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Ulcerative Colitis: HELP
Articles from New York City
Based on 269 articles published since 2008
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These are the 269 published articles about Colitis, Ulcerative that originated from New York City during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Guideline Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. 2010

Kornbluth, Asher / Sachar, David B / Anonymous1490648. ·Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. asher.kornbluth@mssm.edu ·Am J Gastroenterol · Pubmed #20068560.

ABSTRACT: Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifically valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identified as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specific problem. Guidelines are intended to be flexible and must be distinguished from standards of care, which are inflexible and rarely violated. Given the wide range of specifics in any health-care problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the field, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case-control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

2 Editorial A Probiotic for Ulcerative Colitis: The Culture Wars Continue. 2018

Abraham, Bincy P / Quigley, Eamonn M M. ·Fondren IBD Program, Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, 6550 Fannin St., SM 1201, Houston, TX, 77030, USA. bpabraham@houstonmethodist.org. · Fondren IBD Program, Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, 6550 Fannin St., SM 1201, Houston, TX, 77030, USA. ·Dig Dis Sci · Pubmed #29785650.

ABSTRACT: -- No abstract --

3 Editorial Yes, We Are Still Talking about Cylosporin vs. Infliximab in Steroid Resistant Acute Severe Ulcerative Colitis. 2017

Bernstein, Charles N / Kornbluth, Asher. ·IBD Clinical and Research Centre and The Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. · The Henry Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. ·Am J Gastroenterol · Pubmed #29109492.

ABSTRACT: The Spanish IBD Registry (ENEIDA) is reporting in this issue of the Journal on a retrospective assessment of outcomes of cyclosporine use and infliximab use to treat steroid refractory acute severe ulcerative colitis (SR-ASUC) between 1989 and 2013. Overall, they found similar outcomes in terms of 3 month and 1 year colectomy rates. Serious adverse events were lower in cyclosporine users. While this study does not meet the standard of a prospective randomized controlled trial, it does remind us that cyclosporine can be effective in (SR-ASUC) and should be considered in those who have already failed antibody to tumor necrosis factor therapy or as a bridge to immunomodulators that have a slower onset of action.

4 Editorial Editorial: importance of definition of inflammatory bowel disease and an increased incidence in children. 2017

Everhov, Å H / Olén, O / Ludvigsson, J F. ·Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. · Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. · Department of paediatric gastroenterology and nutrition, Sachs' Children and Youth Hospital, Stockholm, Sweden. · Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Department of Paediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden. · Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK. · Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. ·Aliment Pharmacol Ther · Pubmed #28417497.

ABSTRACT: -- No abstract --

5 Editorial Editorial: vedolizumab in pregnancy - is gut selectivity as good for baby as it is for mum? Authors' reply. 2017

Mahadevan, U / Vermeire, S / Lasch, K / Abhyankar, B / Bhayat, F / Blake, A / Dubinsky, M. ·Center for Colitis and Crohn's Disease, University of California San Francisco, San Francisco, CA, USA. · University Hospital Gasthuisberg, Leuven, Belgium. · Takeda Pharmaceuticals USA, Inc., Deerfield, IL, USA. · Takeda Development Centre Europe Ltd, London, UK. · Department of Pediatrics, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ·Aliment Pharmacol Ther · Pubmed #28370036.

ABSTRACT: -- No abstract --

6 Editorial Fecal Microbiota Transplantation for Ulcerative Colitis: Not Just Yet. 2015

Grinspan, Ari M / Kelly, Colleen R. ·Department of Medicine, The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: ari.grinspan@mountsinai.org. · Department of Medicine, Lifespan Women's Medicine Collaborative, The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island. ·Gastroenterology · Pubmed #26021232.

ABSTRACT: -- No abstract --

7 Editorial Association of Serotonin Transporter Promoter Polymorphism (5HTTLPR) with Microscopic Colitis and Ulcerative Colitis: Time to Be AsSERTive? 2015

Goldner, Dana / Margolis, Kara Gross. ·Division of Pediatric Gastroenterology, Hepatology and Nutrition, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA. ·Dig Dis Sci · Pubmed #25732715.

ABSTRACT: -- No abstract --

8 Editorial Isotretinoin and inflammatory bowel disease: trial lawyer misuse of science and FDA warnings. 2014

Tenner, Scott. ·Department of Gastroenterology, Downstate Medical Center, Brooklyn, New York, USA. ·Am J Gastroenterol · Pubmed #24698863.

ABSTRACT: Based on the Food and Drug Administration Adverse Event Reporting System (FAERS), the FDA and Hoffman La Roche issued warnings of a possible causal association between isotretinoin and inflammatory bowel disease. While scientists studied the association, trial lawyers used the courts to award large sums of money to plaintiffs despite the absence of clear scientific evidence of a causal effect. In this Issue of the Journal, a well-designed, large pharmaco-epidemiologic study shows no association. The story of isotretinoin highlights the problems that occur when the FAERS is used in litigation prior to further study and scientific analysis.

9 Review Genomic characterization of colitis-associated colorectal cancer. 2018

Kameyama, Hitoshi / Nagahashi, Masayuki / Shimada, Yoshifumi / Tajima, Yosuke / Ichikawa, Hiroshi / Nakano, Masato / Sakata, Jun / Kobayashi, Takashi / Narayanan, Sumana / Takabe, Kazuaki / Wakai, Toshifumi. ·Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, Niigata, 951-8510, Japan. kame@med.niigata-u.ac.jp. · Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, Niigata, 951-8510, Japan. · Department of Surgical Oncology, Roswell Park Cancer Center Institute, Buffalo, NY, USA. · Breast Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA. · Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA. ·World J Surg Oncol · Pubmed #29966533.

ABSTRACT: BACKGROUND: Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a chronic, idiopathic, repeated inflammatory disease. Colorectal cancer (CRC) that develops in patients with IBD is known as colitis-associated colorectal cancer (CAC), but the underlying carcinogenic mechanism remains unclear. Genomic analysis of sporadic CRC has been well described based on next-generation sequencing (NGS) data. Using NGS, we compared all exons of 415 cancer-associated genes in patients in Japan and the USA who had CRC and found similar genomic alteration patterns among the two populations. However, genomic analysis of CAC has not been thoroughly investigated. MAIN BODY: The molecular pathogenesis of CAC shares many features with sporadic CRC, but there are distinct variations in the time and frequency of some alterations. Gene alterations in CAC are gradually being elucidated using genomic sequencing analyses. Some studies have shown that gene alteration patterns differ between UC and CD. The carcinogenesis of CAC depends on unique environmental, genetic, and immunological factors. CONCLUSIONS: In this review, we have discussed the differences in genomic alterations between sporadic CRC and CAC. NGS in patients with IBD has the potential to detect early CAC and to suggest therapeutic targets.

10 Review Burden of Ulcerative Colitis on Functioning and Well-being: A Systematic Literature Review of the SF-36® Health Survey. 2018

Yarlas, Aaron / Rubin, David T / Panés, Julian / Lindsay, James O / Vermeire, Séverine / Bayliss, Martha / Cappelleri, Joseph C / Maher, Stephen / Bushmakin, Andrew G / Chen, Lea Ann / DiBonaventura, Marco. ·Optum, Johnston, RI, USA. · University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA. · Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain. · Centre for Immunobiology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. · Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium. · Pfizer Inc, Groton, CT, USA. · New York University School of Medicine, New York, NY, USA. · Pfizer Inc, New York, NY, USA. ·J Crohns Colitis · Pubmed #29718244.

ABSTRACT: Background and Aims: This review is the first to evaluate the burden of ulcerative colitis [UC] on patients' quality of life by synthesizing data from studies comparing scores from the SF-36® Health Survey, a generic measure assessing eight quality-of-life domains, between UC patients and matched reference samples. Methods: A systematic review of the published literature identified articles reporting SF-36 domains or physical and mental component summary scores [PCS, MCS] from UC and reference samples. Burden of disease for each SF-36 domain was then summarized across studies by comparing weighted mean differences in scores between patient and reference samples with minimally important difference thresholds. Results: Thirty articles met pre-specified inclusion criteria. SF-36 scores were extracted from five samples of patients with active disease, 11 samples with a mixture of disease activity, five samples of patients in clinical remission, and 13 samples of patients following proctocolectomy with ileostomy or ileal pouch-anal anastomosis, along with respective reference samples. Clinically meaningful burden was observed in samples with active or mixed disease activity [deficits: PCS = 5.6, MCS = 5.5] on all SF-36 domains except Physical Functioning. No burden was observed in samples in remission or post-surgical patients [deficits: PCS = 0.8, MCS = 0.4] except for the General Health perception domain. Conclusions: Patients with active UC experience a clinically meaningful burden of disease across most aspects of quality of life. Patients with inactive UC exhibit negligible disease burden and are comparable to the general population on most quality-of-life outcomes. Thus, treatments which effectively induce and maintain remission may restore physical and mental health status.

11 Review Psychometric validation of the SF-36 2018

Yarlas, Aaron / Bayliss, Martha / Cappelleri, Joseph C / Maher, Stephen / Bushmakin, Andrew G / Chen, Lea Ann / Manuchehri, Alireza / Healey, Paul. ·Optum, 1301 Atwood Avenue, Suite 311N, Johnston, RI, 02919, USA. ayarlas@qualitymetric.com. · Optum, 1301 Atwood Avenue, Suite 311N, Johnston, RI, 02919, USA. · Pfizer Inc, Groton, CT, USA. · New York University School of Medicine, New York, NY, USA. · Pfizer Ltd, Walton Oaks, Augusta, UK. ·Qual Life Res · Pubmed #28849311.

ABSTRACT: PURPOSE: To conduct a systematic literature review of the reliability, construct validity, and responsiveness of the SF-36 METHODS: We performed a systematic search of electronic medical databases to identify published peer-reviewed studies which reported scores from the eight scales and/or two summary measures of the SF-36 collected from adult patients with UC. Study findings relevant to reliability, construct validity, and responsiveness were reviewed. RESULTS: Data were extracted and summarized from 43 articles meeting inclusion criteria. Convergent validity was supported by findings that 83% (197/236) of correlations between SF-36 scales and measures of disease symptoms, disease activity, and functioning exceeded the prespecified threshold (r ≥ |0.40|). Known-groups validity was supported by findings of clinically meaningful differences in SF-36 scores between subgroups of patients when classified by disease activity (i.e., active versus inactive), symptom status, and comorbidity status. Responsiveness was supported by findings of clinically meaningful changes in SF-36 scores following treatment in non-comparative trials, and by meaningfully larger improvements in SF-36 scores in treatment arms relative to controls in randomized controlled trials. The sole study of SF-36 reliability found evidence supporting internal consistency (Cronbach's α ≥ 0.70) for all SF-36 scales and test-retest reliability (intraclass correlation coefficient ≥0.70) for six of eight scales. CONCLUSIONS: Evidence from this systematic literature review indicates that the SF-36 is reliable, valid, and responsive when used with UC patients, supporting the inclusion of the SF-36 as an endpoint in clinical trials for this patient population.

12 Review Probiotics in Inflammatory Bowel Disease. 2017

Abraham, Bincy P / Quigley, Eamonn M M. ·Fondren Inflammatory Bowel Disease Program, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, 6550 Fannin Street, SM 1201, Houston, TX 77030, USA; Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, 6550 Fannin Street, SM 1201, Houston, TX 77030, USA. · Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, 6550 Fannin Street, SM 1201, Houston, TX 77030, USA. Electronic address: equigley@houstonmethodist.org. ·Gastroenterol Clin North Am · Pubmed #29173520.

ABSTRACT: Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. Data derived from animal models of IBD have revealed the potential of several bacterial strains to modify the natural history of IBD. However, thought there is some evidence for efficacy in ulcerative colitis and in pouchitis, in particular, there has been little indication that probiotics exert any benefit in Crohn disease. More targeted approaches involving live bacteria, genetically modified bacteria, and bacterial products are now being evaluated.

13 Review Systematic Review and Meta-analysis: Fecal Microbiota Transplantation for Treatment of Active Ulcerative Colitis. 2017

Narula, Neeraj / Kassam, Zain / Yuan, Yuhong / Colombel, Jean-Frederic / Ponsioen, Cyriel / Reinisch, Walter / Moayyedi, Paul. ·*Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada; †OpenBiome, Somerville, Massachusetts; ‡Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; and §Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands. ·Inflamm Bowel Dis · Pubmed #28906291.

ABSTRACT: BACKGROUND: Changes in the colonic microbiota may play a role in the pathogenesis of ulcerative colitis (UC) and restoration of healthy gut microbiota may ameliorate disease. A systematic review and meta-analysis was conducted to assess fecal microbiota transplantation (FMT) as a treatment for active UC. METHODS: A literature search was conducted to identify high-quality studies of FMT as a treatment for patients with UC. The primary outcome was combined clinical remission and endoscopic remission or response. Secondary outcomes included clinical remission, endoscopic remission, and serious adverse events. Odds ratios with 95% confidence intervals (CIs) are reported. RESULTS: Overall, 4 studies with 277 participants were eligible for inclusion. Among 4 randomized controlled trials, FMT was associated with higher combined clinical and endoscopic remission compared with placebo (risk ratio UC not in remission was 0.80; 95% CI: 0.71-0.89) with a number needed to treat of 5 (95% CI: 4-10). There was no statistically significant increase in serious adverse events with FMT compared with controls (risk ratio adverse event was 1.4; 95% CI: 0.55-3.58). CONCLUSIONS: Among randomized controlled trials, short-term use of FMT shows promise as a treatment to induce remission in active UC based on the efficacy and safety observed. However, there remain many unanswered questions that require further research before FMT can be considered for use in clinical practice.

14 Review Communicating the benefits and risks of inflammatory bowel disease therapy to patients and families. 2017

Picoraro, Joseph A / Rosh, Joel R. ·aDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Center, New York City, New York bDivision of Gastroenterology and Nutrition, Goryeb Children's Hospital, Morristown, New Jersey, USA. ·Curr Opin Pediatr · Pubmed #28692447.

ABSTRACT: PURPOSE OF REVIEW: Treatment options for inflammatory bowel disease (IBD) have rapidly expanded as the treatment paradigm has shifted from controlling symptoms to reducing lifetime inflammatory burden. Families are confronted with the actual and perceived risks of this ever-expanding array of choices. We aim to review the shared decision-making process in pediatric IBD to ensure an optimal therapeutic plan for the child and their family. RECENT FINDINGS: Mucosal healing is a critical treatment target in pediatric IBD but it may not coincide with clinical symptoms. Evidence-based therapies carry important risks, some of which may be less severe than previously suspected, and a family's understanding of these risks plays a crucial role in how they make health decisions. To form an effective shared therapeutic plan, the physician must incorporate an understanding of the values of both the child and family along with their lived experience of illness. SUMMARY: To limit harm and promote health in pediatric IBD, the physician must communicate collaboratively with the child and their family to form mutually understood goals of care - both subjective experiential and objective biological - and appreciate actual and perceived risks of treatment options to effectively educate families and navigate toward the best treatment choices. VIDEO ABSTRACT.

15 Review Emerging treatments for ulcerative colitis: a systematic review. 2017

Kokkinidis, Damianos G / Bosdelekidou, Eftychia E / Iliopoulou, Sotiria Maria / Tassos, Alexandros G / Texakalidis, Pavlos T / Economopoulos, Konstantinos P / Kousoulis, Antonis A. ·a Department of Medicine , Jacobi Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA. · b Society of Junior Doctors , Athens , Greece. · c Innere Medizin , Gastroenterologie und Kardiologie Saint Lukas Klinik Solingen , Solingen , Germany. · d Département de Médecine Interne Rehabilitation et Gériatrie Hôpitaux Universitaires de Genève , Geneva , Switzerland. · e 401 General Army Hospital of Athens , Athens , Greece. · f Edinburgh Medical School , Edinburgh , Scotland , UK. · g Department of Surgery , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA. · h Mental Health Foundation , London , UK. ·Scand J Gastroenterol · Pubmed #28503977.

ABSTRACT: OBJECTIVES: Various investigational medicinal products have been developed for ulcerative colitis (UC). Our aim was to systematically evaluate novel pharmacological therapeutic agents for the treatment of UC. MATERIAL AND METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. A search of the medical literature was conducted in the MEDLINE database for original research papers published between 01 January 2010 and 31 October 2014. RESULTS: Twenty one studies, including 11,524 adults were analyzed. Thirteen different novel therapeutic drug options were identified. Vedolizumab and golimumab were superior to placebo as induction and maintenance therapy. Tofacitinib showed dose related efficacy for induction therapy. Etrolizumab showed higher clinical remission rates compared to placebo. Phosphatidylcholine led to an improved clinical activity index. HMPL-004 may become a mesalamine alternative for mild to moderate UC. PF00547,659 was well tolerated. Statins were not beneficial for acute exacerbations of UC. Abatacept, rituximab and visilizumab did not lead to improved outcomes compared to placebo. Higher concentration of BMS 936557 was associated with improved efficacy compared to placebo. Basiliximab did not enhance corticosteroid efficacy. CONCLUSIONS: Patients with UC might achieve clinical response or remission by utilizing some of these agents with a favorable side effect profile. Further studies are needed to evaluate their short- and long-term efficacy and safety.

16 Review Optimizing pharmacologic management of inflammatory bowel disease. 2017

Chang, Shannon / Hanauer, Stephen. ·a Division of Gastroenterology , New York University Langone Medical Center , New York , NY , USA. · b Division of Gastroenterology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA. ·Expert Rev Clin Pharmacol · Pubmed #28475384.

ABSTRACT: INTRODUCTION: As our medical armamentarium for IBD continues to expand, it is essential that clinicians understand both optimizing and sequencing of individual and combination therapeutic approaches with available medications. Areas covered: This review summarizes dosing strategies and therapeutic drug monitoring for pharmacologic optimization in IBD. Aminosalicylates remain first-line therapies for mild-to-moderate UC but have limited evidence of efficacy in CD. Budesonide provides an alternative to aminosalicylates when targeted to appropriate sites in the distal small bowel and colon, as do conventional corticosteroids when applied rectally. Systemic steroids are highly efficacious but burdened by toxicity. Thiopurines or methotrexate can be utilized as steroid-sparing agents. Biologic agents targeting TNF remain important for steroid-sparing therapy in moderate-to-severe UC and CD. Newer biologics targeting lymphocyte trafficking and lymphocyte activation are also efficacious for moderate-to-severe IBD. Near future conventional drug options include oral agents such as tofacitinib and mongersen. Expert commentary: Positioning therapies according to the location, phenotypes, and severity, as well as the use of therapeutic and clinical targets, will improve outcomes and minimize toxicities and therapeutic futilities. Future IBD treatment should focus on personalized therapy plans based on genetic determinants, targeted mechanisms of action, and pharmacologic optimization.

17 Review Systematic review with meta-analysis: proximal disease extension in limited ulcerative colitis. 2017

Roda, G / Narula, N / Pinotti, R / Skamnelos, A / Katsanos, K H / Ungaro, R / Burisch, J / Torres, J / Colombel, J-F. ·The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Gastroenterology, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. · Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece. ·Aliment Pharmacol Ther · Pubmed #28449361.

ABSTRACT: BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. METHODS: We performed a systematic literature search to identify studies on disease extension of ulcerative colitis (UC) and predictors of disease progression. RESULTS: Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11.2-27.3) from E1 to E3, 27.5% (95% CI 7.6-45.6) from E2 to E3 and 20.8% (95% CI 11.4-26.8) from E1 to E2. Rate of extension was significantly higher in patients younger than 18 years (29.2% (CI 6.4-71.3) compared to older patients (20.2% (CI 13.0-30.1) (P<.0001). Risk of extension was significantly higher in patients from North America (37.8%) than from Europe (19.6%) (P<.0001). CONCLUSIONS: In this meta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin. Predicting those at high risk of disease extension from diagnosis could lead to personalised therapeutic strategies.

18 Review Reviewing treatments and outcomes in the evolving landscape of ulcerative colitis. 2017

Dubinsky, Marla C. ·a Icahn School of Medicine , Mount Sinai Hospital , New York , NY , USA. ·Postgrad Med · Pubmed #28425825.

ABSTRACT: Ulcerative colitis (UC) is a chronic inflammatory disease extending proximally from the rectum to varying lengths of the colon that is characterized by alternating cycles of relapse and remission. Therapeutic goals for patients with active UC include induction and maintenance of remission and improvement in quality of life, as well as mucosal healing, a clinical outcome recently recognized in treatment guidance as being equally important. Mucosal healing is associated with favorable long-term patient outcomes related to remission, surgery, hospitalization, and quality of life. Given the increasing number of newer therapies available, it is important to properly position the use of each agent within the landscape of established UC therapies, evolving therapeutic goals, and established guidelines. Extent of disease is important to consider when selecting a treatment, as is an understanding of the short- and long-term outcomes (e.g. corticosteroid-free remission, mucosal healing) associated with each treatment. The purpose of this narrative review is to provide an overview of newer therapies for the treatment of UC and how they may best fit in the evolving landscape of UC.

19 Review Systematic review with meta-analysis: comparative efficacy of biologics for induction and maintenance of mucosal healing in Crohn's disease and ulcerative colitis controlled trials. 2017

Cholapranee, A / Hazlewood, G S / Kaplan, G G / Peyrin-Biroulet, L / Ananthakrishnan, A N. ·Department of Internal Medicine, Montefiore Medical Center, New York, NY, USA. · Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada. · McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada. · Inserm U954 and Department of Gastroenterology, Nancy University Hospital, Université de Lorraine, Vandoeuvre, France. · Gastroenterology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA. ·Aliment Pharmacol Ther · Pubmed #28326566.

ABSTRACT: BACKGROUND: Mucosal healing is an important therapeutic endpoint in the management of Crohn's disease (CD) and ulcerative colitis (UC). Limited data exist regarding the comparative efficacy of various therapies in achieving this outcome. AIM: To perform a systematic review and meta-analysis of biologics for induction and maintenance of mucosal healing in Crohn's disease and ulcerative colitis. METHODS: We performed a systematic review and meta-analysis of randomised controlled trials (RCT) examining mucosal healing as an endpoint of immunosuppressives, anti-tumour necrosis factor α (anti-TNF) or anti-integrin monoclonal antibody therapy for moderate-to-severe CD or UC. Pooled effect sizes for induction and maintenance of mucosal healing were calculated and pairwise treatment comparisons evaluated using a Bayesian network meta-analysis. RESULTS: A total of 12 RCTs were included in the meta-analysis (CD - 2 induction, 4 maintenance; UC - 8 induction, 5 maintenance). Duration of follow-up was 6-12 weeks for induction and 32-54 weeks for maintenance trials. In CD, anti-TNFs were more effective than placebo for maintaining mucosal healing [28% vs. 1%, Odds ratio (OR) 19.71, 95% confidence interval (CI) 3.51-110.84]. In UC, anti-TNFs and anti-integrins were more effective than placebo for inducing (45% vs. 30%) and maintaining mucosal healing (33% vs. 18%). In network analysis, adalimumab therapy was inferior to infliximab [OR 0.45, 95% credible interval (CrI) 0.25-0.82] and combination infliximab-azathioprine (OR 0.32, 95% CrI 0.12-0.84) for inducing mucosal healing in UC. There was no statistically significant pairwise difference between vedolizumab and anti-TNF agents in UC. CONCLUSIONS: Anti-TNF and anti-integrin biological agents are effective in inducing mucosal healing in UC, with adalimumab being inferior to infliximab or combination therapy. Infliximab and adalimumab were similar in CD.

20 Review Defining endoscopic response and remission in ulcerative colitis clinical trials: an international consensus. 2017

Vuitton, L / Peyrin-Biroulet, L / Colombel, J F / Pariente, B / Pineton de Chambrun, G / Walsh, A J / Panes, J / Travis, S P L / Mary, J Y / Marteau, P. ·Besançon, France. · Vandoeuvre-lès-Nancy, France. · New York, NY, USA. · Lille, France. · Montpellier, France. · Sydney, Australia. · Barcelona, Spain. · Oxford, UK. · Paris, France. ·Aliment Pharmacol Ther · Pubmed #28112419.

ABSTRACT: BACKGROUND: Recently, endpoints for clinical trials have been changing from measuring clinical response to mucosal healing in ulcerative colitis. Endoscopic evaluation is the current gold standard to assess mucosal lesions and has become a major measure of therapeutic efficacy in addition to patients reported outcomes. AIM: To achieve consensus on endoscopic definitions of remission and response for clinical trials in patients with ulcerative colitis. METHODS: In reaching the current international recommendations on an International Organization For the Study of Inflammatory Bowel Disease (IOIBD) initiative, we first performed a systematic review of technical aspects of endoscopic scoring systems. Then, to achieve consensus on endoscopic definitions of remission and response for clinical trials, we conducted a two-round vote using a Delphi-style process among fifteen specialists in the field of inflammatory bowel diseases. RESULTS: The literature review showed that many endoscopic indices have been proposed to evaluate disease activity in ulcerative colitis; most are unvalidated and arbitrary definitions have been used in clinical trials for defining endoscopic response or remission. At the end of the voting process, the investigators ranked initially the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) 0 for the definition of endoscopic remission, and a decrease in Mayo endoscopic score ≥1 grade or a decrease in UCEIS ≥2 points for the definition of endoscopic response in ulcerative colitis. CONCLUSIONS: These international recommendations represent the first consensus on measurement indices for endoscopic outcomes in ulcerative colitis. They should be subject to prospective testing in clinical trials of ulcerative colitis.

21 Review Ulcerative colitis. 2017

Ungaro, Ryan / Mehandru, Saurabh / Allen, Patrick B / Peyrin-Biroulet, Laurent / Colombel, Jean-Frédéric. ·Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland, UK. · Department of Gastroenterology, University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France. · Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: jean-frederic.colombel@mssm.edu. ·Lancet · Pubmed #27914657.

ABSTRACT: Ulcerative colitis is a chronic inflammatory disease affecting the colon, and its incidence is rising worldwide. The pathogenesis is multifactorial, involving genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors. Patients with ulcerative colitis have mucosal inflammation starting in the rectum that can extend continuously to proximal segments of the colon. Ulcerative colitis usually presents with bloody diarrhoea and is diagnosed by colonoscopy and histological findings. The aim of management is to induce and then maintain remission, defined as resolution of symptoms and endoscopic healing. Treatments for ulcerative colitis include 5-aminosalicylic acid drugs, steroids, and immunosuppressants. Some patients can require colectomy for medically refractory disease or to treat colonic neoplasia. The therapeutic armamentarium for ulcerative colitis is expanding, and the number of drugs with new targets will rapidly increase in coming years.

22 Review Appendectomy does not decrease the risk of future colectomy in UC: results from a large cohort and meta-analysis. 2017

Parian, Alyssa / Limketkai, Berkeley / Koh, Joyce / Brant, Steven R / Bitton, Alain / Cho, Judy H / Duerr, Richard H / McGovern, Dermot P / Proctor, Deborah D / Regueiro, Miguel D / Rioux, John D / Schumm, Phil / Taylor, Kent D / Silverberg, Mark S / Steinhart, A Hillary / Hernaez, Ruben / Lazarev, Mark. ·Division of Gastroenterology, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA. · Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Stanford, California, USA. · Division of Gastroenterology, McGill University, Montreal, Québec, Canada. · Division of Gastroenterology, Mount Sinai Hospital, New York, New York, USA. · Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. · Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA. · Division of Digestive Disease, Yale School of Medicine, New Haven, Connecticut, USA. · Division of Medicine, Université de Montréal, Montreal, Québec, Canada. · Department of Health Studies, University of Chicago, Chicago, Illinois, USA. · Division of Gastroenterology, Mount Sinai Hospital, Toronto, Ontario, Canada. ·Gut · Pubmed #27196594.

ABSTRACT: OBJECTIVES: Early appendectomy is inversely associated with the development of UC. However, the impact of appendectomy on the clinical course of UC is controversial, generally favouring a milder disease course. We aim to describe the effect appendectomy has on the disease course of UC with focus on the timing of appendectomy in relation to UC diagnosis. DESIGN: Using the National Institute of Diabetes and Digestive and Kidney Diseases Inflammatory Bowel Disease Genetics Consortium database of patients with UC, the risk of colectomy was compared between patients who did and did not undergo appendectomy. In addition, we performed a meta-analysis of studies that examined the association between appendectomy and colectomy. RESULTS: 2980 patients with UC were initially included. 111 (4.4%) patients with UC had an appendectomy; of which 63 were performed prior to UC diagnosis and 48 after diagnosis. In multivariable analysis, appendectomy performed at any time was an independent risk factor for colectomy (OR 1.9, 95% CI 1.1 to 3.1), with appendectomy performed after UC diagnosis most strongly associated with colectomy (OR 2.2, 95% CI 1.1 to 4.5). An updated meta-analysis showed appendectomy performed either prior to or after UC diagnosis had no effect on colectomy rates. CONCLUSIONS: Appendectomy performed at any time in relation to UC diagnosis was not associated with a decrease in severity of disease. In fact, appendectomy after UC diagnosis may be associated with a higher risk of colectomy. These findings question the proposed use of appendectomy as treatment for UC.

23 Review Thiopurines and inflammatory bowel disease: Current evidence and a historical perspective. 2016

Axelrad, Jordan E / Roy, Abhik / Lawlor, Garrett / Korelitz, Burton / Lichtiger, Simon. ·Jordan E Axelrad, Garrett Lawlor, Simon Lichtiger, Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY 10032, United States. ·World J Gastroenterol · Pubmed #28028358.

ABSTRACT: The use of thiopurines in inflammatory bowel disease (IBD) has been examined in numerous prospective, controlled trials, with a majority demonstrating a clinical benefit. We conducted this review to describe the historical and current evidence in the use of thiopurines in IBD. A systematic search was performed on MEDLINE between 1965 and 2016 to identify studies on thiopurines in IBD. The most robust evidence for thiopurines in IBD includes induction of remission in combination with anti-tumor necrosis factor (anti-TNF) agents, and maintenance of remission and post-operative maintenance in Crohn's disease. Less evidence exists for thiopurine monotherapy in induction of remission, maintenance of ulcerative colitis, chemoprevention of colorectal cancer, and in preventing immunogenicity to anti-TNF. Evidence was often limited by trial design. Overall, thiopurines have demonstrated efficacy in a broad range of presentations of IBD. With more efficacious novel therapeutic agents, the positioning of thiopurines in the management of IBD will change and future studies will analyze the benefit of thiopurines alone and in conjunction with these new medications.

24 Review Biosimilars for the Treatment of Chronic Inflammatory Diseases: A Systematic Review of Published Evidence. 2016

Jacobs, Ira / Petersel, Danielle / Isakov, Leah / Lula, Sadiq / Lea Sewell, K. ·Pfizer Essential Health, Pfizer Inc., 235 East 42nd Street, New York, NY, 10017-5755, USA. ira.jacobs@pfizer.com. · Pfizer Essential Health, Pfizer Inc., 235 East 42nd Street, New York, NY, 10017-5755, USA. · Envision Pharma Group, London, UK. ·BioDrugs · Pubmed #27885553.

ABSTRACT: BACKGROUND: Clinicians are required to assimilate, critically evaluate, and extrapolate information to support appropriate use of biosimilars across indications. OBJECTIVES: The objective of this study was to systematically collate all published data in order to assess the weight (quantity and quality) of available evidence for each molecule and inform and support healthcare decision-making in chronic inflammatory diseases. METHODS: MEDLINE RESULTS: Proposed biosimilars for adalimumab, etanercept, infliximab, and rituximab are reported in the published literature. Across indications, approved biosimilars infliximab CT-P13, SB2, and etanercept SB4 have published studies involving the largest number of patients or healthy subjects (n = 1405, 743, and 734, respectively), mostly in rheumatoid arthritis. At data cut-off, only CT-P13 had published data in ankylosing spondylitis (n = 250; randomized control trial) and ulcerative colitis/Crohn's disease (n = 336; observational studies). Published data were not available for ongoing studies in psoriasis patients. Four intended copies were identified in published studies (total: n = 1430; n = 1372 in observational studies). Thematic analysis of non-empirical publications showed that indication extrapolation remains an issue, particularly for gastroenterologists. CONCLUSIONS: While most agents display a moderate to high degree of similarity to their originator in the published studies identified, large discrepancies persist in the overall amount and type of data available in the public domain. Significant gaps exist particularly for intended copies, reinforcing the need to maintain a clear differentiation between these molecules and true biosimilars.

25 Review The First Endoscopy in Suspected Inflammatory Bowel Disease. 2016

Fausel, Rebecca A / Kornbluth, Asher / Dubinsky, Marla C. ·The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029-6574, USA. Electronic address: rebecca.fausel@mountsinai.org. · The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, 1150 Fifth Avenue, Suite 1B, New York, NY 10128, USA. · Division of Pediatric Gastroenterology and Hepatology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 5th Floor, New York, NY 10029, USA. ·Gastrointest Endosc Clin N Am · Pubmed #27633590.

ABSTRACT: In a patient presenting with suspected inflammatory bowel disease, the initial endoscopic evaluation is a valuable tool for determining the correct disease diagnosis and the extent and severity of disease. A full colonoscopy and ileoscopy should be performed when possible, with systematic biopsies from each segment. When a diagnosis of inflammatory bowel disease is established, it is possible to distinguish between Crohn disease and ulcerative colitis, and specific endoscopic features may assist in this categorization. Because patchy healing can occur with treatment, it is important to obtain a thorough and accurate assessment of disease characteristics and distribution before initiating therapy.

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