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265 results on '"Vasudevan, Abhinav"'

13. The synergy of dual faecal immunochemical and faecal calprotectin testing for accurate assessment of endoscopic and histological activity in inflammatory bowel disease.

Author

Bohra, Anuj, Batt, Nicholas, Dutt, Krishneel, Lewis, Diana, Segal, Jonathan P., Newiadomski, Olga, Vasudevan, Abhinav, and Langenberg, Daniel R. Van

Subjects
INFLAMMATORY bowel diseases, CROHN'S disease, CALPROTECTIN, ULCERATIVE colitis, CLINICAL medicine
Abstract

Background: Faecal biomarkers are increasingly utilized for disease assessment in inflammatory bowel disease (IBD). Objectives: To characterize the relative and combined accuracy of faecal calprotectin (FC) and faecal immunochemical testing (FIT) for detecting endoscopic and histologically active disease in Crohn's disease (CD) and ulcerative colitis (UC), subdivided by disease location. Design: A prospective cohort study. Methods: Patients with confirmed IBD undergoing routine ileocolonoscopy for activity assessment were prospectively recruited and performed both FC and FIT ±30 days of ileocolonoscopy. Endoscopic activity was assessed via the simplified endoscopic score for CD, Mayo endoscopic score for UC and histological activity graded as nil/mild/moderate. Receiver-operator curve analyses were utilized to assess the performance of FC and FIT per disease subtype and location. Results: In all, 137 (79 CD, 57 UC) patients were recruited. FC was more sensitive than FIT in detecting active endoscopic (CD: 91% versus 69%, UC: 94% versus 82%) and histological (CD: 86% versus 55%, UC 88% versus 56%) disease. However, FIT was more specific than FC in detecting active endoscopic (CD: 94% versus 56%, UC: 85% versus 69%) and histological (CD: 93% versus 55%, UC: 96% versus 70%) diseases. FIT was more sensitive and specific than FC in detecting active colonic CD (endoscopic activity: 94% versus 93%, histological activity: 92% versus 77%, respectively); however, it was poorly sensitive for active ileal CD (43% versus 89%). Conclusion: FC demonstrated higher sensitivity and FIT higher specificity for active IBD. Hence, dual testing was synergistic, displaying excellent performance characteristics across most IBD locations and subtypes, holding promise for future clinical application. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Clinical trial: Combination allopurinol‐thiopurine versus standard thiopurine in patients with IBD escalating to immunomodulators (the DECIDER study).

Author

Vasudevan, Abhinav, Con, Danny, De Cruz, Peter, Sparrow, Miles P., Friedman, Antony B., Garg, Mayur, Kashkooli, Soleiman, Gibson, Peter R., and van Langenberg, Daniel R.

Subjects
*CROHN'S disease, *INFLAMMATORY bowel diseases, *IMMUNOMODULATORS, *ULCERATIVE colitis, *CLINICAL trials
Abstract

Summary: Background: Thiopurines are established treatments for inflammatory bowel disease (IBD), yet concerns remain regarding their safety. Aim: To evaluate the use of thiopurine‐allopurinol combination therapy compared to standard thiopurine therapy in IBD. Methods: We performed a multicentre, randomised, placebo‐controlled trial to compare the efficacy and safety of thiopurine‐allopurinol versus thiopurine with placebo for adults commencing a thiopurine for IBD. Patients had active disease at baseline; dosing of therapy was based on a pre‐specified regimen and subsequent metabolites. The primary outcome was the proportion of patients achieving a composite of symptomatic disease activity remission (Harvey Bradshaw Index <5 for Crohn's disease, Simple Clinical Colitis Activity Index <4 for ulcerative colitis) and a faecal calprotectin <150 μg/g after 26 weeks of treatment. Results: The trial was terminated early due to slow recruitment. We randomised 102 participants (54 thiopurine‐allopurinol, 48 thiopurine with placebo) with similar age (median 42 vs 48 years) and sex distribution (46% women per group). A higher proportion achieved the primary outcome in the thiopurine‐allopurinol group (50% vs 35%, p = 0.14) and fewer participants stopped their allocated therapy due to adverse events (11% vs 29%, p = 0.02). Also, within the thiopurine‐allopurinol group, thiopurine dose adjustments were less frequent (69% vs 92%, p = 0.03), a higher proportion achieved an early therapeutic 6‐TGN level at week 6 (71% vs 53%, p = 0.19), and adverse events attributed to therapy were less frequent (15% vs 44%, p = 0.002). Conclusion: Thiopurine‐allopurinol therapy is safe and mitigates thiopurine adverse effects, thus enhancing tolerability without compromising efficacy (ACTRN12613001347752). [ABSTRACT FROM AUTHOR]

Published
2024
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27. Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study

Author

Hanrahan, Timothy P., primary, Chan, Robbie, additional, Tassone, Daniel, additional, Ding, Nik S., additional, Basnayake, Chamara, additional, Schulberg, Julien, additional, Vasudevan, Abhinav, additional, Kamm, Michael, additional, De Gregorio, Michael, additional, van Langenberg, Daniel R., additional, and Niewiadomski, Ola, additional

Published
2022
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42. Long‐term safety and efficacy of tenofovir disoproxil fumarate substitution for hepatitis B immunoglobulin following liver transplantation

Author

Vasudevan, Abhinav, Ardalan, Zaid S, Ahmed, Navera, Apostolov, Ross, Gow, Paul J, Testro, Adam G, Gane, Ed J, and Angus, Peter W

Subjects
liver transplant, Original Article, Original Articles, hepatitis B, Tenofovir
Abstract

Background and Aims Limitations to the use of long‐term Hepatitis B Immunoglobulin (HBIg) following liver transplantation for hepatitis B (HBV) have led to the substitution of HBIg with oral nucleo(s)tide analogue prophylaxis. We prospectively assessed the long‐term safety and efficacy of switching to tenofovir disoproxil fumarate (TDF) from HBIg. Methods An open‐label, multicenter switch study was conducted to evaluate the substitution of TDF for HBIg whilst continuing lamivudine (LAM) therapy in preventing the recurrence of HBV in patients who had been maintained as hepatitis B surface antigen (HBsAg)‐negative posttransplantation for at least 12 months. Results Eighteen patients were enrolled (median age 66 years, range 42–78 years); 84% were male, and 78% on calcineurin inhibitors. Median time after transplantation was 14 years (range 5–19), and median duration of HBIg/LAM prior to the switch was 10 years (range 1–14). Median follow‐up was 5 years (range 5–8). Of 18 patients, 16 (89%) remained HBsAg and HBV DNA negative at the end of follow‐up. Two patients had re‐emergence of HBsAg without a detectable HBV DNA and no clinical sequelae. Creatinine clearance significantly reduced (median 59 mL/min to 51 mL/min, P = 0.03), necessitating dose reduction of TDF in six (33%) participants, with two eventually ceasing TDF. One patient switched back to HBIg by choice. All patients who changed therapy maintained an undetectable HBsAg. Conclusion Substitution of HBIg with TDF in patients on LAM is well tolerated and effective for the long‐term prevention of HBV recurrence posttransplantation. Renal dysfunction occurs frequently in the posttransplant setting and can require dose adjustment of TDF or change of therapy.

Published
2018

48. Development of a Simple, Serum Biomarker-based Model Predictive of the Need for Early Biologic Therapy in Crohn’s Disease

Author

Con, Danny, primary, Parthasarathy, Nina, additional, Bishara, Maria, additional, Luber, Raphael P, additional, Joshi, Neetima, additional, Wan, Anna, additional, Rickard, James A, additional, Long, Tony, additional, Connoley, Declan J, additional, Sparrow, Miles P, additional, Gibson, Peter R, additional, van Langenberg, Daniel R, additional, and Vasudevan, Abhinav, additional

Published
2020
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49. Thiopurines vs methotrexate: Comparing tolerability and discontinuation rates in the treatment of inflammatory bowel disease

Author

Vasudevan, Abhinav, primary, Parthasarathy, Nina, additional, Con, Danny, additional, Nicolaides, Steven, additional, Apostolov, Ross, additional, Chauhan, Ayushi, additional, Bishara, Maria, additional, Luber, Raphael P., additional, Joshi, Neetima, additional, Wan, Anna, additional, Rickard, James A., additional, Long, Tony, additional, Connoley, Declan, additional, Sparrow, Miles P., additional, Gibson, Peter R., additional, and van Langenberg, Daniel R., additional

Published
2020
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