46 results on '"Vrolijk, J.M."'
Search Results
2. Aminotransferases During Treatment Predict Long-Term Survival in Patients With Autoimmune Hepatitis Type 1: A Landmark Analysis
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Bouma, G., de Boer, Y., Drenth, J.P.H., van Gerven, N.M., Beuers, U., van Erpecum, K.J., den Ouden, J.W., Bhalla, A., Brouwer, J.T., Vrolijk, J.M., Koek, G.H., Guichelaar, M.M.J., van der Wouden, E.J., van Meyel, J.J.M., Baak, L.C., Verdonk, R.C., Klemt-Kropp, M., Verhagen, M.A.M.T., Kuijvenhoven, J.Ph., de Jonge, H.M., Biewenga, Maaike, Verhelst, Xavier, Baven-Pronk, Martine, Putter, Hein, van den Berg, Aad, Colle, Isabelle, Schouten, Jeoffrey, Sermon, Filip, Van Steenkiste, Christophe, van Vlierberghe, Hans, van der Meer, Adriaan, and van Hoek, Bart
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- 2022
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3. Association Between Black Race and Presentation and Liver-Related Outcomes of Patients With Autoimmune Hepatitis
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van Gerven, N.M., Beuers, U., van Erpecum, K.J., van Buuren, H.R., den Ouden, J.W., Brouwer, J.T., Vrolijk, J.M., Verdonk, R.C., van Hoek, B., Koek, G.H., Guichelaar, M.M.J., Bloemena, E., van Nieuwkerk, C.M.J., Schreuder, T.C.M.A., van der Wouden, E.J., van Meyel, J.J.M., Baak, L.C., Stadhouders, P.H.G.M., Klemt-Kropp, M., Verhagen, M.A.M.T., Bhalla, A., Kuijvenhoven, J.Ph., de Boer, Ynto S., Gerussi, Alessio, van den Brand, Floris F., Wong, Guan-Wee, Halliday, Neil, Liberal, Rodrigo, Drenth, Joost P.H., Thorburn, Douglas, Bouma, Gerd, and Heneghan, Michael A.
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- 2019
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4. Assessing the efficacy and safety of mycophenolate mofetil versus azathioprine in patients with autoimmune hepatitis (CAMARO trial): study protocol for a randomised controlled trial
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Snijders, R.J.A.L.M., Stoelinga, A.E.C., Gevers, T.J.G., Pape, S., Biewenga, M., Verdonk, R.C., Jonge, H.J.M. de, Vrolijk, J.M., Bakker, S.F., Vanwolleghem, T., Boer, Y.S. de, Pronk, M.A.M.C.B., Beuers, U.H.W., Meer, A.J. van der, Gerven, N.M.F. van, Sijtsma, M.G.M., Verwer, B.J., Gisbertz, I.A.M., Bartelink, M., Brand, F.F. van den, Korkmaz, K.S., Berg, A.P. van den, Guichelaar, M.M.J., Soufidi, K., Levens, A.D., Hoek, B. van, Drenth, J.P.H., Dutch Autoimmune Hepatitis Working, Gastroenterology & Hepatology, Gastroenterology and hepatology, Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Groningen Institute for Organ Transplantation (GIOT), Dutch Autoimmune Hepatitis Working Group, RS: NUTRIM - R2 - Liver and digestive health, Interne Geneeskunde, and MUMC+: MA Maag Darm Lever (9)
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Adult ,Remission ,Immunosuppressive Agents/adverse effects ,First-line treatment ,Medicine (miscellaneous) ,Autoimmune hepatitis ,Biochemical remission ,Severity of Illness Index ,Prednisolone/adverse effects ,Induction therapy ,Hepatitis ,End Stage Liver Disease ,SDG 3 - Good Health and Well-being ,Azathioprine ,Humans ,Multicenter Studies as Topic ,Pharmacology (medical) ,Hepatitis, Autoimmune/diagnosis ,Randomized Controlled Trials as Topic ,Phase IV trial ,Mycophenolate mofetil ,Mycophenolic Acid/adverse effects ,Azathioprine/adverse effects ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,Treatment Outcome ,Randomized controlled trial ,Autoimmune/diagnosis ,Quality of Life ,Human medicine - Abstract
Background Currently, the standard therapy for autoimmune hepatitis (AIH) consists of a combination of prednisolone and azathioprine. However, 15% of patients are intolerant to azathioprine which necessitates cessation of azathioprine or changes in therapy. In addition, not all patients achieve complete biochemical response (CR). Uncontrolled data indicate that mycophenolate mofetil (MMF) can induce CR in a majority of patients. Better understanding of first-line treatment and robust evidence from randomised clinical trials are needed. The aim of this study was to explore the potential benefits of MMF as compared to azathioprine, both combined with prednisolone, as induction therapy in a randomised controlled trial in patients with treatment-naive AIH. Methods CAMARO is a randomised (1:1), open-label, parallel-group, multicentre superiority trial. All patients with AIH are screened for eligibility. Seventy adult patients with AIH from fourteen centres in the Netherlands and Belgium will be randomised to receive MMF or azathioprine. Both treatment arms will start with prednisolone as induction therapy. The primary outcome is biochemical remission, defined as serum levels of alanine aminotransferase and immunoglobulin G below the upper limit of normal. Secondary outcomes include safety and tolerability of MMF and azathioprine, time to remission, changes in Model For End-Stage Liver Disease (MELD)-score, adverse events, and aspects of quality of life. The study period will last for 24 weeks. Discussion The CAMARO trial investigates whether treatment with MMF and prednisolone increases the proportion of patients in remission compared with azathioprine and prednisolone as the current standard treatment strategy. In addition, we reflect on the challenges of conducting a randomized trial in rare diseases. Trial registration EudraCT 2016-001038-91. Prospectively registered on 18 April 2016. Graphical Abstract
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- 2022
5. Aminotransferases During Treatment Predict Long-Term Survival in Patients With Autoimmune Hepatitis Type 1: A Landmark Analysis
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Biewenga, Maaike, primary, Verhelst, Xavier, additional, Baven-Pronk, Martine, additional, Putter, Hein, additional, van den Berg, Aad, additional, Colle, Isabelle, additional, Schouten, Jeoffrey, additional, Sermon, Filip, additional, Van Steenkiste, Christophe, additional, van Vlierberghe, Hans, additional, van der Meer, Adriaan, additional, van Hoek, Bart, additional, Bouma, G., additional, de Boer, Y., additional, Drenth, J.P.H., additional, van Gerven, N.M., additional, Beuers, U., additional, van Erpecum, K.J., additional, den Ouden, J.W., additional, Bhalla, A., additional, Brouwer, J.T., additional, Vrolijk, J.M., additional, Koek, G.H., additional, Guichelaar, M.M.J., additional, van der Wouden, E.J., additional, van Meyel, J.J.M., additional, Baak, L.C., additional, Verdonk, R.C., additional, Klemt-Kropp, M., additional, Verhagen, M.A.M.T., additional, Kuijvenhoven, J.Ph., additional, and de Jonge, H.M., additional
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- 2022
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6. Rapid Response to Treatment of Autoimmune Hepatitis Associated With Remission at 6 and 12 Months
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Pape, S., Gevers, T.J.G., Vrolijk, J.M., Hoek, B. van, Bouma, G., Nieuwkerk, C.M. van, Taubert, R., Jaeckel, E., Manns, M.P., Papp, M., Sipeki, N., Stickel, F., Efe, C., Ozaslan, E., Purnak, T., Nevens, F., Kessener, D.J.N., Kahraman, A., Wedemeyer, H., Hartl, J., Schramm, C., Lohse, A.W., Drenth, J.P.H., Heneghan, M.A., Pape, S., Gevers, T.J.G., Vrolijk, J.M., Hoek, B. van, Bouma, G., Nieuwkerk, C.M. van, Taubert, R., Jaeckel, E., Manns, M.P., Papp, M., Sipeki, N., Stickel, F., Efe, C., Ozaslan, E., Purnak, T., Nevens, F., Kessener, D.J.N., Kahraman, A., Wedemeyer, H., Hartl, J., Schramm, C., Lohse, A.W., Drenth, J.P.H., and Heneghan, M.A.
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Contains fulltext : 219998.pdf (Publisher’s version ) (Closed access), BACKGROUND & AIMS: Changes in serum levels of transaminases immediately after initiation of treatment for autoimmune hepatitis (AIH) might be associated with biochemical markers of remission and liver-related events. We assessed the outcomes of patients with vs without rapid response to treatment of AIH in a large international cohort. METHODS: We performed a retrospective cohort study, collecting data from 2 independent cohorts of adults with AIH from 12 centers in 7 countries in Europe. We collected information on patient demographics; serologic, histologic, and biochemical analyses; and treatment. We used a receiver operating characteristic curve and Youden index to calculate the optimal percentage decrease in level of aspartate aminotransferase (AST) after 8 weeks of treatment that associated with normalization of transaminase levels after 26 weeks of treatment with predniso(lo)ne (primary outcome) in the first (discovery) cohort (n = 370). We evaluated the results in the second (validation) cohort (n = 370). Secondary outcomes were liver-related death or transplantation. We performed univariate and multivariable logistic and Cox regression with correction for confounders. RESULTS: A significant decrease in level of AST after 8 weeks of treatment was significantly associated with normalization of transaminase levels at 26 and 52 weeks (P < .001); a decrease of more than 80% in level of AST was associated with optimal normalization. In both cohorts, rapid responders (≥80% decrease in level of AST after 8 weeks) were more likely to achieve normalization of transaminases at 26 and 52 weeks when compared to non-rapid responders. Rapid responders in the discovery cohort had lower risk of liver-related death or transplantation (adjusted hazard ratio 0.18; 95% CI 0.05-0.63; P = .007), although this was not confirmed in the validation cohort. Results from measurement of alanine aminotransferase did not differ significantly from those of AST for the primary outcome. Slow
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- 2020
7. High discontinuation rate of azathioprine in autoimmune hepatitis, independent of time of treatment initiation
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Pape, S., Gevers, T.J.G., Vrolijk, J.M., Hoek, B. van, Bouma, G., Nieuwkerk, C.M. van, Taubert, R., Jaeckel, E., Manns, M.P., Papp, M., Sipeki, N., Stickel, F., Efe, C., Ozaslan, E., Purnak, T., Nevens, F., Kessener, D.J.N., Kahraman, A., Wedemeyer, H., Hartl, J., Schramm, C., Lohse, A.W., Heneghan, M.A., Drenth, J.P.H., Pape, S., Gevers, T.J.G., Vrolijk, J.M., Hoek, B. van, Bouma, G., Nieuwkerk, C.M. van, Taubert, R., Jaeckel, E., Manns, M.P., Papp, M., Sipeki, N., Stickel, F., Efe, C., Ozaslan, E., Purnak, T., Nevens, F., Kessener, D.J.N., Kahraman, A., Wedemeyer, H., Hartl, J., Schramm, C., Lohse, A.W., Heneghan, M.A., and Drenth, J.P.H.
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Contains fulltext : 225262.pdf (Publisher’s version ) (Open Access), BACKGROUND: Guidelines regarding treatment for autoimmune hepatitis (AIH) favour two strategies for azathioprine (AZA) introduction: concurrent with steroids at induction or delayed by 2-4 weeks. The safety and efficacy of both strategies have been unexplored. METHODS: We established a cohort of 900 AIH patients from 12 centres in 7 European countries. There were 631 patients who used AZA as part of the therapeutic regimen. We distinguished two groups: patients with early AZA (<2 weeks) or delayed AZA initiation (≥2 weeks). Primary outcome was discontinuation of AZA in the first year of treatment. Cox regression and propensity score matching was performed to determine difference in outcomes between groups. RESULTS: Patients with early AZA initiation had significantly lower transaminases and bilirubin at baseline. Discontinuation rates of AZA did not differ between early and delayed starters (16.6% vs 14.2%), which did not reach statistical significance (hazard ratio 0.97, 95% confidence interval 0.61-1.55, P = .90). Stratification according to baseline disease activity or propensity score matching did not alter the results. Main reason for AZA discontinuation was intolerance to treatment (14.0% vs 13.2%, P = .78) with nausea and vomiting as main side effects. AIH remission rates were comparable among groups. CONCLUSION: The discontinuation rate of AZA in AIH treatment is ~15% in the first year of treatment. Early or delayed AZA initiation does not differ in remission and discontinuation rates in AIH induction therapy. Our data suggest that either strategy may be used as part of AIH treatment.
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- 2020
8. Adverse events related to low dose corticosteroids in autoimmune hepatitis
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Brand, F.F. van den, Veen, K.S. van der, Lissenberg-Witte, B.I., Boer, Y.S. de, Hoek, B. van, Drenth, J.P.H., Verdonk, R.C., Vrolijk, J.M., Nieuwkerk, C.M.J. van, Bouma, G., Gerven, N.M. van, Kuijvenhoven, J.P., Schreuder, T.C.M.A., Wouden, E.J. van der, Meyel, J.J.M. van, Baak, L.C., Stadhouders, P.H.G.M., Klemt-Kropp, M., Verhagen, M.A.M.T., Bhalla, A., Ouden, J.W. den, Beuers, U., Erpecum, K.J. van, Buuren, H.R. van, Brouwer, J.T., Dutch Autoimmune Hepatitis Study G, Gastroenterology & Hepatology, Gastroenterology and hepatology, Epidemiology and Data Science, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, AII - Infectious diseases, CCA - Cancer biology and immunology, APH - Methodology, AGEM - Endocrinology, metabolism and nutrition, and Tytgat Institute for Liver and Intestinal Research
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Male ,Cirrhosis ,AZATHIOPRINE ,Azathioprine ,Autoimmune hepatitis ,THERAPY ,Fractures, Bone ,0302 clinical medicine ,Adrenal Cortex Hormones ,Prednisone ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Child ,Aged, 80 and over ,Gastroenterology ,Middle Aged ,Hepatitis, Autoimmune ,ACTIVE LIVER-DISEASE ,Child, Preschool ,Corticosteroid ,Female ,Original Article ,030211 gastroenterology & hepatology ,WITHDRAWAL ,medicine.drug ,Adult ,PREDNISONE ,medicine.medical_specialty ,Adolescent ,Drug-Related Side Effects and Adverse Reactions ,medicine.drug_class ,CONTROLLED-TRIAL ,Young Adult ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,BUDESONIDE ,Internal medicine ,Diabetes mellitus ,Humans ,Adverse effect ,Glucocorticoids ,Safety of Steroids in Autoimmune Hepatitis ,Aged ,Retrospective Studies ,Hepatitis ,Hepatology ,business.industry ,REMISSION ,medicine.disease ,EFFICACY ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,business - Abstract
Contains fulltext : 215386.pdf (Publisher’s version ) (Open Access) BACKGROUND: Autoimmune hepatitis requires long-term therapy, and systemic corticosteroids are the backbone of therapeutic management. Prolonged use of corticosteroids may lead to adverse events but data from long-term studies are mainly derived from studies in rheumatic diseases. AIM: To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long-term maintenance treatment of patients with autoimmune hepatitis. METHODS: We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a generalised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagnosis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. RESULTS: A total of 6634 years, with a median of 13 (range 1-40) per patient were recorded. The median age at diagnosis was 44 years (range 2-88). Adverse events were documented in 120 (25%) patients. Low-dose predniso(lo)ne (0.1-5.0 mg/d) increased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. CONCLUSIONS: Even low doses of corticosteroids frequently lead to substantial adverse events refuting the assumption that adverse events are prevented by administering low doses.
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- 2019
9. Predniso(lo)ne Dosage and Chance of Remission in Patients With Autoimmune Hepatitis
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Pape, S., Gevers, T.J.G., Belias, M., Mustafajev, Ilyas F., Vrolijk, J.M., Hoek, B. van, Heneghan, M.A., Drenth, J.P.H., Pape, S., Gevers, T.J.G., Belias, M., Mustafajev, Ilyas F., Vrolijk, J.M., Hoek, B. van, Heneghan, M.A., and Drenth, J.P.H.
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Contains fulltext : 207058.pdf (publisher's version ) (Closed access)
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- 2019
10. Adverse events related to low dose corticosteroids in autoimmune hepatitis
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van den Brand, F.F., van der Veen, K.S., Lissenberg-Witte, B.I., Boer, Y.S. (Ynto) de, Hoek, B. (Bart) van, Drenth, J.P.H. (Joost), Verdonk, R.C. (Robert), Vrolijk, J.M. (Jan), Nieuwkerk, C.M.J. van, Bouma, G. (Gerben), van Gerven, N.M., Kuijvenhoven, J.P., Schreuder, T., Wouden, E.J. van der, van Meyel, J.J.M., Baak, L.C., Stadhouders, P., Klemt-Kropp, M., Verhagen, M., Bhalla, A., Ouden, J.W. (Jannie) den, Beuers, U. (Ulrich), van Erpecum, KJL, Buuren, H.R. (Henk) van, Brouwer, J.T. (johannes), van den Brand, F.F., van der Veen, K.S., Lissenberg-Witte, B.I., Boer, Y.S. (Ynto) de, Hoek, B. (Bart) van, Drenth, J.P.H. (Joost), Verdonk, R.C. (Robert), Vrolijk, J.M. (Jan), Nieuwkerk, C.M.J. van, Bouma, G. (Gerben), van Gerven, N.M., Kuijvenhoven, J.P., Schreuder, T., Wouden, E.J. van der, van Meyel, J.J.M., Baak, L.C., Stadhouders, P., Klemt-Kropp, M., Verhagen, M., Bhalla, A., Ouden, J.W. (Jannie) den, Beuers, U. (Ulrich), van Erpecum, KJL, Buuren, H.R. (Henk) van, and Brouwer, J.T. (johannes)
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Background: Autoimmune hepatitis requires long‐term therapy, and systemic cor‐ ticosteroids are the backbone of therapeutic management. Prolonged use of corti‐ costeroids may lead to adverse events but data from long‐term studies are mainly derived from studies in rheumatic diseases. Aim: To assess cataract, diabetes and fractures in relation to corticosteroid doses in the long‐term maintenance treatment of patients with autoimmune hepatitis. Methods: We retrospectively collected data on 476 patients (77% women) with an established diagnosis of autoimmune hepatitis. Binary logistic regression with a gen‐ eralised estimating equation was used to analyse the association between current corticosteroid use and the incidence of cataract, diabetes and fractures with onset after autoimmune hepatitis diagnosis. We corrected for sex, age, cirrhosis at diagno‐ sis and predniso(lo)ne use in the prior 3 years to account for possible ongoing effects. Results: A total of 6634 years, with a median of 13 (range 1‐40) per patient were recorded. The median age at diagnosis was 44 years (range 2‐88). Adverse events were documented in 120 (25%) patients. Low‐dose predniso(lo)ne (0.1‐5.0 mg/d) in‐ creased the odds of fractures whereas higher doses (>5.0 mg/d) increased the odds of cataracts and diabetes. Budesonide increased the odds of cataract and fractures; this effect was independent of predniso(lo)ne use in the prior 1, 2 or 3 years. Conclusions: Even low doses of corticosteroids frequently lead to substantial ad‐ verse events refuting the assumption that adverse events are prevented by adminis‐ tering low doses.
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- 2019
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11. Association Between Black Race and Presentation and Liver-Related Outcomes of Patients With Autoimmune Hepatitis
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de Boer, Ynto S., primary, Gerussi, Alessio, additional, van den Brand, Floris F., additional, Wong, Guan-Wee, additional, Halliday, Neil, additional, Liberal, Rodrigo, additional, Drenth, Joost P.H., additional, Thorburn, Douglas, additional, Bouma, Gerd, additional, Heneghan, Michael A., additional, van Gerven, N.M., additional, Beuers, U., additional, van Erpecum, K.J., additional, van Buuren, H.R., additional, den Ouden, J.W., additional, Brouwer, J.T., additional, Vrolijk, J.M., additional, Verdonk, R.C., additional, van Hoek, B., additional, Koek, G.H., additional, Guichelaar, M.M.J., additional, Bloemena, E., additional, van Nieuwkerk, C.M.J., additional, Schreuder, T.C.M.A., additional, van der Wouden, E.J., additional, van Meyel, J.J.M., additional, Baak, L.C., additional, Stadhouders, P.H.G.M., additional, Klemt-Kropp, M., additional, Verhagen, M.A.M.T., additional, Bhalla, A., additional, and Kuijvenhoven, J.Ph., additional
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- 2019
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12. Biochemical efficacy of tioguanine in autoimmune hepatitis: a retrospective review of practice in the Netherlands
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Brand, F.F. van den, Nieuwkerk, C.M. van, Verwer, B.J., Boer, Y.S. de, Boer, N.K. de, Mulder, C.J., Bloemena, E., Bakker, C.M., Vrolijk, J.M., Drenth, J.P.H., Tan, A., Borg, F. ter, Borg, M.J. Ter, Hazel, S.J. van den, Inderson, A., Tushuizen, M.E., Bouma, G., Brand, F.F. van den, Nieuwkerk, C.M. van, Verwer, B.J., Boer, Y.S. de, Boer, N.K. de, Mulder, C.J., Bloemena, E., Bakker, C.M., Vrolijk, J.M., Drenth, J.P.H., Tan, A., Borg, F. ter, Borg, M.J. Ter, Hazel, S.J. van den, Inderson, A., Tushuizen, M.E., and Bouma, G.
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Contains fulltext : 195713.pdf (Publisher’s version ) (Open Access), BACKGROUND: Azathioprine (AZA) and mercaptopurine (MP) are the cornerstone of steroid-sparing strategies in autoimmune hepatitis (AIH). Up to 20% of patients do not tolerate or respond to these regimens. AIM: To evaluate retrospectively the tolerability and efficacy of tioguanine (thioguanine) (TG) therapy in selected patients with AIH and AIH variant syndromes. METHODS: Records of 52 patients who received TG therapy were retrieved from nine hospitals in the Netherlands. Indications for TG treatment were intolerable side effects on AZA or MP (n = 38), insufficient response (n = 11) or first-line treatment (n = 3). Treatment efficacy was defined as normalisation of serum aminotransferases and serum immunoglobulin G. RESULTS: No serious adverse events occurred in patients treated with TG during a median follow-up of 18 months (range 1-194). Treatment was well tolerated in 41 patients (79%), whereas four had tolerable (8%) and seven (13%) intolerable side effects. Thirty-eight patients were treated with TG after intolerable side effects on AZA or MP; 29 patients continued TG therapy of whom 24 (83%) achieved complete biochemical remission, four (14%) had incomplete and one (3%) had no response; nine discontinued treatment. Seven of 11 patients with insufficient response to AZA or MP were responsive to TG, three with complete and four with incomplete biochemical remission; four discontinued due to intolerance (n = 2) and non-response (n = 2). TG was effective in all AIH patients as first-line maintenance treatment. CONCLUSION: In our retrospective review of TG therapy in selected patients with AIH or AIH variants who previously failed on AZA or MP, TG appeared tolerable with biochemical efficacy.
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- 2018
13. Fluid hydration to prevent post-ERCP pancreatitis in average- to high-risk patients receiving prophylactic rectal NSAIDs (FLUYT trial): study protocol for a randomized controlled trial
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Smeets, X.J.N.M., Costa, D.W. da, Fockens, P., Mulder, C.J., Timmer, R., Kievit, W., Zegers, M., Bruno, M.J., Besselink, M.G.H., Vleggaar, F.P., Hulst, R.W. van der, Poen, A.C., Heine, G.D.N., Venneman, N.G., Kolkman, J.J., Baak, L.C., Romkens, T.E.H., Dijk, S.M. van, Hallensleben, N.D., Vrie, W. van de, Seerden, T.C., Tan, A., Voorburg, A., Poley, J.W., Witteman, B.J., Bhalla, A., Hadithi, M., Thijs, W.J., Schwartz, M.P., Vrolijk, J.M., Verdonk, R.C., Delft, F. von, Keulemans, Y., Goor, H. van, Drenth, J.P.H., Geenen, E.J.M. van, Smeets, X.J.N.M., Costa, D.W. da, Fockens, P., Mulder, C.J., Timmer, R., Kievit, W., Zegers, M., Bruno, M.J., Besselink, M.G.H., Vleggaar, F.P., Hulst, R.W. van der, Poen, A.C., Heine, G.D.N., Venneman, N.G., Kolkman, J.J., Baak, L.C., Romkens, T.E.H., Dijk, S.M. van, Hallensleben, N.D., Vrie, W. van de, Seerden, T.C., Tan, A., Voorburg, A., Poley, J.W., Witteman, B.J., Bhalla, A., Hadithi, M., Thijs, W.J., Schwartz, M.P., Vrolijk, J.M., Verdonk, R.C., Delft, F. von, Keulemans, Y., Goor, H. van, Drenth, J.P.H., and Geenen, E.J.M. van
- Abstract
Contains fulltext : 190882.pdf (publisher's version ) (Open Access), BACKGROUND: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of ERCP and may run a severe course. Evidence suggests that vigorous periprocedural hydration can prevent PEP, but studies to date have significant methodological drawbacks. Importantly, evidence for its added value in patients already receiving prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) is lacking and the cost-effectiveness of the approach has not been investigated. We hypothesize that combination therapy of rectal NSAIDs and periprocedural hydration would significantly lower the incidence of post-ERCP pancreatitis compared to rectal NSAIDs alone in moderate- to high-risk patients undergoing ERCP. METHODS: The FLUYT trial is a multicenter, parallel group, open label, superiority randomized controlled trial. A total of 826 moderate- to high-risk patients undergoing ERCP that receive prophylactic rectal NSAIDs will be randomized to a control group (no fluids or normal saline with a maximum of 1.5 mL/kg/h and 3 L/24 h) or intervention group (lactated Ringer's solution with 20 mL/kg over 60 min at start of ERCP, followed by 3 mL/kg/h for 8 h thereafter). The primary endpoint is the incidence of post-ERCP pancreatitis. Secondary endpoints include PEP severity, hydration-related complications, and cost-effectiveness. DISCUSSION: The FLUYT trial design, including hydration schedule, fluid type, and sample size, maximize its power of identifying a potential difference in post-ERCP pancreatitis incidence in patients receiving prophylactic rectal NSAIDs. TRIAL REGISTRATION: EudraCT: 2015-000829-37 . Registered on 18 February 2015. ISRCTN: 13659155 . Registered on 18 May 2015.
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- 2018
14. Fluid hydration to prevent post-ERCP pancreatitis in average- to high-risk patients receiving prophylactic rectal NSAIDs (FLUYT trial): Study protocol for a randomized controlled trial
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Smeets, X.J.N.M. (Xavier J.N.M.), Da Costa, D.W. (David W.), Fockens, P. (Paul), Mulder, C.J.J. (Chris), Timmer, R. (Robin), Kievit, W. (Wietske), Zegers, M. (Marieke), Bruno, M.J. (Marco), Besselink, M.G. (Marc), Vleggaar, F.P. (Frank), Hulst, R.W.M. (René) van der, Poen, A.C. (Alexander), Heine, G.D.N. (Gerbrand D.N.), Venneman, N.G. (Niels), Kolkman, J.J. (Jeroen J.), Baak, L.C. (Lubbertus), Römkens, T.E.H., Dijk, S.M. (Sven) van, Hallensleben, N.D.L. (Nora D.L.), Vrie, W. (Wim) van de, Seerden, T.C.J. (Tom), Tan, A.C. (Adriaan), Voorburg, A.M.C.J. (Annet), Poley, J.-W. (Jan-Werner), Witteman, B.J.M. (Ben), Bhalla, A. (Abha), Hadithi, M. (Muhammed), Thijs, W.J., Schwartz, M.P. (Matthijs), Vrolijk, J.M. (Jan), Verdonk, R.C. (Robert), van Delft, F. (Foke), Keulemans, Y. (Yolande), Goor, H. (Harry) van, Drenth, J.P.H. (Joost), Geenen, E-J.M. (Erwin-Jan), Smeets, X.J.N.M. (Xavier J.N.M.), Da Costa, D.W. (David W.), Fockens, P. (Paul), Mulder, C.J.J. (Chris), Timmer, R. (Robin), Kievit, W. (Wietske), Zegers, M. (Marieke), Bruno, M.J. (Marco), Besselink, M.G. (Marc), Vleggaar, F.P. (Frank), Hulst, R.W.M. (René) van der, Poen, A.C. (Alexander), Heine, G.D.N. (Gerbrand D.N.), Venneman, N.G. (Niels), Kolkman, J.J. (Jeroen J.), Baak, L.C. (Lubbertus), Römkens, T.E.H., Dijk, S.M. (Sven) van, Hallensleben, N.D.L. (Nora D.L.), Vrie, W. (Wim) van de, Seerden, T.C.J. (Tom), Tan, A.C. (Adriaan), Voorburg, A.M.C.J. (Annet), Poley, J.-W. (Jan-Werner), Witteman, B.J.M. (Ben), Bhalla, A. (Abha), Hadithi, M. (Muhammed), Thijs, W.J., Schwartz, M.P. (Matthijs), Vrolijk, J.M. (Jan), Verdonk, R.C. (Robert), van Delft, F. (Foke), Keulemans, Y. (Yolande), Goor, H. (Harry) van, Drenth, J.P.H. (Joost), and Geenen, E-J.M. (Erwin-Jan)
- Abstract
Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of ERCP and may run a severe course. Evidence suggests that vigorous periprocedural hydration can prevent PEP, but studies to date have significant methodological drawbacks. Importantly, evidence for its added value in patients already receiving prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) is lacking and the cost-effectiveness of the approach has not been investigated. We hypothesize that combination therapy of rectal NSAIDs and periprocedural hydration would significantly lower the incidence of post-ERCP pancreatitis compared to rectal NSAIDs alone in moderate- to high-risk patients undergoing ERCP. Methods: The FLUYT trial is a multicenter, parallel group, open label, superiority randomized controlled trial. A total of 826 moderate- to high-risk patients undergoing ERCP that receive prophylactic rectal NSAIDs will be randomized to a control group (no fluids or normal saline with a maximum of 1.5 mL/kg/h and 3 L/24 h) or intervention group (lactated Ringer's solution with 20 mL/kg over 60 min at start of ERCP, followed by 3 mL/kg/h for 8 h thereafter). The primary endpoint is the incidence of post-ERCP pancreatitis. Secondary endpoints include PEP severity, hydration-related complications, and cost-effectiveness. Discussion: The FLUYT trial design, including hydration schedule, fluid type, and sample size, maximize its power of identifying a potential difference in post-ERCP pancreatitis incidence in patients receiving prophylactic rectal NSAIDs.
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- 2018
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15. Epidemiology and clinical characteristics of autoimmune hepatitis in the Netherlands
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Gerven, N.M.F. van, Verwer, B.J., Witte, B.I., Erpecum, K.J. van, Buuren, H.R. van, Maijers, I., Visscher, A.P., Verschuren, E.C., Hoek, B. van, Coenraad, M.J., Beuers, U.H.W., Man, R.A. de, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M.J., Vrolijk, J.M., Mulder, C.J.J., Nieuwkerk, C.M.J. van, Bouma, G., Dutch Autoimmune Hepatitis STUDY, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Gastroenterology and hepatology, Epidemiology and Data Science, CCA - Innovative therapy, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, and Gastroenterology & Hepatology
- Subjects
Liver Cirrhosis ,Male ,Cirrhosis ,diagnosis ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Autoimmune hepatitis ,Liver transplantation ,Gastroenterology ,Primary biliary cirrhosis ,immune system diseases ,Surveys and Questionnaires ,Child ,Fatigue ,Netherlands ,Aged, 80 and over ,medicine.diagnostic_test ,Incidence (epidemiology) ,Incidence ,Liver Neoplasms ,Age Factors ,Alanine Transaminase ,hepatocellular carcinoma ,Middle Aged ,Hepatitis, Autoimmune ,Liver biopsy ,Antibodies, Antinuclear ,Child, Preschool ,Female ,epidemiology ,Immunosuppressive Agents ,Adult ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Adolescent ,prevalence ,Black People ,Jaundice ,White People ,Primary sclerosing cholangitis ,Young Adult ,diagnostic scoring systems ,Sex Factors ,Asian People ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,autoimmune hepatitis ,business.industry ,cirrhosis ,South America ,medicine.disease ,Alkaline Phosphatase ,digestive system diseases ,Transplantation ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,Immunoglobulin G ,business ,transplantation - Abstract
Item does not contain fulltext Abstract Background and aims. Epidemiological data on autoimmune hepatitis (AIH) are scarce. In this study, we determined the clinical and epidemiological characteristics of AIH patients in the Netherlands (16.7 million inhabitants). Methods. Clinical characteristics were collected from 1313 AIH patients (78% females) from 31 centers, including all eight academic centers in the Netherlands. Additional data on ethnicity, family history and symptoms were obtained by the use of a questionnaire. Results. The prevalence of AIH was 18.3 (95% confidential interval [CI]: 17.3-19.4) per 100,000 with an annual incidence of 1.1 (95% CI: 0.5-2) in adults. An incidence peak was found in middle-aged women. At diagnosis, 56% of patients had fibrosis and 12% cirrhosis in liver biopsy. Overall, 1% of patients developed HCC and 3% of patients underwent liver transplantation. Overlap with primary biliary cirrhosis and primary sclerosing cholangitis was found in 9% and 6%, respectively. The clinical course did not differ between Caucasian and non-Caucasian patients. Other autoimmune diseases were found in 26% of patients. Half of the patients reported persistent AIH-related symptoms despite treatment with a median treatment period of 8 years (range 1-44 years). Familial occurrence was reported in three cases. Conclusion. This is the largest epidemiological study of AIH in a geographically defined region and demonstrates that the prevalence of AIH in the Netherlands is uncommon. Although familial occurrence of AIH is extremely rare, our twin data may point towards a genetic predisposition. The high percentage of patients with cirrhosis or fibrosis at diagnosis urges the need of more awareness for AIH.
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- 2014
16. Optimal institution of azathioprine maintenance therapy in autoimmune hepatitis: a multicenter cohort study
- Author
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Pape, S., primary, Gevers, T., additional, Mustafajev, I., additional, van den Brand, F., additional, van Nieuwkerk, K., additional, Bouma, G., additional, Vrolijk, J.M., additional, Hoek, B.V., additional, Hartl, J., additional, Lohse, A., additional, Schramm, C., additional, Wong, G.W., additional, Heneghan, M., additional, and Drenth, J.P., additional
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- 2018
- Full Text
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17. Overcoming Outpatient Loss to Follow-up as a Barrier to Efficiently Instituting Hepatitis B Liver-related Care
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Lieveld, F.I., Arends, J.E., Amelung, L., Dijk, E. van, Gisolf, E.H., Vrolijk, J.M., Erpecum, K.J. van, Siersema, P.D., Spanier, B.W., Hoepelman, A.I., Richter, C., Lieveld, F.I., Arends, J.E., Amelung, L., Dijk, E. van, Gisolf, E.H., Vrolijk, J.M., Erpecum, K.J. van, Siersema, P.D., Spanier, B.W., Hoepelman, A.I., and Richter, C.
- Abstract
Item does not contain fulltext
- Published
- 2017
18. How the concept of biochemical response influenced the management of primary biliary cholangitis over time
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Lammers, W.J., Leeman, M., Ponsioen, C.I., Boonstra, K., Erpecum, K.J. van, Wolfhagen, F.H., Kuyvenhoven, J.P., Vrolijk, J.M., Drenth, J.P.H., Witteman, E.M., Nieuwkerk, C.M. van, Spek, B.W. van der, Witteman, B.J., Erkelens, G.W., Verhagen, M.A., Tuyl, S.A. van, Poen, A.C., Brouwer, J.T., Borg, F. ter, Koek, G.H., Ditzhuijsen, T.J. van, Hansen, B.E., Gastroenterology and hepatology, AGEM - Digestive immunity, Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
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second-line therapy ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,Autoimmune liver disease ,cholestasis - Abstract
Item does not contain fulltext BACKGROUND: Criteria assessing biochemical response to ursodeoxycholic acid (UDCA) are established risk stratification tools in primary biliary cholangitis (PBC). We aimed to evaluate to what extent liver tests influenced patient management during a three decade period, and whether this changed over time. METHODS: 851 Dutch PBC patients diagnosed between 1988 and 2012 were reviewed to assess patient management in relation to liver test results during UDCA treatment. To do so, biochemical response at one year was analysed retrospectively according to Paris-1 criteria. RESULTS: Response was assessable for 687/851 (81%) patients; 157/687 non-responders. During a follow-up of 8.8 years (IQR 4.8-13.9), 141 died and 30 underwent liver transplantation. Transplant-free survival of non-responders (60%) was significantly worse compared with responders (87%) (p < 0.0001). Management was modified in 46/157 (29%) non-responders. The most frequent change observed, noted in 26/46 patients, was an increase in UDCA dosage. Subsequently, 9/26 (35%) non-responders became responders within the next two years. Steroid treatment was started in one patient; 19 patients were referred to a tertiary centre. No trend towards more frequent changes in management over time was observed (p = 0.10). CONCLUSION: Changes in medical management occurred in a minority of non-responders. This can largely be explained by the lack of accepted response criteria and of established second-line treatments for PBC. Nevertheless, the observation that response-guided management did not increase over time suggests that awareness of the concept of biochemical response requires further attention,particularly since new treatment options for PBC will soon become available.
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- 2016
19. HLA-DRB1*03:01 and HLA-DRB1*04:01 modify the presentation and outcome in autoimmune hepatitis type-1
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Gerven, N.M.F. van, Boer, Y.S. de, Zwiers, A., Verwer, B.J., Drenth, J.P.H., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.J., Vrolijk, J.M., Coenraad, M.J., Kraal, G., Mulder, C.J.J., Nieuwkerk, C.M.J. van, Bloemena, E., Verspaget, H.W., Kumar, V., Zhernakova, A., Wijmenga, C., Franke, L., Bouma, G., Dutch Autoimmune Hepatitis Study G, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, Gastroenterology & Hepatology, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Translational Immunology Groningen (TRIGR), Stem Cell Aging Leukemia and Lymphoma (SALL), Gastroenterology and hepatology, Molecular cell biology and Immunology, Pathology, Oral and Maxillofacial Surgery / Oral Pathology, and CCA - Immuno-pathogenesis
- Subjects
Adult ,Male ,musculoskeletal diseases ,Immunology ,Autoimmune hepatitis ,Human leukocyte antigen ,SUSCEPTIBILITY ,DIAGNOSIS ,Cohort Studies ,Liver disease ,SDG 3 - Good Health and Well-being ,LIVER-DISEASE ,immune system diseases ,Genotype ,Genetics ,medicine ,Humans ,Genetic Predisposition to Disease ,Age of Onset ,skin and connective tissue diseases ,HLA-DRB1 ,POLYMORPHISMS ,Genetics (clinical) ,Aged ,Hepatitis ,biology ,Haplotype ,ASSOCIATION ,Middle Aged ,medicine.disease ,Liver Transplantation ,HLA ,Hepatitis, Autoimmune ,Treatment Outcome ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,Alanine transaminase ,Immunoglobulin G ,Multivariate Analysis ,ANTIBODIES ,biology.protein ,Female ,HAPLOTYPES ,HLA-DRB1 Chains - Abstract
The classical human leukocyte antigen (HLA)-DRB1*03:01 and HLA-DRB1*04:01 alleles are established autoimmune hepatitis (AIH) risk alleles. To study the immune-modifying effect of these alleles, we imputed the genotypes from genome-wide association data in 649 Dutch AIH type-1 patients. We therefore compared the international AIH group (IAIHG) diagnostic scores as well as the underlying clinical characteristics between patients positive and negative for these HLA alleles. Seventy-five percent of the AIH patients were HLA-DRB1*03:01/HLA-DRB1*04:01 positive. HLA-DRB1*03:01/HLA-DRB1*04:01-positive patients had a higher median IAIHG score than HLA-DRB1*03:01/HLA-DRB1*04:01-negative patients (P
- Published
- 2015
20. Clinical impact of five large-scale screening projects for chronic hepatitis B in Chinese migrants in the Netherlands
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Coenen, S., Meer, S. van, Vrolijk, J.M., Richter, C., Erpecum, K.J. van, Mostert, M.C., Veldhuijzen, I.K., Reijnders, J.G., Soest, H. van, Dirksen, K., Drenth, J.P.H., Koene, R.P., Bosschart, M., Friederich, P., Borg, M.J. Ter, Daemen, R.H., Arends, J.E., Verhagen, M.A., Schout, C., Spanier, B.W., Coenen, S., Meer, S. van, Vrolijk, J.M., Richter, C., Erpecum, K.J. van, Mostert, M.C., Veldhuijzen, I.K., Reijnders, J.G., Soest, H. van, Dirksen, K., Drenth, J.P.H., Koene, R.P., Bosschart, M., Friederich, P., Borg, M.J. Ter, Daemen, R.H., Arends, J.E., Verhagen, M.A., Schout, C., and Spanier, B.W.
- Abstract
Item does not contain fulltext, BACKGROUND & AIMS: In low-endemic countries it is debated whether first-generation migrants should be screened for chronic hepatitis B infection. We describe the clinical impact of five large-scale Dutch screening projects for hepatitis B in first-generation Chinese migrants. METHODS: Between 2009 and 2013 five independent outreach screening projects for hepatitis B targeting first-generation Chinese migrants were conducted in five main Dutch regions. To explore the relevance of our screening we defined clinical impact as the presence of an indication for: (i) antiviral therapy, (ii) strict follow-up because of high hepatitis B DNA levels and/or (iii) surveillance for hepatocellular carcinoma. RESULTS: In total, 4423 persons participated in the projects of whom 6.0% (n = 264) were HBsAg positive. One hundred and twenty-nine newly diagnosed HBsAg-positive patients were analysed in specialist care. Among these patients prevalence of cirrhosis was 6.9% and antiviral therapy for hepatitis B was started in 32 patients (25%). In patients without a treatment indication, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma was considered indicated in 64 patients (50%). CONCLUSIONS: In our screening project in first-generation Chinese migrants, antiviral treatment, strict follow-up because of high hepatitis B DNA levels and/or surveillance for hepatocellular carcinoma were considered indicated in three of four analysed HBsAg-positive patients. These data show that detection of hepatitis B in Chinese migrants can have considerable impact on patient care.
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- 2016
21. Dutch guidance for the treatment of chronic hepatitis C virus infection in a new therapeutic era
- Author
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Berden, F.A.C., Kievit, W., Baak, L.C., Bakker, C.M., Beuers, U., Boucher, C.A.B., Brouwer, J.T., Burger, D.M., Erpecum, K.J.L. van, Hoek, B. van, Hoepelman, A.I.M., Honkoop, P., Kerbert-Dreteler, M.J., Knegt, R.J. de, Koek, G.H., Nieuwkerk, C.M.J. van, Soest, H. van, Tan, A.C.I.T.L., Vrolijk, J.M., Drenth, J.P.H., Erasmus MC other, Virology, Surgery, Gastroenterology & Hepatology, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
- Subjects
Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,SDG 3 - Good Health and Well-being ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,hepatitis C ,Direct-acting antivirals ,sofosbuvir ,guidance ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] - Abstract
Item does not contain fulltext BACKGROUND: A new era for the treatment of chronic hepatitis C is about to transpire. With the introduction of the first-generation protease inhibitors the efficacy of hepatitis C treatment improved significantly. Since then, the therapeutic agenda has moved further forward with the recent approval of sofosbuvir and the expected approval of agents such as simeprevir and daclatasvir. This paper, developed parallel to the approval of sofosbuvir, is to serve as a guidance for the therapeutic management of chronic hepatitis C. METHODS: We performed a formal search through PubMed, Web of Science and ClinicalTrials.gov to identify all clinical trials that have been conducted with EMA-approved new agents in hepatitis C; for this version (April 2014) we focused on sofosbuvir. For each disease category, the evidence was reviewed and recommendations are based on GRADE. RESULTS: We identified 11 clinical trials with sofosbuvir and for each disease category recommendations for treatment are made. Not all disease categories were studied extensively and therefore in some cases we were unable to provide recommendations. CONCLUSION: The recent approval of sofosbuvir will most likely change the therapeutic landscape of chronic hepatitis C. The use of sofosbuvir-containing regimens can shorten the duration of therapy, increase efficacy and result in less side effects, compared with standard of care. The efficacy relative to standard of care needs to be weighed against the increased costs of sofosbuvir. With future approval of the other direct-acting antivirals, the outcome of hepatitis C treatment will likely improve further and this guidance will be updated.
- Published
- 2014
22. Genome-Wide Association Study Identifies Variants Associated With Autoimmune Hepatitis Type 1
- Author
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Boer, Y.S. de, Gerven, N.M.F. van, Zwiers, A., Verwer, B.J., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M.J., Vrolijk, J.M., Kraal, G., Mulder, C.J.J., Nieuwkerk, C.M.J. van, Fischer, J., Berg, T., Stickel, F., Sarrazin, C., Schramm, C., Lohse, A.W., Weiler-Normann, C., Lerch, M.M., Nauck, M., Volzke, H., Homuth, G., Bloemena, E., Verspaget, H.W., Kumar, V., Zhernakova, A., Wijmenga, C., Franke, L., Bouma, G., Dutch Autoimmune Hepatitis Study, LifeLines Cohort Study, and Study Hlth Pomerania
- Subjects
SH2B Adaptor Protein 3 ,Genetics ,GWAS ,Autoimmunity - Published
- 2014
23. GENOME-WIDE ASSOCIATION STUDY IN AUTOIMMUNE HEPATITIS IDENTIFIES RISK VARIANT IN THE SH2B3 REGION
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Boer, Y.S. de, Gerven, N.M. van, Verwer, B., Zwiers, A., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M.J., Vrolijk, J.M., Kraal, G., Mulder, C.J.J., Nieuwkerk, C.M.J. van, Fischer, J., Berg, T., Stickel, F., Sarrazin, C., Schramm, C., Lohse, A.W., Weiler-Normann, C., Lerch, M.M., Nauck, M., Volzke, H., Homuth, G., Bloemena, E., Kumar, V., Zhernakova, A., Wijmenga, C., Franke, L., Bouma, G., Dutch Autoimmune Hepatitis Study G, LifeLines Cohort Study, and Study Hlth Pomerania
- Published
- 2014
24. HLA-DRB1*03:01 and HLA-DRB1*04:01 modify the presentation and outcome in autoimmune hepatitis type-1
- Author
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Gerven, N.M. van, Boer, Y.S. de, Zwiers, A, Verwer, B.J., Drenth, J.P.H., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Coenraad, M.J., Kraal, G., Mulder, C.J., Nieuwkerk, C.M. van, Bloemena, E., Verspaget, H.W., Kumar, V., Zhernakova, A., Wijmenga, C., Franke, L., Bouma, G., Gerven, N.M. van, Boer, Y.S. de, Zwiers, A, Verwer, B.J., Drenth, J.P.H., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Coenraad, M.J., Kraal, G., Mulder, C.J., Nieuwkerk, C.M. van, Bloemena, E., Verspaget, H.W., Kumar, V., Zhernakova, A., Wijmenga, C., Franke, L., and Bouma, G.
- Abstract
Item does not contain fulltext, The classical human leukocyte antigen (HLA)-DRB1*03:01 and HLA-DRB1*04:01 alleles are established autoimmune hepatitis (AIH) risk alleles. To study the immune-modifying effect of these alleles, we imputed the genotypes from genome-wide association data in 649 Dutch AIH type-1 patients. We therefore compared the international AIH group (IAIHG) diagnostic scores as well as the underlying clinical characteristics between patients positive and negative for these HLA alleles. Seventy-five percent of the AIH patients were HLA-DRB1*03:01/HLA-DRB1*04:01 positive. HLA-DRB1*03:01/HLA-DRB1*04:01-positive patients had a higher median IAIHG score than HLA-DRB1*03:01/HLA-DRB1*04:01-negative patients (P<0.001). We did not observe associations between HLA alleles and alanine transaminase levels (HLA-DRB1*03:01: P=0.2; HLA-DRB1*04:01; P=0.5); however, HLA-DRB1*03:01 was independently associated with higher immunoglobulin G levels (P=0.04). The HLA-DRB1*04:01 allele was independently associated with presentation at older age (P=0.03) and a female predominance (P=0.04). HLA-DRB1*03:01-positive patients received immunosuppressive medication and liver transplantation. In conclusion, the HLA-DRB1*03:01 and HLA-DRB1*04:01 alleles are both independently associated with the aggregate diagnostic IAIHG score in type-1 AIH patients, but are not essential for AIH development. HLA-DRB1*03:01 is the strongest genetic modifier of disease severity in AIH.
- Published
- 2015
25. THU-213 - Optimal institution of azathioprine maintenance therapy in autoimmune hepatitis: a multicenter cohort study
- Author
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Pape, S., Gevers, T., Mustafajev, I., van den Brand, F., van Nieuwkerk, K., Bouma, G., Vrolijk, J.M., Hoek, B.V., Hartl, J., Lohse, A., Schramm, C., Wong, G.W., Heneghan, M., and Drenth, J.P.
- Published
- 2018
- Full Text
- View/download PDF
26. Cytotoxic T lymphocyte antigen-4 +49A/G polymorphism does not affect susceptibility to autoimmune hepatitis
- Author
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Gerven, N.M.F. van, Boer, Y.S. de, Zwiers, A., Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M.J., Vrolijk, J.M., Kraal, G., Mulder, C.J.J., Nieuwkerk, C.M.J. van, Bouma, G., Dutch Autoimmune Hepatitis Study G, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, Gastroenterology & Hepatology, Immunology, Gastroenterology and hepatology, Pathology, Oral and Maxillofacial Surgery / Oral Pathology, Molecular cell biology and Immunology, CCA - Disease profiling, Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
- Subjects
Genotype ,Population ,Single-nucleotide polymorphism ,Autoimmune hepatitis ,Biology ,GENE POLYMORPHISMS ,Polymerase Chain Reaction ,Polymorphism, Single Nucleotide ,DISEASE ,cytotoxic T lymphocyte antigen-4 ,susceptibility ,White People ,SDG 3 - Good Health and Well-being ,Gene Frequency ,single nucleotide polymorphism ,medicine ,CONFER SUSCEPTIBILITY ,Cytotoxic T cell ,Humans ,CTLA-4 Antigen ,Genetic Predisposition to Disease ,Molecular gastro-enterology and hepatology Membrane transport and intracellular motility [IGMD 2] ,Allele ,education ,Allele frequency ,POPULATION ,TYPE-1 ,Netherlands ,PRIMARY BILIARY-CIRRHOSIS ,education.field_of_study ,Analysis of Variance ,Hepatology ,autoimmune hepatitis ,ASSOCIATION ,Sequence Analysis, DNA ,medicine.disease ,Genotype frequency ,Hepatitis, Autoimmune ,Immunology ,CTLA-4 - Abstract
Background & AimsSingle nucleotide polymorphisms (SNP) in the Cytotoxic T lymphocyte antigen-4 gene (CTLA-4) have been associated with several autoimmune diseases including autoimmune Hepatitis (AIH). In this chronic idiopathic inflammatory liver disease, conflicting results have been reported on the association with a SNP at position +49 in the CTLA-4 gene in small patient cohorts. Here, we established the role of this SNP in a sufficiently large cohort of AIH patients. MethodsThe study population consisted of 672 AIH patients derived from academic and regional hospitals in the Netherlands and was compared with 500 controls selected from the Genome of the Netherlands' project cohort. Genotype frequencies were assessed by PCR for patients and by whole genome sequencing for controls. ResultsNo significant differences in allele frequencies were found between patients and controls (G Allele: 40% vs 39%, P=0.7). Similarly, no significant differences in genotype frequencies between patients and controls were found. Finally, there was no relation between disease activity and the G allele or AG and GG genotypes. ConclusionThe Cytotoxic T Lymphocyte Antigen-4 +49 A/G polymorphism does not represent a major susceptibility risk allele for AIH in Caucasians and is not associated with disease severity at presentation.
- Published
- 2012
27. P1267 : Retrieval of patients with chronic hepatitis B and C by intensifying regional collaboration, Arnhem region, the Netherlands
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Richter, C., primary, Waegemaeckers, T., additional, Polling, I., additional, de Graaf, L., additional, Swanink, C., additional, Roelofs, M., additional, Poorterman, C., additional, Spanier, M., additional, Vrolijk, J.M., additional, Gisolf, J., additional, and ter Beest, G., additional
- Published
- 2015
- Full Text
- View/download PDF
28. O122 : Clinical impact of five large-scale screening projects for chronic hepatitis B and C in Chinese migrants in The Netherlands
- Author
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Coenen, S., primary, van Meer, S., additional, Vrolijk, J.M., additional, Richter, C., additional, Drenth, J.P.H., additional, Koopmans, P.P., additional, van Soest, H., additional, van Erpecum, K.J., additional, Arends, J.E., additional, Verhagen, M.A.M.T., additional, Friederich, P., additional, Flink, H.J., additional, ter Borg, M.J., additional, Veldhuijzen, I.K., additional, Reijnders, J.G.P., additional, Mostert, M.C., additional, Dirksen, C.G., additional, Schout, C., additional, Daemen, H.P.J., additional, and Spanier, B.W.M., additional
- Published
- 2015
- Full Text
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29. P1257 : Early identification of patients at risk for chronic hepatitis B and C in arnhem region, the Netherlands
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Ter Beest, G., primary, Gisolf, J., additional, Belgers, M., additional, Waegemaeckers, T., additional, Swanink, C., additional, Spanier, M., additional, Vrolijk, J.M., additional, Van Bentum, P., additional, Roovers, L., additional, and Richter, C., additional
- Published
- 2015
- Full Text
- View/download PDF
30. Epidemiology and clinical characteristics of autoimmune hepatitis in the Netherlands
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Gerven, N.M. van, Verwer, B.J., Witte, B.I., Erpecum, K.J. van, Buuren, H.R. van, Maijers, I., Visscher, A.P., Verschuren, E.C., Hoek, B. van, Coenraad, M.J., Beuers, U.H., Man, R.A. de, Drenth, J.P., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Mulder, C.J., Nieuwkerk, C.M. van, Bouma, G., et al., Gerven, N.M. van, Verwer, B.J., Witte, B.I., Erpecum, K.J. van, Buuren, H.R. van, Maijers, I., Visscher, A.P., Verschuren, E.C., Hoek, B. van, Coenraad, M.J., Beuers, U.H., Man, R.A. de, Drenth, J.P., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Mulder, C.J., Nieuwkerk, C.M. van, Bouma, G., and et al.
- Abstract
Item does not contain fulltext, Background and aims. Epidemiological data on autoimmune hepatitis (AIH) are scarce. In this study, we determined the clinical and epidemiological characteristics of AIH patients in the Netherlands (16.7 million inhabitants). Methods. Clinical characteristics were collected from 1313 AIH patients (78% females) from 31 centers, including all eight academic centers in the Netherlands. Additional data on ethnicity, family history and symptoms were obtained by the use of a questionnaire. Results. The prevalence of AIH was 18.3 (95% confidential interval [CI]: 17.3-19.4) per 100,000 with an annual incidence of 1.1 (95% CI: 0.5-2) in adults. An incidence peak was found in middle-aged women. At diagnosis, 56% of patients had fibrosis and 12% cirrhosis in liver biopsy. Overall, 1% of patients developed HCC and 3% of patients underwent liver transplantation. Overlap with primary biliary cirrhosis and primary sclerosing cholangitis was found in 9% and 6%, respectively. The clinical course did not differ between Caucasian and non-Caucasian patients. Other autoimmune diseases were found in 26% of patients. Half of the patients reported persistent AIH-related symptoms despite treatment with a median treatment period of 8 years (range 1-44 years). Familial occurrence was reported in three cases. Conclusion. This is the largest epidemiological study of AIH in a geographically defined region and demonstrates that the prevalence of AIH in the Netherlands is uncommon. Although familial occurrence of AIH is extremely rare, our twin data may point towards a genetic predisposition. The high percentage of patients with cirrhosis or fibrosis at diagnosis urges the need of more awareness for AIH.
- Published
- 2014
31. Rhabdomyolysis in a hepatitis C virus infected patient treated with telaprevir and simvastatin
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Kanter, C.T.M.M. de, Luin, M. van, Solas, C., Burger, D.M., Vrolijk, J.M., Kanter, C.T.M.M. de, Luin, M. van, Solas, C., Burger, D.M., and Vrolijk, J.M.
- Abstract
Contains fulltext : 136062.pdf (Publisher’s version ) (Open Access), A 46-year old man with a chronic hepatitis C virus infection received triple therapy with ribavirin, pegylated interferon and telaprevir. The patient also received simvastatin. One month after starting the antiviral therapy, the patient was admitted to the hospital because he developed rhabdomyolysis. At admission simvastatin and all antiviral drugs were discontinued because toxicity due to a drug-drug interaction was suspected. The creatine kinase peaked at 62,246 IU/L and the patient was treated with intravenous normal saline. The patient's renal function remained unaffected. Fourteen days after hospitalization, creatine kinase level had returned to 230 IU/L and the patient was discharged. Telaprevir was considered the probable causative agent of an interaction with simvastatin according to the Drug Interaction Probability Scale. The interaction is due to inhibition of CYP3A4-mediated simvastatin clearance. Simvastatin plasma concentration increased 30 times in this patient and statin induced muscle toxicity is related to the concentration of the statin in blood. In conclusion, with this case we illustrate that telaprevir as well as statins are susceptible to clinical relevant drug-drug interactions.
- Published
- 2014
32. P390 IMPACT IN DAILY PRACTICE OF THE CONCEPT OF TREATMENT RESPONSE IN PRIMARY BILIARY CIRRHOSIS. A NATIONAL COHORT STUDY
- Author
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Leeman, M., primary, Lammers, W.J., additional, Ponsioen, C.Y., additional, Boonstra, K., additional, van Erpecum, K.J., additional, Wolfhagen, F.H.J., additional, Kuyvenhoven, J.P., additional, Vrolijk, J.M., additional, Drenth, J.P.H., additional, Witteman, E.M., additional, van Nieuwkerk, C.M.J., additional, van der Spek, B.W., additional, Witteman, B.J.M., additional, Erkelens, G.W., additional, Verhagen, M.A.M.T., additional, van Tuyl, S.A.C., additional, Poen, A.C., additional, Brouwer, J.T., additional, ter Borg, F., additional, Koek, G.H., additional, van Ditzhuijsen, T.J.M., additional, Hansen, B.E., additional, and van Buuren, H.R., additional
- Published
- 2014
- Full Text
- View/download PDF
33. O131 GENOME-WIDE ASSOCIATION STUDY IN AUTOIMMUNE HEPATITIS IDENTIFIES RISK VARIANT IN THE SH2B3 REGION
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de Boer, Y.S., primary, van Gerven, N.M., additional, Verwer, B., additional, Zwiers, A., additional, van Hoek, B., additional, van Erpecum, K.J., additional, Beuers, U., additional, van Buuren, H.R., additional, Drenth, J.P.H., additional, den Ouden, J.W., additional, Verdonk, R.C., additional, Koek, G.H., additional, Brouwer, J.T., additional, Guichelaar, M.M.J., additional, Vrolijk, J.M., additional, Kraal, G., additional, Mulder, C.J.J., additional, van Nieuwkerk, C.M.J., additional, Fischer, J., additional, Berg, T., additional, Stickel, F., additional, Sarrazin, C., additional, Schramm, C., additional, Lohse, A.W., additional, Weiler-Normann, C., additional, Lerch, M.M., additional, Nauck, M., additional, Völzke, H., additional, Homuth, G., additional, Bloemena, E., additional, Kumar, V., additional, Zhernakova, A., additional, Wijmenga, C., additional, Franke, L., additional, and Bouma, G., additional
- Published
- 2014
- Full Text
- View/download PDF
34. Cytotoxic T Lymphocyte Antigen-4 +49A/G polymorphism does not affect susceptibility to autoimmune hepatitis
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Gerven, N.M. van, Boer, Y.S. de, Zwiers, A, Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Kraal, G., Mulder, C.J., Nieuwkerk, C.M. van, Bouma, G., et al., Gerven, N.M. van, Boer, Y.S. de, Zwiers, A, Hoek, B. van, Erpecum, K.J. van, Beuers, U., Buuren, H.R. van, Drenth, J.P.H., Ouden, J.W. den, Verdonk, R.C., Koek, G.H., Brouwer, J.T., Guichelaar, M.M., Vrolijk, J.M., Kraal, G., Mulder, C.J., Nieuwkerk, C.M. van, Bouma, G., and et al.
- Abstract
Item does not contain fulltext, BACKGROUND & AIMS: Single nucleotide polymorphisms (SNP) in the Cytotoxic T lymphocyte antigen-4 gene (CTLA-4) have been associated with several autoimmune diseases including autoimmune Hepatitis (AIH). In this chronic idiopathic inflammatory liver disease, conflicting results have been reported on the association with a SNP at position +49 in the CTLA-4 gene in small patient cohorts. Here, we established the role of this SNP in a sufficiently large cohort of AIH patients. METHODS: The study population consisted of 672 AIH patients derived from academic and regional hospitals in the Netherlands and was compared with 500 controls selected from the 'Genome of the Netherlands' project cohort. Genotype frequencies were assessed by PCR for patients and by whole genome sequencing for controls. RESULTS: No significant differences in allele frequencies were found between patients and controls (G Allele: 40% vs 39%, P = 0.7). Similarly, no significant differences in genotype frequencies between patients and controls were found. Finally, there was no relation between disease activity and the G allele or AG and GG genotypes. CONCLUSION: The Cytotoxic T Lymphocyte Antigen-4 +49 A/G polymorphism does not represent a major susceptibility risk allele for AIH in Caucasians and is not associated with disease severity at presentation.
- Published
- 2013
35. The 2012 revised Dutch national guidelines for the treatment of chronic hepatitis B virus infection
- Author
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Buster, E.H., Baak, B.C., Bakker, C.M., Beuers, U.H., Brouwer, J.T., Drenth, J.P.H., Erpecum, K.J. van, Hoek, B. van, Honkoop, P., Kerbert-Dreteler, M.J., Koek, G.H., Nieuwkerk, K.M. van, van Soest, H., van der Spek, B.W., Tan, A.C., Vrolijk, J.M., Janssen, H.L., Buster, E.H., Baak, B.C., Bakker, C.M., Beuers, U.H., Brouwer, J.T., Drenth, J.P.H., Erpecum, K.J. van, Hoek, B. van, Honkoop, P., Kerbert-Dreteler, M.J., Koek, G.H., Nieuwkerk, K.M. van, van Soest, H., van der Spek, B.W., Tan, A.C., Vrolijk, J.M., and Janssen, H.L.
- Abstract
Item does not contain fulltext, In 2008, the Netherlands Association of Gastroenterologists and Hepatologists (Nederlands Vereniging van Maag-Darm-Leverartsen) published the Dutch national guidelines for the treatment of chronic hepatitis B virus infection. New insights into the treatment of chronic hepatitis B with relevance for clinical practice have been adopted in these concise, revised guidelines. The most important changes include the choice of initial antiviral therapy, licensing of tenofovir for the treatment of chronic hepatitis B and the management of antiviral resistance.
- Published
- 2012
36. No beneficial effects of amantadine in treatment of chronic hepatitis C patients.
- Author
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Soest, H. van, Schaar, P.J. van der, Koek, G.H., Vries, R.A. de, Ooteghem, N.A. van, Hoek, B. van, Drenth, J.P.H., Vrolijk, J.M., Lieverse, R.J., Houben, P., Sluys Veer, A. van der, Siersema, P.D., Schipper, M.E., Erpecum, K.J. van, Boland, G.J., Soest, H. van, Schaar, P.J. van der, Koek, G.H., Vries, R.A. de, Ooteghem, N.A. van, Hoek, B. van, Drenth, J.P.H., Vrolijk, J.M., Lieverse, R.J., Houben, P., Sluys Veer, A. van der, Siersema, P.D., Schipper, M.E., Erpecum, K.J. van, and Boland, G.J.
- Abstract
1 juli 2010, Contains fulltext : 89730.pdf (publisher's version ) (Closed access), BACKGROUND: Benefit of adding amantadine to antiviral therapy for hepatitis C is controversial. AIMS: We aimed to examine whether such policy enhances sustained viral response in treatment-naive patients. METHODS: 297 naive hepatitis C patients were randomized for treatment with amantadine 200mg or placebo, combined with weight-based ribavirin and 12-day high-dose interferon alpha-2b induction therapy, followed by PEG-interferon alpha-2b (1.5 microg/kg/week up to 26 weeks and thereafter, 1.0 microg/kg/week until week 52). Treatment was discontinued if hepatitis C virus (HCV) RNA was positive at week 24. RESULTS: 49% of patients were (former) drug users. Genotype 1 occurred in 45%, high viral load in 70% and severe fibrosis/cirrhosis in 32%, without differences between amantadine or placebo groups. 90 patients prematurely discontinued treatment, mainly because of grade 3 or 4 toxicity. Intention-to-treat analysis revealed sustained viral response in 47% and 51% of amantadine and placebo groups (p=0.49). Amantadine did not enhance sustained viral response in patients with genotype 1 or high viral load nor did it improve primary non-response, breakthrough or relapse rates. Genotype non-1 and lower pre-treatment gamma GT levels were independent predictors for sustained viral response. CONCLUSION: Adding amantadine to antiviral therapy of previously untreated chronic hepatitis C patients has no beneficial effects.
- Published
- 2010
37. Antibodies neutralizing peginterferon alfa during retreatment of hepatitis C [13]
- Author
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Eijck, A.A. (Annemiek), Vrolijk, J.M. (Jan), Haagmans, B.L. (Bart), Eijck, A.A. (Annemiek), Vrolijk, J.M. (Jan), and Haagmans, B.L. (Bart)
- Published
- 2006
- Full Text
- View/download PDF
38. Response in Hepatitis C Virus Non-Responders
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Vrolijk, J.M. (Jan) and Vrolijk, J.M. (Jan)
- Published
- 2005
39. The relation between plasma tyrosine concentration and fatigue in primary biliary cirrhosis and primary sclerosing cholangitis.
- Author
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Fekkes, D. (Durk), Vrolijk, J.M. (Jan), Buuren, H.R. (Henk) van, Borg, P.C.J. (Pieter) ter, Fekkes, D. (Durk), Vrolijk, J.M. (Jan), Buuren, H.R. (Henk) van, and Borg, P.C.J. (Pieter) ter
- Abstract
BACKGROUND: In primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) fatigue is a major clinical problem. Abnormal amino acid (AA) patterns have been implicated in the development of fatigue in several non-hepatological conditions but for PBC and PSC no data are available. This study aimed to identify abnormalities in AA patterns and to define their relation with fatigue. METHODS: Plasma concentrations of tyrosine, tryptophan, phenylalanine, valine, leucine and isoleucine were determined in plasma of patients with PBC (n = 45), PSC (n = 27), chronic hepatitis C (n = 22) and healthy controls (n = 73). Fatigue and quality of life were quantified using the Fisk fatigue severity scale, a visual analogue scale and the SF-36. RESULTS: Valine, isoleucine, leucine were significantly decreased in PBC and PSC. Tyrosine and phenylalanine were increased (p < 0.0002) and tryptophan decreased (p < 0.0001) in PBC. In PBC, but not in PSC, a significant inverse relation between tyrosine concentrations and fatigue and quality of life was found. Patients without fatigue and with good quality of life had increased tyrosine concentrations compared to fatigued patients. Multivariate analysis indicated that this relation was independent from disease activity or severity or presence of cirrhosis. CONCLUSION: In patients with PBC and PSC, marked abnormalities in plasma AA patterns occur. Normal tyrosine concentrations, compared to increased concentrations, may be associated with fatigue and diminished quality of life.
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- 2005
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40. Psychiatric Side Effects and Fluctuations in Serotonergic Parameters in the Treatment of Chronic Hepatitis C Infection
- Author
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Bezemer, G., primary, Van Gool, A.R., additional, Fekkes, D., additional, Vrolijk, J.M., additional, Hansen, B.E., additional, Janssen, H.L.A., additional, and de Knegt, R.J., additional
- Published
- 2012
- Full Text
- View/download PDF
41. The treatment of hepatitis C: history, presence and future
- Author
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Vrolijk, J.M. (Jan), Knegt, R.J. (Robert) de, Veldt, B.J. (Bart), Orlent, H. (Hans), Schalm, S.W. (Solko), Vrolijk, J.M. (Jan), Knegt, R.J. (Robert) de, Veldt, B.J. (Bart), Orlent, H. (Hans), and Schalm, S.W. (Solko)
- Abstract
The treatment of chronic hepatitis C has made remarkable progress over the past two decades. For interferon-alpha monotherapy, sustained virological response rates were between 2 and 9% in genotype 1 and between 16 and 23% in genotypes 2 and 3. By adjusting treatment duration up to 48 weeks for genotype 1 and combining regular interferon-alpha with ribavirin, sustained response rates could be improved to 28 to 31% in genotype 1 and around 65% in genotypes 2 and 3. Attempts to further increase efficacy included the addition of amantadine without conclusive evidence up till now. With the recent introduction of long-acting pegylated interferon-alpha in combination with ribavirin, sustained virological response rates of 8o% can be obtained in genotypes 2 and 3. However, sustained virological response rates for patients with either genotype 1, nonresponse to prior treatment, cirrhosis or a combination of these characteristics are still less than 50%. In view of results with daily high-dose interferon-alpha induction in combination with prolongation of treatment duration up to 18 months, such patients might benefit from induction and prolonged PEG-IFN-alpha treatment and should be treated in an experimental setting.
- Published
- 2004
42. The optimal treatment strategy for chronic hepatitis C
- Author
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de Rave, S., primary, Vrolijk, J.M., additional, and Schalm, S.W., additional
- Published
- 2005
- Full Text
- View/download PDF
43. Hyperpigmentation during interferon-alpha therapy for chronic hepatitis C virus infection
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Willems, M., primary, Munte, K., additional, Vrolijk, J.M., additional, den Hollander, J.C., additional, Bohm, M., additional, Kemmeren, M.H., additional, de Man, R.A., additional, and Brouwer, J.T., additional
- Published
- 2003
- Full Text
- View/download PDF
44. Pretreatment intrahepatic CD8+ cell number correlates with virological response to antiviral therapy in chronic hepatitis C
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Vrolijk, J.M., primary, Janssen, H.L.A., additional, Kwekkeboom, J., additional, Hansen, B.E., additional, Zondervan, P., additional, Osterhaus, A.D.M.E., additional, Schalm, S.W., additional, and Haagmans, B.L., additional
- Published
- 2003
- Full Text
- View/download PDF
45. Monitoring intrahepatic CD8+ T cells by fine-needle aspiration cytology in chronic hepatitis C infection.
- Author
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Vrolijk, J.M., Tang, T.J., Kwekkeboom, J., Haagmans, B.L., Herscheid, A.J., Kusters, J.G., Janssen, H.L., Brouwer, J.T., and Schalm, S.W.
- Subjects
- *
HEPATITIS C , *CD antigens , *NEEDLE biopsy , *LIVER diseases , *T cells , *CYTOLOGY - Abstract
Infection of the liver with hepatitis C virus (HCV) causes compartmentalization of CD8+ cytotoxic T cells to the site of disease. These cells are thought to be involved in viral clearance during interferon therapy. The repetitive analysis of the intrahepatic immune response is hampered by the difficulty to obtain the intrahepatic T cells. The fine-needle aspiration biopsy (FNAB) technique was evaluated for its use to obtain liver-derived CD8+ T cells in a minimally invasive way. In 26 chronic HCV patients who were evaluated for Peg-interferon and ribavirin combination therapy, pre-treatment FNABs and peripheral blood specimens were obtained simultaneously with liver tissue biopsies, and CD3+ and CD8+ T cells were quantified by immunocytochemistry. The CD8+/CD3+ ratio was significantly higher in the FNABs than in peripheral blood ( P < 0.01), and similar to those in portal areas in the tissue biopsies. A significant correlation was observed between numbers of CD3+CD8+ T lymphocytes in the FNABs and the numbers of CD8+ cells in the lobular fields or in the portal tracts of the liver tissue biopsies, but not with CD3+CD8+ T lymphocytes in peripheral blood. Finally, the ratio of CD8+/CD3+ T lymphocytes in FNABs was significantly higher in those patients who responded rapidly to therapy when compared with slow responders at 4 weeks of treatment ( P = 0.02). These findings demonstrate that the intrahepatic T-cell composition is reflected in FNABs, and that the FNAB technique can be used for predicting early virological response to therapy of patients chronically infected with HCV. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
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46. The 2012 revised Dutch national guidelines for the treatment of chronic hepatitis B virus infection
- Author
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Buster, E.H.C.J., Baak, B.C., Bakker, C.M., Beuers, U.H.W., Brouwer, J.T., Drenth, J.P.H., Erpecum, K.J. van, Hoek, B. van, Honkoop, P., Kerbert-Dreteler, M.J., Koek, G.H., Nieuwkerk, K.M.J. van, Soest, H. van, Spek, B.W. van der, Tan, A.C.I.T.L., Vrolijk, J.M., Janssen, H.L.A., Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, Gastroenterology & Hepatology, Hematology, Gastroenterology and hepatology, CCA - Innovative therapy, Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
- Subjects
Hepatitis B virus ,SDG 3 - Good Health and Well-being ,antiviral therapy ,guidelines ,pregnancy ,Molecular gastro-enterology and hepatology Membrane transport and intracellular motility [IGMD 2] - Abstract
Item does not contain fulltext In 2008, the Netherlands Association of Gastroenterologists and Hepatologists (Nederlands Vereniging van Maag-Darm-Leverartsen) published the Dutch national guidelines for the treatment of chronic hepatitis B virus infection. New insights into the treatment of chronic hepatitis B with relevance for clinical practice have been adopted in these concise, revised guidelines. The most important changes include the choice of initial antiviral therapy, licensing of tenofovir for the treatment of chronic hepatitis B and the management of antiviral resistance.
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