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1. Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based studyResearch in context

Author

Hélène Sarter, Thibaut Crétin, Guillaume Savoye, Mathurin Fumery, Ariane Leroyer, Luc Dauchet, Thierry Paupard, Hugues Coevoet, Pauline Wils, Nicolas Richard, Dominique Turck, Delphine Ley, Corinne Gower-Rousseau, Eric Agoute, Najib Al Ghossaini, Raied Al Hameedi, Myriam Al Khatib, Saria Al Turk, Jean-Marie Andre, Matthieu Antoine, Michel Antonietti, Amar Aouakli, Laura Armengol-Debeir, Ibrahim Aroichane, Fadi Assi, Eric Auxenfants, Alina Avram, Kassem Azzouzi, Damyan Bankovski, Bernard Barbry, Nicolas Bardoux, Philippe Baron, Anne Baudet, Pauline Bayart, Brice Bazin, Arash Bebahani, Jean-Pierre Becqwort, Houssem Ben Ali, Emmanuel Ben Soussan, Coralie Benard, Vincent Benet, Corinne Benguigui, Abdeslam Bental, Sara Bentaleb-Bellati, Isabelle Berkelmans, Jacques Bernet, Karine Bernou, Nathalie Bertiaux-Vandaele, Pauline Bertot, Valérie Bertrand, Emilie Biloud, Nathalie Biron, Benjamin Bismuth, Cyril Blanchard, Maurice Bleuez, Fabienne Blondel, Valérie Blondin, Marius Bobula, Philippe Bohont, Eléonore Boivin, Vanessa Bon Djemah, Eric Boniface, Philippe Bonniere, Pierre Bonvarlet, Arnaud Boruchowicz, Raoul Bostvironnois, Médina Boualit, Ahlem Bouazza, Bruno Bouche, Christian Boudailler, Claude Bourgeaux, Morgane Bourgeois-Fumery, Arnaud Bourguet, Agnès Bourienne, Hamza Boutaleb, Alexis Bouthors, Julien Branche, Franck Brazier, Marie Bridenne, Hélène Brihier, Laura Bril, Philippe Bulois, Pierre Burgiere, Joël Butel, Jean-Yves Canva, Valérie Canva-Delcambre, Florence Cardot, Sandrine Carette, Pierre Carpentier, Michel Cassagnou, Jean-François Cassar, François Castex, Pascale Catala, Stéphane Cattan, Sylviane Catteau, Bernard Caujolle, Gérard Cayron, Catherine Chandelier, Cloé Charpentier, Marthe Chavance-Thelu, Agathe Cheny, Dinu Chirita, Antoine Choteau, Jean-François Claerbout, Pierre-Yves Clergue, Gil Cohen, Marie Colin, Régis Collet, Jean-Frédéric Colombel, Stéphanie Coopman, Lucie Cordiez, Antoine Cortot, Jean Corvisart, Frédéric Couttenier, Jean-François Crinquette, Valérie Crombe, Abdelhakim Daoudi, Vincent Dapvril, Thierry Davion, Sébastien Decoster, Laurent Defontaine, Nicolas Degrave, Aurélien Dejaeger, Richard Delcenserie, Marine Deleplanque, Dorothée Delesalle, Olivier Delette, Thierry Delgrange, Laurence Delhoustal, Jean-Stéphane Delmotte, Sabri Demmane, Guy Deregnaucourt, Constance Deschepper, Jean-Pierre Desechalliers, Patrick Desmet, Pierre Desreumaux, Gérard Desseaux, Philippe Desurmont, Alain Devienne, Eve Devouge, Alex Devroux, Arnaud Dewailly, Sébastien Dharancy, Aude Di Fiore, Emmanuel Diaz, Djamal-Dine Djeddi, Rachid Djedir, Wissam Doleh, Marie-Laure Dreher-Duwat, Richard Dubois, Clothilde Duburque, Frédéric Ducrot, Philippe Ducrotte, André Dufilho, Christian Duhamel, Caroline Dumant-Forest, Jean-Louis Dupas, Frédéric Dupont, Yves Duranton, Arnaud Duriez, Nicolas Duveau, Mohammadi El Farisi, Khalil El Hachkar, Caroline Elie, Marie-Claire Elie-Legrand, Matthieu Eoche, Essmaeel Essmaeel, Dominique Evrard, Jean-Paul Evrard, Armelle Fatome, Karima Fellah-Sekkai, Bernard Filoche, Laurent Finet, Mathilde Flahaut, Camille Flamme, David Foissey, Peggy Fournier, Philippe Foutrein, Marie-Christine Foutrein-Comes, Thierry Frere, Julie Galand, Philippe Gallais, Claudine Gamblin, Serge Ganga, Romain Gerard, Guillaume Geslin, Yves Gheyssens, Salah Ghrib, Thierry Gilbert, Bénédicte Gillet, Denis Godart, Jean-Michel Godchaux, Guetty Goeguebeur, Odile Goria, Frédéric Gottrand, Philippe Gower, Lucien Grados, Brigitte Grandmaison, Marion Groux, Claire Guedon, Loïc Guerbeau, Mathilde Gueroult-Dero, Jean-François Guillard, Laurence Guillem, François Guillemot, Dominique Guimber, Baya Haddouche, Vincent Hautefeuille, Philippe Hecketsweiller, Geneviève Hecquet, Jean-Pierre Hedde, Hassina Hellal, Pierre-Emmanuel Henneresse, Michel Heraud, Sophie Herve, Bruno Heyman, Patrick Hochain, Philippe Houcke, Lucie Houssin-Baillly, Bruno Huguenin, Silviu Iobagiu, Shata Istanboli, Alexsandar Ivanovic, Isabelle Iwanicki-Caron, Eric Janicki, Marine Jarry, Charlotte Jean Bart, Claude Jonas, Julia Jougon, Anne Jouvenet, Naeim Kassar, Fadi Katherin, Alfred Kerleveo, Ali Khachfe, Alfred Kiriakos, Jean Kiriakos, Olivier Klein, Matthieu Kohut, Richard Kornhauser, Demetrios Koutsomanis, Jean-Eric Laberenne, Eric Lacotte, Guy Laffineur, Marine Lagarde, Anouck Lahaye, Arnaud Lalanne, Ambroise Lalieu, Pierre Lannoy, José Lapchin, Michel Laprand, Denis Laude, Christian Le Couteulx, Charles Le Goffic, Alain Le Grix, Jean-Philippe Le Mouel, Pauline Le Roy, Rachida Leblanc, Paul Lecieux, Stéphane Lecleire, Nathalie Leclerc, Jean Ledent, Jean Lefebvre, Pascale Lefilliatre, Céline Legrand, Patrick Lelong, Bernard Leluyer, Caroline Lemaitre, Lucie Lepileur, Antoine Leplat, Elodie Lepoutre-Dujardin, Gabriel Leppeut, Henri Leroi, Maryvonne Leroy, Benoît Lesage, Jocelyn Lesage, Xavier Lesage, Isabelle Lescanne-Darchis, Dominique Lescut, Bruno Leurent, Michel Lhermie, Louise Libier, Bernard Lisambert, Isabelle Loge, Julien Loreau, Alexandre Louvet, Joséphine Lozinguez, Henri Lubrez, Damien Lucidarme, Jean-Jacques Lugand, Olivier Macaigne, Denis Maetz, Dominique Maillard, Hubert Mancheron, Olivia Manolache, Anne-Bérengère Marks-Brunel, Charline Marre, Raymond Marti, Eric Marzloff, Philippe Mathurin, Jacques Mauillon, Vincent Maunoury, Jean-Luc Maupas, Michèle-Ange Medam Djomo, Chloé Melchior, Ziad Melki, B. Mesnard, Patrice Metayer, Lofti Methari, Franck Meurisse, Laurent Michaud, Patricia Modaine, Angélique Monthe, Loïk Morel, Mathilde Morin, Pierre-Eugène Mortier, Perrine Mortreux, Olivier Mouterde, Nicolas Mozziconaci, Jean Mudry, Maria Nachuri, Minh Dung Ngo, Eric N'guyen Khac, Bertrand Notteghem, Vincent Ollevier, Atika Ouraghi, Barriza Oussadou, Dominique Ouvry, Bernard Paillot, Claire Painchart, Nicole Panien-Claudot, Christian Paoletti, Arsène Papazian, Bruno Parent, Jean-Claude Paris, Philippe Patrier, Bernard Pauwels, Mathieu Pauwels, Richard Petit, Muriel Piat, Sandrine Piotte, Christophe Plane, Bernard Plouvier, Eric Pollet, Pierre Pommelet, Daniela Pop, Charlotte Pordes, Gérard Pouchain, Philippe Prades, Jean-Christophe Prevost, Manon Pruit, Gilles Quartier, Anne-Marie Queuniet, Jean-François Quinton, Alain Rabache, Gilles Raclot, Sébastien Ratajczyk, Nicole Reix, Thibaud Renaut-Vantroys, Marine Revillion, Ghassan Riachi, Clémentine Riault, Cécile Richez, Benoît Rimbert, Philippe Robinson, Juan Daniel Rodriguez, Jean Roger, Jean-Marc Roux, Alain Rudelli, Clémence Saingier, Patrick Schlossberg, David Sefrioui, Michel Segrestin, David Seguy, Célik Seminur, François Sevenet, Jean Silvie, Claire Spyckerelle, Nathalie Talbodec, Noémie Tavernier, Henriette Tchandeu, Aurore Techy, Jean-Luc Thelu, Henri Thiebault, Jean-Marie Thorel, Christophe Thuillier, Guillaume Tielman, Manuella Tode, Jean Tonnel, Jean-Yves Touchais, Audrey Toulemonde-Huguet, Pierre Toumelin, Yvan Touze, Léa Tran, Jean-Luc Tranvouez, Nadia Triki, Justine Turpin, Eric Vaillant, Claude Valmage, Dominique Vanco, Nathalie Vandaele-Bertiaux, Hélène Vandamme, Elise Vander Eeken, Etienne Vanderbercq, Philippe Vandermollen, Philippe Vandevenne, Lionel Vandeville, Alain Vandewalle, Jean-Pierre Vanhoove, Audrey Vanrenterghem, Charlotte Vanveuren, Iona Vasies, Guy Verbiese, Juliette Verlynde, Philippe Vermelle, Christine Verne, Gwenola Vernier-Massouille, Perrine Vezelier-Cocq, Juliette Viart, Benoît Vigneron, Marc Vincendet, Jacques Viot, Y.M. Voiment, Jean-Yves Wallez, Michel Wantier, Faustine Wartel, Jean-Christian Weber, Jean-Louis Willocquet, Nathalie Wizla, Eric Wolschies, Tajiogue Yimfor, Oana Zahara, Alberto Zalar, Sonia Zaoui, and Anne Zellweger

Subjects
Inflammatory bowel disease, Incidence, Prevalence, Population-based registry, Crohn’s disease, Ulcerative colitis, Public aspects of medicine, RA1-1270
Abstract

Summary: Background: In industrialized countries, the incidence of inflammatory bowel disease (IBD) appears stabilized. This study examined the incidence and phenotype of IBD in Northern France over a 30-year period. Methods: Including all IBD patients recorded in the EPIMAD population-based registry from 1988 to 2017 in Northern France, we described the incidence and clinical presentation of IBD according to age, sex and time. Findings: A total of 22,879 incident IBD cases were documented (59% (n = 13,445) of Crohn’s disease (CD), 38% (n = 8803) of ulcerative colitis (UC), 3% (n = 631) of IBD unclassified (IBDU)). Over the study period, incidence of IBD, CD and UC was 12.7, 7.2 and 5.1 per 105 person-years, respectively. The incidence of CD increased from 5.1/105 in 1988–1990 to 7.9/105 in 2015–2017 (annual percent change (APC): +1.9%, p

Published
2024
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2. Obesity in adult patients with inflammatory bowel disease: Clinical features and impact on disability. A cross-sectional survey from the GETAID

Author

Rose Al Bacha, Yoram Bouhnik, Melanie Serrero, Jerome Filippi, Xavier Roblin, Anne Bourrier, Guillaume Bouguen, Denis Franchimont, Guillaume Savoye, Anthony Buisson, Edouard Louis, Stephane Nancey, Vered Abitbol, Jean-Marie Reimund, Olivier DeWit, Lucine Vuitton, Nicolas Mathieu, Laurent Peyrin-Biroulet, Cyrielle Gilletta, Matthieu Allez, Stephanie Viennot, Catherine Le Berre, David Laharie, Maria Nachury, Aurelien Amiot, Sara Tadbiri, Charlotte Gagniere, Jenny Tannoury, Benjamin Pariente, Pauline Wils, Carmen Stefanescu, Xavier Treton, Carole Martins, Mathieu Uzzan, Xavier Hébuterne, Nadia Arab, Virginie Cluzeau, Emilie Del Tedesco, Laurent Beaugerie, Philippe Seksik, Cecilia Landmann, Julien Kirchgesner, Harry Sokol, Laurent Siproudhis, Marie DeWitte, Catherine Reenaers, Gilles Boschetti, Claire Gay, Pauline Danion, Bernard Flourié, Georgia Malamut, Benedicte Caron, Olivier DeWitt, Sandie Pestour, Thomas Chateau, Camille Zallot, Jean-Marc Gornet, Clotilde Baudry, Arnaud Bourreille, Caroline Trang-Poisson, Nina Dib, Hedi Brixi, Guillaume Cadiot, Medina Boualit, Claire Painchart, Laurianne Plastaras, Romain Altwegg, Lucile Boivineau, Mathurin Fumery, Ludovic Caillo, Pauline Riviere, Florian Poullenot, Benoit Coffin, Henri Duboc, Stephane Nahon, Noemie Tavernier, Marion Simon, Baya Coulibaly, Morgane Amil, Duveau Nicolas, Sherine Khater, Mehdi Kaassis, Felix Goutorbe, Driffa Moussata, Laurence Picon, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM], Immunité muqueuse et vaccination, Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), CHU Rouen, Normandie Université (NU), CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Centre Hospitalier Universitaire de Liège (CHU-Liège), Hospices Civils de Lyon (HCL), Hôpital Cochin [AP-HP], Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Service de Gastro-Entérologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Grenoble, Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hopital Saint-Louis [AP-HP] (AP-HP), CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), and This study was supported by Abbvie.

Subjects
Crohn's disease, Disability, Ulcerative colitis, Hepatology, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Fatigue, Inflammatory bowel disease, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background: In recent years, an increasing prevalence of obesity in inflammatory bowel disease (IBD) has been observed. However, only a few studies have focused on the impact of overweight and obesity on IBD-related disability.Aims: To identify the factors associated with obese and overweight patients with IBD, including IBD-related disability.Patients and methods: In this cross-sectional study, we included 1704 consecutive patients with IBD in 42 centres affiliated with the Groupe d'Etude Therapeutique des Affections Inflammatoires du tube Digestif (GETAID) using a 4-page questionnaire. Factors associated with obesity and overweight were assessed using univariate and multivariate analyses (odds ratios (ORs) are provided with 95% confidence intervals).Results: The prevalence rates of overweight and obesity were 24.1% and 12.2%, respectively. Multivariable analyses were stratified by age, sex, type of IBD, clinical remission and age at diagnosis of IBD. Overweight was significantly associated with male sex (OR = 0.52, 95% CI [0.39-0.68], p < 0.001), age (OR = 1.02, 95% CI [1.01-1.03], p < 0.001) and body image subscore (OR = 1.15, 95% CI [1.10-1.20], p < 0.001) (Table 2). Obesity was significantly associated with age (OR = 1.03, 95% CI [1.02-1.04], p < 0.001), joint pain subscore (OR = 1.08, 95% CI [1.02-1.14], p < 0.001) and body image subscore (OR = 1.25, 95% CI [1.19-1.32], p < 0.001) (Table 3).Conclusion: The increasing prevalence of overweight and obesity in patients with IBD is associated with age and poorer body image. A holistic approach to IBD patient care should be encouraged to improve IBD-related disability and to prevent rheumatological and cardiovascular complications.

Published
2023
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3. Adalimumab in biologic-naïve patients with Crohn’s disease after resolution of an intra-abdominal abscess: a prospective study from the GETAID

Author

Yoram Bouhnik, Guillaume Pineton de Chambrun, Jérôme Lambert, Maria Nachury, Philippe Seksik, Romain Altwegg, Lucine Vuitton, Carmen Stefanescu, Stéphane Nancey, Alexandre Aubourg, Mélanie Serrero, Jérôme Filippi, Kristell Desseaux, Stéphanie Viennot, Vered Abitbol, Madina Boualit, Arnaud Bourreille, Cyrielle Giletta, Anthony Buisson, Xavier Roblin, Nina Dib, Georgia Malamut, Aurélien Amiot, Mathurin Fumery, Edouard Louis, Yasmine Elgharabawy, Laurent Peyrin-Biroulet, Jacques Moreau, Xavier Treton, Charlotte Mailhat, Justine Pollet, Carole Martins, Guillaume Savoye, Noémie Tavernier, Jean-Yves Mary, Magali Zappa, Claire Painchart, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Hopital Saint-Louis [AP-HP] (AP-HP), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Gastro-Entérologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Nord [CHU - APHM], Centre Hospitalier Universitaire de Nice (CHU Nice), Université Paris Diderot - Paris 7 (UPD7), Université Sorbonne Paris Cité (USPC), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Gastro-entérologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), and Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie

Subjects
Crohn’s disease, surgery, Hepatology, adalimumab, Gastroenterology, abscess, anti-TNF, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background & aims: The management of intra-abdominal abscesses complicating Crohn's disease (CD) is challenging and surgery with delayed intestinal resection is often recommended. The aims of this study were to estimate the success rate of adalimumab (ADA) in CD patients with an intra-abdominal abscess resolved without surgery, and to identify predictive factors for success.Methods: A multicenter, prospective study was conducted in biologic-naïve CD patients with resolved intra-abdominal abscess treated with ADA with a two-year follow-up. The primary endpoint was ADA failure at W24 defined as a need for steroids after W12, intestinal resection, abscess recurrence, and clinical relapse. Secondary post-hoc endpoint was the long-term success defined as the survival without abscess relapse or intestinal resection at W104. The factors associated with ADA failure at W24 and W104 were identified using a logistic and a cox regression, respectively.Results: From April 2013 to December 2017, 190 patients from 27 GETAID centers were screened, and 117 were included in the analysis. Fifty-eight (50%) patients were male and the median age at baseline was 28 years. At W24, 87 (74%, 95%CI: 65.5-82.0, n=117) patients achieved ADA success. Among the 30 patients with ADA failure, 15 underwent surgery. At W104, the survival rate without abscess recurrence or surgery was 72·9% (95%CI: 62.1-79.8, n=109). Abscess drainage was significantly associated with ADA failure at W24 (OR=4.18; 95%CI: 1.06-16.5; p=0.043). Disease duration (HR=1.32, 95%CI: 1.09-1.59, p=0.008), abscess drainage (HR=5.59, 95%CI: 2.21-14.15, p=0.001), and inflammatory changes in mesenteric fat (HR=0.4, 95%CI: 0.17-0.94, p=0.046) were significantly associated with ADA failure at W104.Conclusion: Provided that the abscess was carefully managed before initiating medical treatment, this study showed the high efficacy of ADA in the short and long term in biologic-naïve patients with CD complicated by an intra-abdominal abscess.

Published
2023
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4. Prevalence of anti-TNF contraindications in Crohn’s disease: A cross-sectional survey from the GETAID

Author

Aurelien Amiot, Philippe Seksik, Jean-Marie Reimund, Maria Nachury, Romain Altwegg, Arnaud Bourreille, Stephanie Viennot, Mathurin Fumery, Xavier Roblin, Melanie Serrero, Matthieu Allez, Claire Painchart, Elise Chanteloup, Lucine Vuitton, Ginette Fotsing, Anthony Buisson, Baya Coulibaly, Stephane Nancey, Cyrielle Gilletta, Laurianne Plastaras, Vered Abitbol, Lucas Guillo, Marion Simon, Stephane Nahon, David Laharie, Laurent Peyrin-Biroulet, Guillaume Bouguen, Charlotte Gagniere, Pauline Wils, Yoram Bouhnik, Carmen Stefanescu, Xavier Treton, Carole Martins, Mathieu Uzzan, Emilie Del Tedesco, Laurent Beaugerie, Anne Bourrier, Cecilia Landmann, Julien Kirchgesner, Harry Sokol, Gilles Boschetti, Claire Gay, Pauline Danion, Bernard Flourié, Georgia Malamut, Benedicte Caron, Camille Zallot, Jean-Marc Gornet, Clotilde Baudry, Caroline Trang-Poisson, Medina Boualit, Lucile Boivineau, Pauline Riviere, Florian Poullenot, Benoit Coffin, Henri Duboc, Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), University Hospital of Montpellier, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Amiens-Picardie, Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Aix Marseille Université (AMU), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier [Valenciennes, Nord], Hôpital Saint-Joseph [Marseille], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Clermont-Ferrand, Centre Hospitalier Henri Duffaut (Avignon), Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CH Colmar, Hôpital Cochin [AP-HP], Institut Mutualiste de Montsouris (IMM), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, CHU Bordeaux [Bordeaux], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], This study was supported by an institutional grant by Takeda, CRHU Nancy, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Saint-Etienne, and CHU Toulouse [Toulouse]

Subjects
Crohn’s disease, Hepatology, Contraindications, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Inflammatory bowel disease, Anti-TNF, Cross-Sectional Studies, Treatment Outcome, Crohn Disease, Prevalence, Humans, Tumor Necrosis Factor Inhibitors, Ustekinumab, Contraindication
Abstract

International audience; BACKGROUND: The exact rate of contraindications to anti-TNF therapy and physician perspectives on treatment choices facing to anti-TNF contraindication, are poorly reported. METHODS: A two-week cross-sectional study was conducted in 31 centres. Physicians completed a questionnaire for a total of 1,314 consecutive outpatients with Crohn’s disease, assessing each patient’s potential contraindications to anti-TNF therapy, the choice of alternative therapy to anti-TNFs, and their preference in an unrestricted reimbursement setting. RESULTS: Among the 1,293 responses to the first item, 148 (11.5%) reported 32 absolute contraindications (2.5%) and 116 relative contraindications (9.0%) to anti-TNF therapy. When asked about their preference of alternative therapies in those cases with contraindications to anti-TNF, physicians chose ustekinumab and vedolizumab, 75.6% and 23.9%, respectively. In multivariable analysis, the choice of vedolizumab was the preferred choice for patients aged > 60 years with the L2 phenotype and the absence of perianal lesions. In a hypothetical setting of unrestricted reimbursement, anti-TNFs remained physicians’ preferred first-line biological therapy choice for 78.2%. CONCLUSION: Anti-TNF contraindications occurred in up to 11.5% of patients with Crohn’s disease. Physicians’ choices for alternative therapy to anti-TNF relied on ustekinumab in 75.6% and vedolizumab in 23.9% of these cases. This choice was driven mainly by phenotypical criteria and age.

Published
2022
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5. Patients’ real-world experience with inflammatory bowel disease: A cross-sectional survey in tertiary care centres from the GETAID group

Author

Maria Nachury, Yoram Bouhnik, Melanie Serrero, Jerome Filippi, Xavier Roblin, Julien Kirchgesner, Guillaume Bouguen, Denis Franchimont, Guillaume Savoye, Anthony Buisson, Edouard Louis, Stephane Nancey, Vered Abitbol, Jean-Marie Reimund, Olivier DeWit, Lucine Vuitton, Nicolas Matthieu, Laurent Peyrin-Biroulet, Cyrielle Gilletta, Sara Tadbiri, Matthieu Allez, Stephanie Viennot, Arnaud Bourreille, David Laharie, Aurelien Amiot, Charlotte Gagniere, Jenny Tannoury, Benjamin Pariente, Pauline Wils, Carmen Stefanescu, Xavier Treton, Xavier Hébuterne, Nadia Arab, Virginie Cluzeau, Emilie Del Tedesco, Laurent Beaugerie, Philippe Seksik, Anne Bourrier, Cecilia Landmann, Harry Sokol, Laurent Siproudhis, Marie DeWitte, Catherine Reenaers, Gilles Boschetti, Claire Gay, Pauline Danion, Bernard Flourié, Georgia Malamut, Benedicte Caron, Olivier DeWitt, Nicolas Mathieu, Sandie Pestour, Camille Zallot, Jean-Marc Gornet, Clotilde Baudry, Caroline Trang-Poisson, Nina Dib, Hedi Brixi, Guillaume Cadiot, Medina Boualit, Claire Painchart, Laurianne Plastaras, Romain Altwegg, Lucile Boivineau, Mathurin Fumery, Ludovic Caillo, Pauline Riviere, Florian Poullenot, Benoit Coffin, Henri Duboc, Stephane Nahon, Noemie Tavernier, Marion Simon, Baya Coulibaly, Morgane Amil, Duveau Nicolas, Sherine Khater, Mehdi Kaassis, Felix Goutorbe, Driffa Moussata, Laurence Picon, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM], CIC - Biotherapie - Marseille, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Pasteur [Nice] (CHU), Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire des biomolécules (LBM UMR 7203), Chimie Moléculaire de Paris Centre (FR 2769), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Département de Chimie - ENS Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), CHU Rouen, Normandie Université (NU), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Centre Hospitalier Universitaire de Liège (CHU-Liège), Service d'Hépatologie et de Gastroentérologie [Lyon], Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de Hautepierre [Strasbourg], Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC - Inserm U1113), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC)-Fédération de Médecine Translationelle de Strasbourg (FMTS), Cliniques Universitaires Saint-Luc [Bruxelles], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire [Grenoble] (CHU), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hopital Saint-Louis [AP-HP] (AP-HP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque - CHU de Bordeaux (Centre médico chirurgical Magellan), AbbVie, GETAID-patient experience study group: Aurelien Amiot , Sara Tadbiri , Charlotte Gagniere , Jenny Tannoury , Maria Nachury , Benjamin Pariente , Pauline Wils , Yoram Bouhnik , Carmen Stefanescu , Xavier Treton , Melanie Serrero , Jerome Filippi , Xavier Hébuterne , Nadia Arab , Virginie Cluzeau , Xavier Roblin , Emilie Del Tedesco , Laurent Beaugerie , Philippe Seksik , Anne Bourrier , Cecilia Landmann , Julien Kirchgesner , Harry Sokol , Guillaume Bouguen , Laurent Siproudhis , Marie DeWitte , Denis Franchimont , Guillaume Savoye , Anthony Buisson , Edouard Louis , Catherine Reenaers , Stephane Nancey , Gilles Boschetti , Claire Gay , Pauline Danion , Bernard Flourié , Vered Abitbol , Georgia Malamut , Jean-Marie Reimund , Benedicte Caron , Olivier DeWitt , Lucine Vuitton , Nicolas Mathieu , Sandie Pestour , Laurent Peyrin-Biroulet , Camille Zallot , Cyrielle Gilletta , Matthieu Allez , Jean-Marc Gornet , Clotilde Baudry , Stephanie Viennot , Arnaud Bourreille , Caroline Trang-Poisson , Nina Dib , Hedi Brixi , Guillaume Cadiot , Medina Boualit , Claire Painchart , Laurianne Plastaras , Romain Altwegg , Lucile Boivineau , Mathurin Fumery , Ludovic Caillo , David Laharie , Pauline Riviere , Florian Poullenot , Benoit Coffin , Henri Duboc , Stephane Nahon , Noemie Tavernier , Marion Simon , Baya Coulibaly , Morgane Amil , Duveau Nicolas , Sherine Khater , Mehdi Kaassis , Felix Goutorbe , Driffa Moussata , Laurence Picon, CHU Saint-Etienne, Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Département de Chimie - ENS Paris, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Chimie Moléculaire de Paris Centre (FR 2769), Institut de Chimie du CNRS (INC)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Autophagie infection et immunité - Autophagy Infection Immunity (APY), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Catholique de Louvain = Catholic University of Louvain (UCL), CHU Toulouse [Toulouse], CIC - Biotherapie - CHU Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Département de Chimie - ENS Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Crohn’s disease, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Cross-sectional study, [SDV]Life Sciences [q-bio], Disease, Patients experience, Inflammatory bowel disease, Tertiary care, digestive system, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Belgium, Physicians, Outpatients, medicine, Quantitative assessment, Humans, Adverse effect, Crohn's disease, Physician-Patient Relations, Hepatology, business.industry, Gastroenterology, Middle Aged, Patient Acceptance of Health Care, medicine.disease, Inflammatory Bowel Diseases, Ulcerative colitis, digestive system diseases, 3. Good health, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Family medicine, 030211 gastroenterology & hepatology, Female, France, Self Report, business
Abstract

International audience; BACKGROUND: Patients’ experience with healthcare professionals could influence their clinical outcomes. AIMS: To assess inflammatory bowel disease (IBD) patients’ experience with their disease, their treatment and their relationship with their physician. METHODS: A one-week cross-sectional study was conducted in 42 IBD centres. 2011 consecutive outpatients with IBD completed an anonymous self-report questionnaire assessing their experience with and knowledge of IBD. RESULTS: A quantitative assessment of the doctor-patient relationship revealed that patients’ knowledge of IBD and IBD treatment ranged from 7.4 to 8.3 out of 10. In addition to IBD physicians, other sources of information about IBD and current treatment mainly included the internet (80% and 63%, respectively) and general practitioners (61% and 54%). Knowledge about education programmes (28%) was poor, resulting in a lack of willingness to further use these resources (25%). Concerns about IBD treatment were raised in 76% of patients, mostly related to the fear of adverse events (47%) and a lack of efficacy (33%). The need of alternative healthcare professionals was reported by 89% of the sample. CONCLUSION: In a large cohort of patients, we highlighted gaps in the management of patients with IBD regarding the need for higher-quality information and the implementation of alternative healthcare professionals.

Published
2021
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6. Ustekinumab Serum Trough Levels May Identify Suboptimal Responders to Ustekinumab in Crohn’s Disease

Author

Nicolas Duveau, Benjamin Pariente, Claire Painchart, Thomas Lambin, Pierre Desreumaux, Clémentine Lauriot Dit Prevost, Maria Nachury, Myriam Labalette, Romain Gerard, Julien Branche, Medina Boualit, Pauline Wils, and Séverine Brabant

Subjects
Adult, Male, medicine.medical_specialty, Physiology, Trough (economics), Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Refractory, Reference Values, Internal medicine, Ustekinumab, medicine, Humans, Trough Concentration, Prospective Studies, Prospective cohort study, Crohn's disease, business.industry, Induction Chemotherapy, Middle Aged, Hepatology, medicine.disease, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Female, 030211 gastroenterology & hepatology, business, Biomarkers, medicine.drug
Abstract

The aim of this study was to evaluate the association between serum ustekinumab (UST) trough levels and response to induction and maintenance UST treatment in refractory Crohn’s Disease (CD) patients. We performed a prospective study including CD patients who received UST from September 2015 to January 2017. Patients received 90 mg of UST subcutaneously at weeks 0, 4, and 12, then every 8 weeks. Two cohorts of patients were analyzed: an induction cohort and a maintenance cohort. We evaluated clinical, biological, and imaging/endoscopic response to UST treatment. UST trough levels and anti-UST antibodies were dosed at weeks 12 and 28 in the induction cohort, and at a single time point in the maintenance cohort. Forty-nine patients were enrolled in the maintenance cohort. Mean concentrations of UST were 1.88 ± 1.40 µg/mL. UST trough levels were not significantly different in patients with or without clinical, biological, or imaging/endoscopic responses to UST treatment (p > 0.11). Twenty-three consecutive patients were included in the induction cohort. At week 12, mean UST concentrations were 1.45 ± 1.15 µg/mL. Patients with a biological response to UST treatment had significant higher serum UST trough concentration (median 1.72 µg/mL) than non-responders (median 0.56 µg/mL, p = 0.02). A UST trough level ≥ 1.10 µg/mL at week 12 was associated with a biological response to UST treatment at 6 months. UST trough levels were associated with a biological response at the end of the induction phase. In patients with low levels of UST, optimization treatment may be necessary to obtain a sustained response.

Published
2019
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