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431 results on '"Seow, Cynthia H."'

4. Global Hospitalization Trends for Crohn’s Disease and Ulcerative Colitis in the 21st Century: A Systematic Review With Temporal Analyses

Author

Buie, Michael J., Quan, Joshua, Windsor, Joseph W., Coward, Stephanie, Hansen, Tawnya M., King, James A., Kotze, Paulo G., Gearry, Richard B., Ng, Siew C., Mak, Joyce W.Y., Abreu, Maria T., Rubin, David T., Bernstein, Charles N., Banerjee, Rupa, Yamamoto-Furusho, Jesus K., Panaccione, Remo, Seow, Cynthia H., Ma, Christopher, Underwood, Fox E., Ahuja, Vineet, Panaccione, Nicola, Shaheen, Abdel-Aziz, Holroyd-Leduc, Jayna, Kaplan, Gilaad G., Balderramo, Domingo, Chong, Vui Heng, Juliao-Baños, Fabián, Dutta, Usha, Simadibrata, Marcellus, Kaibullayeva, Jamilya, Sun, Yang, Hilmi, Ida, Raja Ali, Raja Affendi, Paudel, Mukesh Sharma, Altuwaijri, Mansour, Hartono, Juanda Leo, Wei, Shu Chen, Limsrivilai, Julajak, El Ouali, Sara, Vergara, Beatriz Iade, Dao, Viet Hang, Kelly, Paul, Hodges, Phoebe, Miao, Yinglei, and Li, Maojuan

Published
2023
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5. Management of Inflammatory Bowel Diseases in Special Populations: Obese, Old, or Obstetric

Author

Singh, Siddharth, Picardo, Sherman, and Seow, Cynthia H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Autoimmune Disease, Obesity, Inflammatory Bowel Disease, Nutrition, Cardiovascular, Crohn's Disease, Clinical Research, Digestive Diseases, 2.1 Biological and endogenous factors, Aetiology, Oral and gastrointestinal, Good Health and Well Being, Aged, Comorbidity, Female, Hospitalization, Humans, Inflammatory Bowel Diseases, Pregnancy, Prevalence, Elderly, Body Weight, Gastroenterology & Hepatology, Clinical sciences
Abstract

The epidemiology of inflammatory bowel disease (IBD) is progressively evolving impacting the type of patients with IBD we will see in clinical practice. In this review, we discuss specific challenges and solutions in the management of (1) obese, (2) older and (3) obstetric (pregnant) patients with IBD. With the global obesity epidemic, almost 1 in 3 patients with IBD are obese. Obesity is associated with greater difficulty in achieving remission, higher risk of disease relapse and higher burden and costs of hospitalization in patients with IBD. Obese patients also have inferior response to biologic therapy related to altered pharmacokinetics and obesity-mediated chronic inflammation. Surgical management of obese patients with IBD is also challenging. Similar to obesity, the prevalence of IBD in older patients is rising and it is anticipated that almost one-third of patients with IBD will be older than 60 years within the next decade. Older patients present unique diagnostic and therapeutic dilemmas, and management of these individuals warrants careful consideration of the risks of disease-related versus treatment-related complications, non-IBD-related extra-intestinal complications (eg, cardiovascular disease, malignancy), in the context of individual values, preferences, functional status and comorbidities. With evolving therapeutics, medical management of IBD surrounding pregnancy continues to be challenging. Overall, the management of pregnant patients requires a pro-active, multidisciplinary approach, with an emphasis on optimal disease control not just during, but prior to pregnancy. This often involves continuation of highly effective therapies, of which the vast majority are safe during pregnancy and breastfeeding, resulting in a reduction of risk of adverse maternal fetal outcomes.

Published
2020

6. Transition Readiness in Youth with Inflammatory Bowel Disease

Author

Foster, Alice, Chan, Justin M., Wine, Eytan, El-Matary, Wael, Carroll, Matthew W., Kroeker, Karen I., deBruyn, Jennifer C., Seow, Cynthia H., Lawrence, Sally, Evans, Kathy, Kluthe, Cheryl, Sharifi, Nastaran, Pears, Christina, Nicol, Simone, Olayinka, Lily, Fu, Nancy, Huynh, Hien Q., Bressler, Brian, Bernstein, Charles N., and Jacobson, Kevan

Published
2023
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8. Review article: Optimisation of biologic (monoclonal antibody) therapeutic response in inflammatory bowel disease.

Author

Chaemsupaphan, Thanaboon, Leong, Rupert W., Vande Casteele, Niels, and Seow, Cynthia H.

Subjects
INFLAMMATORY bowel diseases, DRUG utilization, DRUG monitoring, DRUG efficacy, DISEASE remission, MONOCLONAL antibodies
Abstract

Summary: Background: There are a plethora of therapeutic options for the management of inflammatory bowel disease (IBD). Despite this, clinical outcomes with standard dosing often fall short of established targets. While efforts centre on developing novel therapies, there is an ongoing need to optimise the use of existing agents. Aims: To focus on strategies to optimise response to biologic (monoclonal antibody) therapies in IBD, including use of therapeutic drug monitoring (TDM). Methods: An extensive review of the published literature. Results: TDM is a strategy aimed at enhancing the effectiveness of drugs with variable exposure‐response relationships by measuring serum concentrations of biologic therapies and detecting neutralising antibodies. Reactive TDM is performed when therapeutic goals have not been achieved. Tumour necrosis factor alpha (TNF) inhibitors are the treatment class most frequently associated with immunogenicity and loss of response. Immunogenicity can be reduced through avoidance of low serum drug concentrations by dose optimisation or use of concomitant immunomodulator therapy. Subtherapeutic dosing in the absence of antidrug antibodies is best managed by dose escalation or dose interval reduction. Persistent neutralising drug antibodies necessitate switching to an alternative therapy. Proactively ensuring adequate serum trough levels might help sustain treatment durability and prevent loss of response. Newer non‐TNF inhibitors demonstrate less robust exposure‐response relationships, and TDM may not prove as beneficial. Conclusions: In the treat‐to‐target paradigm of IBD treatment, optimising treatment effect with dose optimisation, which may involve strategies including TDM, increases the likelihood of achieving clinical remission and may accomplish deeper levels of remission beyond symptom control. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Inflammatory Bowel Disease Among Canadian Children: Comparison Between Children of Non-European Descent and Children of European Descent

Author

Jeong, Jocelyn, Walters, Thomas D, Huynh, Hien Q, Lawrence, Sally, Mack, David R, Deslandres, Colette, Otley, Anthony, El-Matary, Wael, Sherlock, Mary, Griffiths, Anne M, Wine, Eytan, Jacobson, Kevan, Church, Peter, Carroll, Matthew W, Benchimol, Eric I, Brill, Herbert, Critch, Jeff, Bax, Kevin, Jantchou, Prévost, Rashid, Mohsin, Kaplan, Gilaad G, Seow, Cynthia H, Novak, Kerri, and deBruyn, Jennifer C

Published
2023
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13. Epidemiology, linkage to care and natural history of women of childbearing age with chronic hepatitis B: A population‐based study.

Author

Kochaksaraei, Golasa Samadi, Yang, Fengjuan, Seow, Cynthia H., Barkema, Herman W., Coffin, Carla S., and Shaheen, Abdel‐Aziz

Subjects
CHRONIC hepatitis B, NATURAL history, CHILDBEARING age, WOMEN'S history, HEPATITIS B, EPIDEMIOLOGY
Abstract

Pregnant women with chronic hepatitis B (CHB) are a priority population for hepatitis B care. Identification of HBV status prior to pregnancy would facilitate timely maternal interventions and perinatal care. In our study, we aimed to study the epidemiology of CHB among women of childbearing age (WoCBA, 18–49 years) in Alberta, Canada. We retrospectively analysed Alberta Analytics databases to study CHB epidemiology, natural history and care linkage among WoCBA in Alberta, between April 2012 and March 2021. A Poisson regression was conducted to estimate incidence of newly identified CHB cases and prevalence trends, whereas predictors of care linkage were determined using logistic regression. Age/sex‐adjusted incidence of newly identified CHB among WoCBA between 2015 and 2020 was 36.2/100,000 person/years, highest among individuals aged 30–39 years. Incidence of newly identified CHB decreased from 52.6 to 18.2/100,000 between 2015 and 2020, but prevalence increased from 131.7 to 248.6/100,000 in the same period. Newly identified CHB incident cases (n = 2124) had lower survival rates than age/sex‐matched Canadians, with a standardized mortality ratio of 5.7 (95% CI 2.6–11.0). Increasing age (years) at diagnosis (HR, 1.2; 95% CI 1.1–1.3) was independently associated with mortality. Comorbid hepatocellular carcinoma, anti‐HBV treatment and year of diagnosis were not significantly associated with mortality. Of the 1927 women with 2436 hepatitis B surface antigen‐positive pregnancies from 2012 to 2020, only 27.6% had recommended HBV assessment during pregnancy. Of those women meeting criteria for antiviral therapy to prevent mother‐to‐child transmission (MTCT), only 66.4% received treatment. Suboptimal management during pregnancy and overall lower survival rates highlight the need to address care linkage barriers in women of childbearing age living with CHB. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease

Author

Panaccione, Remo, Steinhart, A. Hillary, Bressler, Brian, Khanna, Reena, Marshall, John K., Targownik, Laura, Afif, Waqqas, Bitton, Alain, Borgaonkar, Mark, Chauhan, Usha, Halloran, Brendan, Jones, Jennifer, Kennedy, Erin, Leontiadis, Grigorios I., Loftus, Edward V., Jr., Meddings, Jonathan, Moayyedi, Paul, Murthy, Sanjay, Plamondon, Sophie, Rosenfeld, Greg, Schwartz, David, Seow, Cynthia H., Williams, Chadwick, and Bernstein, Charles N.

Published
2019
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17. Trends in hospitalisation rates for inflammatory bowel disease in western versus newly industrialised countries: a population-based study of countries in the Organisation for Economic Co-operation and Development

Author

King, James A, Underwood, Fox E, Panaccione, Nicola, Quan, Josh, Windsor, Joseph W, Kotze, Paulo G, Ng, Siew C, Ghosh, Subrata, Lakatos, Peter L, Jess, Tine, Panaccione, Remo, Seow, Cynthia H, Ben-Horin, Shomron, Burisch, Johan, Colombel, Jean-Frédéric, Loftus, Edward V, Jr, Gearry, Richard, Halfvarson, Jonas, and Kaplan, Gilaad G

Published
2019
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23. Commentary on the Epidemiology of Inflammatory Bowel Disease in Compounding Prevalence Nations: Toward Sustaining Healthcare Delivery

Author

Bitton, Alain, Forbes, Angela, Rowan, Catherine, Lees, Charlie W., Seow, Cynthia H., Turner, Dan, Brunet-Mas, Eduard, Loftus, Edward V., Jr., Singh, Harminder, St-Pierre, Joëlle, Burisch, Johan, Windsor, Joseph W., Ernest-Suarez, Kenneth, Targownik, Laura E., Hracs, Lindsay, Martin, Meaghan, Lakatos, Peter L., Panaccione, Remo, Gearry, Richard B., Murthy, Sanjay K., Ng, Siew C., El-Matary, Wael, Herauf, Michelle, Coward, Stephanie, Peña-Sánchez, Juan-Nicolás, Bernstein, Charles N., Benchimol, Eric I., and Kaplan, Gilaad G.

Published
2024
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26. The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy

Author

Bitton, Alain, Bressler, Brian, Fowler, Sharyle, Marshall, John K., Palatnick, Carrie, Pupco, Anna, Ray, Joel, Targownik, Laura, van der Woude, Janneke, Paterson, William, Nguyen, Geoffrey C., Seow, Cynthia H., Maxwell, Cynthia, Huang, Vivian, Leung, Yvette, Jones, Jennifer, Leontiadis, Grigorios I., Tse, Frances, Mahadevan, Uma, and van der Woude, C. Janneke

Published
2016
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29. Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Toronto Consensus

Author

Afif, Waqqas, Bernard, Edmond-Jean, Borgaonkar, Mark, Devlin, Shane, Fedorak, Richard, Nguyen, Geoffrey C., Penner, Robert, Peyrin-Biroulet, Laurent, Reinisch, Walter, Seow, Cynthia H., Sy, Richmond, Targownik, Laura, Thomson, Peter, Van Assche, Gert, Williams, Chadwick, Bressler, Brian, Marshall, John K., Bernstein, Charles N., Bitton, Alain, Jones, Jennifer, Leontiadis, Grigorios I., Panaccione, Remo, Steinhart, A. Hillary, Tse, Francis, and Feagan, Brian

Published
2015
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31. Inflammatory bowel disease in 2024 and beyond.

Author

Gearry, Richard B., Seow, Cynthia H., and Subramanian, Sreedhar

Subjects
*CROHN'S disease, *INFLAMMATORY bowel diseases, *DRUG monitoring, *TYPE 1 diabetes, *DIETARY patterns
Abstract

This article is a special edition of the journal Alimentary Pharmacology & Therapeutics focused on inflammatory bowel disease (IBD). It includes a range of articles written by experts in the field, covering topics such as disease prevention, disease severity, the gut-brain axis, dietary management, and the optimization of biologic drugs for treatment. The authors provide a roadmap for IBD prevention, discuss the various factors that contribute to disease severity, highlight the importance of managing psychological health in IBD patients, present dietary strategies for managing symptoms, and explore the optimization of biologic drugs through therapeutic drug monitoring. The article concludes with a guide for clinicians on recently approved and emerging therapies for IBD. The authors express their gratitude to the contributing authors and hope that readers will find these papers informative. [Extracted from the article]

Published
2024
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34. Differences in Healthcare Utilization in Women with and without Inflammatory Bowel Diseases During Preconception, Pregnancy and Postpartum: A Population-Based Cohort Study.

Author

Tandon, Parul, Huang, Vivian W, Feig, Denice S, Saskin, Refik, Maxwell, Cynthia, Gao, Yiding, Fell, Deshayne B, Seow, Cynthia H, Snelgrove, John W, and Nguyen, Geoffrey C

Abstract

Background and Aims Compared to those without inflammatory bowel disease [IBD], women with IBD may have increased healthcare utilization during pregnancy and postpartum, though this remains to be confirmed. We aimed to characterize this healthcare use between these groups. Methods Administrative databases were accessed to identify women [aged 18–55 years] with and without IBD who had a live, singleton pregnancy between 2003 and 2018. Differences in emergency department [ED] visits, hospitalizations and prenatal care during 12 months preconception, pregnancy and 12 months postpartum were characterized. Multivariable negative binomial regression was performed to report incidence rate ratios [IRRs] with 95% confidence intervals [95% CIs]. Covariates included maternal age at conception, location of residence, socioeconomic status and maternal comorbidity. Results In total, 6163 women with IBD [9158 pregnancies] and 1091 013 women without IBD [1729 411 pregnancies] were included. Women with IBD were more likely to visit the ED [IRR 1.13, 95% CI 1.08–1.18] and be hospitalized [IRR 1.11, 95% CI 1.01–1.21] during pregnancy, and visit the ED [IRR 1.21, 95% CI 1.15–1.27] and be hospitalized [IRR 1.18, 95% CI 1.05–1.32] during postpartum. On unadjusted analysis, women with IBD were more likely to be hospitalized for venous thromboembolic events. There was no difference in healthcare use in preconception. Finally, women with IBD also had a greater number of prenatal visits during pregnancy and were more likely to receive a first-trimester prenatal visit. Conclusion Women with IBD have increased healthcare utilization during pregnancy and postpartum. Efforts should be made to increase ambulatory care access during this period, which in turn may reduce this health-services utilization. [ABSTRACT FROM AUTHOR]

Published
2023
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37. Australian inflammatory bowel disease consensus statements for preconception, pregnancy and breast feeding.

Author

Laube, Robyn, Selinger, Christian P., Seow, Cynthia H., Christensen, Britt, Flanagan, Emma, Kennedy, Debra, Mountifield, Reme, Seeho, Sean, Shand, Antonia, Williams, Astrid-Jane, and Leong, Rupert W.

Subjects
INFLAMMATORY bowel diseases, VAGINAL fistula, BREASTFEEDING, MALE infertility, MEDICAL personnel, PREGNANCY, RESTORATIVE proctocolectomy
Published
2023
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39. Su1790 ACCELERATED INTERMITTENT THETA-BURST STIMULATION TRANSCRANIAL MAGNETIC STIMULATION IS NOT MORE EFFECTIVE THAN SHAM FOR IMPROVING DEPRESSION AND ANXIETY SYMPTOMS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A RANDOMIZED, SHAM-CONTROLLED, PILOT TRIAL

Author

Ma, Christopher, McGirr, Alexander, Diribe, Chinedu, Cole, Jaeden, Buhler, Katherine A., Guizzetti, Leonardo, Lameu, Ewandson L., Sharkey, Keith A., Goodyear, Bradley, Arrieta, Marie-Claire, Buresi, Michelle, Kaplan, Gilaad, Seow, Cynthia H., Novak, Kerri L., Lu, Cathy, Ingram, Richard J., Panaccione, Remo, Nasser, Yasmin, and Swain, Mark G.

Published
2024
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48. Meta‐analysis: Placebo rates in microscopic colitis randomised trials and applications for future drug development using a historical control arm.

Author

Hamilton, Patrick, Buhler, Katherine, MacDonald, John K., Kaplan, Gilaad G., Seow, Cynthia H., Lu, Cathy, Novak, Kerri L., Andrews, Christopher N., Singh, Siddharth, Jairath, Vipul, Panaccione, Remo, and Ma, Christopher

Subjects
DRUG development, COLITIS, PLACEBOS, RANDOMIZED controlled trials, DRUG utilization
Abstract

Summary: Background: Effective medical therapies for patients with microscopic colitis (MC) who fail budesonide are lacking. However, conducting randomised controlled trials (RCTs) in MC has been challenging due to small sample sizes. Understanding placebo responses can help inform more efficient future trials. Aims: The aim of this study is to estimate clinical and histologic placebo response rates and to determine factors associated with placebo response in MC. Methods: EMBASE, MEDLINE, and CENTRAL were searched until 7 January 2022, to identify placebo‐controlled RCTs in adult patients with MC. Clinical and histologic response in the placebo arms were pooled using random‐effects models. Stratified analyses based on disease‐ and trial‐level characteristics, leave‐one‐out meta‐analysis, and cumulative meta‐analysis were performed. Results: Twelve RCTs enrolling a total of 391 patients (placebo n = 163) with MC were included. Pooled clinical and histologic placebo response rates were 24.4% (95% CI: 12.4%–38.4%), I2 = 60.8%, p < 0.01, and 19.9% (95% CI: 5.3%–39.0%), I2 = 66.4%, p = 0.01 (tests for heterogeneity), respectively. Clinical response to placebo was numerically higher in patients with lymphocytic compared to collagenous colitis (39.9% vs. 19.8%, p = 0.08). Heterogeneity in clinical response to placebo was significantly reduced when the Miehlke 2014 RCT was excluded in the leave‐one‐out meta‐analysis or when a more stringent secondary definition of response based on the Hjortswang criteria was applied. Conclusions: Approximately one‐quarter of patients in MC trials respond to placebo, although with substantial heterogeneity, reflecting the need for standardised outcome definitions and study designs for MC. This analysis also serves to inform future MC trials that may consider incorporating an external, historical placebo control arm, rather than directly randomising patients to placebo. [ABSTRACT FROM AUTHOR]

Published
2023
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