0000000000775216

AUTHOR

Marta Mazza

Pegylated-interferon-α(2a) in clinical practice: how to manage patients suffering from side effects

Introduction: The goal of antiviral therapy in patients with chronic hepatitis C is to slow or halt the progression of fibrosis and prevent the development of cirrhosis. Accordingly, antiviral treatment is proposed for a large population of patients with chronic hepatitis. Areas covered: The standard-of-care for chronic hepatitis C is the combination of pegylated IFN (PEG-IFN) and ribavirin. The use of these drugs has been correlated with a range of adverse effects, including influenza-like symptoms, hematological changes and neuropsychiatric disturbances. The effects of these adverse events associated with PEG-IFN therapy are manifold and are a major reason why patients decline or stop the…

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Clinical Presentation of Crohn’s Disease

Crohn’s disease is an idiopathic chronic inflammatory disease of the gut, which may involve the entire gastrointestinal tract from the mouth to the perianal area, though preferring in most cases the distal small bowel and the proximal large bowel. Its heterogeneous nature is reflected in a number of different phenotypes. Approximately 80 % of patients have small bowel involvement, usually in the distal ileum, with one-third of patients having exclusively ileitis. Approximately 50 % of patients have ileocolitis which refers to involvement of both the ileum and colon. From 20 to 25 % of patients have disease confined to the colon. Involvement of the esophagus, stomach, or duodenum is rare and…

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Six year adalimumab efficacy in steroid-dependent Crohn's disease patients: A prospective single-center real life study.

Abstract Background Adalimumab is effective in the treatment of Crohn's disease. We have already reported data on the efficacy of adalimumab in 110 steroid-dependent patients. At the end of the study 90 patients (64.5%) maintained clinical remission. Aims To assess efficacy and safety of adalimumab after 6 years in patients of the original cohort who responded to treatment. Methods The present study is an extension of the published paper on 90/110 patients. We report results on clinical remission and safety of 6 year maintenance therapy with adalimumab. Results Of the original cohort 90 patients completed the study, 17 were lost to follow-up and 3 died. At the end of follow-up (74.16 ± 10.3…

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The Impact of Antiviral Therapy and the Influence of Metabolic Cofactors on the Outcome of Chronic HCV Infection

Natural history of HCV related chronic hepatitis is influenced and modified by many factors: virus features, coinfections and host characteristics. In particular, a peculiar genetic background of the host by conditioning the occurrence of intracellular metabolic derangements (i.e., insulin resistance) might contribute to accelerate the rate of progression to cirrhosis and eventually the occurrence of hepatocellular carcinoma (HCC) and death. Likely, direct interplays between virus genotype and host genetic background might be hypothesized at this level. Morbidity and mortality in cirrhosis is primarily associated with complications of liver cirrhosis (ascites, hepatic encephalopathy, jaundi…

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