Search results for "CROHN'S DISEASE"

Anxiety, depression, chronic inflammation and aortic stiffness in Crohn's disease: the brain--gut--vascular axis.

2020

Background Patients with Crohn's disease have an increased aortic stiffness, a known cardiovascular risk factor. Anxiety, a key factor of the brain--gut axis in patients with Crohn's disease, is implicated in the pathogenesis and progression of the disease, and is linked with aortic stiffening in other clinical settings. Objectives Considering that depression is frequently linked to anxiety in Crohn's disease, we performed a mediation analysis to reveal the potential link between anxiety, depression and aortic stiffness in these patients. Methods Multicentre observational cross-sectional study of 86 consecutive patients with Crohn's disease and 86 matched control individuals. The connection…

Efficacy of adalimumab as second-line therapy in a pediatric cohort of Crohn’s disease patients who failed infliximab therapy: the Italian Society of…

2019

Patrizia Alvisi,1 Serena Arrigo,2 Salvatore Cucchiara,3 Paolo Lionetti,4 Erasmo Miele,5 Claudio Romano,6 Alberto Ravelli,7 Daniela Knafelz,8 Stefano Martelossi,9 Graziella Guariso,10 Salvatore Accomando,11 Giovanna Zuin,12 Costantino De Giacomo,13 Lucio Balzani,14 Monia Gennari,15 Marina Aloi3 On behalf of the SIGENP IBD Working Group 1Pediatric Gastroenterology Unit, Pediatric Department, Maggiore Hospital, Bologna, Italy; 2Pediatric Gastroenterology and Endoscopy Unit, G Gaslini Children’s Hospital, Genoa, Italy; 3Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy; 4Gastroenterology and Nutrition Unit, Meyer Children’s Hospital, Florenc…

Perception of improved state of health and subjective quality of life in Crohn's disease patients treated with Infliximab.

2009

International audience; UNLABELLED: BACKGROUND AND AIMS AND METHOD: Although Infliximab is a very potent therapy of refractory Crohn's disease, its administration requires iterative infusions in hospital and there are concerns regarding its long-term safety. The aim of this study was to assess in a sample of 51 patients suffering from CD the impact of type of treatment (intravenous Infliximab versus conventional therapy without Infliximab) on the evaluation of the state of health (CGI) and the quality of life (MOS-SF36). Secondary variables were also assessed: the impact of depression (MADRS), the impact of activity of the disease (Harvey-Bradshaw Index). RESULTS: Overall, the assessments m…

Optimization of the treatment with immunosuppressants and biologics in inflammatory bowel disease

2014

Many placebo controlled trials and meta-analyses evaluated the efficacy of different drugs for the treatment of inflammatory bowel disease (IBD), including immunosuppressants and biologics. Their use is indicated in moderate to severe disease in non responders to corticosteroids and in steroid-dependent patients, as induction and maintainance treatment. Infliximab, as well as cyclosporine, is considered a second line therapy in the case of severe ulcerative colitis, or non-responders to intravenous corticosteroids. An adequate dosage and duration of therapy with thiopurines should be reached before evaluating their efficacy. Methotrexate is a valid option in patients with Crohn’s disease bu…

Inflammation and Aortic Stiffness: An Individual Participant Data Meta‐Analysis in Patients With Inflammatory Bowel Disease

2017

Background The recent finding that aortic pulse wave velocity ( aPWV ) is increased in patients with inflammatory bowel disease may explain why the cardiovascular risk is increased despite the low prevalence of traditional cardiovascular risk factors. We aimed to test whether inflammation is associated with aortic stiffening in this setting after adjustment for major confounders and to perform subgroup analyses. Methods and Results A systematic literature search for aPWV in inflammatory bowel disease was performed using PubMed, Scopus, Web of Science, and Google Scholar databases (last accessed May 7, 2017). Inclusion criterion was peer‐reviewed publications on clinical studies reporting o…

The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin.

2014

Aim This technical note describes the use of an endostapler for the definitive treatment of supralevator abscess upward from an intersphincteric origin. Method A two-stage treatment was performed. First an endoanal drainage was performed by inserting a mushroom catheter in the supralevator abscess cavity. In the second stage transanal unroofing of the fistula was performed with an endostapler. Results Since 2011, three patients have been treated in this way. After 2 years of follow up, none of the patients had recurrence of the abscess or been referred for anal incontinence. Conclusion The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin may be an al…

Use of telemedicine in inflammatory bowel disease: a real monitoring option?

2016

Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic and relapsing disorder characterized by inflammation of the gastrointestinal tract. The natural progression includes periods of flares and remission, requiring continuous and personalized follow-up to achieve long remission and minimize short and long term damage. In fact, IBD patients show significantly higher rates of utilization of healthcare resources than patients with other conditions [1]. It is important to emphasize that 30-45% of adults are nonadherents [2], making these patients five times more likely to suffer relapses and consequently increasing health care costs [3]. …

Investigational agents for Crohn's disease.

2010

IMPORTANCE OF THE FIELD: Increased understanding of the biological mechanisms of Crohn's disease has opened the door to a large number of new molecules; some of these are approved for clinical use, while others remain under evaluation. In this review, we examine the clinical efficacy of all the new drugs that have been evaluated in controlled trials in the last 12 years. AREAS COVERED IN THIS REVIEW: Anti-TNF therapy has been reviewed briefly, given the many comprehensive reviews on this topic; attention is focused mainly on the other biological therapies. In assessing the clinical efficacy of these molecules, we consider only the remission rate, as this is considered the most meaningful en…

Role of multidetector-CT enteroclysis (MSCT-E) in complications of advanced Crohn's disease (CD) patients

2007

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…