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1. Effectiveness and safety of azathioprine for inflammatory pouch disorders: results from the RESERVO study of GETECCU

Author

Francisco Mesonero, Yamile Zabana, Agnès Fernández-Clotet, Eduardo Leo-Carnerero, Berta Caballol, Andrea Núñez-Ortiz, María José García, Federico Bertoletti, Alejandro Mínguez, Gerard Suris, Begoña Casis, Rocío Ferreiro-Iglesias, Margalida Calafat, Itxaso Jiménez, José Miranda-Bautista, Luis Javier Lamuela, Ingrid Fajardo, Leyanira Torrealba, Rodrigo Nájera, Rosa María Sáiz-Chumillas, Irene González, Miren Vicuña, Natalia García-Morales, Ana Gutiérrez, Alicia López-García, José Manuel Benítez, Cristina Rubín de Célix, Coral Tejido, Eduard Brunet, Alejandro Hernández-Camba, Cristina Suárez, Iago Rodríguez-Lago, Marta Piqueras, Andrés Castaño, Laura Ramos, Ana Sobrino, María Carmen Rodríguez-Grau, Alfonso Elosua, Miguel Montoro, Ruth Baltar, José María Huguet, Benito Hermida, Antonio Caballero-Mateos, Luis Sánchez-Guillén, Abdel Bouhmidi, Ramón Pajares, Iria Baston-Rey, Antonio López-Sanromán, Agustin Albillos, and Manuel Barreiro-de Acosta

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders. Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders. Design: This was a retrospective and multicentre study. Methods: We included patients diagnosed with inflammatory pouch disorders treated with azathioprine in monotherapy. Effectiveness was evaluated at 1 year and in the long term based on normalization of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or any improvement in these symptoms (clinical response). Endoscopic response was evaluated using the Pouchitis Disease Activity Index (PDAI). Results: In all, 63 patients were included [54% males; median age, 49 (28–77) years]. The therapy was used to treat pouchitis ( n = 37) or Crohn’s disease of the pouch ( n = 26). The rate of clinical response, remission and non-response at 12 months were 52%, 30% and 18%, respectively. After a median follow-up of 23 months (interquartile range 11–55), 19 patients (30%) were in clinical remission, and 45 (66%) stopped therapy. Endoscopic changes were evaluated in 19 cases. PDAI score decreased from 3 (range 2–4) to 1 (range 0–3). In all, 21 patients (33%) presented adverse events and 16 (25%) needed to stop therapy. Conclusion: Azathioprine may be effective in the long term for the treatment of inflammatory pouch disorders and could be included as a therapeutic option.

Published
2024
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2. The EPAGE guidelines are not an effective strategy for managing colonoscopies during the COVID-19 pandemic☆

Author

Lorena Rodríguez-Alonso, Francisco Rodríguez-Moranta, Sandra Maisterra, Josep M. Botargues, Ana Berrozpe, Alexandra Ruíz-Cerulla, Gerard Suris, Blau Camps, Joan B. Gornals, and Jordi Guardiola

Subjects
Immunologic faecal occult blood test, Prioritization, Test de sangre oculta en heces, Priorización, EPAGE, Original Article, EPAGE guidelines, Colonoscopia, General Medicine, Colonoscopy, Suitability, Adecuación
Abstract

Introduction The pandemic caused by the SARS-CoV-2 virus has had a serious impact on the functioning of gastrointestinal endoscopy Units. The Asociación Española de Gastroenterología [Spanish Association of Gastroenterology] (AEG) and the Sociedad Española de Endoscopia Digestiva [Spanish Association of Gastrointestinal Endoscopy] (SEED) have proposed the EPAGE guidelines for managing postponed colonoscopies. Objective To evaluate the EPAGE guidelines as a management tool compared to the immunologic faecal occult blood test (iFOBT) and compared to risk score (RS) that combines age, sex and the iFOBT for the detection of colorectal cancer (CRC) and significant bowel disease (SBD). Methods A prospective, single-centre study enrolling 743 symptomatic patients referred for a diagnostic colonoscopy. Each order was classified according to the EPAGE guidelines as appropriate, indeterminate or inappropriate. Patients underwent an iFOBT and had their RS calculated. Results The iFOBT (P

Published
2022

3. Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

Author

Yamile, Zabana, Ignacio, Marín-Jiménez, Iago, Rodríguez-Lago, Isabel, Vera, María Dolores, Martín-Arranz, Iván, Guerra, Javier, P Gisbert, Francisco, Mesonero, Olga, Benítez, Carlos, Taxonera, Ángel, Ponferrada-Díaz, Marta, Piqueras, Alfredo, J Lucendo, Berta, Caballol, Míriam, Mañosa, Pilar, Martínez-Montiel, Maia, Bosca-Watts, Jordi, Gordillo, Luis, Bujanda, Noemí, Manceñido, Teresa, Martínez-Pérez, Alicia, López, Cristina, Rodríguez-Gutiérrez, Santiago, García-López, Pablo, Vega, Montserrat, Rivero, Luigi, Melcarne, María, Calvo, Marisa, Iborra, Manuel, Barreiro de Acosta, Beatriz, Sicilia, Jesús, Barrio, José Lázaro, Pérez Calle, David, Busquets, Isabel, Pérez-Martínez, Mercè, Navarro-Llavat, Vicent, Hernández, Federico, Argüelles-Arias, Fernando, Ramírez Esteso, Susana, Meijide, Laura, Ramos, Fernando, Gomollón, Fernando, Muñoz, Gerard, Suris, Jone, Ortiz de Zarate, José María, Huguet, Jordina, Llaó, Mariana Fe, García-Sepulcre, Mónica, Sierra, Miguel, Durà, Sandra, Estrecha, Ana, Fuentes Coronel, Esther, Hinojosa, Lorenzo, Olivan, Eva, Iglesias, Ana, Gutiérrez, Pilar, Varela, Núria, Rull, Pau, Gilabert, Alejandro, Hernández-Camba, Alicia, Brotons, Daniel, Ginard, Eva, Sesé, Daniel, Carpio, Montserrat, Aceituno, José Luis, Cabriada, Yago, González-Lama, Laura, Jiménez, María, Chaparro, Antonio, López-San Román, Cristina, Alba, Rocío, Plaza-Santos, Raquel, Mena, Sonsoles, Tamarit-Sebastián, Elena, Ricart, Margalida, Calafat, Sonsoles, Olivares, Pablo, Navarro, Federico, Bertoletti, Horacio, Alonso-Galán, Ramón, Pajares, Pablo, Olcina, Pamela, Manzano, Eugeni, Domènech, Maria, Esteve, On Behalf Of The Eneida Registry Of Geteccu, Universidad de Sevilla. Departamento de Medicina, Instituto de Salud Carlos III, FEDER (Fondo Europeo de Desarrollo Regional), [Zabana Y] Hospital Universitari Mútua Terrassa, Terrassa, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. [Marín-Jiménez I] Hospital Gregorio Marañón, Madrid, Spain. [Rodríguez-Lago I] Gastroenterology Department, Hospital Universitario de Galdakao, Galdakao, Spain. Biocruces Bizkaia Health Research Institute, Galdakao, Spain. [Vera I] Hospital Universitario Puerta de Hierro, Majadahonda, Spain. [Martín-Arranz MD] Hospital Universitario La Paz, Madrid, Spain. [Guerra I] Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPaz), Madrid, Spain. [Piqueras M, Mena R] Servei de Digestologia, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain, and Consorci Sanitari de Terrassa

Subjects
COVID-19, SARS-CoV-2, inflammatory bowel disease, 5-aminosalicylates, immunosuppression, Immunosupressió, Factors de risc en les malalties, Risk factors in diseases, terapéutica::terapia biológica::inmunomodulación::inmunoterapia::inmunosupresión [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], General Medicine, Inflammatory bowel diseases, COVID-19 (Malaltia), enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::enfermedad inflamatoria intestinal [ENFERMEDADES], Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunosuppression [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Inflammatory bowel disease, Malalties inflamatòries intestinals, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Digestive System Diseases::Gastrointestinal Diseases::Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Inflammatory Bowel Diseases [DISEASES], Intestins - Inflamació, Immunosuppression
Abstract

COVID-19; Immunosuppression; Inflammatory bowel disease COVID-19; Immunosupressió; Malaltia inflamatòria intestinal COVID-19; Inmunosupresión; Enfermedad inflamatoria intestinal (1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case−control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March−July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3−5.9), occupational risk (OR: 2.9; 95%CI: 1.8−4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2−2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09−0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution.

Published
2022

4. THU-258-Comparison of a fast corticosteroid tapering with the standard corticosteroid schedule in severe alcoholic hepatitis

Author

Nuria Cañete, Elida Oblitas, Berta Cuyas, Helena Masnou, Eva Román, Carlos Guarner, José Castellote, Marc Batlle, Alberto Amador, Germán Soriano, Maria A. Poca, Gerard Suris, and Margarita Sala

Subjects
Schedule, Pediatrics, medicine.medical_specialty, Hepatology, medicine.drug_class, business.industry, medicine, Corticosteroid, Alcoholic hepatitis, Tapering, business, medicine.disease
Published
2019
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