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103. Relevant Infections in Inflammatory Bowel Disease, and Their Relationship With Immunosuppressive Therapy and Their Effects on Disease Mortality

Author

Zabana, Yamile, primary, Rodríguez, Lorena, additional, Lobatón, Triana, additional, Gordillo, Jordi, additional, Montserrat, Antonia, additional, Mena, Raquel, additional, Beltrán, Belén, additional, Dotti, Marina, additional, Benitez, Olga, additional, Guardiola, Jordi, additional, Domènech, Eugeni, additional, Garcia-Planella, Esther, additional, Calvet, Xavier, additional, Piqueras, Marta, additional, Aceituno, Montserrat, additional, Fernández-Bañares, Fernando, additional, and Esteve, Maria, additional

Published
2019
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104. Inflammatory bowel disease integral care units: Evaluation of a nationwide quality certification programme. The GETECCU experience

Author

Barreiro‐de Acosta, Manuel, Gutiérrez, Ana, Zabana, Yamile, Beltrán, Belén, Calvet, Xavier, Chaparro, María, Domènech, Eugeni, Esteve, Maria, Panés, Julian, Gisbert, Javier P., and Nos, Pilar

Abstract

One of the most valued targets in inflammatory bowel disease (IBD) is for physicians to provide and patients to receive a high‐level quality of care. This study aimed to evaluate the implementation of a nationwide quality certification programme for IBD units. Identification of quality indicators (QI) for IBD Unit certification was based on Delphi methodology that selected 53 QI, which were subjected to a normalisation process. Selected QI were then used in the certification process. Coordinated by GETECCU, this process began with a consulting round and an audit drill followed by a formal audit carried out by an independent certifying agency. This audit involved the scrutiny of the selected QI in medical records. If 80%–90% compliance was achieved, the IBD unit audited received the qualification of “advanced”, and if it exceeded 90% the rating was “excellence”. Afterwards, an anonymous survey was conducted among certified units to assess satisfaction with the programme for IBD units. As of January 2021, 66 IBD units adhere to the nationwide certification programme. Among the 53 units already audited by January 2021, 31 achieved the certification of excellence, 20 the advanced certification, and two did not obtain the certification. The main survey results indicated high satisfaction with an average score of 8.5 out of 10. Certification of inflammatory bowel disease units by GETECCU is the largest nationwide certification programme for IBD units reported. More than 90% of IBD units adhered to the programme achieved the certification.

Published
2021
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105. Tratamiento del brote grave de colitis ulcerosa

Author

Aceituno Montserrat, Zabana Yamile, and Esteve Maria

Subjects
medicine.medical_specialty, Hepatology, Medical treatment, business.industry, musculoskeletal, neural, and ocular physiology, Disease progression, Gastroenterology, macromolecular substances, medicine.disease, Ulcerative colitis, Infliximab, Tratamiento farmacologico, nervous system, Internal medicine, Severity of illness, medicine, business, medicine.drug
Abstract

The treatment of severe ulcerative colitis remains a challenge for gastroenterologists. A not inconsiderable number of patients will experience severe flares throughout their lives and will require hospitalization. Mortality in severe ulcerative colitis is still high and consequently treatment must be aggressive, avoiding delays in rescue therapies or even surgery. The aim of this review was to describe the medical treatment of severe ulcerative colitis, highlighting recent therapeutic advances.

Published
2014

106. Diagnosis and natural history of preclinical and early inflammatory bowel disease.

Author

Rodríguez-Lago, Iago, Zabana, Yamile, and Acosta, Manuel Barreiro-de

Subjects
*INFLAMMATORY bowel diseases, *CROHN'S disease, *DIAGNOSIS, *C-reactive protein, *CALPROTECTIN
Abstract

Inflammatory bowel disease is a chronic and progressive disorder of the gastrointestinal tract. A relevant proportion of patients develop complicated lesions, defined as strictures, fistulas and/or abscesses already at diagnosis, and this proportion increases over time. The preclinical phase defines the period of time from the appearance of the first immune disturbances until the development of overt disease, and it may be present months to years before the diagnosis. Multiple biomarkers (e.g., C-reactive protein, interleukin-6, fecal calprotectin) and cellular mechanisms (e.g., complement cascade, lysosomes, innate immunity, and glycosaminoglycan metabolism) are already altered during this period. Research in this area allows the description of the initial immune disturbances that may identify potential targets and lead to the development of new drug therapies. During this period, different interventions in high-risk individuals, including drugs or environmental factors, will open the possibility of innovative strategies focused on the reduction of complications, or even prevention trials for inflammatory bowel disease. Here, we review the most relevant findings regarding the characteristics, prevalence and biomarkers associated with preclinical disease, along with their possible use in our future clinical practice. [ABSTRACT FROM AUTHOR]

Published
2020
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109. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients

Author

Barreiro-de Acosta, Manuel, primary, Marín-Jiménez, Ignacio, additional, Panadero, Abel, additional, Guardiola, Jordi, additional, Cañas, Mercedes, additional, Gobbo Montoya, Milena, additional, Modino, Yolanda, additional, Alcaín, Guillermo, additional, Bosca-Watts, Marta Maia, additional, Calvet, Xavier, additional, Casellas, Francesc, additional, Chaparro, María, additional, Fernández Salazar, Luis, additional, Ferreiro-Iglesias, Rocío, additional, Ginard, Daniel, additional, Iborra, Marisa, additional, Manceñido, Noemí, additional, Mañosa, Miriam, additional, Merino, Olga, additional, Rivero, Montserrat, additional, Roncero, Oscar, additional, Sempere, Laura, additional, Vega, Pablo, additional, Zabana, Yamile, additional, Mínguez, Miguel, additional, Nos, Pilar, additional, and Gisbert, Javier P., additional

Published
2018
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113. Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry

Author

Andújar, Xavier, Loras, Carme, González, Begoña, Socarras, Milena, Sanchiz, Vicente, Boscà, Maia, Domenech, Eugeni, Calafat, Margalida, Rodríguez, Esther, Sicilia, Beatriz, Calvet, Xavier, Barrio, Jesús, Guardiola, Jordi, Iglesias, Eva, Casanova, María José, Ber, Yolanda, Monfort, David, López-Sanromán, Antonio, Rodríguez-Lago, Iago, Bujanda, Luís, Márquez, Lucía, Martín-Arranz, María Dolores, Zabana, Yamile, Fernández-Bañares, Fernando, and Esteve, María

Abstract

Background: There is no information regarding the outcome of Crohn’s disease (CD) patients treated with endoscopic balloon dilation (EBD) in non-referral hospitals, nor on the efficacy of EBD in ulcerative colitis (UC). We report herein the results of the largest series published to date. Aim: To assess the efficacy and safety of EBD for inflammatory bowel disease (IBD) stenosis performed in 19 hospitals with different levels of complexity and to determine factors related to therapeutic success. Methods: We identified IBD patients undergoing EBD in the ENEIDA database. Efficacy of EBD was compared between CD and UC and between secondary and tertiary hospitals. Predictive factors of therapeutic success were assessed with multivariate analysis. Results: Four-hundred dilations (41.2% anastomotic) were performed in 187 IBD patients (13 UC/Indeterminate colitis). Technical and therapeutic success per dilation was achieved in 79.5% and 55.3%, respectively. Therapeutic success per patient was achieved in 78.1% of cases (median follow-up: 40 months) with 49.7% requiring more than one dilation. No differences related to either diagnosis or hospital complexity was found. Technical success [OR 4.12 (95%CI 2.4–7.1)] and not receiving anti-TNF at the time of dilation [OR 1.7 (95% CI 1.1–2.6)] were independently related to therapeutic success per dilation. A stricture length ≤ 2 cm [HR 2.43 (95% CI 1.11–5.31)] was a predictive factor of long-term success per patient. The rate of major complications was 1.3%. Conclusions: EBD can be performed with similar efficacy and safety in hospitals with differing levels of complexity and it might be a suitable treatment for UC with short stenosis. To achieve a technical success and the short length of the stenosis seem to be critical for long-term therapeutic success.

Published
2020
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114. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations

Author

Miehlke, Stephan, Guagnozzi, Danila, Zabana, Yamile, Tontini, Gian E, Fiehn, Anne-Marie Kanstrup, Wildt, Signe, Bohr, Johan, Bonderup, Ole, Bouma, Gerd, D’Amato, Mauro, Engel, Peter Johan Heiberg, Fernandez-Banares, Fernando, Macaigne, Gilles, Hjortswang, Henrik, Hultgren-Hörnquist, Elisabeth, Koulaouzidis, Anastasios, Kupcinskas, Jouzas, Landolfi, Stefania, Latella, Giovanni, Lucendo, Alfredo, Lyutakov, Ivan, Madisch, Ahmed, Magro, Fernando, Marlicz, Wojciech, Mihaly, Emese, Munck, Lars Kristian, Ostvik, Ann-Elisabeth, Patai, Árpád V, Penchev, Plamen, Skonieczna-Żydecka, Karolina, Verhaegh, Bas, and Münch, Andreas

Abstract

Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder.Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method.Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice.Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

Published
2024
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115. [Treatment of severe ulcerative colitis flares]

Author

Montserrat, Aceituno, Aceituno, Montserrat, Yamile, Zabana, Zabana, Yamile, Maria, Esteve, and Esteve, Maria

Subjects
Disease Progression, Humans, Colitis, Ulcerative, Severity of Illness Index, Algorithms, Forecasting
Abstract

The treatment of severe ulcerative colitis remains a challenge for gastroenterologists. A not inconsiderable number of patients will experience severe flares throughout their lives and will require hospitalization. Mortality in severe ulcerative colitis is still high and consequently treatment must be aggressive, avoiding delays in rescue therapies or even surgery. The aim of this review was to describe the medical treatment of severe ulcerative colitis, highlighting recent therapeutic advances.

Published
2014

117. Regional Specialisation of T Cell Subsets and Apoptosis in the Human Gut Mucosa: Differences Between Ileum and Colon in Healthy Intestine and Inflammatory Bowel Diseases

Author

Carrasco, Anna, primary, Fernández-Bañares, Fernando, additional, Pedrosa, Elisabet, additional, Salas, Antonio, additional, Loras, Carme, additional, Rosinach, Mercè, additional, Aceituno, Montserrat, additional, Andújar, Xavier, additional, Forné, Montserrat, additional, Zabana, Yamile, additional, and Esteve, Maria, additional

Published
2016
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120. Long-term outcome of patients wih distal ulcerative colitis and inflammation of the appendiceal orifice

Author

Lorenzo-Zúñiga García, Naves, Juan E., Marín, Laura, Mañosa, Míriam, Oller, Blanca, Moreno, Vicente, Zabana, Yamile, Boix, Jaume, Cabré, Eduard, and Domènech, Eugeni

Subjects
Treatment, Ulcerative colitis, 3207 Patología, 3205 Medicina Interna, Outcomes, Appendiceal, Prognosis
Abstract

Background & Aims: Skip inflammation of the appendiceal orifice has been described in distal UC (UC-IAO) but long-term clinical outcomes are poorly established. Our aim was to evaluate the long-term clinical outcomes of UC-IAO as compared to classic distal UC. Methods: Patients with UC-IAO were identified from the local IBD database. Disease outcome and therapeutic requirements during follow-up were accurately collected, and compared with a control group of patients with distal UC without periappendiceal involvement matched by disease extent (proctitis/distal), smoking habit, and date and age at diagnosis. Results: Fourteen UC patients were found to have UC-IAO, most of them with initial extent of UC limited to the rectum. All patients were initially managed with mesalazine administered orally (28.5%), topically (28.5%), or in combination (43%). After a median follow-up of 78 months (interquartile range - IQR 45-123) most UC-IAO patients were successfully managed with oral and/or topical aminosalycilates. Only one of them developed proximal disease progression. As compared to controls, no differences in clinical outcomes or therapeutic requirements were found. Conclusions: Patients with UC-IAO tend to present a mild course, with a low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy. CIBERehd of Fondo de Investigación Sanitaria of the Instituto de Salud Carlos III, from the Spanish Ministry of Health Medicina

Published
2011

122. Sa1117 Extracolonic Neoplasias in Inflammatory Bowel Disease Patients: Data From the GETECCU Eneida Registry

Author

Chaparro, Maria, primary, Cantero, Jose Manuel Benitez, additional, García, Alicia López, additional, Juan, Alba Juan, additional, Guardiola, Jordi, additional, Minguez, Miguel, additional, Calvet, Xavier, additional, Marquez, Lucía, additional, Salazar, Luis Fernandez, additional, Bujanda, Luis, additional, López-SanRomán, Antonio, additional, Zabana, Yamile, additional, Lorente, Rufo, additional, Barrio, Jesus, additional, Hinojosa, Joaquin, additional, Iborra, Marisa, additional, Cajal, Manuel Domínguez, additional, Van Domselaar, Manuel, additional, García-Sepulcre, Mariana Fe, additional, Gomollon, Fernando, additional, Piqueras, Marta, additional, Martínez, Guillermo Alcaín, additional, Ramas, Mercedes, additional, García-Sánchez, Valle, additional, Panes, Julian, additional, Domenech, Eugeni, additional, and Gisbert, Javier P., additional

Published
2015
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123. Portal hypertension in patients with inflammatory bowel disease | Hipertensión portal en pacientes con enfermedad inflamatoria intestinal

Author

Leal-Valdivieso, Carles, Naves, Juan E., Mañosa, Miriam, Zabana, Yamile, Cabré, Eduard, and Domènech, Eugeni

Subjects
digestive system, digestive system diseases
Abstract

Portal hypertension (PH) is a complication that may occur in patients with inflammatory bowel disease (IBD). In these patients, the etiology of PH may not be alcoholic or viral cirrhosis (which cause 90% of cases in the general population). Consequently, etiologic study of PH in patients with IBD should always include a wide spectrum of possibilities. Moreover, the development of PH in IBD patients often requires a distinct therapeutic approach to IBD (both medical and surgical) as PH may be a contraindication for some drugs and is a risk factor for surgical morbidity and mortality. We present the cases of two patients with IBD who developed PH and review the most likely causes of PH in IBD, as well as preventive and therapeutic strategies. © 2009 Elsevier España, S.L.

Published
2010

124. Sa1223 Phenotypic Characteristics and Use of Therapeutic Resources in Elderly-Onset Inflammatory Bowel Disease: A Multicentre, Case-Control Study

Author

Mañosa, Míriam, primary, Calafat, Margalida, additional, de Francisco, Ruth, additional, Caparrós, Carmen García, additional, Casanova, María José, additional, Huelín, Patricia, additional, Calvo, Marta, additional, Salazar, Luis Fernandez, additional, Minguez, Miguel, additional, Ruiz-Cerulla, Alexandra, additional, Zabana, Yamile, additional, Bastida, Guillermo, additional, Hinojosa, Joaquin, additional, Marquez, Lucía, additional, Acosta, Manuel Barreiro-de, additional, Calvet, Xavier, additional, Monfort, David, additional, Gómez, Rosario, additional, Rodríguez, Esther, additional, Huguet, José María, additional, Rojas-Feria, Maria, additional, Hervias, Daniel, additional, Atienza, Ramón, additional, Busquets, David, additional, Zapata, Eva, additional, Dueñas-Sadornil, Carmen, additional, Charro, Mara, additional, Martínez-Cerezo, Francesc J., additional, Plaza, Rocío, additional, Morón, Juan María Vázquez, additional, Gisbert, Javier P., additional, Cabré, Eduard, additional, and Domenech, Eugeni, additional

Published
2014
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136. S1035 The Risk of Severe Crohn's Disease: Validation of a Clinical Prediction Rule

Author

Bastida, Guillermo, primary, Merino, Olga, additional, Aguas, Mariam, additional, Barreiro, Manuel, additional, Zabana, Yamile, additional, Ginard, Daniel, additional, Ceballos, Daniel, additional, Huguet, Jose María, additional, Muñoz, Fernando, additional, Garcia, Valle, additional, Catalán, Ignacio, additional, Lucendo, Alfredo J., additional, de la Coba, Cristobal, additional, Mante, Xavier Aldeguer, additional, Palau, Antonio, additional, and Loras, Carme, additional

Published
2009
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137. Tuberculous chemoprophylaxis requirements and safety in inflammatory bowel disease patients prior to anti-TNF therapy

Author

Zabana, Yamile, primary, Domènech, Eugeni, additional, San Román, Antonio López, additional, Beltrán, Belén, additional, Cabriada, José Luis, additional, Saro, Cristina, additional, Araméndiz, Robert, additional, Ginard, Daniel, additional, Hinojosa, Joaquín, additional, Gisbert, Javier P., additional, Mañosa, Míriam, additional, Cabré, Eduard, additional, and Gassull, Miquel A., additional

Published
2008
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138. Long-term Methotrexate for Crohn's Disease

Author

Domènech, Eugeni, primary, Mañosa, Míriam, additional, Navarro, Mercè, additional, Masnou, Helena, additional, Garcia-Planella, Esther, additional, Zabana, Yamile, additional, Cabré, Eduard, additional, and Gassull, Miquel A., additional

Published
2008
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143. Need for therapeutic escalation in patients with refractory ulcerative proctitis: Results from the PROCU study of the ENEIDA registry.

Author

Ferreiro‐Iglesias, Rocío, Porto Silva, Sol, Marín, Sandra, Casanova, María José, Mañosa, Míriam, González‐Muñoza, Carlos, de Francisco, Ruth, Caballol, Berta, Arias, Lara, Piqueras, Marta, Zabana, Yamile, Rivero, Montserrat, Calvet, Xavier, Mesonero, Francisco, Varela Trastoy, Pilar, Busta Nistal, Reyes, Gómez Perosanz, Raquel, Vega, Pablo, Gonzalez‐Vivo, Maria, and Iborra, Marisa

Subjects
*CLINICAL trials, *ULCERATIVE colitis, *RANDOMIZED controlled trials, *IMMUNOSUPPRESSIVE agents, *BIOLOGICALS
Abstract

Summary: Background: Ulcerative proctitis (UP) can have a milder, less aggressive course than left‐sided colitis or extensive colitis. Therefore, immunosuppressants tend to be used less in patients with this condition. Evidence, however, is scarce because these patients are excluded from randomised controlled clinical trials. Our aim was to describe the characteristics of patients with refractory UP and their disease‐related complications, and to identify the need for immunosuppressive therapies. Methods: We identified patients with UP from the prospective ENEIDA registry sponsored by the GETECCU. We evaluated socio‐demographic data and complications associated with immunosuppression. We defined immunosuppression as the use of immunomodulators, biologics and/or small molecules. We used logistic regression to identify factors associated with immunosuppressive therapy. Results: From a total of 34,716 patients with ulcerative colitis, we identified 6281 (18.1%) with UP; mean ± SD age 53 ± 15 years, average disease duration of 12 ± 9 years. Immunosuppression was prescribed in 11% of patients, 4.2% needed one biologic agent and 1% needed two; 2% of patients required hospitalisation, and 0.5% underwent panproctocolectomy or subtotal colectomy. We identified 0.2% colorectal tumours and 5% extracolonic tumours. Patients with polyarthritis (OR 3.56, 95% CI 1.86–6.69; p < 0.001) required immunosuppressants. Conclusions: Among patients with refractory UP, 11% required immunosuppressant therapy, and 4.2% required at least one biologic agent. [ABSTRACT FROM AUTHOR]

Published
2024
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144. Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa sobre la importancia, el cribado y la vacunación en pacientes con enfermedad inflamatoria intestinal

Author

Ferreiro-Iglesias, Rocío, Piqueras, Marta, Ricart, Elena, Sempere Robles, Laura, Roca Andreu, Mariona, Martín de Carpi, Javier, Benítez, Olga, Zabana, Yamile, Mañosa, Míriam, Rodríguez Moranta, Francisco, and Barreiro-de Acosta, Manuel

Abstract

Los pacientes con enfermedad inflamatoria intestinal (EII) pueden requerir diferentes tratamientos inmunosupresores a lo largo del curso de su enfermedad. Por ello, es fundamental evaluar el estado de inmunización en el momento del diagnóstico o, si no es posible, siempre antes de iniciar un tratamiento inmunosupresor, y administrar las vacunas apropiadas.

Published
2022
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145. SARS-CoV-2 vaccine acceptance among gastroenterologists and inflammatory bowel disease patients: VACUNEII project

Author

Ferreiro-Iglesias, Rocío, Hernández-Camba, Alejandro, Labajos, Ruth Serrano, Rodríguez-Lago, Iago, Zabana, Yamile, and Acosta, Manuel Barreiro-de

Abstract

Introduction: Several vaccines against SARS-CoV-2 are currently in use and are recommended in inflammatory bowel disease (IBD) patients. Data are scarce about the gastroenterologists and IBD patient’s acceptance of SARS-CoV-2 vaccines. The aim of the study was to evaluate the intention to get vaccination with SARS-CoV-2 vaccine among IBD patients from gastroenterologists and patient’s perspective.

Published
2021
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146. Correction to: Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry

Author

Andújar, Xavier, Loras, Carme, González, Begoña, Socarras, Milena, Sanchiz, Vicente, Boscà, Maia, Domenech, Eugeni, Calafat, Margalida, Rodríguez, Esther, Sicilia, Beatriz, Calvet, Xavier, Barrio, Jesús, Guardiola, Jordi, Iglesias, Eva, Casanova, María José, Ber, Yolanda, Monfort, David, López-Sanromán, Antonio, Rodríguez-Lago, Iago, Bujanda, Luís, Márquez, Lucía, Martín-Arranz, María Dolores, Zabana, Yamile, Fernández-Bañares, Fernando, and Esteve, María

Abstract

Javier P. Gisbert was listed incorrectly as Javier Pérez-Gisbert.

Published
2020
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148. Safety and Effectiveness of Vedolizumab and Ustekinumab in Elderly Patients with Inflammatory Bowel Disease: A Real-Life Multicentric Cohort Study.

Author

Holvoet, Tom, Truyens, Marie, De Galan, Cara, Peeters, Harald, Gismero, Francisco Mesonero, Elorza, Ainara, Torres, Paola, Vandermeulen, Liv, Jauregui-Amezaga, Aranzazu, Ferreiro-Iglesias, Rocio, Zabana, Yamile, Reverter, Laia Peries, Geldof, Jeroen, and Lobatón, Triana

Subjects
*INFLAMMATORY bowel diseases, *OLDER patients, *VEDOLIZUMAB, *COHORT analysis, *OLDER people
Abstract

Background: Data on ustekinumab and vedolizumab in the elderly inflammatory bowel disease (IBD) population are limited. The aim of the current study was to assess the safety and effectiveness of both in an elderly real-life population. Methods: A multicentric retrospective study was performed on IBD patients who started vedolizumab or ustekinumab between 2010 and 2020. Clinical and endoscopic remission rates and (serious) adverse events (AE) were assessed. Results: A total of 911 IBD patients were included, with 171 (19%) aged above 60 (111 VDZ, 60 UST). Elderly patients treated with vedolizumab or ustekinumab had an increased risk for non-IBD hospitalization (10.5% vs. 5.7%, p = 0.021) and malignancy (2.3% vs. 0.5%, p = 0.045) compared to the younger population. Corticosteroid-free clinical (50% vs. 44%; p = 0.201) and endoscopic remission rates (47.9% vs. 31%, p = 0.07) at 1 year were similar. Comparing vedolizumab to ustekinumab in the elderly population, corticosteroid-free (47.9% vs. 31%, p = 0.061) and endoscopic remission rates (66.7% vs. 64.4%, p = 0.981) were similar. Vedolizumab- and ustekinumab-treated patients had comparable infection rates (13.5% vs. 10.0%, p = 0.504), IBD flare-ups (4.5% vs. 5%, p = 1.000), the occurrence of new EIMs (13.5% vs. 10%, p = 0.504), a risk of intestinal surgery (5.4% vs. 6.7%, p = 0.742), malignancy (1.8% vs. 3.3%, p = 0.613), hospitalization (9.9% vs. 11.7%, p = 0.721), and mortality (0.9% vs. 1.7%, p = 1.000). AE risk was associated only with corticosteroid use. Conclusions: Ustekinumab and vedolizumab show comparable effectiveness and safety in the elderly IBD population. Elderly IBD patients have an increased risk for non-IBD hospitalizations and malignancy compared to the younger IBD population, with corticosteroid use as the main risk factor. [ABSTRACT FROM AUTHOR]

Published
2024
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149. Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

Author

García, M. J., Rivero, M., Miranda-Bautista, J., Bastón-Rey, I., Mesonero, F., Leo-Carnerero, E., Casas-Deza, D., Cagigas Fernández, C., Martin-Cardona, A., El Hajra, I., Hernández-Aretxabaleta, N., Pérez-Martínez, I., Fuentes-Valenzuela, E., Jiménez, N., Rubin de Célix, C., Gutiérrez, A., Suárez Ferrer, C., Huguet, J. M., Fernández-Clotet, A., González-Vivó, M., Del Val, B., Castro-Poceiro, J., Melcarne, L., Dueñas, C., Izquierdo, M., Monfort, D., Bouhmidi, A., Ramírez de la Piscina, P., Romero, E., Molina, G., Zorrilla, J., Calvino-Suárez, C., Sánchez, E., Núñez, A., Sierra, O., Castro, B., Zabana, Y., González-Partida, I., De la Maza, S., Castaño, A., Nájera-Muñoz, R., Sánchez-Guillén, L., Riat Castro, M., Rueda, J. L., Benítez, J. M., Delgado-Guillena, P., Tardillo, C., Peña, E., Frago-Larramona, S., Rodríguez-Grau. M. C., Plaza, R., Pérez-Galindo, P., Martínez-Cadilla, J., Menchén, L., Barreiro-De Acosta, M., Sánchez-Aldehuelo, R., De la Cruz, M. D., Lamuela, L. J., Marín, I., Nieto-García, L., López San Román, A., Herrera, J. M., Chaparro, M., Gisbert, J. P., Young Group of GETECCU, [García MJ, Rivero M] Gastroenterology Department, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain. [Miranda-Bautista J] Gastroenterology Department, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Departamento de Medicina, Universidad Complutense, Madrid, Spain. [Bastón-Rey I] Gastroenterology Department, Hospital Universitario Clínico de Santiago, Santiago de Compostela, Spain. [Mesonero F] Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. [Leo-Carnerero E] Gastroenterology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Delgado-Guillena P] Gastroenterology Department, Hospital General de Granollers, Granollers, Spain, Hospital General de Granollers, [Jose Garcia, Maria] Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Gastroenterol Dept, Santander 37008, Spain, [Rivero, Montserrat] Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Gastroenterol Dept, Santander 37008, Spain, [Castro, Beatriz] Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Gastroenterol Dept, Santander 37008, Spain, [Miranda-Bautista, Jose] Univ Complutense, Hosp Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Gastroenterol Dept, Madrid 28009, Spain, [Menchen, Luis] Univ Complutense, Hosp Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Gastroenterol Dept, Madrid 28009, Spain, [Marin, Ignacio] Univ Complutense, Hosp Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Gastroenterol Dept, Madrid 28009, Spain, [Miranda-Bautista, Jose] Univ Complutense, Dept Med, Madrid 28009, Spain, [Menchen, Luis] Univ Complutense, Dept Med, Madrid 28009, Spain, [Marin, Ignacio] Univ Complutense, Dept Med, Madrid 28009, Spain, [Baston-Rey, Iria] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain, [Calvino-Suarez, Cristina] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain, [Barreiro-De Acosta, Manuel] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain, [Nieto-Garcia, Laura] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain, [Mesonero, Francisco] Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain, [Sanchez, Eugenia] Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain, [Sanchez-Aldehuelo, Ruben] Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain, [Lopez-San Roman, Antonio] Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain, [Leo-Carnerero, Eduardo] Hosp Univ Virgen del Rocio, Gastroenterol Dept, Seville 41013, Spain, [Nunez, Andrea] Hosp Univ Virgen del Rocio, Gastroenterol Dept, Seville 41013, Spain, [Dolores De la Cruz, Maria] Hosp Univ Virgen del Rocio, Gastroenterol Dept, Seville 41013, Spain, [Manuel Herrera, Jose] Hosp Univ Virgen del Rocio, Gastroenterol Dept, Seville 41013, Spain, [Casas-Deza, Diego] Hosp Univ Miguel Servet, Inst Invest Sanitaria Aragon IISA, Gastroenterol Dept, Zaragoza 50009, Spain, [Sierra, Olivia] Hosp Univ Miguel Servet, Inst Invest Sanitaria Aragon IISA, Gastroenterol Dept, Zaragoza 50009, Spain, [Javier Lamuela, Luis] Hosp Univ Miguel Servet, Inst Invest Sanitaria Aragon IISA, Gastroenterol Dept, Zaragoza 50009, Spain, [Cagigas Fernandez, Carmen] Hosp Univ Marques de Valdecilla, Dept Gen & Digest Surg, Colorectal Unit, Santander 39008, Spain, [Martin-Cardona, Albert] Hosp Univ Mutua Terrassa, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Terrassa 08221, Spain, [Zabana, Yamile] Hosp Univ Mutua Terrassa, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Terrassa 08221, Spain, [El Hajra, Ismael] Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda 28220, Spain, [Gonzalez-Partida, Irene] Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda 28220, Spain, [Hernandez-Aretxabaleta, Nerea] Hosp Univ Basurto, Gastroenterol Dept, Bilbao 48013, Spain, [De la Maza, Saioa] Hosp Univ Basurto, Gastroenterol Dept, Bilbao 48013, Spain, [Perez-Martinez, Isabel] Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA 33, Dept Gastroenterol, Oviedo 33011, Spain, [Castano, Andres] Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA 33, Dept Gastroenterol, Oviedo 33011, Spain, [Fuentes-Valenzuela, Esteban] Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid 47012, Spain, [Najera-Munoz, Rodrigo] Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid 47012, Spain, [Jimenez, Nuria] Hosp Gen Univ Elche, Gastroenterol Dept, Alicante 03203, Spain, [Rubin de Celix, Cristina] Univ Autonoma Madrid UAM, Gastroenterol Dept, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP,Ctr Invest, Madrid 28006, Spain, [Castro, Micaela Riat] Univ Autonoma Madrid UAM, Gastroenterol Dept, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP,Ctr Invest, Madrid 28006, Spain, [Chaparro, Maria] Univ Autonoma Madrid UAM, Gastroenterol Dept, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP,Ctr Invest, Madrid 28006, Spain, [Gisbert, Javier P.] Univ Autonoma Madrid UAM, Gastroenterol Dept, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP,Ctr Invest, Madrid 28006, Spain, [Gutierrez, Ana] Hosp Gen Alicante, Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante 03010, Spain, [Suarez Ferrer, Cristina] Hosp Univ La Paz, Gastroenterol Dept, Madrid 28046, Spain, [Luis Rueda, Jose] Hosp Univ La Paz, Gastroenterol Dept, Madrid 28046, Spain, [Maria Huguet, Jose] Hosp Gen Univ Valencia, Gastroenterol Dept, Valencia 46014, Spain, [Fernandez-Clotet, Agnes] Hosp Clin Barcelona, Gastroenterol Dept, Barcelona 08036, Spain, [Gonzalez-Vivo, Maria] Hosp del Mar, Gastroenterol Dept, Barcelona 08003, Spain, [Del Val, Blanca] Hosp Rafael Mendez, Gastroenterol Dept, Lorca 30817, Spain, [Castro-Poceiro, Jesus] Hosp St Joan Despi Moises Broggi, Gastroenterol Dept, Barcelona 08970, Spain, [Melcarne, Luigi] Hosp Univ Parc Tauli, Gastroenterol Dept, Sabadell, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona 08208, Spain, [Duenas, Carmen] Hosp Univ Caceres, Gastroenterol Dept, Caceres 10003, Spain, [Izquierdo, Marta] Hosp Univ Cabuenes, Gastroenterol Dept, Gijon 33203, Spain, [Monfort, David] Consorcio Sanitario Terrasa, Gastroenterol Dept, Barcelona 08227, Spain, [Bouhmidi, Abdel] Hosp Santa Barbara, Gastroenterol Dept, Puertollano 13500, Spain, [Ramirez De la Piscina, Patricia] Hosp Univ Vitoria Gasteiz, Gastroenterol Dept, Vitoria 01002, Spain, [Romero, Eva] Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia 46010, Spain, [Molina, Gema] Hosp Arquitecto Marcide, Gastroenterol Dept, Ferrol 15405, Spain, [Zorrilla, Jaime] Hosp Univ Gregorio Maranon, Dept Colorectal & Gastrointestinal Surg, Madrid 28009, Spain, [Sanchez-Guillen, Luis] Hosp Gen Univ Elche, Dept Colorectal & Gastrointestinal Surg, Alicante 03203, Spain, [Manuel Benitez, Jose] Hosp Reina Sofia, Gastroenterol Dept, IMIBIC, Cordoba 14004, Spain, [Delgado-Guillena, Pedro] Hosp Gen Granollers, Gastroenterol Dept, Granollers 08042, Spain, [Tardillo, Carlos] Hosp Nuestra Sanora de la Candelaria, Gastroenterol Dept, Tenerife 38010, Spain, [Pena, Elena] Hosp Royo Villanova, Gastroenterol Dept, Zaragoza 50007, Spain, [Frago-Larramona, Santiago] Complejo Hosp Soria, Gastroenterol Dept, Soria 42005, Spain, [Carmen Rodriguez-Grau, Maria] Hosp Univ Henares, Gastroenterol Dept, Coslada 28002, Spain, [Plaza, Rocio] Hosp Univ Infanta Leonor, Gastroenterol Dept, Madrid 28031, Spain, [Perez-Galindo, Pablo] Complejo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra 36071, Spain, [Martinez-Cadilla, Jesus] Hosp Alvaro Cunqueiro Vigo, Gastroenterol Dept, Vigo 36312, Spain, and Spanish Working Group in Crohn's Disease and Ulcerative Colitis (GETECCU)

Subjects
Gastroenterología y hepatología, Crohn’s disease, vedolizumab, medicine.medical_specialty, Crohns-disease, Cirurgia - Complicacions, Surgical complications, Productes biològics, Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease [DISEASES], Outcomes, Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications [DISEASES], Crohn, Malaltia de, Lower risk, Inflammatory bowel disease, Article, ustekinumab, Vedolizumab, surgery, inflammatory bowel disease, Internal medicine, Ustekinumab, postoperative complications, Medicine, Risk factor, ulcerative colitis, Crohn's disease, preoperative therapy, business.industry, Postoperative infectious complications, Retrospective cohort study, General Medicine, anti-TNF, Metaanalysis, medicine.disease, Resection, mezclas complejas::productos biológicos [COMPUESTOS QUÍMICOS Y DROGAS], Ulcerative colitis, afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias [ENFERMEDADES], Gastrointestinal surgery, enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn [ENFERMEDADES], Risk-factors, Ulcerative-colitis, Preoperative steroid use, Complex Mixtures::Biological Products [CHEMICALS AND DRUGS], business, medicine.drug
Abstract

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5, 95% CI: 1.2–2.0), urgent surgery (OR: 1.6, 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5, 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8, 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2, 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5, 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.

Published
2021

150. Long-term Outcome of Patients with Distal Ulcerative Colitis and Inflammation of the Appendiceal Orifice.

Author

Naves, Juan E., Lorenzo-Zúñiga, Vicente, Marín, Laura, Mañosa, Míriam, Oller, Blanca, Moreno, Vicente, Zabana, Yamile, Boix, Jaume, Cabré, Eduard, and Domènech, Eugeni

Subjects
*PROGNOSIS, *ULCERATIVE colitis, *INFLAMMATION, *SMOKING, *DISEASE progression, *COLECTOMY, *PATIENTS
Abstract

Background & Aims: Skip inflammation of the appendiceal orifice has been described in distal UC (UCIAO) but long-term clinical outcomes are poorly established. Our aim was to evaluate the long-term clinical outcomes of UC-IAO as compared to classic distal UC. Methods: Patients with UC-IAO were identified from the local IBD database. Disease outcome and therapeutic requirements during followup were accurately collected, and compared with a control group of patients with distal UC without periappendiceal involvement matched by disease extent (proctitis/distal), smoking habit, and date and age at diagnosis. Results: Fourteen UC patients were found to have UC-IAO, most of them with initial extent of UC limited to the rectum. All patients were initially managed with mesalazine administered orally (28.5%), topically (28.5%), or in combination (43%). After a median follow-up of 78 months (interquartile range - IQR 45-123) most UC-IAO patients were successfully managed with oral and/or topical aminosalycilates. Only one of them developed proximal disease progression. As compared to controls, no differences in clinical outcomes or therapeutic requirements were found. Conclusions: Patients with UC-IAO tend to present a mild course, with a low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy. [ABSTRACT FROM AUTHOR]

Published
2011

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