10 results on '"Vrolijk, Jan M."'
Search Results
2. Liver decompensation in HIV/Hepatitis B coinfection in the combination antiretroviral therapy era does not seem increased compared to hepatitis B mono-infection
- Author
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MS MDL 1, Cancer, MS Infectieziekten, Circulatory Health, Infection & Immunity, MS Interne Geneeskunde, Lieveld, Faydra I., Smit, Colette, Richter, Clemens, van Erpecum, Karel J., Spanier, Bernhard W.M., Gisolf, Elisabeth H., Vrolijk, Jan M., Siersema, Peter D., Hoepelman, Andy I.M., Reiss, Peter, Arends, Joop E., MS MDL 1, Cancer, MS Infectieziekten, Circulatory Health, Infection & Immunity, MS Interne Geneeskunde, Lieveld, Faydra I., Smit, Colette, Richter, Clemens, van Erpecum, Karel J., Spanier, Bernhard W.M., Gisolf, Elisabeth H., Vrolijk, Jan M., Siersema, Peter D., Hoepelman, Andy I.M., Reiss, Peter, and Arends, Joop E.
- Published
- 2019
3. Adverse events related to low dose corticosteroids in autoimmune hepatitis.
- Author
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Brand, Floris F., Veen, Koen S., Lissenberg‐Witte, Birgit I., Boer, Ynto S., Hoek, Bart, Drenth, Joost P. H., Verdonk, Robert C., Vrolijk, Jan M., Nieuwkerk, Carin M. J., Bouma, Gerd, van Gerven, N. M., Kuijvenhoven, J. Ph., Schreuder, T. C. M. A., van der Wouden, E. J., van Meyel, J. J. M., Baak, L. C., Stadhouders, P. H. G. M., Klemt‐Kropp, M., Verhagen, M. A. M. T., and Bhalla, A.
- Subjects
CHRONIC active hepatitis ,ADVERSE health care events ,CORTICOSTEROIDS ,RHEUMATISM ,LOGISTIC regression analysis ,CATARACT - Abstract
Summary: Background: Autoimmune hepatitis requires long‐term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long‐term studies are mainly derived from studies in rheumatic diseases. Aim: To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long‐term maintenance treatment of patients with autoimmune hepatitis. Methods: We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. Results: A total of 6634 years, with a median of 13 (range 1‐40) per patient were recorded. The median age at diagnosis was 44 years (range 2‐88). Adverse events were documented in 120 (25%) patients. Low‐dose predniso(lo)ne (0.1‐5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. Conclusions: Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
4. Liver decompensation in HIV/Hepatitis B coinfection in the combination antiretroviral therapy era does not seem increased compared to hepatitis B mono‐infection.
- Author
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Hoepelman, Andy I. M., Arends, Joop E., Lieveld, Faydra I., van Erpecum, Karel J., Siersema, Peter D., Smit, Colette, Reiss, Peter, Richter, Clemens, Gisolf, Elisabeth H., Spanier, Bernhard W. M., and Vrolijk, Jan M.
- Subjects
HEPATITIS B - Abstract
Background & Aims: HIV/hepatitis B virus (HBV) coinfected subjects are thought to have faster progression to end‐stage liver disease (ESLD) than HBV mono‐infected subjects. We assessed whether this remains in the current cART‐era. Methods: Data from subjects with follow‐up completion post‐2003 were compared between HIV/HBV coinfected subjects in the Dutch HIV Monitoring database and HBV mono‐infected subjects from two centres. The primary outcomes of composite ESLD included portal hypertension, decompensated cirrhosis, hepatocellular carcinoma, liver transplantation and liver‐related mortality. Outcomes were analysed using time‐dependent cause‐specific Cox regression models adjusted for follow‐up time and relevant covariates. Subset‐analyses were done in subjects with follow‐up pre‐2003. Results: In the 1336 co‐ vs 742 mono‐infected subjects, coinfected subjects had no increased probability for ESLD compared to mono‐infected subjects (cHR 0.7 (95% CI 0.4‐1.1), but had increased probabilities for all‐cause (cHR 7.4 [4.9‐11.1]) and liver‐related mortality (cHR 3.4 [1.6‐7.5]). In the current combined cohort, treatment with tenofovir or entecavir was inversely associated with ESLD, all‐cause and liver‐related mortality (cHR 0.4 [95% CI 0.3‐0.7], cHR 0.003 [0.001‐0.01]), cHR 0.007 [0.001‐0.05]). Other predictors for ESLD were older age, being of Sub‐Sahara African descent, increased alanine aminotransferase levels and hepatitis C virus coinfection. While the probability for all‐cause mortality was increased in coinfected subjects, this rate decreased compared to pre‐2003 (HR 40.2 (95% CI: 8.7‐186.2). Conclusions: HIV/HBV coinfected patients no longer seem to be at increased risk for progression to ESLD compared to HBV mono‐infected patients, likely due to widespread use of highly effective cART with dual HBV and HIV activity. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
5. Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands
- Author
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Coenen, Sandra, van Meer, Suzanne, Vrolijk, Jan M, Richter, Clemens, van Erpecum, Karel J, Mostert, Marijke C, Veldhuijzen, Irene K, Reijnders, Jurriën G P, van Soest, Hanneke, Dirksen, Kees, Drenth, Joost P H, Koene, René P M, Bosschart, Maaike, Friederich, Pieter, Ter Borg, Martijn J, Daemen, Rick H P J, Arends, Joop E, Verhagen, Marc A M T, Schout, Christine, Spanier, B W Marcel, Coenen, Sandra, van Meer, Suzanne, Vrolijk, Jan M, Richter, Clemens, van Erpecum, Karel J, Mostert, Marijke C, Veldhuijzen, Irene K, Reijnders, Jurriën G P, van Soest, Hanneke, Dirksen, Kees, Drenth, Joost P H, Koene, René P M, Bosschart, Maaike, Friederich, Pieter, Ter Borg, Martijn J, Daemen, Rick H P J, Arends, Joop E, Verhagen, Marc A M T, Schout, Christine, and Spanier, B W Marcel
- Published
- 2016
6. Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands
- Author
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Unit Opleiding Aios, MS MDL 1, Other research (not in main researchprogram), Cancer, MS Infectieziekten, Infection & Immunity, MS Interne Geneeskunde, Coenen, Sandra, van Meer, Suzanne, Vrolijk, Jan M, Richter, Clemens, van Erpecum, Karel J, Mostert, Marijke C, Veldhuijzen, Irene K, Reijnders, Jurriën G P, van Soest, Hanneke, Dirksen, Kees, Drenth, Joost P H, Koene, René P M, Bosschart, Maaike, Friederich, Pieter, Ter Borg, Martijn J, Daemen, Rick H P J, Arends, Joop E, Verhagen, Marc A M T, Schout, Christine, Spanier, B W Marcel, Unit Opleiding Aios, MS MDL 1, Other research (not in main researchprogram), Cancer, MS Infectieziekten, Infection & Immunity, MS Interne Geneeskunde, Coenen, Sandra, van Meer, Suzanne, Vrolijk, Jan M, Richter, Clemens, van Erpecum, Karel J, Mostert, Marijke C, Veldhuijzen, Irene K, Reijnders, Jurriën G P, van Soest, Hanneke, Dirksen, Kees, Drenth, Joost P H, Koene, René P M, Bosschart, Maaike, Friederich, Pieter, Ter Borg, Martijn J, Daemen, Rick H P J, Arends, Joop E, Verhagen, Marc A M T, Schout, Christine, and Spanier, B W Marcel
- Published
- 2016
7. Biochemical efficacy of tioguanine in autoimmune hepatitis: a retrospective review of practice in the Netherlands.
- Author
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van den Brand, Floris F., van Nieuwkerk, Carin M. J., de Boer, Ynto S., de Boer, Nanne K. H., Mulder, Chris J. J., Bouma, Gerd, van den Hazel, Sven J., Inderson, Akin, Tushuizen, Maarten E., Verwer, Bart J., Bloemena, Elisabeth, Bakker, Christine M., Vrolijk, Jan M., Drenth, Joost P. H., Tan, Adriaan C. I. T. L., ter Borg, Frank, and ter Borg, Martijn J.
- Subjects
CHRONIC active hepatitis ,AZATHIOPRINE ,IMMUNOGLOBULIN G ,AMINOTRANSFERASES - Abstract
Summary: Background: Azathioprine (AZA) and mercaptopurine (MP) are the cornerstone of steroid‐sparing strategies in autoimmune hepatitis (AIH). Up to 20% of patients do not tolerate or respond to these regimens. Aim: To evaluate retrospectively the tolerability and efficacy of tioguanine (thioguanine) (TG) therapy in selected patients with AIH and AIH variant syndromes. Methods: Records of 52 patients who received TG therapy were retrieved from nine hospitals in the Netherlands. Indications for TG treatment were intolerable side effects on AZA or MP (n = 38), insufficient response (n = 11) or first‐line treatment (n = 3). Treatment efficacy was defined as normalisation of serum aminotransferases and serum immunoglobulin G. Results: No serious adverse events occurred in patients treated with TG during a median follow‐up of 18 months (range 1‐194). Treatment was well tolerated in 41 patients (79%), whereas four had tolerable (8%) and seven (13%) intolerable side effects. Thirty‐eight patients were treated with TG after intolerable side effects on AZA or MP; 29 patients continued TG therapy of whom 24 (83%) achieved complete biochemical remission, four (14%) had incomplete and one (3%) had no response; nine discontinued treatment. Seven of 11 patients with insufficient response to AZA or MP were responsive to TG, three with complete and four with incomplete biochemical remission; four discontinued due to intolerance (n = 2) and non‐response (n = 2). TG was effective in all AIH patients as first‐line maintenance treatment. Conclusion: In our retrospective review of TG therapy in selected patients with AIH or AIH variants who previously failed on AZA or MP, TG appeared tolerable with biochemical efficacy. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
8. Adverse events related to low dose corticosteroids in autoimmune hepatitis.
- Author
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van den Brand FF, van der Veen KS, Lissenberg-Witte BI, de Boer YS, van Hoek B, Drenth JPH, Verdonk RC, Vrolijk JM, van Nieuwkerk CMJ, and Bouma G
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Fractures, Bone chemically induced, Fractures, Bone epidemiology, Glucocorticoids administration & dosage, Glucocorticoids adverse effects, Hepatitis, Autoimmune epidemiology, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones adverse effects, Drug-Related Side Effects and Adverse Reactions epidemiology, Hepatitis, Autoimmune drug therapy
- Abstract
Background: Autoimmune hepatitis requires long-term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long-term studies are mainly derived from studies in rheumatic diseases., Aim: To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long-term maintenance treatment of patients with autoimmune hepatitis., Methods: We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects., Results: A total of 6634 years, with a median of 13 (range 1-40) per patient were recorded. The median age at diagnosis was 44 years (range 2-88). Adverse events were documented in 120 (25%) patients. Low-dose predniso(lo)ne (0.1-5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years., Conclusions: Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses., (© 2019 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
9. Liver decompensation in HIV/Hepatitis B coinfection in the combination antiretroviral therapy era does not seem increased compared to hepatitis B mono-infection.
- Author
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Lieveld FI, Smit C, Richter C, van Erpecum KJ, Spanier BWM, Gisolf EH, Vrolijk JM, Siersema PD, Hoepelman AIM, Reiss P, and Arends JE
- Subjects
- Adult, Anti-Retroviral Agents adverse effects, Databases, Factual, Disease Progression, Drug Therapy, Combination, End Stage Liver Disease diagnosis, End Stage Liver Disease mortality, End Stage Liver Disease virology, Female, HIV Infections diagnosis, HIV Infections mortality, Hepatitis B diagnosis, Hepatitis B mortality, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands epidemiology, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Anti-Retroviral Agents therapeutic use, Coinfection, End Stage Liver Disease epidemiology, HIV Infections drug therapy, Hepatitis B epidemiology
- Abstract
Background & Aims: HIV/hepatitis B virus (HBV) coinfected subjects are thought to have faster progression to end-stage liver disease (ESLD) than HBV mono-infected subjects. We assessed whether this remains in the current cART-era., Methods: Data from subjects with follow-up completion post-2003 were compared between HIV/HBV coinfected subjects in the Dutch HIV Monitoring database and HBV mono-infected subjects from two centres. The primary outcomes of composite ESLD included portal hypertension, decompensated cirrhosis, hepatocellular carcinoma, liver transplantation and liver-related mortality. Outcomes were analysed using time-dependent cause-specific Cox regression models adjusted for follow-up time and relevant covariates. Subset-analyses were done in subjects with follow-up pre-2003., Results: In the 1336 co- vs 742 mono-infected subjects, coinfected subjects had no increased probability for ESLD compared to mono-infected subjects (cHR 0.7 (95% CI 0.4-1.1), but had increased probabilities for all-cause (cHR 7.4 [4.9-11.1]) and liver-related mortality (cHR 3.4 [1.6-7.5]). In the current combined cohort, treatment with tenofovir or entecavir was inversely associated with ESLD, all-cause and liver-related mortality (cHR 0.4 [95% CI 0.3-0.7], cHR 0.003 [0.001-0.01]), cHR 0.007 [0.001-0.05]). Other predictors for ESLD were older age, being of Sub-Sahara African descent, increased alanine aminotransferase levels and hepatitis C virus coinfection. While the probability for all-cause mortality was increased in coinfected subjects, this rate decreased compared to pre-2003 (HR 40.2 (95% CI: 8.7-186.2)., Conclusions: HIV/HBV coinfected patients no longer seem to be at increased risk for progression to ESLD compared to HBV mono-infected patients, likely due to widespread use of highly effective cART with dual HBV and HIV activity., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
10. Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands.
- Author
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Coenen S, van Meer S, Vrolijk JM, Richter C, van Erpecum KJ, Mostert MC, Veldhuijzen IK, Reijnders JG, van Soest H, Dirksen K, Drenth JP, Koene RP, Bosschart M, Friederich P, Ter Borg MJ, Daemen RH, Arends JE, Verhagen MA, Schout C, and Spanier BW
- Subjects
- Adult, Aged, Aged, 80 and over, Antiviral Agents therapeutic use, Asian People, China ethnology, Demography, Female, Hepatitis B Surface Antigens blood, Hepatitis B virus genetics, Hepatitis B, Chronic drug therapy, Humans, Male, Middle Aged, Netherlands epidemiology, Transients and Migrants, Young Adult, Carcinoma, Hepatocellular ethnology, Hepatitis B, Chronic ethnology, Liver Cirrhosis ethnology, Liver Neoplasms ethnology, Mass Screening methods
- Abstract
Background & Aims: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants., Methods: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma., Results: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%)., Conclusions: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
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