77 results on '"Llaó J"'
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2. Post-operative morbidity and mortality of a cohort of steroid refractory acute severe ulcerative colitis: Nationwide multicenter study of the GETECCU ENEIDA Registry
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Ordás, I, Domènech, E, Mañosa, M, García-Sánchez, V, Iglesias-Flores, E, Rodríguez-Moranta, F, Márquez, L, Merino, O, Fernández-Bañares, F, Gomollón, F, Vera, M, Gutiérrez, A, LLaó, J, Gisbert, JP, Aguas, M, Arias, L, Rodríguez-Lago, I, Muñoz, C, Alcaide, N, Calvet, X, Rodríguez, C, Montoro, MA, García, S, De Castro, ML, Piqueras, M, Pareja, L, Ribes, J, Panés, J, Esteve, M, and on behalf of the ENEIDA registry of GETECCU
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- 2018
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3. P327 Characteristics of esophago-gastro-duodenal Crohn's disease in the biologic era: a nationwide study of the Young GETECCU Group
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López García, A, primary, Benítez, J M, additional, Maroto-Martín, C, additional, Fernández-Prada, S J, additional, Marquina, V, additional, Rodríguez, G E, additional, Mesonero, F, additional, Lucendo, A J, additional, Flórez-Díez, P, additional, Casanova, M J, additional, García-Morales, N, additional, Miranda, J, additional, Vicuña, M, additional, Font, G, additional, Suárez-Ferrer, C, additional, Bernal, L, additional, Peries, L, additional, Mínguez, A, additional, Tejedor, J, additional, Pérez-Galindo, P, additional, Elosua, A, additional, Lastiri, E A, additional, Brunet, E, additional, Llaó, J, additional, Rodríguez-Lago, I, additional, Ferreiro-Iglesias, R, additional, López, L, additional, González, I, additional, Ortega, S P, additional, Monsalve, S, additional, Márquez-Mosquera, L, additional, González-Vivó, M, additional, Murciano, F, additional, Zabana, Y, additional, and Barreiro-de Acosta, M, additional
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- 2023
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4. P625 Randomized controlled trial on the effect of megaboluses of intravenous corticosteroids added to oral corticosteroids in the treatment of moderately active ulcerative colitis
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Llaó, J, primary, Martín-Arranz, E, additional, Zabana, Y, additional, Navarro-Llavat, M, additional, Garcia-Planella, E, additional, Busquets, D, additional, Monfort, D, additional, Pineda, J R, additional, Gutiérrez, A, additional, Villoria, A, additional, Menchén, L, additional, Bastida, G, additional, García-Alonso, F J, additional, Rivero, M, additional, Chaparro, M, additional, Riestra, S, additional, Merino, O, additional, Rodríguez-Lago, I, additional, Barreiro-de-Acosta, M, additional, and Domènech Moral, E, additional
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- 2023
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5. OP034 The initiation of thiopurines in elderly patients with inflammatory bowel disease is associated with an increased risk of adverse effects: a case–control study of the ENEIDA registry
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Calafat, M, Mañosa, M, Cañete, F, Panés, J, García Sánchez, V, Calvo, M, Rodríguez-Moranta, F, Taxonera, C, Nos, P, López Sanromán, A, Martín Arranz, M D, Mínguez, M, Gisbert, J P, García-López, S, de Francisco, R, Gomollón, F, Calvet, X, Garcia-Planella, E, Rivero, M, Martínez-Cadilla, J, Argüelles, F, Arias García, L, Cimavilla, M, Zabana, Y, Márquez, L, Gutiérrez, A, Alcaín, G, Martínez Montiel, P, Lázaro, J, Busquets, D, García Sepulcre, M F, Verdejo, C, Bermejo, F, Mora, M, Monfort, D, Romero, P, Velayos, B, Rodríguez, C, Rodríguez, A, Merino, O, Rodríguez-Pescador, A, Bujanda, L, Ber, Y, Vela, M, Roncero, O, Huguet, J M, García-Bosch, O, Barreiro-de-Acosta, M, Madrigal, R E, Ramos, L, Van Domselaar, M, Almela, P, Llaó, J, Lucendo, A J, Muñoz Vilafranca, C, Abad, À, Charro, M, Legido, J, Riera, J, Khorrami, S, Sesé, E, Trapero, A M, and Domènech, E
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- 2018
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6. Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry
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Zabana Y, Marín-Jiménez I, Rodríguez-Lago I, Vera I, Martín-Arranz MD, Guerra I, Gisbert JP, Mesonero F, Benítez O, Taxonera C, Ponferrada-Díaz Á, Piqueras M, Lucendo AJ, Caballol B, Mañosa M, Martínez-Montiel P, Bosca-Watts M, Gordillo J, Bujanda L, Manceñido N, Martínez-Pérez T, López A, Rodríguez-Gutiérrez C, García-López S, Vega P, Rivero M, Melcarne L, Calvo M, Iborra M, Barreiro de-Acosta M, Sicilia B, Barrio J, Pérez JL, Busquets D, Pérez-Martínez I, Navarro-Llavat M, Hernández V, Argüelles-Arias F, Ramírez Esteso F, Meijide S, Ramos L, Gomollón F, Muñoz F, Suris G, de Zarate JO, Huguet JM, Llaó J, García-Sepulcre MF, Sierra M, Durà M, Estrecha S, Fuentes Coronel A, Hinojosa E, Olivan L, Iglesias E, Gutiérrez A, Varela P, Rull N, Gilabert P, Hernández-Camba A, Brotons A, Ginard D, Sesé E, Carpio D, Aceituno M, Cabriada JL, González-Lama Y, Jiménez L, Chaparro M, López-San Román A, Alba C, Plaza-Santos R, Mena R, Tamarit-Sebastián S, Ricart E, Calafat M, Olivares S, Navarro P, Bertoletti F, Alonso-Galán H, Pajares R, Olcina P, Manzano P, Domènech E, Esteve M, On Behalf Of The Eneida Registry Of Geteccu, [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, Consorci Sanitari de Terrassa, and Universidad de Sevilla. Departamento de Medicina
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index ,Pronòstic mèdic ,Risk factors in diseases ,COVID-19 (Malaltia) ,Article ,Inflammatory bowel disease ,Comorbiditat ,inflammatory bowel disease ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Comorbidity [PUBLIC HEALTH] ,Factors de risc en les malalties ,SARS-CoV-2 ,COVID-19 ,determinants ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,General Medicine ,Prognosis ,enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::enfermedad inflamatoria intestinal [ENFERMEDADES] ,infection ,epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::comorbilidad [SALUD PÚBLICA] ,Medicine ,Digestive System Diseases::Gastrointestinal Diseases::Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Inflammatory Bowel Diseases [DISEASES] ,Intestins - Inflamació - Abstract
We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged >= 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having >= 2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD. This study is funded by the Carlos III Health Institute (COV20/00227: Co-IP Dra. Maria Esteve and Dra. Yamile Zabana), FEDER (Fondo Europeo de Desarrollo Regional) and supported by GETECCU. The ENEIDA Registry of GETECCU is supported by Takeda, Pfizer, Galapagos, AbbVie and Biogen.
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- 2022
7. P371 The addition of intravenous, high dose, bolus of methyl-prednisolone increases the early clinical response to oral corticosteroids in moderately active ulcerative colitis. Preliminary results of a prospective, controlled, multicentre, randomised, open-label study
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Domènech Moral PhD, E, primary, Llaó, J, additional, Mañosa, M, additional, Martín-Arranz, E, additional, Zabana, Y, additional, Navarro-Llavat, M, additional, Garcia-Planella, E, additional, Busquets, D, additional, Pineda, J R, additional, Monfort, D, additional, Gutiérrez, A, additional, García-Alonso, F J, additional, Menchén, L A, additional, and Villoria, A, additional
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- 2022
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8. P276 Influence of vedolizumab on extraintestinal manifestations in Inflammatory Bowel Disease: a nationwide multicenter study of the GETECCU Eneida registry
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Pérez Galindo, P, primary, Gisbert, J P, additional, Carrillo-Palau, M, additional, Bertoletti, F, additional, González-Vivó, M, additional, Ferrer, J A, additional, Pajares, R, additional, Merino, O, additional, Castaño, A, additional, Chaparro, M, additional, Calvo, M, additional, Barreiro-de-Acosta, M, additional, Rodríguez, A, additional, Lorente, R H, additional, Algaba, A, additional, Riado, D, additional, Vela, M, additional, De-la-Maza, S, additional, Llaó, J, additional, Vega, P, additional, Utrilla, A, additional, Almela, P, additional, and Carpio, D, additional
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- 2021
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9. Inflammatory Bowel Disease (IBD) and immunosuppression do not worsen the prognosis of COVID-19. Results from the ENEIDA Project of GETECCU
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Zabana Abdo, Y, primary, Marín-Jiménez, I, additional, Rodríguez-Lago, I, additional, Ramírez Esteso, F, additional, Meijilde, S, additional, Ramos, L, additional, Gomollón, F, additional, Muñoz, F, additional, Suris, G, additional, Ortiz de Zárate, J, additional, Huguet, J M, additional, Llaó, J, additional, García-Sepulcre, M, additional, Sierra, M, additional, Durà, M, additional, Estrecha, S, additional, Fuentes Coronel, A, additional, Hinojosa, E, additional, Olivan, L, additional, Iglesias, E, additional, Gutiérrez, A, additional, Varela, P, additional, Rull, N, additional, Gilabert, P, additional, Hernández-Camba, A, additional, Brotons, A, additional, Ginard, D, additional, Sesé, E, additional, Carpio, D, additional, Aceituno, M, additional, Cabriada, J L, additional, González-Lama, Y, additional, Jiménez, L, additional, Chaparro, M, additional, López-San Román, A, additional, Alba, C, additional, Plaza-Santos, R, additional, Piqueras, M, additional, Domènech, E, additional, and Esteve, M, additional
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- 2021
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10. Noninvasive assessment of liver fibrosis in Crohn's disease patients exposed to methotrexate
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Llaó J, Masnou H, Romero C, Bargalló A, Gely C, Mañosa M, Gordillo J, Garcia-Planella E, and Domènech E
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s disease ,elastography ,Crohn’ ,methotrexate ,liver fibrosis - Abstract
Background: Methotrexate is widely used to treat some inflammatory chronic disorders, though it is hampered by the risk of liver fibrosis. Many recommendations have been made to assess methotrexate-related hepatotoxicity, including liver biopsy. However, other noninvasive methods to assess liver fibrosis have been developed and could be implemented for patients treated with methotrexate. Aim: The aim of the study was to compare the prevalence of liver fibrosis by means of noninvasive methods [aspartate transaminase-to-platelet ratio index (APRI) Forns index, and transient elastography] in patients with Crohn's disease exposed or not to methotrexate, and to identify risk factors for liver fibrosis. Methods: Prospective, cross-sectional study. All patients with Crohn's disease exposed to methotrexate were included and compared to an unselected cohort of outpatients with Crohn's disease never exposed to methotrexate. Results: A total of 84 patients with Crohn's disease, 56 exposed to methotrexate, and 28 controls, were included. Significant liver fibrosis was found in 7% of methotrexate-exposed patients with Crohn's disease and 10% of controls as measured by transient elastography, and in 7% of controls as measured by the Forns index. No cases of liver fibrosis were detected by APRI. Only alcohol consumption, diabetes mellitus, and age were associated with significant liver fibrosis. Conclusions: Significant liver fibrosis is uncommon among patients with Crohn's disease, even among those exposed to methotrexate. The risk of liver fibrosis in Crohn's disease seems to depend on common risk factors for liver disease.
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- 2021
11. Rapidity of clinical response to adalimumab and improvement of quality of life in luminal Crohn's disease: RAPIDA study
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Marín-Jiménez I, Acosta MB, Esteve M, Castro-Laria L, García-López S, Ceballos D, Echarri A, Martín-Arranz MD, Busquets D, Llaó J, Navarro-Llavat M, Huguet JM, Argüelles-Arias F, Vicente R, Boudet JM, Díaz G, Sánchez-Migallón AM, Casellas F, and for RAPIDA trial investigators
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Inflammation ,Biologic therapies ,Crohn's disease ,Inflamación ,Enfermedad inflamatoria intestinal ,Terapias biológicas ,Enfermedad de Crohn ,Inflammatory bowel disease - Abstract
OBJECTIVE: No studies evaluating the rapidity of response to biological therapies are available for Crohn's disease (CD). The aim of this study was to evaluate rapidity of onset of clinical response and impact on quality of life (QoL) of adalimumab therapy in adult anti-TNF-naïve patients with moderately-to-severely active CD. PATIENTS AND METHODS: RAPIDA was an open-label, single-arm, prospective, multicenter clinical trial. Adult patients with moderately-to-severely active luminal CD, anti-TNF-naïve, and unresponsive to conventional therapy were treated with adalimumab. Clinical disease activity, QoL and inflammatory biomarkers were measured at day 4, and weeks 1, 2, 4, and 12 after treatment initiation. RESULTS: Eighty-six patients were included in the intention-to-treat (ITT) analyses. Clinical disease activity was reduced from a median of 9.0 points to 6.0 points at day 4. Clinical response (= 3-point reduction in the Harvey-Bradshaw Index, HBI) was achieved by 61.6% (d4) and 75.6% (w1) of patients in the ITT population (median 2.5 days) and with non-responder imputation (NRI), by 55.8% and 53.4%, respectively. The proportion of patients in clinical remission (HBI
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- 2021
12. Short and long-term effectiveness and safety of vedolizumab in inflammatory bowel disease: results from the ENEIDA registry
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Chaparro M, Garre A, Ricart E, Iborra M, Mesonero F, Vera I, Riestra S, García-Sánchez V, Luisa De Castro M, Martin-Cardona A, Aldeguer X, Mínguez M, de-Acosta MB, Rivero M, Muñoz F, Andreu M, Bargalló A, González-Muñoza C, Pérez Calle JL, García-Sepulcre MF, Bermejo F, Huguet JM, Cabriada JL, Gutiérrez A, Mañosa M, Villoria A, Carbajo AY, Lorente R, García-López S, Piqueras M, Hinojosa E, Arajol C, Sicilia B, Conesa AM, Sainz E, Almela P, Llaó J, Roncero O, Camo P, Taxonera C, Domselaar MV, Pajares R, Legido J, Madrigal R, Lucendo AJ, Alcaín G, Doménech E, Gisbert JP, and GETECCU study group
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Adult ,Male ,medicine.medical_specialty ,Antibodies, Monoclonal, Humanized ,Communicable Diseases ,Inflammatory bowel disease ,Vedolizumab ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Gastrointestinal Agents ,Interquartile range ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Registries ,Adverse effect ,Prospective cohort study ,Hepatology ,business.industry ,Proportional hazards model ,Remission Induction ,Gastroenterology ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,Ulcerative colitis ,Discontinuation ,Treatment Outcome ,Spain ,030220 oncology & carcinogenesis ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,business ,Follow-Up Studies ,medicine.drug - Abstract
Background: Effectiveness of vedolizumab in real world clinical practice is unknown. Aim: To evaluate the short and long-term effectiveness of vedolizumab in patients with inflammatory bowel disease (IBD). Methods: Patients who received at least 1 induction dose of vedolizumab were included. Effectiveness was defined based on Harvey-Bradshaw index (HBI) in Crohn's disease (CD) and Partial Mayo Score (PMS) in ulcerative colitis (UC). Short-term response was assessed at week 14. Variables associated with short-term remission were identified by logistic regression analysis. The Kaplan-Meier method was used to evaluate the long-term durability of vedolizumab treatment. Cox model was used to identify factors associated with discontinuation of treatment and loss of response. Results: 521 patients were included (median follow-up 10 months [interquartile range 5-18 months]). At week 14, 46.8% had remission and 15.7% clinical response. CD (vs UC), previous surgery, higher CRP concentration and disease severity at baseline were significantly associated with impaired response. The rate of vedolizumab discontinuation was 37% per patient-year of follow-up (27.6% in UC and 45.3% in CD, P < 0.01). CD (vs UC), anaemia at baseline, steroids during induction and CRP concentration were associated with lower durability of treatment. Seven per cent of patients developed adverse events, infections being the most frequent. Conclusions: Over 60% of IBD patients respond to vedolizumab. Many patients discontinue treatment over time. CD and disease burden impair both short- and long-term response. Vedolizumab seems to be safe in clinical practice.
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- 2018
13. OP29 Tofacitinib in ulcerative colitis: Real-world evidence from Eneida Registry
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Chaparro, M, primary, Garre, A, additional, Mesonero, F, additional, Rodríguez, C, additional, Barreiro-de Acosta, M, additional, Martínez-Cadilla, J, additional, Arroyo, M T, additional, Manceñido, N, additional, Sierra-Ausín, M, additional, Vera-Mendoza, I, additional, Casanova, M J, additional, Nos, P, additional, González-Muñoza, C, additional, Martínez, T, additional, Boscá-Watts, M, additional, Busquets, D, additional, Calafat, M, additional, Girona, E, additional, Llaó, J, additional, Martín-Arranz, M D, additional, Piqueras, M, additional, Ramos, L, additional, Suis, G, additional, Bermejo, F, additional, Carbajo, A Y, additional, Casas-Deza, D, additional, Fernández-Clotet, A, additional, García, M J, additional, Ginard, D, additional, Gutiérrez-Casbas, A, additional, Hernández-Villalba, L, additional, Lucendo, A J, additional, Márquez, L, additional, Merino-Ochoa, O, additional, Rancel, F J, additional, Taxonera, C, additional, López Sanromán, A, additional, Rubio, S, additional, Domènech, E, additional, and Gisbert, J P, additional
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- 2020
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14. P544 Comparison of the efficacy of a second intravenous or subcutaneous anti-TNF in the treatment of ulcerative colitis: Real-world data from the ENEIDA registry
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Torres-Rodriguez, P, primary, Cañete, F, additional, Calafat, M, additional, Sánchez-Aldehuelo, R, additional, Rivero, M, additional, Iborra, M, additional, González-Vivo, M, additional, Vera, I, additional, de Castro, L, additional, Bujanda, L, additional, Barreiro-de Acosta, M, additional, Calvet, X, additional, Benítez, J M, additional, Llorente, M, additional, Surís, G, additional, Arias-García, L, additional, David, M, additional, Castaño-García, A, additional, Garcia-Alonso, F J, additional, Rufo, L, additional, Ferrer, J A, additional, Camo, P, additional, Gisbert, J P, additional, Huguet, J M, additional, Pajares, R, additional, Morales, V, additional, Llaó, J, additional, Rodríguez, A, additional, Rodríguez, C, additional, Navarro, M, additional, Gomollón, F, additional, Carrillo-Palau, M, additional, Sesé, E, additional, Almela, P, additional, Ramírez de la Piscina, P, additional, Rodríguez-Lago, I, additional, Papo, M, additional, Vela, M, additional, Mañosa, M, additional, and Domènech, E, additional
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- 2020
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15. P774 Low adhesion to latent tuberculosis (TB) screening recommendations in inflammatory bowel disease (IBD) patients: Results of the INFEII registry of GETECCU
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Zabana Abdo, Y, primary, de Francisco, R, additional, Rodríguez-Lago, I, additional, Chaparro, M, additional, Gomollón, F, additional, Piqueras, M, additional, Llaó, J, additional, Sicilia, B, additional, Domènech, E, additional, García-Bosch, O, additional, de Castro, L, additional, Calvet, X, additional, Morales, V, additional, Rivero, M, additional, Lucendo, A J, additional, Navarro, P, additional, Márquez, L, additional, Busquets, D, additional, Guardiola, J, additional, Gordillo, J, additional, Iglesias, E, additional, Beltrán, B, additional, Sesé, E, additional, Ferreiro-Iglesias, R, additional, Francisco, M, additional, Pajares, R, additional, Algaba, A, additional, Vicente, R, additional, Benítez, O, additional, Aceituno, M, additional, Riestra, S, additional, Rodríguez-Pescador, A, additional, Gisbert, J P, additional, Arroyo, M T, additional, Mena, R, additional, Sáinz, E, additional, Arias-García, L, additional, Mañosa, M, additional, Navarro, M, additional, Sanromán, L, additional, Villória, A, additional, Delgado-Villena, P, additional, García, M J, additional, Angueira, T, additional, Mínguez, M, additional, Murciano, F, additional, Arajol, C, additional, and Esteve, M, additional
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- 2020
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16. P550 Long-term effectiveness of anti-TNF agents in symptomatic stricturing Crohn’s disease
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Rodríguez-Lago, I, primary, Del Hoyo, J, additional, Casanova, M J, additional, Fernández-Clotet, A, additional, García, M J, additional, Ferreiro-Iglesias, R, additional, Piqueras, M, additional, Suárez, C, additional, López-García, A, additional, Arroyo, M, additional, Sierra, M, additional, Delgado-Guillena, P, additional, Guerra, I, additional, Merino, O, additional, Arranz, L, additional, Llaó, J, additional, Plaza, R, additional, Molina, G, additional, Torres, P, additional, Pérez-Galindo, P, additional, Herrera-deGuise, C, additional, Armesto, E, additional, Mesonero, F, additional, Aguirre, U, additional, and Gisbert, J P, additional
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- 2020
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17. Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study
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Chavarría, C, primary, Casanova, M J, additional, Chaparro, M, additional, Barreiro-de Acosta, M, additional, Ezquiaga, E, additional, Bujanda, L, additional, Rivero, M, additional, Argüelles-Arias, F, additional, Martín-Arranz, M D, additional, Martínez-Montiel, M P, additional, Valls, M, additional, Ferreiro-Iglesias, R, additional, Llaó, J, additional, Moraleja-Yudego, I, additional, Casellas, F, additional, Antolín-Melero, B, additional, Cortés, X, additional, Plaza, R, additional, Pineda, J R, additional, Navarro-Llavat, M, additional, García-López, S, additional, Robledo-Andrés, P, additional, Marín-Jiménez, I, additional, García-Sánchez, V, additional, Merino, O, additional, Algaba, A, additional, Arribas-López, M R, additional, Banales, J M, additional, Castro, B, additional, Castro-Laria, L, additional, Honrubia, R, additional, Almela, P, additional, and Gisbert, J P, additional
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- 2019
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18. P437 Risk of immunomediated adverse events or secondary loss of response to infliximab in elderly patients with inflammatory bowel disease: a cohort study of the ENEIDA registry
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Calafat, M, primary, Mañosa, M, additional, Panes, J, additional, Nos, P, additional, Iglesias, E, additional, Vera, I, additional, López-Sanromán, A, additional, Guardiola, J, additional, Taxonera, C, additional, Mínguez, M, additional, Martín, M D, additional, de Castro, L, additional, Riestra, S, additional, Rivero, M, additional, García-Planella, E, additional, Calvet, X, additional, García-López, S, additional, Andreu, M, additional, Gomollón, F, additional, Barrio, J, additional, Esteve, M, additional, Rodríguez, A, additional, Gisbert, J P, additional, Gutierrez, A, additional, Hinojosa, J, additional, Argüelles, F, additional, Busquets, D, additional, Bujanda, L, additional, Lázaro, J, additional, Sicilia, B, additional, Merino, O, additional, Martínez, P, additional, Bermejo, F, additional, Lorente, R, additional, Barreiro-de-Acosta, M, additional, Rodríguez, C, additional, Fe, M, additional, Piqueras, M, additional, Romero, P, additional, Rodríguez, E, additional, Roncero, Ó, additional, Llaó, J, additional, Alcaín, G, additional, Riera, J, additional, Sierra, M, additional, Fdez. Salazar, L I, additional, Jair, V, additional, Navarro, M, additional, Montoro, M A, additional, Muñoz, C, additional, Lucendo, A J, additional, Van Domselaar, M, additional, Moraleja, I, additional, Huguet, J M, additional, Ramos, L, additional, Ramírez, P, additional, Almeda, P, additional, Pajares, R, additional, Khorrami, S, additional, Madrigal, R E, additional, Sesé, E, additional, Trapero, A M, additional, Legido, J, additional, Abad, Á, additional, Cañete, F, additional, Cabré, E, additional, and Domènech, E, additional
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- 2019
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19. P439 Effectiveness and safety of the sequential use of a second and third anti-TNF agent in patients with inflammatory bowel disease: results from the ENEIDA registry
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Casanova, M J, primary, Chaparro, M, additional, Mínguez, M, additional, Ricart, E, additional, Taxonera, C, additional, García-López, S, additional, Guardiola, J, additional, López-San Román, A, additional, Iglesias, E, additional, Beltrán, B, additional, Sicilia, B, additional, Vera, M I, additional, Hinojosa, J, additional, Riestra, S, additional, Domènech, E, additional, Calvet, X, additional, Pérez-Calle, J L, additional, Martín-Arranz, M D, additional, Aldeguer, X, additional, Rivero, M, additional, Monfort, D, additional, Barrio, J, additional, Esteve, M, additional, Márquez, L, additional, Lorente, R, additional, García-Planella, E, additional, de Castro, L, additional, Bermejo, F, additional, Merino, O, additional, Rodríguez-Pérez, A, additional, Martínez-Montiel, P, additional, Van Domselaar, M, additional, Alcaín, G, additional, Domínguez-Cajal, M, additional, Muñoz, C, additional, Gomollón, F, additional, Fernández-Salazar, L, additional, García-Sepulcre, M F, additional, Rodríguez-Lago, I, additional, Gutiérrez, A, additional, Argüelles-Arias, F, additional, Rodriguez, C, additional, Rodríguez, G E, additional, Bujanda, L, additional, Llaó, J, additional, Varela, P, additional, Ramos, L, additional, Huguet, J M, additional, Almela, P, additional, Romero, P, additional, Navarro-Llavat, M, additional, Abad, Á, additional, Ramírez-de la Piscina, P, additional, Lucendo, A J, additional, Sesé, E, additional, Madrigal, R E, additional, Charro, M, additional, García-Herola, A, additional, Pajares, R, additional, Khorrami, S, additional, and Gisbert, J P, additional
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- 2019
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20. Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study
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Casanova MJ, Chaparro M, García-Sánchez V, Nantes O, Leo E, Rojas-Feria M, Jauregui-Amezaga A, García-López S, Huguet JM, Arguelles-Arias F, Aicart M, Marín-Jiménez I, Gómez-García M, Muñoz F, Esteve M, Bujanda L, Cortés X, Tosca J, Pineda JR, Mañosa M, Llaó J, Guardiola J, Pérez-Martínez I, Muñoz C, González-Lama Y, Hinojosa J, Vázquez JM, Martinez-Montiel MP, Rodríguez GE, Pajares R, García-Sepulcre MF, Hernández-Martínez A, Pérez-Calle JL, Beltrán B, Busquets D, Ramos L, Bermejo F, Barrio J, Barreiro-de Acosta M, Roncedo O, Calvet X, Hervías D, Gomollón F, Domínguez-Antonaya M, Alcaín G, Sicilia B, Dueñas C, Gutiérrez A, Lorente-Poyatos R, Domínguez M, Khorrami S, Taxonera C, Rodríguez-Pérez A, Ponferrada A, Van Domselaar M, Arias-Rivera ML, Merino O, Castro E, Marrero JM, Martín-Arranz M, Botella B, Fernández-Salazar L, Monfort D, Opio V, García-Herola A, Menacho M, Ramírez-de la Piscina P, Ceballos D, Almela P, Navarro-Llavat M, Robles-Alonso V, Vega-López AB, Moraleja I, Novella MT, Castaño-Milla C, Sánchez-Torres A, Benítez JM, Rodríguez C, Castro L, Garrido E, Domènech E, García-Planella E, and Gisbert JP
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Male ,Constriction, Pathologic ,Inflammatory bowel disease ,Gastroenterology ,Deprescriptions ,0302 clinical medicine ,Crohn Disease ,Recurrence ,Risk Factors ,Medicine ,Young adult ,Mesalamine ,Aged, 80 and over ,Incidence ,Incidence (epidemiology) ,Remission Induction ,Age Factors ,Middle Aged ,Antirheumatic Agents ,030220 oncology & carcinogenesis ,Retreatment ,Disease Progression ,Female ,030211 gastroenterology & hepatology ,Tumor necrosis factor alpha ,Adult ,medicine.medical_specialty ,Adolescent ,Drug-Related Side Effects and Adverse Reactions ,Colon ,Young Adult ,03 medical and health sciences ,Ileum ,Internal medicine ,Humans ,Immunologic Factors ,Colitis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Hepatology ,Tumor Necrosis Factor-alpha ,business.industry ,Proportional hazards model ,Adalimumab ,Retrospective cohort study ,Protective Factors ,Inflammatory Bowel Diseases ,medicine.disease ,Infliximab ,Discontinuation ,Methotrexate ,Colitis, Ulcerative ,business ,Follow-Up Studies - Abstract
OBJECTIVES: The aims of this study were to assess the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) drugs in patients with inflammatory bowel disease (IBD), to identify the factors associated with relapse, and to evaluate the overcome after retreatment with the same anti-TNF in those who relapsed. METHODS: This was a retrospective, observational, multicenter study. IBD patients who had been treated with anti-TNFs and in whom these drugs were discontinued after clinical remission was achieved were included. RESULTS: A total of 1,055 patients were included. The incidence rate of relapse was 19% and 17% per patient-year in Crohn's disease and ulcerative colitis patients, respectively. In both Crohn's disease and ulcerative colitis patients in deep remission, the incidence rate of relapse was 19% per patient-year. The treatment with adalimumab vs. infliximab (hazard ratio (HR)=1.29; 95% confi dence interval (CI)= 1.01-1.66), elective discontinuation of anti-TNFs (HR=1.90; 95% CI= 1.07-3.37) or discontinuation because of adverse events (HR= 2.33; 95% CI= 1.27-2.02) vs. a top-down strategy, colonic localization (HR= 1.51; 95% CI= 1.13-2.02) vs. ileal, and stricturing behavior (HR= 1.5; 95% CI= 1.09-2.05) vs. inflammatory were associated with a higher risk of relapse in Crohn's disease patients, whereas treatment with immunomodulators after discontinuation (HR= 0.67; 95% CI= 0.51-0.87) and age (HR= 0.98; 95% CI= 0.97-0.99) were protective factors. None of the factors were predictive in ulcerative colitis patients. Retreatment of relapse with the same anti-TNF was effective (80% responded) and safe. CONCLUSIONS: The incidence rate of infl ammatory bowel disease relapse after anti-TNF discontinuation is relevant. Some predictive factors of relapse after anti-TNF withdrawal have been identifi ed. Retreatment with the same anti-TNF drug was effective and safe.
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- 2017
21. P391 The availability of anti-TNF agents is associated with reduced early surgical requirements in Crohn’s disease but not in ulcerative colitis. A nationwide study from the Eneida registry
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Guasch, M, primary, Clos, A, additional, Ordás, I, additional, García-Sánchez, V, additional, Gisbert, J P, additional, Taxonera, C, additional, Vera, I, additional, Mínguez, M, additional, Guardiola, J, additional, López-Sanromán, A, additional, Rivero-Tirado, M, additional, Nos, P, additional, Gomollón, F, additional, Carbajo, A Y, additional, de Francisco, R, additional, Martín-Arranz, M D, additional, Garcia-Planella, E, additional, García-López, S, additional, de Castro, L, additional, Calvet, X, additional, Camargo, R, additional, Esteve, M, additional, Sicilia, B, additional, Andreu, M, additional, Macho, A, additional, Piqueras, M, additional, Bermejo, F, additional, Gutiérrez, A, additional, Busquets, D, additional, Martínez-Montiel, P, additional, Hinojosa, J, additional, Pérez-Calle, J L, additional, Bujanda, L, additional, Rodríguez-Pérez, A, additional, Lorente, R, additional, Jiménez, N, additional, Navarro-Llavat, M, additional, Cabriada, J L, additional, Camo, P, additional, Van Domselaar, M, additional, Rodríguez-González, E, additional, Rodríguez-Gutiérrez, C, additional, Huguet, J M, additional, Lucendo, A J, additional, Argüelles, F, additional, Almela, P, additional, Merino, O, additional, Calafat, M, additional, Ogueta, M, additional, Charro, M, additional, Llaó, J, additional, Muñoz, C, additional, Ramos, L, additional, Abad, Á, additional, Roncero, Ó, additional, Barreiro-de-Acosta, M, additional, Sesé, E, additional, Mañosa, M, additional, and Domènech, E, additional
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- 2018
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22. How and when should NSAIDs be used for preventing post-ERCP pancreatitis? A systematic review and meta-analysis
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Puig, I., primary, Calvet, X., additional, Baylina, M., additional, Isava, A., additional, Sort, P., additional, Llaó, J., additional, Porta, F., additional, and Vida, F., additional
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- 2013
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23. P439 Management and outcome of severe attacks of ulcerative colitis in the era of biologicals
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Llaó, J., primary, Naves, J.E., additional, Ruiz-Cerulla, A., additional, Gordillo, J., additional, Mañosa, M., additional, Maisterra, S., additional, Cabré, E., additional, Garcia-Planella, E., additional, Guardiola, J., additional, and Domènech, E., additional
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- 2013
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24. P486 Intravenous corticosteroids in moderate active ulcerative colitis not responding to oral corticosteroids
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Llaó, J., primary, Naves, J.E., additional, Ruiz-Cerulla, A., additional, Marín, L., additional, Mañosa, M., additional, Rodríguez-Alonso, L., additional, Cabré, E., additional, Garcia-Planella, E., additional, Guardiola, J., additional, and Domènech, E., additional
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- 2013
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25. 942 LONG-TERM SURVIVAL AFTER VARICEAL BLEEDING: INFLUENCE OF EARLY EVENTS AND EVENTUAL RETURN TO THE COMPENSATED STAGE OF CIRRHOSIS
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Poca, M., primary, Puente, A., additional, Graupera, I., additional, Hernández-Gea, V., additional, Colomo, A., additional, Llaó, J., additional, Concepción, M., additional, Miñana, J., additional, Aracil, C., additional, Guarner, C., additional, and Villanueva, C., additional
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- 2011
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26. DOP051 Usefulness of a faecal calprotectin rapid semiquantitative test in predicting relapse in patients with ulcerative colitis in remission
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Garcia-Planella, E., Manyosa, M., Chaparro, M., Barreiro-de-Acosta, M., Beltrán, B., Ricart, E., García-Sánchez, V., Esteve, M., Piqueras, M., Bermejo, F., López-Sanromán, A., Taxonera, C., Llao, J., Gisbert, J.P., Cabré, E., and Domènech, E.
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- 2014
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27. Influence of familial forms of inflammatory bowel disease on the use of immunosuppressants, biological agents, and surgery in the era of biological therapies. Results from the ENEIDA project.
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González-Muñoza C, Calafat M, Gisbert JP, Iglesias E, Mínguez M, Sicilia B, Aceituno M, Gomollón F, Calvet X, Ricart E, De Castro L, Rivero M, Mesonero F, Márquez L, Nos P, Rodríguez-Pescador A, Guardiola J, García-Sepulcre M, García-López S, Lorente-Poyatos RH, Alba C, Sánchez-Ocaña R, Vera I, Madero L, Riestra S, Navarro-Llavat M, Pérez-Calle JL, Camps B, Van Domselaar M, Lucendo AJ, Martín-Arranz MD, Montoro-Huguet MA, Sierra-Ausín M, Llaó J, Carpio D, Varela P, Merino O, Fernández-Salazar LI, Piqueras M, Sesé E, Busquets D, Tardillo C, Maroto N, Riera J, Martínez-Flores C, Muñoz F, Gordillo-Ábalos J, Bertoletti F, Garcia-Planella E, and Domènech E
- Abstract
Background and Aims: Familial inflammatory bowel disease (IBD) history is a controversial prognostic factor in IBD. We aimed to evaluate the impact of a familial history of IBD on the use of medical and surgical treatments in the biological era., Methods: Patients included in the prospectively maintained ENEIDA database and diagnosed with IBD after 2005 were included. Familial forms were defined as those cases with at least one first-degree relative diagnosed with IBD. Disease phenotype, the use of biological agents, or surgical treatments were the main outcomes., Results: A total of 5263 patients [2627 Crohn's disease (CD); 2636 ulcerative colitis (UC)] were included, with a median follow-up of 31 months. Of these, 507 (10%) corresponded to familial forms. No clinical differences were observed between familial and sporadic IBD forms except a lower age at IBD diagnosis and a higher rate of males in familial forms of UC. In CD, the proportions of patients treated with thiopurines (54.4% vs 46.7%; P = .015) and survival time free of thiopurines (P = .009) were lower in familial forms. No differences were found regarding the use of biological agents. Concerning surgery, a higher rate of intestinal resections was observed in sporadic CD (14.8% vs 9.9%, P = .027). No differences were observed in UC., Conclusions: In the era of biological therapies, familial and sporadic forms of IBD show similar phenotypes and are managed medically in a similar way; whether these is due to lack of phenotypical differences or an effect of biological therapies is uncertain. What is already known on this topic: IBD's etiopathogenesis points to an interaction between environmental and genetic factors, being familial history a controversial prognostic factor. Biological agents use and need for surgery regarding familial or sporadic forms of IBDs present conflicting results. What this study adds: Familial and sporadic forms of IBD have similar phenotypes and are managed medically and surgically in a similar way. How this study might affect research, practice or policy: Familial aggregation should not be considered a factor associated with more aggressive disease., (© The Author(s) 2024. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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28. Predictive role of ITPA genetic variants in thiopurine-related myelotoxicity in Crohn's disease patients.
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Salazar J, Riera P, Gordillo J, Altès A, Martínez M, Serès M, Llaó J, Giordano A, and Garcia-Planella E
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- Humans, Female, Male, Adult, Retrospective Studies, Middle Aged, Young Adult, Immunosuppressive Agents adverse effects, Immunosuppressive Agents therapeutic use, Adolescent, Pharmacogenomic Variants genetics, Polymorphism, Single Nucleotide genetics, Polymorphism, Genetic genetics, Mercaptopurine adverse effects, Mercaptopurine therapeutic use, Multivariate Analysis, Aged, Risk Factors, Nudix Hydrolases, Inosine Triphosphatase, Crohn Disease genetics, Crohn Disease drug therapy, Pyrophosphatases genetics, Azathioprine adverse effects, Azathioprine therapeutic use, Methyltransferases genetics
- Abstract
Thiopurines, an effective therapy for Crohn's disease (CD), often lead to adverse events (AEs). Gene polymorphisms affecting thiopurine metabolism may predict AEs. This retrospective study in CD patients (n = 114) with TPMT activity > 5 Units/Red Blood Cells analyzed TPMT (c.238 G > C, c.460 G > A, c.719 A > G), ITPA (c.94 C > A, IVS2 + 21 A > C), and NUDT15 (c.415 C > T) polymorphisms. All patients received azathioprine (median dose 2.2 mg/kg) with 41.2% experiencing AEs, mainly myelotoxicity (28.1%). No NUDT15 polymorphisms were found, 7% had TPMT, and 31.6% had ITPA polymorphisms. AEs led to therapy modifications in 41.2% of patients. Multivariate analysis identified advanced age (OR 1.046, p = 0.007) and ITPA IVS2 + 21 A > C (OR 3.622, p = 0.015) as independent predictors of AEs. IVS2 + 21 A > C was also associated with myelotoxicity (OR 2.863, p = 0.021). These findings suggest that ITPA IVS2 + 21 A > C polymorphism and advanced age predict AEs during thiopurine therapy for CD with intermediate-normal TPMT activity., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
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- 2024
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29. Trends in Targeted Therapy Usage in Inflammatory Bowel Disease: TRENDY Study of ENEIDA.
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Gómez-Labrador C, Ricart E, Iborra M, Iglesias E, Martín-Arranz MD, de Castro L, De Francisco R, García-Alonso FJ, Sanahuja A, Gargallo-Puyuelo CJ, Mesonero F, Casanova MJ, Mañosa M, Rivero M, Calvo M, Sierra-Ausin M, González-Muñoza C, Calvet X, García-López S, Guardiola J, Arias García L, Márquez-Mosquera L, Gutiérrez A, Zabana Y, Navarro-Llavat M, Lorente Poyatos R, Piqueras M, Torrealba L, Bermejo F, Ponferrada-Díaz Á, Pérez-Calle JL, Barreiro-de Acosta M, Tejido C, Cabriada JL, Marín-Jiménez I, Roncero Ó, Ber Y, Fernández-Salazar L, Camps Aler B, Lucendo AJ, Llaó J, Bujanda L, Muñoz Villafranca C, Domènech E, Chaparro M, and Gisbert JP
- Abstract
Markers that allow for the selection of tailored treatments for individual patients with inflammatory bowel diseases (IBD) are yet to be identified. Our aim was to describe trends in real-life treatment usage. For this purpose, patients from the ENEIDA registry who received their first targeted IBD treatment (biologics or tofacitinib) between 2015 and 2021 were included. A subsequent analysis with Machine Learning models was performed. The study included 10,009 patients [71% with Crohn's disease (CD) and 29% with ulcerative colitis (UC)]. In CD, anti-TNF (predominantly adalimumab) were the main agents in the 1st line of treatment (LoT), although their use declined over time. In UC, anti-TNF (mainly infliximab) use was predominant in 1st LoT, remaining stable over time. Ustekinumab and vedolizumab were the most prescribed drugs in 2nd and 3rd LoT in CD and UC, respectively. Overall, the use of biosimilars increased over time. Machine Learning failed to identify a model capable of predicting treatment patterns. In conclusion, drug positioning is different in CD and UC. Anti-TNF were the most used drugs in IBD 1st LoT, being adalimumab predominant in CD and infliximab in UC. Ustekinumab and vedolizumab have gained importance in CD and UC, respectively. The approval of biosimilars had a significant impact on treatment.
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- 2024
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30. Comparative Study of the Effectiveness of Vedolizumab Versus Ustekinumab After Anti-TNF Failure in Crohn's Disease (Versus-CD): Data from the ENEIDA Registry.
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García MJ, Rivero M, Fernández-Clotet A, de Francisco R, Sicilia B, Mesonero F, de Castro ML, Casanova MJ, Bertoletti F, García-Alonso FJ, López-García A, Vicente R, Calvet X, Barreiro-de Acosta M, Ferrer Rosique J, Varela Trastoy P, Nuñez A, Ricart E, Riestra S, Arias García L, Rodríguez M, Arranz L, Pajares R, Mena R, Calafat M, Camo P, Bermejo F, Ponferrada Á, Madrigal RE, Llaó J, Sesé E, Sánchez E, Pineda Mariño JR, González Muñoza C, Carbajo López AY, Julián AB, Villoria Ferrer A, Baston-Rey I, Jara L, Almela P, Codesido L, de la Maza S, Leal C, Caballol B, Pérez-Martínez I, Vinuesa Campo R, Crespo J, Domènech E, Chaparro M, and Gisbert JP
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- Humans, Tumor Necrosis Factor Inhibitors therapeutic use, Remission Induction, Tumor Necrosis Factor-alpha, Registries, Treatment Outcome, Retrospective Studies, Ustekinumab therapeutic use, Crohn Disease drug therapy, Antibodies, Monoclonal, Humanized
- Abstract
Background: Both vedolizumab and ustekinumab are approved for the management of Crohn's disease [CD]. Data on which one would be the most beneficial option when anti-tumour necrosis factor [anti-TNF] agents fail are limited., Aims: To compare the durability, effectiveness, and safety of vedolizumab and ustekinumab after anti-TNF failure or intolerance in CD., Methods: CD patients from the ENEIDA registry who received vedolizumab or ustekinumab after anti-TNF failure or intolerance were included. Durability and effectiveness were evaluated in both the short and the long term. Effectiveness was defined according to the Harvey-Bradshaw index [HBI]. The safety profile was compared between the two treatments. The propensity score was calculated by the inverse probability weighting method to balance confounder factors., Results: A total of 835 patients from 30 centres were included, 207 treated with vedolizumab and 628 with ustekinumab. Dose intensification was performed in 295 patients. Vedolizumab [vs ustekinumab] was associated with a higher risk of treatment discontinuation (hazard ratio [HR] 2.55, 95% confidence interval [CI]: 2.02-3.21), adjusted by corticosteroids at baseline [HR 1.27; 95% CI: 1.00-1.62], moderate-severe activity in HBI [HR 1.79; 95% CI: 1.20-2.48], and high levels of C-reactive protein at baseline [HR 1.06; 95% CI: 1.02-1.10]. The inverse probability weighting method confirmed these results. Clinical response, remission, and corticosteroid-free clinical remission were higher with ustekinumab than with vedolizumab. Both drugs had a low risk of adverse events with no differences between them., Conclusion: In CD patients who have failed anti-TNF agents, ustekinumab seems to be superior to vedolizumab in terms of durability and effectiveness in clinical practice. The safety profile is good and similar for both treatments., (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2024
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31. Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry.
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Calafat M, Torres P, Tosca-Cuquerella J, Sánchez-Aldehuelo R, Rivero M, Iborra M, González-Vivo M, Vera I, de Castro L, Bujanda L, Barreiro-de Acosta M, González-Muñoza C, Calvet X, Benítez JM, Llorente-Barrio M, Surís G, Cañete F, Arias-García L, Monfort D, Castaño-García A, Garcia-Alonso FJ, Huguet JM, Marín-Jímenez I, Lorente R, Martín-Cardona A, Ferrer JÁ, Camo P, Gisbert JP, Pajares R, Gomollón F, Castro-Poceiro J, Morales-Alvarado J, Llaó J, Rodríguez A, Rodríguez C, Pérez-Galindo P, Navarro M, Jiménez-García N, Carrillo-Palau M, Blázquez-Gómez I, Sesé E, Almela P, Ramírez de la Piscina P, Taxonera C, Rodríguez-Lago I, Cabrinety L, Vela M, Mínguez M, Mesonero F, García MJ, Aguas M, Márquez L, Silva Porto M, Pineda JR, García-Etxebarría K, Bertoletti F, Brunet E, Mañosa M, and Domènech E
- Abstract
Background: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF., Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients., Design: Retrospective observational study., Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially)., Results: Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission., Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy., Competing Interests: MC has served as a speaker for Takeda, Janssen, Faes Farma, and MSD; FC has served as a speaker or has received educational grants from Takeda, Janssen, MSD, and Ferring; MR has served as a speaker or has received research or educational funding or advisory fees from MSD, Abbvie, Pfizer, Takeda, and Janssen; MI has served as a speaker or has received research or educational funding or advisory fees from MSD, Janssen, Adacyte, and Takeda; LC has served as a speaker or has received research or educational funding or advisory fees from Abbvie, Dr. Falk Pharma, and Tillots Pharma; LB has served as a speaker or has received research or educational funding or advisory fees from Ikan Biotech; MBA has served as a speaker or has received research or educational funding or advisory fees from MSD, AbbVie, Janssen, Kern Pharma, Celltrion, Takeda, Gillead, Celgene, Pfizer, Sandoz, Biogen, Fresenius, Ferring, Faes Farma, Dr. Falk Pharma, Chiesi, Gebro Pharma, Adacyte, and Vifor Pharma; CG-M has received educational funding fees from AbbVie, Janssen, Pfizer, Ferring, Kern Pharma, Norgine, and Tillots Pharma; JMH has served as a speaker or has received research or educational funding or advisory fees from Merck Sharp & Dohme, Ferring, Abbvie, Janssen, Biogen, Sandoz, Kern Pharma, Faes Farma, Vifor Pharma, and Takeda; RL has served as a speaker or has received research or educational funding or advisory fees from MSD, Abbvie, Pfizer, Takeda, Janssen, and Dr. Falk; AM-C has received research or educational funding from Abbvie, Biogen, Ferring, Janssen, MSD, Takeda, Dr. Falk Pharma, and Tillotts; JPG has served as a speaker or has received research or educational funding or advisory fees from MSD, Abbvie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene/Bristol Myers, Gilead/Galapagos, Lilly, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Norgine, and Vifor Pharma; FG has served as a speaker or has received research or educational funding or advisory fees from Faes-Farma, Galápagos, Takeda, Pfizer, Janssen, and Abbvie; PA has served as a speaker or has received research or educational funding or advisory fees from MSD, Abbvie, Takeda, Janssen, Gebro Pharma, Tillotts Pharma, and Biogen; CT has served as a speaker or has received research or educational funding or advisory fees from MSD, AbbVie, Pfizer, Takeda, Janssen, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Galapagos, and Tillots; IR-L has served as a speaker or has received research or educational funding or advisory fees from MSD, Pfizer, Abbvie, Takeda, Janssen, Tillotts Pharma, Kern, Celltrion, Roche, Ferring, Dr. Falk Pharma, Galapagos, Otsuka Pharmaceutical, and Adacyte; MM has served as a speaker and has received research or educational funding from MSD, AbbVie, Takeda, Janssen, Ferring, and Pfizer; ED has served as a speaker or has received research or educational funding or advisory fees from AbbVie, Adacyte Therapeutics, Biogen, Celltrion, Galapagos, Gilead, Janssen, Kern Pharma, MSD, Pfizer, Roche, Samsung, Takeda, and Tillots; MJG has served as a speaker or has received research or educational funding or advisory fees from Janssen, Pfizer, Abbvie, Takeda, Kern Pharma, and Ferring; MA has served as a speaker or has received research or educational funding or advisory fees from Faes, Ferring, and Janssen, and received educational grants from Janssen; JRP has served as a speaker or has received research or educational funding or advisory fees from MSD, AbbVie, and Tillots Pharma; FB received educational funding fees from AbbVie, Janssen, Pfizer, Ferring, Kern Pharma, Norgine, and Tillots Pharma. The remaining authors declared no conflicts of interest., (© The Author(s), 2024.)
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- 2024
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32. Real-World Evidence of Tofacinitib in Ulcerative Colitis: Short-Term and Long-Term Effectiveness and Safety.
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Chaparro M, Acosta D, Rodríguez C, Mesonero F, Vicuña M, Barreiro-de Acosta M, Fernández-Clotet A, Hernández Martínez Á, Arroyo M, Vera I, Ruiz-Cerulla A, Sicilia B, Cabello Tapia MJ, Muñoz Villafranca C, Castro-Poceiro J, Martínez Cadilla J, Sierra-Ausín M, Vázquez Morón JM, Vicente Lidón R, Bermejo F, Royo V, Calafat M, González-Muñoza C, Leo Carnerero E, Manceñido Marcos N, Torrealba L, Alonso-Galán H, Benítez JM, Ber Nieto Y, Diz-Lois Palomares MT, García MJ, Muñoz JF, Armesto González EM, Calvet X, Hernández-Camba A, Madrigal Domínguez RE, Menchén L, Pérez Calle JL, Piqueras M, Dueñas Sadornil C, Botella B, Martínez-Pérez TJ, Ramos L, Rodríguez-Grau MC, San Miguel E, Fernández Forcelledo JL, Fradejas Salazar PM, García-Sepulcre M, Gutiérrez A, Llaó J, Sesé Abizanda E, Boscá-Watts M, Iyo E, Keco-Huerga A, Martínez Bonil C, Peña González E, Pérez-Galindo P, Varela P, and Gisbert JP
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- Humans, Treatment Outcome, Remission Induction, Retrospective Studies, Colitis, Ulcerative drug therapy
- Abstract
Introduction: The objective of this study was to assess the durability, short-term and long-term effectiveness, and safety of tofacitinib in ulcerative colitis (UC) in clinical practice., Methods: This is a retrospective multicenter study including patients with UC who had received the first tofacitinib dose at least 8 weeks before the inclusion. Clinical effectiveness was based on partial Mayo score., Results: A total of 408 patients were included. Of them, 184 (45%) withdrew tofacitinib during follow-up (mean = 18 months). The probability of maintaining tofacitinib was 67% at 6 m, 58% at 12 m, and 49% at 24 m. The main reason for tofacitinib withdrawal was primary nonresponse (44%). Older age at the start of tofacitinib and a higher severity of clinical activity were associated with tofacitinib withdrawal. The proportion of patients in remission was 38% at week 4, 45% at week 8, and 47% at week 16. Having moderate-to-severe vs mild disease activity at baseline and older age at tofacitinib start were associated with a lower and higher likelihood of remission at week 8, respectively. Of 171 patients in remission at week 8, 83 (49%) relapsed. The probability of maintaining response was 66% at 6 m and 54% at 12 m. There were 93 adverse events related to tofacitinib treatment (including 2 pulmonary thromboembolisms [in patients with risk factors] and 2 peripheral vascular thrombosis), and 29 led to tofacitinib discontinuation., Discussion: Tofacitinib is effective in both short-term and long-term in patients with UC. The safety profile is similar to that previously reported., (Copyright © 2023 by The American College of Gastroenterology.)
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- 2023
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33. Endoscopic treatment (endoscopic balloon dilation/self-expandable metal stent) vs surgical resection for the treatment of de novo stenosis in Crohn's disease (ENDOCIR study): an open-label, multicentre, randomized trial.
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Loras C, Ruiz-Ramirez P, Romero J, Andújar X, Bargallo J, Bernardos E, Boscá-Watts MM, Brugiotti C, Brunet E, Busquets D, Cerrillo E, Cortina FJ, Díaz-Milanés JA, Dueñas C, Farrés R, Golda T, González-Huix F, Gornals JB, Guardiola J, Julià D, Lira A, Llaó J, Mañosa M, Marin I, Millán M, Monfort D, Moro D, Mullerat J, Navarro M, Pérez Roldán F, Pijoan E, Pons V, Reyes J, Rufas M, Sainz E, Sanchiz V, Serracant A, Sese E, Soto C, Troya J, Zaragoza N, Tebé C, Paraira M, Sudrià-Lopez E, Mayor V, Fernández-Bañares F, and Esteve M
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- Humans, Constriction, Pathologic, Dilatation, Quality of Life, Treatment Outcome, Stents adverse effects, Crohn Disease complications, Crohn Disease diagnosis, Crohn Disease surgery
- Abstract
Background: Stenosis is one of the most common complications in patients with Crohn's disease (CD). Endoscopic balloon dilation (EBD) is the treatment of choice for a short stenosis adjacent to the anastomosis from previous surgery. Self-expandable metal stents (SEMS) may be a suitable treatment option for longer stenoses. To date, however, there is no scientific evidence as to whether endoscopic (EBD/SEMS) or surgical treatment is the best approach for de novo or primary stenoses that are less than 10 cm in length., Methods/design: Exploratory study as "proof-of-concept", multicentre, open-label, randomized trial of the treatment of de novo stenosis in the CD; endoscopic treatment (EBD/SEMS) vs surgical resection (SR). The type of endoscopic treatment will initially be with EDB; if a therapeutic failure occurs, then a SEMS will be placed. We estimate 2 years of recruitment and 1 year of follow-up for the assessment of quality of life, costs, complications, and clinical recurrence. After the end of the study, patients will be followed up for 3 years to re-evaluate the variables over the long term. Forty patients with de novo stenosis in CD will be recruited from 15 hospitals in Spain and will be randomly assigned to the endoscopic or surgical treatment groups. The primary aim will be the evaluation of the patient quality of life at 1 year follow-up (% of patients with an increase of 30 points in the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32). The secondary aim will be evaluation of the clinical recurrence rate, complications, and costs of both treatments at 1-year follow-up., Discussion: The ENDOCIR trial has been designed to determine whether an endoscopic or surgical approach is therapeutically superior in the treatment of de novo stenosis in CD., Trial Registration: ClinicalTrials.gov NCT04330846. Registered on 1 April 1 2020. https://clinicaltrials.gov/ct2/home., (© 2023. The Author(s).)
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- 2023
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34. Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case-Control Study (COVID-19-EII).
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Zabana Y, Marín-Jiménez I, Rodríguez-Lago I, Vera I, Martín-Arranz MD, Guerra I, P Gisbert J, Mesonero F, Benítez O, Taxonera C, Ponferrada-Díaz Á, Piqueras M, J Lucendo A, Caballol B, Mañosa M, Martínez-Montiel P, Bosca-Watts M, Gordillo J, Bujanda L, Manceñido N, Martínez-Pérez T, López A, Rodríguez-Gutiérrez C, García-López S, Vega P, Rivero M, Melcarne L, Calvo M, Iborra M, Barreiro de Acosta M, Sicilia B, Barrio J, Pérez Calle JL, Busquets D, Pérez-Martínez I, Navarro-Llavat M, Hernández V, Argüelles-Arias F, Ramírez Esteso F, Meijide S, Ramos L, Gomollón F, Muñoz F, Suris G, Ortiz de Zarate J, Huguet JM, Llaó J, García-Sepulcre MF, Sierra M, Durà M, Estrecha S, Fuentes Coronel A, Hinojosa E, Olivan L, Iglesias E, Gutiérrez A, Varela P, Rull N, Gilabert P, Hernández-Camba A, Brotons A, Ginard D, Sesé E, Carpio D, Aceituno M, Cabriada JL, González-Lama Y, Jiménez L, Chaparro M, López-San Román A, Alba C, Plaza-Santos R, Mena R, Tamarit-Sebastián S, Ricart E, Calafat M, Olivares S, Navarro P, Bertoletti F, Alonso-Galán H, Pajares R, Olcina P, Manzano P, Domènech E, Esteve M, and On Behalf Of The Eneida Registry Of Geteccu
- Abstract
(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.
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- 2022
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35. Rapidity of clinical response to adalimumab and improvement of quality of life in luminal Crohn's disease: RAPIDA study.
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Marín-Jiménez I, Acosta MB, Esteve M, Castro-Laria L, García-López S, Ceballos D, Echarri A, Martín-Arranz MD, Busquets D, Llaó J, Navarro-Llavat M, Huguet JM, Argüelles-Arias F, Vicente R, Boudet JM, Díaz G, Sánchez-Migallón AM, and Casellas F
- Subjects
- Adult, Aged, Biomarkers blood, Crohn Disease blood, Fatigue drug therapy, Female, Humans, Intention to Treat Analysis, Male, Middle Aged, Prospective Studies, Remission Induction, Severity of Illness Index, Spain, Time Factors, Treatment Outcome, Young Adult, Adalimumab therapeutic use, Crohn Disease drug therapy, Quality of Life, Tumor Necrosis Factor Inhibitors therapeutic use
- Abstract
Objective: No studies evaluating the rapidity of response to biological therapies are available for Crohn's disease (CD). The aim of this study was to evaluate rapidity of onset of clinical response and impact on quality of life (QoL) of adalimumab therapy in adult anti-TNF-naïve patients with moderately-to-severely active CD., Patients and Methods: RAPIDA was an open-label, single-arm, prospective, multicenter clinical trial. Adult patients with moderately-to-severely active luminal CD, anti-TNF-naïve, and unresponsive to conventional therapy were treated with adalimumab. Clinical disease activity, QoL and inflammatory biomarkers were measured at day 4, and weeks 1, 2, 4, and 12 after treatment initiation., Results: Eighty-six patients were included in the intention-to-treat (ITT) analyses. Clinical disease activity was reduced from a median of 9.0 points to 6.0 points at day 4. Clinical response (≥ 3-point reduction in the Harvey-Bradshaw Index, HBI) was achieved by 61.6% (d4) and 75.6% (w1) of patients in the ITT population (median 2.5 days) and with non-responder imputation (NRI), by 55.8% and 53.4%, respectively. The proportion of patients in clinical remission (HBI<5) at weeks 2 and 4 in the ITT population was 54.7% and 62.8%, respectively (median 7.0 days), and 38.4% and 45.3% in the NRI population. All QoL scores significantly improved and inflammatory biomarkers significantly decreased from day 4 onwards (p<0.0001)., Conclusion: Rapid clinical response and remission, improvement in QoL and fatigue, and a reduction of inflammatory biomarkers were achieved with adalimumab as early as day 4 in adult anti-TNF-naïve patients with moderately-to-severely active CD., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)
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- 2022
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36. MultiPaths: a Python framework for analyzing multi-layer biological networks using diffusion algorithms.
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Marín-Llaó J, Mubeen S, Perera-Lluna A, Hofmann-Apitius M, Picart-Armada S, and Domingo-Fernández D
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Summary: High-throughput screening yields vast amounts of biological data which can be highly challenging to interpret. In response, knowledge-driven approaches emerged as possible solutions to analyze large datasets by leveraging prior knowledge of biomolecular interactions represented in the form of biological networks. Nonetheless, given their size and complexity, their manual investigation quickly becomes impractical. Thus, computational approaches, such as diffusion algorithms, are often employed to interpret and contextualize the results of high-throughput experiments. Here, we present MultiPaths, a framework consisting of two independent Python packages for network analysis. While the first package, DiffuPy, comprises numerous commonly used diffusion algorithms applicable to any generic network, the second, DiffuPath, enables the application of these algorithms on multi-layer biological networks. To facilitate its usability, the framework includes a command line interface, reproducible examples and documentation. To demonstrate the framework, we conducted several diffusion experiments on three independent multi-omics datasets over disparate networks generated from pathway databases, thus, highlighting the ability of multi-layer networks to integrate multiple modalities. Finally, the results of these experiments demonstrate how the generation of harmonized networks from disparate databases can improve predictive performance with respect to individual resources., Availability and Implementation: DiffuPy and DiffuPath are publicly available under the Apache License 2.0 at https://github.com/multipaths., Supplementary Information: Supplementary data are available at Bioinformatics online., (© The Author(s) 2020. Published by Oxford University Press.)
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- 2021
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37. Tofacitinib in Ulcerative Colitis: Real-world Evidence From the ENEIDA Registry.
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Chaparro M, Garre A, Mesonero F, Rodríguez C, Barreiro-de Acosta M, Martínez-Cadilla J, Arroyo MT, Manceñido N, Sierra-Ausín M, Vera-Mendoza I, Casanova MJ, Nos P, González-Muñoza C, Martínez T, Boscá-Watts M, Calafat M, Busquets D, Girona E, Llaó J, Martín-Arranz MD, Piqueras M, Ramos L, Surís G, Bermejo F, Carbajo AY, Casas-Deza D, Fernández-Clotet A, García MJ, Ginard D, Gutiérrez-Casbas A, Hernández L, Lucendo AJ, Márquez L, Merino-Ochoa O, Rancel FJ, Taxonera C, López Sanromán A, Rubio S, Domènech E, and Gisbert JP
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- Dose-Response Relationship, Drug, Drug Monitoring methods, Female, Humans, Male, Middle Aged, Patient Acuity, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects, Recurrence, Registries statistics & numerical data, Spain epidemiology, Treatment Outcome, Colitis, Ulcerative diagnosis, Colitis, Ulcerative drug therapy, Colitis, Ulcerative epidemiology, Piperidines administration & dosage, Piperidines adverse effects, Pyrimidines administration & dosage, Pyrimidines adverse effects, Remission Induction methods
- Abstract
Aim: To evaluate the effectiveness and safety of tofacitinib in ulcerative colitis [UC] in real life., Methods: Patients from the prospectively maintained ENEIDA registry and treated with tofacitinib due to active UC were included. Clinical activity and effectiveness were defined based on Partial Mayo Score [PMS]. Short-term response/remission was assessed at Weeks 4, 8, and 16., Results: A total of 113 patients were included. They were exposed to tofacitinib for a median time of 44 weeks. Response and remission at Week 8 were 60% and 31%, respectively. In multivariate analysis, higher PMS at Week 4 (odds ratio [OR] = 0].2; 95% confidence interval [CI] = 0].1-0.4) was the only variable associated with lower likelihood of achieving remission at Week 8. Higher PMS at Week 4 [OR = 0.5; 95% CI = 0.3-0.7] and higher PMS at Week 8 [OR = 0.2; 95% CI = 0.1-0.5] were associated with lower probability of achieving remission at Week 16. A total of 45 patients [40%] discontinued tofacitinib over time. Higher PMS at Week 8 was the only factor associated with higher tofacitinib discontinuation [hazard ratio = 1.5; 95% CI = 1.3-1.6]. A total of 34 patients had remission at Week 8; of these, 65% had relapsed 52 weeks after achieving remission; the dose was increased to 10 mg/12 h in nine patients, and five of them reached remission again. Seventeen patients had adverse events., Conclusions: Tofacitinib is effective and safe in UC patients in real practice, even in a highly refractory cohort. A relevant proportion of patients discontinue the drug over time, mainly due to primary failure., (© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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38. Early treatment with anti-tumor necrosis factor agents improves long-term effectiveness in symptomatic stricturing Crohn's disease.
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Rodríguez-Lago I, Hoyo JD, Pérez-Girbés A, Garrido-Marín A, Casanova MJ, Chaparro M, Fernández-Clotet A, Castro-Poceiro J, García MJ, Sánchez S, Ferreiro-Iglesias R, Bastón I, Piqueras M, Careda LEIB, Mena R, Suárez C, Cordón JP, López-García A, Márquez L, Arroyo M, Alfambra E, Sierra M, Cano N, Delgado-Guillena P, Morales-Alvarado V, Aparicio JC, Guerra I, Aulló C, Merino O, Arranz L, Hidalgo MA, Llaó J, Plaza R, Molina G, Torres P, Pérez-Galindo P, Romero MG, Herrera-deGuise C, Armesto E, Mesonero F, Frago-Larramona S, Benítez JM, Calvo M, Martín MDCL, Elorza A, Larena A, Peña E, Rodríguez-Grau MDC, Miguel-Criado J, Botella B, Olmos JA, López L, Aguirre U, and Gisbert JP
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- Adalimumab pharmacology, Adalimumab therapeutic use, Adult, Age Factors, Biological Factors pharmacology, Constriction, Pathologic diagnosis, Constriction, Pathologic immunology, Constriction, Pathologic therapy, Crohn Disease complications, Crohn Disease diagnosis, Crohn Disease immunology, Endoscopy, Gastrointestinal adverse effects, Female, Follow-Up Studies, Humans, Infliximab pharmacology, Infliximab therapeutic use, Intestines drug effects, Intestines immunology, Intestines surgery, Male, Middle Aged, Patient Admission statistics & numerical data, Postoperative Complications etiology, Retrospective Studies, Risk Factors, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Young Adult, Biological Factors therapeutic use, Crohn Disease therapy, Endoscopy, Gastrointestinal statistics & numerical data, Postoperative Complications epidemiology, Time-to-Treatment
- Abstract
Background: There is limited evidence on the effectiveness of biological therapy in stricturing complications in patients with Crohn's disease., Aim: The study aims to determine the effectiveness of anti-tumor necrosis factor (TNF) agents in Crohn's disease complicated with symptomatic strictures., Methods: In this multicentric and retrospective study, we included adult patients with symptomatic stricturing Crohn's disease receiving their first anti-TNF therapy, with no previous history of biological, endoscopic or surgical therapy. The effectiveness of the anti-TNF agent was defined as a composite outcome combining steroid-free drug persistence with no use of new biologics or immunomodulators, hospital admission, surgery or endoscopic therapy during follow-up., Results: Overall, 262 patients with Crohn's disease were included (53% male; median disease duration, 35 months, 15% active smokers), who received either infliximab ( N = 141, 54%) or adalimumab ( N = 121, 46%). The treatment was effective in 87% and 73% of patients after 6 and 12 months, respectively, and continued to be effective in 26% after a median follow-up of 40 months (IQR, 19-85). Nonetheless, 15% and 21% of individuals required surgery after 1 and 2 years, respectively, with an overall surgery rate of 32%. Postoperative complications were identified in 15% of patients, with surgical site infection as the most common. Starting anti-TNF therapy in the first 18 months after the diagnosis of Crohn's disease or the identification of stricturing complications was associated with a higher effectiveness (HR 1.62, 95% CI 1.18-2.22; and HR 1.55, 95% CI 1.1-2.23; respectively). Younger age, lower albumin levels, strictures located in the descending colon, concomitant aminosalicylates use or presence of lymphadenopathy were associated with lower effectiveness., Conclusions: Anti-TNF agents are effective in approximately a quarter of patients with Crohn's disease and symptomatic intestinal strictures, and 68% of patients are free of surgery after a median of 40 months of follow-up. Early treatment and some potential predictors of response were associated with treatment success in this setting.
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- 2020
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39. Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry.
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Casanova MJ, Chaparro M, Mínguez M, Ricart E, Taxonera C, García-López S, Guardiola J, López-San Román A, Iglesias E, Beltrán B, Sicilia B, Vera MI, Hinojosa J, Riestra S, Domènech E, Calvet X, Pérez-Calle JL, Martín-Arranz MD, Aldeguer X, Rivero M, Monfort D, Barrio J, Esteve M, Márquez L, Lorente R, García-Planella E, de Castro L, Bermejo F, Merino O, Rodríguez-Pérez A, Martínez-Montiel P, Van Domselaar M, Alcaín G, Domínguez-Cajal M, Muñoz C, Gomollón F, Fernández-Salazar L, García-Sepulcre MF, Rodríguez-Lago I, Gutiérrez A, Argüelles-Arias F, Rodriguez C, Rodríguez GE, Bujanda L, Llaó J, Varela P, Ramos L, Huguet JM, Almela P, Romero P, Navarro-Llavat M, Abad Á, Ramírez-de la Piscina P, Lucendo AJ, Sesé E, Madrigal RE, Charro M, García-Herola A, Pajares R, Khorrami S, and Gisbert JP
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- Adalimumab administration & dosage, Adalimumab therapeutic use, Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infliximab administration & dosage, Infliximab therapeutic use, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Registries, Remission Induction, Spain, Tumor Necrosis Factor Inhibitors adverse effects, Young Adult, Colitis, Ulcerative drug therapy, Crohn Disease drug therapy, Tumor Necrosis Factor Inhibitors therapeutic use
- Abstract
Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients., Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent., Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug., Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response., (© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2020
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40. PathMe: merging and exploring mechanistic pathway knowledge.
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Domingo-Fernández D, Mubeen S, Marín-Llaó J, Hoyt CT, and Hofmann-Apitius M
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- Computational Biology, Databases as Topic, Databases, Factual, Humans, TOR Serine-Threonine Kinases metabolism, Signal Transduction, Software
- Abstract
Background: The complexity of representing biological systems is compounded by an ever-expanding body of knowledge emerging from multi-omics experiments. A number of pathway databases have facilitated pathway-centric approaches that assist in the interpretation of molecular signatures yielded by these experiments. However, the lack of interoperability between pathway databases has hindered the ability to harmonize these resources and to exploit their consolidated knowledge. Such a unification of pathway knowledge is imperative in enhancing the comprehension and modeling of biological abstractions., Results: Here, we present PathMe, a Python package that transforms pathway knowledge from three major pathway databases into a unified abstraction using Biological Expression Language as the pivotal, integrative schema. PathMe is complemented by a novel web application (freely available at https://pathme.scai.fraunhofer.de/ ) which allows users to comprehensively explore pathway crosstalk and compare areas of consensus and discrepancies., Conclusions: This work has harmonized three major pathway databases and transformed them into a unified schema in order to gain a holistic picture of pathway knowledge. We demonstrate the utility of the PathMe framework in: i) integrating pathway landscapes at the database level, ii) comparing the degree of consensus at the pathway level, and iii) exploring pathway crosstalk and investigating consensus at the molecular level.
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- 2019
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41. Prognostic Value of the Burden of Cytomegalovirus Colonic Reactivation Evaluated by Immunohistochemical Staining in Patients with Active Ulcerative Colitis.
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Clos-Parals A, Rodríguez-Martínez P, Cañete F, Mañosa M, Ruiz-Cerulla A, José Paúles M, Llaó J, Gordillo J, Fumagalli C, Garcia-Planella E, Ojanguren I, Cabré E, Guardiola J, and Domènech E
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Age Factors, Antiviral Agents therapeutic use, Azathioprine therapeutic use, Colitis, Ulcerative complications, Colitis, Ulcerative drug therapy, Colon pathology, Cytomegalovirus Infections complications, Female, Humans, Immunohistochemistry, Immunosuppressive Agents therapeutic use, Male, Middle Aged, Prognosis, Tumor Necrosis Factor-alpha antagonists & inhibitors, Valganciclovir therapeutic use, Colectomy, Colitis, Ulcerative surgery, Colon virology, Cytomegalovirus physiology, Cytomegalovirus Infections drug therapy, Virus Activation
- Abstract
Background: Colonic cytomegalovirus [CMV] reactivation has been involved in steroid refractoriness in patients with active ulcerative colitis [UC]. The benefits of antiviral therapy in this clinical setting are still under debate, but the burden of viral reactivation has been associated with a poorer outcome in some studies. Our aim was to assess whether the burden of CMV reactivation measured by the number of viral inclusions by immunohistochemistry [IHC-CMV] is associated with a risk of colectomy., Methods: Biopsy sets of UC patients with positive IHC-CMV were identified from the Pathology departments of three university hospitals. All biopsies were reviewed by expert pathologists, and the maximum number of IHC-CMV-positive cells in each biopsy set was re-assessed. Epidemiological and clinical features and clinical outcomes were recorded., Results: Forty-six positive IHC-CMV cases with UC were included. At the time of CMV reactivation, 70% were receiving corticosteroids, 33% azathioprine, and 24% anti-tumour necrosis factor [TNF] agents. Thirty-two patients [70%] were treated with antiviral therapy. The median number of IHC-CMV-positive cells was 2 cells/biopsy [IQR 1-4]. Fourteen patients [30%] underwent colectomy, and 4 of them [29%] showed persistence of CMV in the surgical specimen. In the multivariate analysis, colectomy was only associated with >2 positive cells/biopsy [p = 0.048] and younger age [p = 0.023]., Conclusions: The burden of CMV colonic reactivation in patients with active UC, as measured by IHC, seems to be related to the risk of colectomy, and more data is needed to understand whether antiviral therapy guided by CMV burden will alter the clinical outcome., (Copyright © 2018 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2019
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42. Erratum: Publisher Correction: ComPath: an ecosystem for exploring, analyzing, and curating mappings across pathway databases.
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Domingo-Fernández D, Hoyt CT, Bobis-Álvarez C, Marín-Llaó J, and Hofmann-Apitius M
- Abstract
[This corrects the article DOI: 10.1038/s41540-018-0078-8.].
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- 2019
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43. PTSD Biomarker Database: deep dive metadatabase for PTSD biomarkers, visualizations and analysis tools.
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Domingo-Fernández D, Provost A, Kodamullil AT, Marín-Llaó J, Lasseter H, Diaz K, Daskalakis NP, Lancashire L, Hofmann-Apitius M, and Haas M
- Subjects
- Biomarkers, Humans, Databases, Factual, Metadata, Stress Disorders, Post-Traumatic
- Abstract
The PTSD Biomarker Database (PTSDDB) is a database that provides a landscape view of physiological markers being studied as putative biomarkers in the current post-traumatic stress disorder (PTSD) literature to enable researchers to explore and compare findings quickly. The PTSDDB currently contains over 900 biomarkers and their relevant information from 109 original articles published from 1997 to 2017. Further, the curated content stored in this database is complemented by a web application consisting of multiple interactive visualizations that enable the investigation of biomarker knowledge in PTSD (e.g. clinical study metadata, biomarker findings, experimental methods, etc.) by compiling results from biomarker studies to visualize the level of evidence for single biomarkers and across functional categories. This resource is the first attempt, to the best of our knowledge, to capture and organize biomarker and metadata in the area of PTSD for storage in a comprehensive database that may, in turn, facilitate future analysis and research in the field., (© The Author(s) 2019. Published by Oxford University Press.)
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- 2019
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44. ComPath: an ecosystem for exploring, analyzing, and curating mappings across pathway databases.
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Domingo-Fernández D, Hoyt CT, Bobis-Álvarez C, Marín-Llaó J, and Hofmann-Apitius M
- Subjects
- Data Mining methods, Humans, Parkinson Disease genetics, Parkinson Disease metabolism, Databases, Factual, Genomics methods, Metabolomics methods, Software
- Abstract
Although pathways are widely used for the analysis and representation of biological systems, their lack of clear boundaries, their dispersion across numerous databases, and the lack of interoperability impedes the evaluation of the coverage, agreements, and discrepancies between them. Here, we present ComPath, an ecosystem that supports curation of pathway mappings between databases and fosters the exploration of pathway knowledge through several novel visualizations. We have curated mappings between three of the major pathway databases and present a case study focusing on Parkinson's disease that illustrates how ComPath can generate new biological insights by identifying pathway modules, clusters, and cross-talks with these mappings. The ComPath source code and resources are available at https://github.com/ComPath and the web application can be accessed at https://compath.scai.fraunhofer.de/., Competing Interests: The authors declare no competing interests.
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- 2018
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45. Prevalence and risk factors for colorectal adenomas in patients with ulcerative colitis.
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Gordillo J, Zabana Y, Garcia-Planella E, Mañosa M, Llaó J, Gich I, Marín L, Szafranska J, Sáinz S, Bessa X, Cabré E, and Domènech E
- Abstract
Background: Patients with ulcerative colitis (UC) have an increased risk of colorectal cancer. Scarce data regarding the development of adenomas in these patients are available both for normal and colitic mucosa., Objective: The objective of this article is to evaluate the prevalence of adenomatous polyps and associated risk factors in patients with UC., Methods: Patients with UC were identified from the databases of two tertiary referral centers. Medical, endoscopic and histologic reports were reviewed., Results: A total of 403 patients were included (53% male; 33% extensive colitis) and 1065 colonoscopies (median per patient, 2) were recorded and analyzed. Seventy-four adenomas in 47 patients (11.7%) and three cases of colorectal cancer were found during a median follow-up of 6.3 years. The cumulative risk of colorectal adenoma was 4.7%, 16.7%, 23.6% and 34.4% at 10, 20, 30 and 40 years from UC diagnosis, respectively. The cumulative risk of developing metachronous colorectal adenoma was 66.7%, 87.9%, and 90.9% at 5, 10, and 15 years from first adenoma detection. Older age at UC diagnosis and longer disease duration were independent risk factors for colorectal adenoma development., Conclusions: The prevalence of colorectal adenomas among UC patients seems to be higher than previously reported, although lower than in the background population.
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- 2018
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46. Serial semi-quantitative measurement of fecal calprotectin in patients with ulcerative colitis in remission.
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Garcia-Planella E, Mañosa M, Chaparro M, Beltrán B, Barreiro-de-Acosta M, Gordillo J, Ricart E, Bermejo F, García-Sánchez V, Piqueras M, Llaó J, Gisbert JP, Cabré E, and Domènech E
- Subjects
- Adult, Biomarkers analysis, Colonoscopy, Female, Humans, Intestinal Mucosa pathology, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Recurrence, Remission Induction, Severity of Illness Index, Spain, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Colitis, Ulcerative drug therapy, Feces chemistry, Leukocyte L1 Antigen Complex analysis, Mesalamine therapeutic use
- Abstract
Background: Fecal calprotectin (FC) correlates with clinical and endoscopic activity in ulcerative colitis (UC), and it is a good predictor of relapse. However, its use in clinical practice is constrained by the need for the patient to deliver stool samples, and for their handling and processing in the laboratory. The availability of hand held devices might spread the use of FC in clinical practice., Objectives: To evaluate the usefulness of a rapid semi-quantitative test of FC in predicting relapse in patients with UC in remission., Materials and Methods: Prospective, multicenter study that included UC patients in clinical remission for ≥6 months on maintenance treatment with mesalamine. Patients were evaluated clinically and semi-quantitative FC was measured using a monoclonal immunochromatography rapid test at baseline and every three months until relapse or 12 months of follow-up., Results: One hundred and ninety-one patients had at least one determination of FC. At the end of follow-up, 33 patients (17%) experienced clinical relapse. Endoscopic activity at baseline (p = .043) and having had at least one FC > 60 μg/g during the study period (p = .03) were associated with a higher risk of relapse during follow-up. We obtained a total of 636 semi-quantitative FC determinations matched with a three-month follow-up clinical assessment. Having undetectable FC was inversely associated with early relapse (within three months), with a negative predictive value of 98.6% and a sensitivity of 93.9%., Conclusions: Serial, rapid semi-quantitative measurement of FC may be a useful, easy and cheap monitoring tool for patients with UC in remission.
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- 2018
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47. Improved outcome of acute severe ulcerative colitis while using early predictors of corticosteroid failure and rescue therapies.
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Llaó J, Naves JE, Ruiz-Cerulla A, Gordillo J, Mañosa M, Maisterra S, Cabré E, Garcia-Planella E, Guardiola J, and Domènech E
- Subjects
- Administration, Intravenous, Adult, Colectomy, Cyclosporine therapeutic use, Female, Follow-Up Studies, Humans, Infliximab therapeutic use, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Spain, Tertiary Care Centers, Treatment Failure, Adrenal Cortex Hormones therapeutic use, Colitis, Ulcerative therapy, Gastrointestinal Agents therapeutic use, Immunosuppressive Agents therapeutic use
- Abstract
Background and Aim: Intravenous corticosteroids remain the first line therapy for severe attacks of ulcerative colitis although up to 30-40% of patients do not respond to treatment. The availability of alternative therapies to colectomy and the knowledge of early predictors of response to corticosteroids should have improved the clinical outcomes of patients with severe refractory ulcerative colitis. The aim of the study is to describe the current need, way of use, and efficacy of rescue therapies, as well as colectomy rates in patients with severe ulcerative colitis flares., Methods: Between January 2005 and December 2011, all patients admitted in three referral centres for a severe ulcerative colitis flare who received intravenous corticosteroids were identified and clinical and biological data were accurately collected. Patients were followed-up until colectomy, death, or date of data collection., Results: Sixty-two flares were included. Initial efficacy of intravenous corticosteroids (mild activity or inactive disease without rescue treatment, at day 7 after starting intravenous corticosteroids) was achieved in 50% of flares, and rescue therapies were used in 27 episodes (43%). After a median follow-up of 18 months, the colectomy rate was 6.5%. Failed oral corticosteroids for the index flare were the only baseline feature that predicted the need for rescue therapy and colectomy., Conclusions: There is a marked reduction in the colectomy rate and an increased use of medical rescue therapies as compared to historical series. Patients worsening while on oral corticosteroids for a moderate flare are at high risk of rescue therapy and colectomy and, therefore, should be directly treated with rescue therapies instead of attempting intravenous corticosteroids., (Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
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- 2016
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48. Relative adrenal insufficiency in severe acute variceal and non-variceal bleeding: influence on outcomes.
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Graupera I, Pavel O, Hernandez-Gea V, Ardevol A, Webb S, Urgell E, Colomo A, Llaó J, Concepción M, and Villanueva C
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- Acute Disease, Adrenal Insufficiency pathology, Aged, Aged, 80 and over, Biopsy, Needle, Comorbidity, Confidence Intervals, Endoscopy, Gastrointestinal methods, Esophageal and Gastric Varices pathology, Female, Gastrointestinal Hemorrhage pathology, Humans, Incidence, Liver Cirrhosis epidemiology, Liver Cirrhosis pathology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Prospective Studies, Risk Assessment, Severity of Illness Index, Spain, Statistics, Nonparametric, Survival Analysis, Adrenal Insufficiency epidemiology, Cause of Death, Esophageal and Gastric Varices epidemiology, Gastrointestinal Hemorrhage epidemiology
- Abstract
Background & Aims: Relative adrenal insufficiency (RAI) is common in critical illness and in cirrhosis, and is related with worse outcomes. The prevalence of RAI may be different in variceal and non-variceal bleeding and whether it may influence outcomes in these settings is unclear. This study assesses RAI and its prognostic implications in cirrhosis with variceal bleeding and in peptic ulcer bleeding., Methods: Patients with severe bleeding (systolic pressure <100 mmHg and/or haemoglobin <8 g/L) from oesophageal varices or from a peptic ulcer were included. Adrenal function was evaluated within the first 24 h and RAI was diagnosed as delta cortisol <250 nmol/L after 250 μg of i.v. corticotropin., Results: Sixty-two patients were included, 36 had cirrhosis and variceal bleeding and 26 without cirrhosis had ulcer bleeding. Overall, 15 patients (24%) had RAI, 8 (22%) with variceal and 7 (24%) with ulcer bleeding. Patients with RAI had higher rate of bacterial infections. Baseline serum and salivary cortisol were higher in patients with RAI (P < 0.001) while delta cortisol was lower (P < 0.001). There was a good correlation between plasma and salivary cortisol (P < 0.001). The probability of 45-days survival without further bleeding was lower in cirrhotic patients with variceal bleeding and RAI than in those without RAI (25% vs 68%, P = 0.02), but not in non-cirrhotic patients with peptic ulcer bleeding with or without RAI (P = 0.75)., Conclusion: The prevalence of RAI is similar in ulcer bleeding and in cirrhosis with variceal bleeding. Cirrhotic patients with RAI, but not those with bleeding ulcers, have worse prognosis., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2015
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49. Diagnostic accuracy of abdominal ultrasound in the screening of esophageal varices in patients with cirrhosis.
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Sort P, Muelas M, Isava A, Llaó J, Porta F, Puig I, Domínguez-Curell C, Esteve E, Yanguas C, and Vida F
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- Biomarkers blood, Endoscopy, Gastrointestinal, Esophageal and Gastric Varices blood, Esophageal and Gastric Varices etiology, Female, Humans, Liver Cirrhosis blood, Liver Cirrhosis complications, Male, Middle Aged, Predictive Value of Tests, Prognosis, Reproducibility of Results, Retrospective Studies, Risk Assessment, Risk Factors, Ultrasonography, Esophageal and Gastric Varices diagnostic imaging, Liver Cirrhosis diagnostic imaging
- Abstract
Background: Abdominal ultrasound (US) may provide data on the presence of esophageal varices in cirrhosis. We assess the diagnostic accuracy of this procedure., Patients and Methods: Retrospective recording of clinical data was carried out in cirrhotic patients who underwent abdominal US and upper gastrointestinal endoscopy. We compared patients with and without large varices and assessed the value of US in predicting the presence of these lesions as well as other significant variables., Results: Of the 353 patients included, 123 (35%) had esophageal varices. The presence of US signs of portal hypertension independently predicted the existence of esophageal varices with a sensitivity of 87.9%, a specificity of 34.9%, a positive predictive value of 40.6%, and a negative predictive value of 85.1%, which could increase to 91.5% if the patient presented plasma albumin and platelet concentrations above the mean values (3.1 g/dl and 122×10 cells/l, respectively). Plasma albumin and platelet concentrations were the two other variables with independent predictive capacity. Applying these selection criteria, up to 30% of screening endoscopies may not be necessary, and up to 43% in patients with compensated cirrhosis. In patients with decompensated cirrhosis, however, US does not have predictive capacity. The results obtained are comparable with those reported for transient elastography., Conclusion: Abdominal US is a highly reliable technique for detecting patients with a low risk of presenting esophageal varices. Its use may avoid up to 43% of screening endoscopies in patients with compensated cirrhosis. The results obtained are similar to those observed using transient elastography.
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- 2014
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50. Intravenous corticosteroids in moderately active ulcerative colitis refractory to oral corticosteroids.
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Llaó J, Naves JE, Ruiz-Cerulla A, Marín L, Mañosa M, Rodríguez-Alonso L, Cabré E, Garcia-Planella E, Guardiola J, and Domènech E
- Subjects
- Administration, Intravenous, Administration, Oral, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antibodies, Monoclonal therapeutic use, Colectomy, Colitis, Ulcerative surgery, Cyclosporine therapeutic use, Female, Follow-Up Studies, Humans, Immunosuppressive Agents therapeutic use, Infliximab, Male, Methylprednisolone adverse effects, Middle Aged, Prednisone administration & dosage, Retreatment, Retrospective Studies, Severity of Illness Index, Treatment Failure, Anti-Inflammatory Agents administration & dosage, Colitis, Ulcerative drug therapy, Methylprednisolone administration & dosage
- Abstract
Background: Oral corticosteroids remain the mainstay of treatment for moderately active ulcerative colitis (UC). In patients who fail to respond to oral corticosteroids, attempting the intravenous route before starting rescue therapies is an alternative, although no evidence supports this strategy., Aim: To evaluate clinical outcomes after a course of intravenous corticosteroids for moderate attacks of UC according to the failed oral corticosteroids or not., Methods: All episodes of active UC admitted to three university hospitals between January 2005 and December 2011 were identified and retrospectively reviewed. Only moderately active episodes treated with intravenous corticosteroids were included. Treatment outcome was compared between episodes which failed to outpatient oral corticosteroids for the index flare and those directly treated by intravenous corticosteroids., Results: 110 episodes were included, 45% of which failed to outpatient oral corticosteroids (median dose 60mg/day [IQR 50-60], median length of course 10days [IQR 7-17]). Initial response (defined as mild severity or inactive disease at day 7 after starting intravenous corticosteroids, without rescue therapy) was achieved in 75%, with no between-group differences (78% vs. 75%). After a median follow-up of 12months (IQR 4-24), 35% of the initial responders developed steroid-dependency and up to 13% required colectomy. Unsuccessful response to oral corticosteroids was the only factor associated with steroid-dependency in the long term (P=0.001)., Conclusions: Intravenous corticosteroids are efficient for inducing remission in moderately active UC unresponsive to oral corticosteroids, but almost half of these patients develop early steroid-dependency. Alternative therapeutic strategies should be assessed in this clinical setting., (Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2014
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