0000000000241217

AUTHOR

Claudio Papi

showing 11 related works from this author

Infliximab in the treatment of Crohn's disease: Predictors of response in an Italian multicentric open study

2005

Abstract Background. Almost 20% of patients with active Crohn's disease are refractory to conventional therapy. Infliximab is a treatment of proven efficacy in this group of patients and it is not clear which variables predict a good response. Aims. To evaluate the role of infliximab looking at the predictors of response in a large series of patients with Crohn's disease. Patients and methods. Five hundred and seventy-three patients with luminal refractory Crohn's disease (Crohn's Disease Activity Index (CDAI) > 220–400) (312 patients) or with fistulising disease (190 patients) or both of them (71 patients) were treated with a dose of 5 mg/kg in 12 Italian referral centres. The primary endp…

AdultMalemedicine.medical_specialtyFistulaPredictors of responseAge at diagnosisDiseaseGastroenterologyAntibodiesDose-Response RelationshipCrohn DiseaseGastrointestinal AgentsRefractoryInternal medicineMonoclonalmedicineHumansinfliximab.crohn's disease.Settore MED/12 - GastroenterologiaCrohn's diseaseDose-Response Relationship DrugHepatologybusiness.industryRemission InductionSmokingGastroenterologyAntibodies Monoclonalmedicine.diseaseCrohn's Disease Activity IndexInfliximabInfliximabSurgeryOpen studyCrohn's diseaseCrohn's disease; Infliximab; Predictors of response; Adult; Antibodies Monoclonal; Crohn Disease; Dose-Response Relationship Drug; Female; Fistula; Gastrointestinal Agents; Humans; Infliximab; Italy; Male; Multivariate Analysis; Remission Induction; SmokingItalyConcomitantMultivariate AnalysisFemaleCrohn's disease; Infliximab; Predictors of responseDrugbusinessmedicine.drugDigestive and Liver Disease
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Use of corticosteroids and immunosuppressive drugs in inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of …

2017

Abstract The two main forms of intestinal bowel disease, namely ulcerative colitis and Crohn’s disease, are not curable but can be controlled by various medical therapies. The Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) has prepared clinical practice guidelines to help physicians prescribe corticosteroids and immunosuppressive drugs for these patients. The guidelines consider therapies that induce remission in patients with active disease as well as treatment regimens that maintain remission. These guidelines complement already existing guidelines from IG-IBD on the use of biological drugs in patients with inflammatory bowel diseases.

medicine.medical_specialtyIBDDiseaseGuidelineGuidelinesInflammatory bowel diseaseGastroenterologyBiological drugs03 medical and health sciences0302 clinical medicineAdrenal Cortex HormonesInternal medicineMedicalmedicineCorticosteroidCorticosteroidsHumansIn patient030212 general & internal medicineCorticosteroids; Crohn's disease; Guidelines; IBD; Immunosuppressors; Ulcerative colitis; Hepatology; GastroenterologySocieties MedicalCrohn's diseaseSettore MED/12 - GastroenterologiaUlcerative colitiHepatologybusiness.industryImmunosuppressorsRemission InductionGastroenterologyInflammatory Bowel Diseasesmedicine.diseaseInflammatory Bowel DiseasesUlcerative colitisdigestive system diseasesClinical PracticeCrohn's diseaseUlcerative colitisItalyImmunosuppressorCorticosteroids; Crohn's disease; Guidelines; IBD; Immunosuppressors; Ulcerative colitis; Adrenal Cortex Hormones; Humans; Immunosuppressive Agents; Inflammatory Bowel Diseases; Italy; Remission Induction; Societies Medical030211 gastroenterology & hepatologybusinessSocietiesImmunosuppressive Agents
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Advanced age is an independent risk factor for severe infections and mortality in patients given anti-tumor necrosis factor therapy for inflammatory …

2011

See related article, Oostlander AE et al, on page 116 in Gastroenterology. BACKGROUND & AIMS: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients. METHODS: We collected data from patients with IBD treated with infliximab (n 2475) and adalimumab (n 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn’s disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 yea…

MaleAgingSettore MED/09 - Medicina InternaBiologicantagonists /&/ inhibitors/immunology Young AdultInflammatory bowel diseaseHumanized AntibodieElderlyNeoplasmsMonoclonalYoung adultAged 80 and overSettore MED/12 - GastroenterologiaCrohn's diseaseGastroenterologyAge FactorsAntibodies MonoclonalMiddle AgedUlcerative colitisepidemiology Opportunistic InfectionFemaleDrug ComplicationSafetymedicine.drugAdultmedicine.medical_specialtyAdolescentIBDOpportunistic InfectionsAntibodies Monoclonal HumanizedYoung AdultInternal medicinemedicineAdalimumab80 and over AntibodieHumansImmunologic FactorsRisk factoradverse effects/therapeutic use Inflammatory Bowel DiseaseAgedHepatologymortality/therapy Male Middle Aged Neoplasmepidemiology Tumor Necrosis Factor-alphabusiness.industryTumor Necrosis Factor-alphaAdalimumabmedicine.diseaseInflammatory Bowel DiseasesCrohn's Disease Activity IndexInfliximabInfliximabSurgeryInflammation Side Effects Drug ComplicationsSide Effectinflammationadverse effects/therapeutic use Female Humans Immunologic FactorAdolescent Adult Age Factors Aged Agedbusiness
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Two mesalazine regimens in the prevention of the post-operative recurrence of Crohn's disease: a pragmatic, double-blind, randomized controlled trial

2003

Summary Background : The role of mesalazine in preventing the clinical recurrence of Crohn's disease after surgery has been shown in a meta-analysis of all published studies. No clear relationship, however, has been shown between dosage and response. Aim : To evaluate whether 4.0 g/day of mesalazine may offer therapeutic advantages over 2.4 g/day in the prevention of both endoscopic and clinical post-operative recurrence of Crohn's disease. Methods : The study was a double-blind, randomized, multi-centre, prospective, controlled clinical trial. Two hundred and six patients, submitted to first or second intestinal resection for Crohn's disease limited to the terminal ileum, with or without i…

BudesonideCrohn's diseasemedicine.medical_specialtyHepatologymedicine.diagnostic_testbusiness.industryGastroenterologymedicine.diseaseGastroenterologylaw.inventionEndoscopyClinical trialchemistry.chemical_compoundRegimenMesalazinechemistryRandomized controlled triallawInternal medicineMedicineAscending colonPharmacology (medical)businessmedicine.drugAlimentary Pharmacology & Therapeutics
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Infliximab, azathioprine or combination therapy in the treatment of active Crohn's disease.

2010

The treatment of moderate-to-severe steroid-dependent Crohn's disease has been a challenging issue for the gastroenterologist. Until to 10 years ago, immunosuppressors, mainly azathioprine or 6-mercaptopurine, were the best possible treatments available, and remission rates ranged from 30 to 60% according to the results of open studies and controlled trials. Recently, infliximab has been shown to be effective in steroid-dependent patients and, combined with azathioprine, it has been shown to increase 1-year remission rates. A recent large randomized controlled trial comparing infliximab, azathioprine and infliximab plus azathioprine demonstrated that the combination of infliximab plus azath…

musculoskeletal diseasesCrohn's diseasemedicine.medical_specialtySettore MED/09 - Medicina InternaHepatologyCombination therapybusiness.industryGastroenterologyAzathioprinemedicine.diseaseGastroenterologyInfliximablaw.inventionSurgeryRandomized controlled triallawInternal medicinemedicineInfliximab azathioprine Crohnbusinessmedicine.drug
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Management of ulcerative colitis in a real-life setting: An Italian multicenter, prospective, observational AIGO study

2019

Abstract Background No data are available on the variability in the clinical management of ulcerative colitis (UC) patients by Italian gastroenterologists. Therefore, improving the standards of UC care as provided by the National Welfare Clinical Path (PDTA), in accordance with the European Crohn’s and Colitis Organization (ECCO) guidelines for UC, is not easy. Aims To assess the management of UC by Italian gastroenterologists in a real-life setting taking into account its variability. Methods This prospective, cross-sectional, observational study included IBD-specialized gastroenterologists (GSIBDs) and general gastroenterologists (GGs) working in Italian public hospital units. Consecutive…

AdultMalemedicine.medical_specialtyAdolescentDiseaseReal life settingSeverity of Illness IndexYoung Adult03 medical and health sciences0302 clinical medicineSurveys and QuestionnairesHumansMedicineProspective StudiesMedical prescriptionAgedAged 80 and overHepatologyManagement of ulcerative colitisbusiness.industryGastroenterologyDisease ManagementMiddle Agedmedicine.diseaseUlcerative colitisHospitalizationClinical PracticeCross-Sectional StudiesItaly030220 oncology & carcinogenesisPractice Guidelines as TopicPublic hospitalEmergency medicineColitis UlcerativeFemale030211 gastroenterology & hepatologyObservational studyGuideline AdherencebusinessDigestive and Liver Disease
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PD-L1 in small bowel adenocarcinoma is associated with etiology and tumor-infiltrating lymphocytes, in addition to microsatellite instability

2020

Small bowel adenocarcinomas (SBAs) are often associated with poor prognosis and have limited therapeutic options. Programmed cell death protein-1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway blockade is an effective treatment in many microsatellite instability-high (MSI-H) solid tumors. We aimed at investigating PD-L1 and PD-1 expression in non-hereditary, non-ampullary SBAs, associated with celiac disease (CeD), Crohn’s disease (CrD), or sporadic, recruited through the Small Bowel Cancer Italian Consortium. We assessed PD-L1 and PD-1 by immunohistochemistry in a series of 121 surgically resected SBAs, including 34 CeD-SBAs, 49 CrD-SBAs, and 38 sporadic SBAs. PD-L1 and PD-1 express…

0301 basic medicineMalePD-L1 - small bowel adenocarcinoma - tumor-infiltrating lymphocytes - microsatellite instabilityPathologyBLOCKADEColorectal cancerLymphocyteSmall bowel adenocarcinomaGastroenterologyB7-H1 AntigenSettore MED/120302 clinical medicineCrohn DiseaseIntestine Smallsmall bowel adenocarcinomaSmall bowel adenocarcinomasMEDULLARY CARCINOMA; MORPHOLOGY; EXPRESSION; BLOCKADE; CANCERbiologymicrosatelliteinstabilityMiddle AgedCANCERmedicine.anatomical_structureMedullary carcinomatumor infiltrating lymphocytes030220 oncology & carcinogenesistumor-infiltrating lymphocytesAdenocarcinomaFemaleMicrosatellite InstabilityPD-L1Adultmedicine.medical_specialtysmall bowel adenocarcinoma tumor-infiltrating lymphocytes microsatelliteinstabilitySettore MED/08 - Anatomia PatologicaAdenocarcinomaMEDULLARY CARCINOMAPD-L1 small bowel adenocarcinomaNOPathology and Forensic Medicine03 medical and health sciencesLymphocytes Tumor-InfiltratingInternal medicinePD-L1expressionIntestinal NeoplasmsBiomarkers TumormedicineHumansPD-L1; small bowel adenocarcinoma; tumor infiltrating lymphocytesPD-L1 in small bowel adenocarcinoma MSI-HSmall bowel adenocarcinoma expression microsatellite instability biomarkersAgedRetrospective Studiesbusiness.industryTumor-infiltrating lymphocytesbiomarkersCancerCorrectionMicrosatellite instabilitymedicine.diseaseCeliac Disease030104 developmental biologybiology.proteinEtiologyMORPHOLOGYbusiness
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Late-onset Crohn's disease: a comparison of disease behaviour and therapy with younger adult patients: the Italian Group for the Study of Inflammator…

2019

BACKGROUND Disease phenotype and outcome of late-onset Crohn's disease are still poorly defined. METHODS In this Italian nationwide multicentre retrospective study, patients diagnosed ≥65 years (late-onset) were compared with young adult-onset with 16-39 years and adult-onset Crohn's disease 40-64 years. Data were collected for 3 years following diagnosis. RESULTS A total of 631 patients (late-onset 153, adult-onset 161, young adult-onset 317) were included. Colonic disease was more frequent in late-onset (P < 0005), stenosing behaviour was more frequent than in adult-onset (P < 0003), but fistulising disease was uncommon. Surgery rates were not different between the three age groups. Syste…

MaleDiseaseConstriction PathologictumoursInflammatory bowel diseaseLate Onset DisordersCohort Studiessurgery0302 clinical medicineCrohn DiseaseLate Onset DisordersMedicineYoung adultDigestive System Surgical ProceduresCrohn's diseaseGastroenterologyIleitisMiddle AgedColitisItaly030220 oncology & carcinogenesisoutcome030211 gastroenterology & hepatologyFemaleColorectal NeoplasmsCohort studysteroidsAdultmedicine.medical_specialtyAdolescentcomorbiditieselderly03 medical and health sciencesYoung AdultInternal medicineIntestinal FistulaHumansImmunologic FactorsGlucocorticoidsAgedRetrospective StudiesPolypharmacyHepatologybusiness.industrythiopurinesRetrospective cohort studymedicine.diseasecomorbidities; elderly; outcome; steroids; surgery; thiopurines; tumoursPolypharmacyTumor Necrosis Factor Inhibitorsbusiness
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Cancer in Crohn's Disease patients treated with infliximab: a long-term multicenter matched pair study

2011

Background: The long-term risk of neoplasia in Crohn's disease (CD) patients treated with infliximab is undefined. The aim was to assess, in a multicenter, matched-pair study, whether infliximab use in CD is associated with an increased frequency of neoplasia in the long term. Methods: A multicenter, long-term, matched-pair study was conducted in 12 referral inflammatory bowel disease (IBD) centers. An initial cohort of 808 CD patients, including 404 infliximab-treated (CD-IFX) and 404 matched CD controls never treated with infliximab (CD-C) studied from 1999 to 2004, was followed up for an additional 4 years (2004–2008). Cases and controls were matched for: sex, age (±5 years), CD site, fo…

MaleAdultmedicine.medical_specialtyTime FactorsCROHN'S DISEASECrohn’s disease infliximab cancer matched-pairInflammatory bowel diseaseGastroenterologyAntibodiesCohort StudiesGastrointestinal AgentsCrohn DiseaseInternal medicineNeoplasmsINFLIXIMABMonoclonalmedicineImmunology and AllergyHumanstherapeutic use Case-Control Studies Cohort Studies Crohn Diseaseetiology Survival Rate Time Factors Treatment OutcomeSurvival rateAgedCancer Infliximab Inflammatory bowel diseaseCrohn's diseasebusiness.industryGastroenterologyCase-control studyAntibodies MonoclonalCancerMiddle Ageddrug therapy Female Follow-Up Studies Gastrointestinal Agenttherapeutic use Humans Male Middle Aged Neoplasmmedicine.diseaseTreatment Outcome; Male; Time Factors; Survival Rate; Middle Aged; Female; Neoplasms; Gastrointestinal Agents; Humans; Cohort Studies; Follow-Up Studies; Aged; Adult; Antibodies Monoclonal; Case-Control Studies; Crohn DiseaseCANCERInfliximabSurgerySurvival RateSettore MED/18 - Chirurgia GeneraleTreatment OutcomeCase-Control StudiesCohortFemaleAdult Aged Antibodiebusinessmedicine.drugCohort studyFollow-Up Studies
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Small Bowel Carcinomas in Coeliac or Crohn’s Disease: Clinico-pathological, Molecular, and Prognostic Features. A Study From the Small Bowel Cancer I…

2017

Background and aims An increased risk of small bowel carcinoma [SBC] has been reported in coeliac disease [CD] and Crohn's disease [CrD]. We explored clinico-pathological, molecular, and prognostic features of CD-associated SBC [CD-SBC] and CrD-associated SBC [CrD-SBC] in comparison with sporadic SBC [spo-SBC]. Methods A total of 76 patients undergoing surgical resection for non-familial SBC [26 CD-SBC, 25 CrD-SBC, 25 spo-SBC] were retrospectively enrolled to investigate patients' survival and histological and molecular features including microsatellite instability [MSI] and KRAS/NRAS, BRAF, PIK3CA, TP53, HER2 gene alterations. Results CD-SBC showed a significantly better sex-, age-, and st…

Male0301 basic medicineNeuroblastoma RAS viral oncogene homologOncologySurvivalReceptor ErbB-2Colorectal cancermedicine.disease_causeInflammatory bowel diseaseInflammatory bowel diseasetumour-infiltrating lymphocyteErbB-20302 clinical medicineCrohn DiseaseRetrospective StudieRisk Factors80 and overChildClass I Phosphatidylinositol 3-KinaseAged 80 and overColonic NeoplasmSettore MED/12 - GastroenterologiaCrohn's diseaseMLH1 methylationTumour-infiltrating lymphocytesGastroenterologyGeneral MedicineMiddle AgedPrognosisInflammatory bowel disease; Microsatellite instability; MLH1 promoter methylation; Survival; Tumour-infiltrating lymphocytes; Gastroenterology030220 oncology & carcinogenesisColonic NeoplasmsSurvival AnalysiKRASHumanReceptorAdultProto-Oncogene Proteins B-rafmedicine.medical_specialtyPrognosiClass I Phosphatidylinositol 3-KinasesSettore MED/08 - Anatomia PatologicaNOProto-Oncogene Proteins p21(ras)MLH1 promoter methylationYoung Adult03 medical and health sciencesInternal medicinemedicineCarcinomaHumansMLH1 methylation; inflammatory bowel disease; microsatellite instability; survival; tumour-infiltrating lymphocytesneoplasmsAgedRetrospective StudiesInflammatory bowel disease; Microsatellite instability; MLH1 promoter methylation; Survival; Tumour-infiltrating lymphocytes; Adult; Aged; Aged 80 and over; Celiac Disease; Child; Class I Phosphatidylinositol 3-Kinases; Colonic Neoplasms; Crohn Disease; Humans; Male; Microsatellite Instability; Middle Aged; Prognosis; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins p21(ras); Receptor ErbB-2; Retrospective Studies; Risk Factors; Survival Analysis; Tumor Suppressor Protein p53; Young Adult; Gastroenterologybusiness.industryTumour-infiltrating lymphocyteRisk FactorCancerMicrosatellite instabilityinflammatory bowel disease; microsatellite instability; MLH1 promoter methylation; tumour-infiltrating lymphocytes; survivalmedicine.diseaseSurvival Analysiseye diseasesdigestive system diseasesCeliac Disease030104 developmental biologyMicrosatellite instabilityTumor Suppressor Protein p53businessJournal of Crohn's and Colitis
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Infliximab three-dose induction regimen in severe corticosteroid-refractory ulcerative colitis: Early and late outcome and predictors of colectomy

2014

Abstract Background Infliximab is effective as rescue therapy in severe corticosteroid-refractory ulcerative colitis. The optimal dose regimen and the long term benefits are not well defined. The aim of the present study was to evaluate short- and long-term colectomy rate in a cohort of patients with severe corticosteroid-refractory ulcerative colitis who received a three-dose infliximab induction regimen. Methods One hundred and thirteen patients admitted to 11 Italian IBD referral centres and treated with infliximab according to an intention to treat three-dose regimen were included. The co-primary endpoints were 3- and 12-month colectomy rate. The secondary end-points were the overall co…

AdultMalemedicine.medical_specialtyAdolescentSettore MED/12 - GASTROENTEROLOGIAmedicine.medical_treatmentUlcerative colitis;GastroenterologyDrug Administration ScheduleYoung AdultAdrenal Cortex HormonesInternal medicineHumansMedicineTreatment FailureAdverse effectColectomyInfliximab;AgedColectomyIntention-to-treat analysisbusiness.industryAnti-Inflammatory Agents Non-SteroidalGastroenterologyAntibodies MonoclonalGeneral MedicineMiddle Agedmedicine.diseaseUlcerative colitisInfliximabInfliximabRegimenTreatment OutcomeUlcerative colitisRelative riskCohortColitis UlcerativeFemalebusinessmedicine.drugJournal of Crohn's and Colitis
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