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For: Limketkai BN, Parian AM, Chen PH, Colombel JF. Treatment With Biologic Agents Has Not Reduced Surgeries Among Patients With Crohn's Disease With Short Bowel Syndrome. Clin Gastroenterol Hepatol 2017;15:1908-1914.e2. [PMID: 28666947 DOI: 10.1016/j.cgh.2017.06.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/20/2017] [Accepted: 06/23/2017] [Indexed: 02/07/2023]

For:	Limketkai BN, Parian AM, Chen PH, Colombel JF. Treatment With Biologic Agents Has Not Reduced Surgeries Among Patients With Crohn's Disease With Short Bowel Syndrome. Clin Gastroenterol Hepatol 2017;15:1908-1914.e2. [PMID: 28666947 DOI: 10.1016/j.cgh.2017.06.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/20/2017] [Accepted: 06/23/2017] [Indexed: 02/07/2023]

Number

Cited by Other Article(s)

Wu TH, Brandt CF, Scheike T, Burisch J, Jeppesen PB. The Natural History of Crohn's Disease Leading to Intestinal Failure: A Longitudinal Cohort Study from 1973 to 2018. J Crohns Colitis 2025;19:jjae114. [PMID: 39039902 DOI: 10.1093/ecco-jcc/jjae114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Indexed: 07/24/2024]

Abstract

BACKGROUND AND AIMS

The natural history of Crohn's disease leading to intestinal failure is not well characterised. This study aims to describe the clinical course of Crohn's disease preceding intestinal failure and to compare disease course and burden between Crohn's disease patients with and without intestinal failure.

METHODS

Patients with Crohn's disease complicated by intestinal failure from Rigshospitalet, Copenhagen [n = 182] and a nationwide Danish Crohn's disease cohort without intestinal failure [n = 22,845] were included. Using nationwide registries in Denmark, disease course was determined from hospitalisations, surgeries, and outpatient medications, and disease burden was determined from employment and mortality data.

RESULTS

The 10-year cumulative incidence of intestinal failure following Crohn's disease diagnosis declined from 2.7% prior to 1980 to 0.2% after 2000. Compared with Crohn's disease patients without intestinal failure, those with intestinal failure experienced significantly longer duration of severe disease [50 vs 19 years per 100 patient-years, p < 0.01], secondary to greater corticosteroid use [71% vs 60%, p = 0.02], inpatient contacts [98% vs 55%, p < 0.01], and abdominal surgeries [99% vs 48%, p < 0.01]. However, exposure to biologics was not different between the two groups [20.4% vs 21%, p = 0.95], and duration on biologics was shorter in Crohn's disease patients with intestinal failure [2068 vs 4126 days per 100 patient-years, p = 0.02]. Standard mortality ratio in Crohn's disease patients with intestinal failure was 3.66 (97.5% confidence interval [CI] 2.79, 4.72].

CONCLUSION

Patients with Crohn's disease complicated by intestinal failure experienced a more persistently severe preceding course of Crohn's disease but were not more likely to be treated with biological therapy.

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Giordano A, Pérez-Martínez I, Gisbert JP, Ricart E, Martín-Arranz MD, Mesonero F, Parga MLDC, Rivero M, Iglesias E, Fernández-Prada S, Calafat M, Villarino MTA, de Jorge Turrión MÁ, Hernández-Camba A, Lidón RV, Carpio D, Brunet E, Moranta FR, García LA, Cuquerella JT, Bermejo F, Madero L, Esteve M, González-Muñoza C, Martínez-Montiel P, Huguet JM, Pérez Calle JL, Rodríguez-Lago I, Ausín MS, Poyatos RHL, García-Bosch O, Marín GS, Taxonera C, Ponferrada-Diaz Á, Acosta MBD, Bujanda L, Serra RB, Ramos L, Vera I, Abizanda ES, Piqueras M, Gómez CS, García-Sepulcre MF, Arregui MV, Murillo NR, Llaó J, Lucendo AJ, Marín-Jiménez I, Camps-Aler B, Villafranca CM, Ceballos D, Ver Y, Fernández-Salazar LI, Alcaín G, Valldosera G, Andrés PR, Martínez-Flores C, Coronel AF, Ginard D, García L, Gómez IB, Argüelles-Arias F, Miyashiro EI, De la Piscina PR, Villalba LH, Notari PA, de Jesús Martínez-Pérez T, Fernández H, Gilabert P, Rosas CM, Nos P, Gil JL, Navas López VM, Muñoz F, Palomares MTDL, Lucio AS, Merino O, de Prado IN, Leal C, de Carpi JM, Sánchez LB, Arce NM, Frago S, Mateu BB, Domènech E, Garcia Planella E. Ileal Predominance in Crohn's Disease Is Associated With Increased Intestinal Surgery and Biological Therapy Use, With Lower Treatment Persistence. Am J Gastroenterol 2025;120:194-203. [PMID: 39745305 DOI: 10.14309/ajg.0000000000003207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 10/22/2024] [Indexed: 02/02/2025]

Abstract

INTRODUCTION

Crohn's disease (CD) varies by location, potentially affecting therapy efficacy and surgery risk, although research on this topic is conflicting. This study aims to investigate the independent association between CD location and therapeutic patterns.

METHODS

We analyzed patients with CD diagnosed from January 2005 to May 2023 registered in the nationwide ENEIDA registry. A univariate Cox regression analysis assessed the association of disease location with biologic use and persistence (with treatment discontinuation as a failure event), as well as the use of intestinal resections. A multivariate model was constructed to evaluate the independent association of disease location with therapeutic patterns, controlling for potential confounders such as sex, age at inclusion and diagnosis, disease duration and behavior, previous surgery or biological therapy, extraintestinal manifestations, and perianal disease.

RESULTS

The study included 17,292 patients with a median follow-up period of 6 years (interquartile range 2-10 years). Ileocolonic location was associated with a higher biologic use than colonic location (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.22-1.38) and ileal disease (HR 1.21, 95% CI 1.16-1.27), independently predicting biologic use (P < 0.001). Ileal location was associated with a lower biologic persistence than ileocolonic location (HR 1.14, 95% CI 1.07-1.21) and colonic disease (HR 1.10, 95% CI 1.01-1.20), independently predicting biologic persistence (P = 0.019). Ileal disease was associated with a higher likelihood of intestinal resections than colonic (HR 2.82, 95% CI 2.45-3.25) and ileocolonic location (HR 1.13, 95% CI 1.05-1.22), independently predicting the use of surgery (P < 0.001).

DISCUSSION

CD location with ileal predominance is associated with a distinct therapeutic pattern, including higher biologic use, lower treatment persistence, and increased rates of intestinal resections.

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Affiliation(s)

Antonio Giordano IBD Unit, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
Isabel Pérez-Martínez Gastroenterology Department, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
Javier P Gisbert Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
Elena Ricart Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
María Dolores Martín-Arranz Gastroenterology Department, Hospital Universiario La Paz and Instituto de Investigación Sanitaria La Paz (IdiPaz), Universidad Autónoma de Madrid (UAM), Madrid, Spain
Francisco Mesonero Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
María Luisa De Castro Parga Gastroenterology Department, Hospital Álvaro Cunqueiro, Vigo, Spain
Montserrat Rivero Gastroenterology Department, Hospital Universitario Marqués de Valdecilla e IDIVAL, Santander, Spain
Eva Iglesias Gastroenterology Department, Hospital Reina Sofía, Córdoba, Spain
Samuel Fernández-Prada Gastroenterology Department, Hospital Universitario Río Hortega, Valladolid, Spain
Margalida Calafat Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
María Teresa Arroyo Villarino Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain Instituto de investigación sanitaria de Aragón (IIS), Zaragoza, Spain
Miguel Ángel de Jorge Turrión Gastroenterology Department, Hospital Universitario de Cabueñes, Gijón, Spain
Alejandro Hernández-Camba Gastroenterology Department, Hospital Universitario Nuestra Sra. de la Candelaria, Santa Cruz de Tenerife, Spain
Raquel Vicente Lidón Gastroenterology Department, Hospital Universitario Miguel Servet, Instituto de investigación sanitaria de Aragón (IIS), Zaragoza, Spain
Daniel Carpio Gastroenterology Department, Complexo Hospitlario Universitario de Pontevedra, Pontevedra, Spain
Eduard Brunet Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
Francisco Rodríguez Moranta Gastroenterology Department, Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Lara Arias García Gastroenterology Department, Hospital Universitario de Burgos, Burgos, Spain
Joan Tosca Cuquerella Gastroenterology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
Fernando Bermejo Gastroenterology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
Lucía Madero Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital General Universitario Dr Balmis e ISABIAL, Alicante, Spain
Maria Esteve Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital Universitari Mútua Terrassa, University of Barcelona, Barcelona, Spain
Carlos González-Muñoza IBD Unit, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
Pilar Martínez-Montiel Gastroenterology Department, Hospital 12 de Octubre, Madrid, Spain
Jose M Huguet Gastroenterology Department, Hospital General Universitario de Valencia, Valencia, Spain
Jose Lázaro Pérez Calle Gastroenterology Department, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
Iago Rodríguez-Lago Gastroenterology Department, Hospital de Galdakao, Biobizkaia Health Research Institute, Vizcaya, Spain
Mónica Sierra Ausín Gastroenterology Department, Complejo Asistencial Universitario de León, León, Spain
Rufo H Lorente Poyatos Gastroenterology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
Orlando García-Bosch Gastroenterology Department, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
Gerard Surís Marín Gastroenterology Department, Hospital del Mar, Barcelona, Spain IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
Carlos Taxonera Inflammatory Bowel Disease Unit, Gastroenterology Department, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
Ángel Ponferrada-Diaz Gastroenterology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
Manuel Barreiro-de Acosta Gastroenterology Department, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
Luis Bujanda Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Biodonostia Health Research Institute, Universidad del País Vasco (UPV/EHU), San Sebastián, Spain
Rosa Blat Serra Gastroenterology Department, Hospital Dr. Josep Trueta, Girona, Spain
Laura Ramos Gastroenterology Department, Hospital Universitario de Canarias, La Laguna, Spain
Isabel Vera Gastroenterology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
Eva Sesé Abizanda Gastroenterology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain
Marta Piqueras Gastroenterology Department, Consorci Sanitari de Terrassa, Terrassa, Spain
Cristina Sánchez Gómez Gastroenterology Department, Complexo Hospitalario Universitario de Ourense, Ourence, Spain
Mariana Fe García-Sepulcre Gastroenterology Department, Hospital General Universitario de Elche, Elche, Spain
Miren Vicuña Arregui Gastroenterology Department, Hospital Universitario de Navarra, Pamplona, Spain
Nuria Rull Murillo Gastroenterology Department, Hospital son Llàtzer, Palma, Spain
Jordina Llaó Gastroenterology Department, Althaia Xarxa Assistencial Universitaria de Manresa, Manresa, Spain
Alfredo J Lucendo Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital General de Tomelloso, Tomelloso, Spain Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
Ignacio Marín-Jiménez Gastroenterology Department, IiSGM, Hospital Gregorio Marañón, Madrid, Spain Medicine Faculty, Complutense University, Madrid, Spain
Blau Camps-Aler Gastroenterology Department, Hospital General de Granollers, Granollers, Spain
Carmen Muñoz Villafranca Gastroenterology Department, Hospital de Basurto, Bilbao, Spain
Daniel Ceballos Gastroenterology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
Yolanda Ver Gastroenterology Department, Hospital San Jorge, Huesca, Spain
Luis Ignacio Fernández-Salazar Gastroenterology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Guillermo Alcaín Gastroenterology Department, Hospital Virgen de la Victoria, Málaga, Spain
Gemma Valldosera Gastroenterology Department, Hospital Joan XXIII, Tarragona, Spain
Pilar Robledo Andrés Gastroenterology Department, Hospital Universitario de Cáceres, Cáceres, Spain
Carlos Martínez-Flores Gastroenterology Department, Hospital General La Mancha Centro, Alcázar de San Juan, Spain
Ana Fuentes Coronel Gastroenterology Department, Complejo Asistencial de Zamora, Zamora, Spain
Daniel Ginard Gastroenterology Department, Hospital Son Espases, Palma de Mallorca, Spain
Laura García Gastroenterology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain
Isabel Blázquez Gómez Gastroenterology Department, Hospital Universitario de Torrejón, Universidad Francisco de Vitoria, Torrejón, Spain
Federico Argüelles-Arias Gastroenterology Department, Hospital Universitario Virgen Macarena, Universidad de Sevilla (Facultad de Medicina), Sevilla, Spain
Eduardo Iyo Miyashiro Gastroenterology Department, Hospital de Inca, Inca, Spain
Patricia Ramírez De la Piscina Gastroenterology Department, Hospital Universitario de Álava, Vitoria, Spain
Luís Hernández Villalba Gastroenterology Department, Hospital Santos Reyes, Aranda del Duero, Spain
Pedro Almela Notari Gastroenterology Department, Hospital General de Castelló, Castellón, Spain
Teresa de Jesús Martínez-Pérez Gastroenterology Department, Hospital Virgen de la Luz, Cuenca, Spain
Hipólito Fernández Gastroenterology Department, Hospital de San Pedro, Logroño, Spain
Pau Gilabert Gastroenterology Department, Hospital de Viladecans, Viladecans, Spain
Concepción Muñóz Rosas Gastroenterology Department, Hospital de Toledo, Toledo, Spain
Pilar Nos Gastroenterology Department, Hospital Universitari i Politècnic La Fe, València, Spain
Jesús Legido Gil Gastroenterology Department, Complejo Asistencial de Segovia, Segovia, Spain
Víctor Manuel Navas López Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
Fernando Muñoz Gastroenterology Department, Hospital Universitario de Salmanca, Salamanca, Spain
María Teresa Diz-Lois Palomares Gastroenterology Department, Hospital Universitario A Coruña, A Coruña, Spain
Ana Santos Lucio Gastroenterology Department, Hospital de Mérida, Badajoz, Spain
Olga Merino Gastroenterology Department, Hospital de Cruces, Bilbao, Spain
Isabel Nicolás de Prado Gastroenterology Department, Hospital General Universitario Reina Sofía, Murcia, Spain
Carles Leal Gastroenterology Department, Consorci Hospitalari de Vic, Universitat de Vic-UCC, Barcelona, Spain
Javier Martín de Carpi Gastroenterology Department, Hospital Sant Joan de Déu, Barcelona, Spain
Lidia Buendía Sánchez Gastroenterology Department, Hospital Vega Baja, Orihuela, Spain
Nuria Maroto Arce Gastroenterology Department, Hospital de Manises, Valencia, Spain
Santiago Frago Gastroenterology Department, Hospital de Santa Bárgara, Soria, Spain
Belén Botella Mateu Gastroenterology Department, Hospital Universitario Infanta Cristina, Parla, Spain
Eugeni Domènech Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain
Esther Garcia Planella IBD Unit, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain

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Dahiya DS, Wachala J, Solanki S, Solanki D, Kichloo A, Holcomb S, Mansuri U, Haq KS, Ali H, Gangwani MK, Shah YR, Varghese T, Khan HMA, Horslen SP, Schiano TD, Jafri SM. Sepsis during short bowel syndrome hospitalizations: Identifying trends, disparities, and clinical outcomes in the United States. World J Gastrointest Pathophysiol 2024;15:92085. [PMID: 38682025 PMCID: PMC11045357 DOI: 10.4291/wjgp.v15.i1.92085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/10/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open

Abstract

BACKGROUND

Short bowel syndrome (SBS) hospitalizations are often complicated with sepsis. There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe.

AIM

To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States.

METHODS

The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between 2005-2014. The study cohort was further divided based on the presence or absence of sepsis. Trends were identified, and hospitalization characteristics and clinical outcomes were compared. Predictors of mortality for SBS hospitalizations complicated with sepsis were assessed.

RESULTS

Of 247097 SBS hospitalizations, 21.7% were complicated by sepsis. Septic SBS hospitalizations had a rising trend of hospitalizations from 20.8% in 2005 to 23.5% in 2014 (P trend < 0.0001). Compared to non-septic SBS hospitalizations, septic SBS hospitalizations had a higher proportion of males (32.8% vs 29.3%, P < 0.0001), patients in the 35-49 (45.9% vs 42.5%, P < 0.0001) and 50-64 (32.1% vs 31.1%, P < 0.0001) age groups, and ethnic minorities, i.e., Blacks (12.4% vs 11.3%, P < 0.0001) and Hispanics (6.7% vs 5.5%, P < 0.0001). Furthermore, septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation (0.33% vs 0.22%, P < 0.0001), inpatient mortality (8.5% vs 1.4%, P < 0.0001), and mean length of stay (16.1 d vs 7.7 d, P < 0.0001) compared to the non-sepsis cohort. A younger age, female gender, White race, and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS hospitalizations.

CONCLUSION

Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

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Affiliation(s)

Dushyant Singh Dahiya Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, United States
Jennifer Wachala Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
Shantanu Solanki Division of Gastroenterology Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Dhanshree Solanki Department of Medicine, Institute for Foreign Medical Graduate Education, Houston, TX 77030, United States
Asim Kichloo Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
Samantha Holcomb Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
Uvesh Mansuri Department of Internal Medicine, MedStar Harbor Hospital, Baltimore, MD 21225, United States
Khwaja Saad Haq Department of Internal Medicine, WellStar Spalding Regional Hospital, Griffin, GA 30224, United States
Hassam Ali Division of Gastroenterology, Hepatology and Nutrition, East Carolina University/Brody School of Medicine, Greenville, NC 27858, United States
Manesh Kumar Gangwani Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Yash R Shah Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI 48341, United States
Teresa Varghese Department of Internal Medicine, WellStar Spalding Regional Hospital, Griffin, GA 30224, United States
Hafiz Muzaffar Akbar Khan Division of Gastroenterology and Hepatology, SUNY Upstate Medical University, Syracuse, NY 13210, United States
Simon Peter Horslen Department of Pediatrics, School of Medicine and UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15219, United States
Thomas D Schiano Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Syed-Mohammed Jafri Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI 48202, United States

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Pizzoferrato M, Puca P, Ennas S, Cammarota G, Guidi L. Glucagon-like peptide-2 analogues for Crohn’s disease patients with short bowel syndrome and intestinal failure. World J Gastroenterol 2022;28:6258-6270. [PMID: 36504557 PMCID: PMC9730438 DOI: 10.3748/wjg.v28.i44.6258] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/01/2022] [Accepted: 11/17/2022] [Indexed: 02/06/2023] Open

Eberhardson M, Myrelid P, Söderling JK, Ekbom A, the SWIBREG Study GroupStrid

Hans

Hjortswang

Henrik

Olsson

Malin

Björk

Jan

Bengtsson

Jonas L.

Halfvarson

Jonas

Andersson

Marie A.

Karling

Pontus

Rejler

Martin

Jäghult

Susanna

Fagerberg

Ulrika L.

Grip

Olof

Nordenvall

Caroline

, Everhov ÅH, Hedin CRH, Neovius M, Ludvigsson JF, Olén O. Tumour necrosis factor inhibitors in Crohn's disease and the effect on surgery rates. Colorectal Dis 2022;24:470-483. [PMID: 34905282 PMCID: PMC9306633 DOI: 10.1111/codi.16021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 12/01/2021] [Indexed: 12/13/2022]

Affiliation(s)

Michael Eberhardson Department of Gastroenterology and HepatologyUniversity HospitalLinköpingSweden,Department of Medicine SolnaKarolinska InstitutetStockholmSweden,Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
Pär Myrelid Division of SurgeryDepartment of Biomedical and Clinical SciencesFaculty of Health SciencesLinköping UniversityLinköpingSweden,Department of SurgeryUniversity HospitalLinköpingSweden
Jonas K. Söderling Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden
Anders Ekbom Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden
the SWIBREG Study GroupStridHansHjortswangHenrikOlssonMalinBjörkJanBengtssonJonas L.HalfvarsonJonasAnderssonMarie A.KarlingPontusRejlerMartinJäghultSusannaFagerbergUlrika L.GripOlofNordenvallCaroline
Åsa H. Everhov Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden,Department of Clinical Science and Education, Södersjukhuset, Karolinska InstitutetStockholmSweden
Charlotte R. H. Hedin Department of Medicine SolnaKarolinska InstitutetStockholmSweden,Division of GastroenterologyMedical Unit Gastroenterology, Dermatovenereology and RheumatologyKarolinska University HospitalStockholmSweden
Martin Neovius Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden
Jonas F. Ludvigsson Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of PediatricsÖrebro University HospitalÖrebroSweden,Division of Epidemiology and Public HealthSchool of MedicineUniversity of NottinghamNottinghamUK,Department of MedicineColumbia University College of Physicians and SurgeonsNew YorkNew YorkUSA
Ola Olén Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden,Department of Clinical Science and Education, Södersjukhuset, Karolinska InstitutetStockholmSweden

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Privitera G, Pugliese D, Lopetuso LR, Scaldaferri F, Papa A, Rapaccini GL, Gasbarrini A, Armuzzi A. Orphan patients with inflammatory bowel disease - when we treat beyond evidence. World J Gastroenterol 2021;27:8047-8057. [PMID: 35068853 PMCID: PMC8704270 DOI: 10.3748/wjg.v27.i47.8047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open

Affiliation(s)

Giuseppe Privitera Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Daniela Pugliese CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
Loris Riccardo Lopetuso CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche , Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome 00168, Italy Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti 66100, Italy Center for Advanced Studies and Technology (CAST), “G.d’Annunzio” University of Chieti-Pescara, Chieti 66100, Italy
Franco Scaldaferri CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
Alfredo Papa Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
Gian Lodovico Rapaccini Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
Antonio Gasbarrini Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
Alessandro Armuzzi Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy

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Bernstein CN, Nugent Z, Shaffer S, Singh H, Marrie RA. Comorbidity before and after a diagnosis of inflammatory bowel disease. Aliment Pharmacol Ther 2021;54:637-651. [PMID: 34156724 DOI: 10.1111/apt.16444] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 12/16/2022]

Limketkai BN, Akobeng AK, Gordon M, Adepoju AA. Probiotics for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2020;7:CD006634. [PMID: 32678465 PMCID: PMC7389339 DOI: 10.1002/14651858.cd006634.pub3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]

Abstract

BACKGROUND

Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract, in which the pathogenesis is believed to be partly influenced by the gut microbiome. Probiotics can be used to manipulate the microbiome and have therefore been considered as a potential therapy for CD. There is some evidence that probiotics benefit other gastrointestinal conditions, such as irritable bowel syndrome and ulcerative colitis, but their efficacy in CD is unclear. This is the first update of a Cochrane Review previously published in 2008.

OBJECTIVES

To assess the efficacy and safety of probiotics for the induction of remission in CD.

SEARCH METHODS

The following electronic databases were searched: MEDLINE (from inception to 6 July 2020), Embase (from inception to 6 July 2020), the Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane IBD Review Group Specialised Trials Register, World Health Organization (WHO) International Clinical Trials Registry, and ClinicalTrials.gov.

SELECTION CRITERIA

Randomised controlled trials (RCTs) that compared probiotics with placebo or any other non-probiotic intervention for the induction of remission in CD were eligible for inclusion.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data and assessed the methodological quality of included studies. The primary outcome was clinical remission. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for dichotomous outcomes.

MAIN RESULTS

There were two studies that met criteria for inclusion. One study from Germany had 11 adult participants with mild-to-moderate CD, who were treated with a one-week course of corticosteroids and antibiotics (ciprofloxacin 500 mg twice daily and metronidazole 250 mg three times a day), followed by randomised assignment to Lactobacillus rhamnosus strain GG (two billion colony-forming units per day) or corn starch placebo. The other study from the United Kingdom (UK) had 35 adult participants with active CD (CDAI score of 150 to 450) randomised to receive a synbiotic treatment (comprised of freeze-dried Bifidobacterium longum and a commercial product) or placebo. The overall risk of bias was low in one study, whereas the other study had unclear risk of bias in relation to random sequence generation, allocation concealment, and blinding. There was no evidence of a difference between the use of probiotics and placebo for the induction of remission in CD (RR 1.06; 95% CI 0.65 to 1.71; 2 studies, 46 participants) after six months. There was no difference in adverse events between probiotics and placebo (RR 2.55; 95% CI 0.11 to 58.60; 2 studies, 46 participants). The evidence for both outcomes was of very low certainty due to risk of bias and imprecision.

AUTHORS' CONCLUSIONS

The available evidence is very uncertain about the efficacy or safety of probiotics, when compared with placebo, for induction of remission in Crohn's disease. There is a lack of well-designed RCTs in this area and further research is needed.

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Strictureplasty for Crohn’s disease of the small bowel in the biologic era: long-term outcomes and risk factors for recurrence. Tech Coloproctol 2020;24:711-720. [DOI: 10.1007/s10151-020-02208-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/01/2020] [Indexed: 02/08/2023]

Buchman AL. We Cannot Say Biologic Therapy Is Not Useful in Patients With Short-Bowel Syndrome From Resections Related to Crohn's Disease, nor Can We Conclude They Are of Value. Clin Gastroenterol Hepatol 2018;16:784-785. [PMID: 29678241 DOI: 10.1016/j.cgh.2018.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 02/07/2023]

Limketkai BN, Colombel JF. Reply. Clin Gastroenterol Hepatol 2018;16:785. [PMID: 29678242 DOI: 10.1016/j.cgh.2018.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 01/31/2018] [Indexed: 02/07/2023]