Anorectal Function and Clinical Characteristics Associated with Faecal Incontinence in Patients with Crohn’s Disease

Codes, Lina Maria Goes de; Jesus, Ana Carolina Costa de; Codes, João Jorge Góes de; Ferreira, Reginaldo Freitas; Sacramento, Carolina da Silva Beda; Cruz, Isabela Dias Marques da; Fidelis, Flávia de Castro Ribeiro; Carvalho, Alexandre Lopes de; Motta, Marina Pamponet; Alves, Candida de Oliveira; Netto, Eduardo Martins; Santana, Genoile Oliveira

doi:10.1093/ecco-jcc/jjad048

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Among patients from private services, only those with moderate-to-severe CD had access to anti-TNFs, anti-integrins, and anti-interleukins. The publication of national epidemiological studies 2,3,5,[30][31][32][33]37,[44][45][46][47][48] , physicians´ perceptions of IBD in Brazil 43 , and studies on the socioeconomic impact of IBD, including absence from work 27,49,50 , served to alert the authorities and resulted in the incorporation of biological therapy for UC in the public sphere in 2020 and in the private system in 2021.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors associated with severity in patients with inflammatory bowel disease in Brazil based on 2-year national registry data from GEDIIB

Fróes,

Andrade,

Faria

et al. 2024

Sci Rep

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The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) established a national registry of inflammatory bowel disease (IBD). The aim of the study was to identify clinical factors associated with disease severity in IBD patients in Brazil. A population-based risk model aimed at stratifying the severity of IBD based on previous hospitalization, use of biologics, and need for surgery for ulcerative colitis (UC) and Crohn’s Disease (CD) and on previous complications for CD. A total of 1179 patients (34.4 ± 14.7y; females 59%) were included: 46.6% with UC, 44.2% with CD, and 0.9% with unclassified IBD (IBD-U). The time from the beginning of the symptoms to diagnosis was 3.85y. In CD, 41.2% of patients presented with ileocolic disease, 32% inflammatory behavior, and 15.5% perianal disease. In UC, 46.3% presented with extensive colitis. Regarding treatment, 68.1%, 67%, and 47.6% received biological therapy, salicylates and immunosuppressors, respectively. Severe disease was associated with the presence of extensive colitis, EIM, male, comorbidities, and familial history of colorectal cancer in patients with UC. The presence of Montreal B2 and B3 behaviors, colonic location, and EIM were associated with CD severity. In conclusion, disease severity was associated with younger age, greater disease extent, and the presence of rheumatic EIM.

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Section: Discussionmentioning

confidence: 99%

Clinical factors associated with severity in patients with inflammatory bowel disease in Brazil based on 2-year national registry data from GEDIIB

Fróes,

Andrade,

Faria

et al. 2024

Sci Rep

Self Cite

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Monitoring-Based Model for Personalizing Fecal Incontinence in Patients With Crohn’s Disease: A Multicenter Inception Cohort Study

Wang,

Yang,

Qiao

et al. 2024

Inflammatory Bowel Diseases

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Background and Aims Fecal incontinence (FI) is a common complaint that greatly affects the quality of life of patients with Crohn’s disease (CD) and is associated with the clinical characteristics of CD. We aimed to identify risk factors related to FI and construct a risk prediction model for FI in patients with CD. Methods This retrospective study included 600 Chinese patients with CD from 4 IBD centers between June 2016 and October 2021. The patients were assigned to the training (n = 480) and testing cohorts (n = 120). Two nomograms were developed based on the logistic regression and Cox regression models to predict the risk factors for FI in patients with CD. The discriminatory ability and accuracy of the nomograms were evaluated using the receiver operating characteristic (ROC) curves and the area under the ROC curves (AUCs). Additionally, the Kaplan-Meier survival curve was also used further to validate the clinical efficacy of the Cox regression model. Results The overall prevalence of FI was 22.3% (n = 134 of 600). In the logistic regression model, age at diagnosis (odds ratio [OR], 1.032; P = .033), penetrating behavior of disease (OR, 3.529; P = .008) and Perianal Disease Activity Index score >4 (OR, 3.068; P < .001) were independent risk factors for FI. In the Cox regression model, age at diagnosis (hazard ratio [HR], 1.027; P = .018), Montreal P classification (HR, 2.608; P = .011), and Perianal Disease Activity Index score >4 (HR, 2.190; P = .001) were independent predictors of the prevalence of FI over time. Two nomograms were developed to facilitate risk score calculation, and they showed good discrimination ability according to AUCs. Conclusions In this study, we identified 4 risk factors related to the prevalence of FI and developed 2 models to effectively predict the risk scores of FI in CD patients, helping to delay the course of FI and improve the prognosis with timely intervention.

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New objective scoring system to clinically assess fecal incontinence

Garg¹,

Sudoł‐Szopińska²,

Kołodziejczak³

et al. 2023

World J Gastroenterol

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Tumor necrosis factor-α (TNF-α) antagonists, the first biologics approved for treating patients with inflammatory bowel disease (IBD), are effective for the induction and maintenance of remission and significantly improving prognosis. However, up to one-third of treated patients show primary nonresponse (PNR) to anti-TNF-α therapies, and 23%-50% of IBD patients experience loss of response (LOR) to these biologics during subsequent treatment. There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs. This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients. Most predictors remain controversial, and only previous surgical history, disease manifestations, drug concentrations, antidrug antibodies, serum albumin, some biologic markers, and some genetic markers may be potentially predictive. In addition, we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists. Therapeutic drug monitoring plays an important role in treatment selection. Dose escalation, combination therapy, switching to a different anti-TNF drug, or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.

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Anorectal Function and Clinical Characteristics Associated with Faecal Incontinence in Patients with Crohn’s Disease

Cited by 3 publications

References 35 publications

Clinical factors associated with severity in patients with inflammatory bowel disease in Brazil based on 2-year national registry data from GEDIIB

Clinical factors associated with severity in patients with inflammatory bowel disease in Brazil based on 2-year national registry data from GEDIIB

Monitoring-Based Model for Personalizing Fecal Incontinence in Patients With Crohn’s Disease: A Multicenter Inception Cohort Study

New objective scoring system to clinically assess fecal incontinence

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