CMV colitis. CONCLUSIONS: Blood-based CMV PCR together with simple clinical parameters can exclude clinically relevant CMV colitis at a high specificity.

24 Article T-cell Composition in Ileal and Colonic Creeping Fat - Separating Ileal from Colonic Crohn's Disease. 2019

Kredel, Lea I / Jödicke, Lisa J / Scheffold, Alexander / Gröne, Jörn / Glauben, Rainer / Erben, Ulrike / Kühl, Anja A / Siegmund, Britta. ·Medical Department, Division of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. · Medical Department [Rheumatology, Clinical Immunology], Department of Cellular Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. · Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. · Department of Surgery, Rotes Kreuz Krankenhaus Bremen, Bremen, Germany. · iPATH, Core Unit/Research Center ImmunoSciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. ·J Crohns Colitis · Pubmed #30272118.

ABSTRACT: Background and Aims: Creeping fat [CF] is a hyperplasia of adipose tissue adjacent to inflamed intestine in Crohn's disease [CD]. Data from genome-wide association studies [GWAS] distinguished Crohn's colitis from ileal CD and ulcerative colitis [UC]. This study analysed the T-cell compartments of ileal and colonic mesenteric fat and corresponding mucosa to provide cellular proof for the suggested GWAS classification. Methods: Samples were obtained from 34 CD or UC patients. Cells were analysed by immunohistochemistry and flow cytometry, and tissue cytokine release was assessed by cytometric bead array. Results: Only ileal CF revealed the distinct adipocyte hyperplasia combined with dense T-cell infiltration and fibrosis; colonic fat from CD and UC patients lacked these findings. T-cell subpopulations differed between mesenteric fat in ileal CD, colonic CD and UC: ileal CF had nearly 10 times more T-cells than colonic fat. The proportions of regulatory and central memory T-cells were significantly higher in ileal CF compared with colonic fat in CD and UC. In all groups, the mucosal T-cell compartment was distinct from the mesenteric fat. Remarkably, correlation between disease activity and proportion of pro- and anti-inflammatory T-cell subpopulations was inverse, comparing ileal and colonic fat in CD. Conclusions: This first in-depth analysis of the T-cell compartment in ileal and colonic mesenteric adipose tissue in CD and UC identifies a unique T-cell niche in the ileal mesenteric fat tissue in CD. From a clinical point of view, our findings underscore the novel concept of colonic and ileal CD as distinct IBD entities.

25 Article Effectiveness and Safety of Vedolizumab in Anti-TNF-Naïve Patients With Inflammatory Bowel Disease-A Multicenter Retrospective European Study. 2018

Kopylov, Uri / Verstockt, Bram / Biedermann, Luc / Sebastian, Shaji / Pugliese, Daniela / Sonnenberg, Elena / Steinhagen, Peter / Arebi, Naila / Ron, Yulia / Kucharzik, Torsten / Roblin, Xavier / Ungar, Bella / Shitrit, Ariella Bar-Gil / Ardizzone, Sandro / Molander, Pauliina / Coletta, Marina / Peyrin-Biroulet, Laurent / Bossuyt, Peter / Avni-Biron, Irit / Tsoukali, Emmanouela / Allocca, Mariangela / Katsanos, Konstantinos / Raine, Tim / Sipponen, Taina / Fiorino, Gionata / Ben-Horin, Shomron / Eliakim, Rami / Armuzzi, Alessandro / Siegmund, Britta / Baumgart, Daniel C / Kamperidis, Nikolaos / Maharshak, Nitsan / Maaser, Christian / Mantzaris, Gerassimos / Yanai, Henit / Christodoulou, Dimitrious K / Dotan, Iris / Ferrante, Marc. ·Sheba Medical Center, Gastroenterology, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Israel. · Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. · Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. · IBD Unit, Hull & East Yorkshire Hospitals NHS Trust, Hull, United Kingdom. · IBD Unit, Presidio Columbus Fondazione Policlinico Gemelli Università Cattolica, Rome, Italy. · Department of Medicine (Gastroenterology, Infectious DIseases, Rheumatology), Campus Benjamin Franklin, Charité-Universitätsmedizin, Berlin, Germany. · Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Charité Medical School, Humboldt-University of Berlin, Berlin, Germany. · Department of Inflammatory Bowel Disease, St Mark's Hospital, Harrow, London, United Kingdom. · IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Gastroenterology, Lüneburg Hospital, University of Hamburg, Lüneburg, Germany. · CHU de Saint-Etienne, Gastroenterology, Saint Etiennne, France. · Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel. · Department of Gastroenterology, DIBIC, ASST Fatebenefratelli Sacco, Milan University, Milan, Italy. · Department of Gastroenterology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. · Department of Pathophysiology and Transplantation, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano, Milan, Italy. · Department of Hepatogastroenterology, Nancy University Hospital, Université de Lorraine, Vandoeuvre-lès-Nancy, France. · Imelda GI Clinical Research Center, Gastroenterology, Bonheiden, Belgium. · Division of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tikva, and Sackler School of Medicine, Tel Aviv University, Israel. · Gastroenterology, Humanitas Gradenigo, Turin, Italy. · Division of Gastroenterology, School of Health Sciences and Univeristy Hospital of Ioannina, Ioannina, Greece. · Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom. · IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy. · Department of Gastroenterology, "Evaggelismos-Ophthalmiatreion Athinon-Polycliniki, Athens, Greece. ·Inflamm Bowel Dis · Pubmed #29788318.

ABSTRACT: Background: Vedolizumab (VDZ) is effective for treatment of ulcerative colitis (UC) and Crohn's disease (CD). In GEMINI trials, anti-tumor necrosis factor (anti-TNF)-naïve patients had a superior response compared with anti-TNF-exposed patients. In real-world experience (RWE), the number of included anti-TNF-naïve patients was low. We aimed to evaluate the effectiveness and safety of VDZ in anti-TNF-naïve patients in an RWE setting. Methods: This retrospective multicenter European pooled cohort study included consecutive active anti-TNF-naïve IBD patients treated with VDZ. The primary end point was clinical response at week 14. Patients with follow-up beyond week 14 and those discontinuing VDZ at any time were included for maintenance outcomes analysis. Results: Since January 2015, 184 anti-TNF-naïve patients from 23 centers initiated VDZ treatment (Crohn's disease [CD], 50; ulcerative colitis [UC], 134). In CD, 42/50 (82%) patients responded by week 14 and 32 (64%) were in clinical remission; 26/50 (52%) achieved corticosteroid-free remission (CSFR). At last follow-up (44 weeks; interquartile range [IQR], 30-52 weeks), 27/35 (77.1%) patients with available data responded to treatment; 24/35 (68.6%) were in clinical remission, 21/35 (60%) were in CSFR. For UC, 116/134 (79.1%) responded to treatment by week 14, including 53 (39.5%) in clinical remission; 49/134 (36.6%) achieved CSFR. At last follow-up (42.5 weeks; IQR, 30-52 weeks), 79/103 (76.7%) patients responded to treatment, 69/103 (67.0%) were in remission, and 61/103 (59.2%) were in CSFR. Adverse effects were reported in 20 (11%) of the patients, leading to treatment discontinuation in 6 (3.3%). Conclusions: VDZ is similarly effective in ant-TNF-naïve CD and UC patients. The efficacy is higher than reported in anti-TNF-experienced patients and is comparable to that of anti-TNF biologics in this population.

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