Corticotropin versus hydrocortisone in the intravenous treatment of ulcerative colitis

Meyers, Samuel; Sachar, David B.; Goldberg, Judith D.; Janowitz, Henry D.

doi:10.1016/0016-5085(83)90323-2

Cited by 142 publications

(42 citation statements)

References 10 publications

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“…Randomized controlled trials of corticosteroids in patients with severe CD have not been performed, but it is likely that the remission rate in CD for parenteral corticosteroids is similar to that in UC. The prolongation of therapy with parenteral J Gastroenterol (2010) 45:571-583 575 corticosteroids beyond 7-10 days has not been proven to add any benefit and may in fact be deleterious [100][101][102][103].…”

Section: Aminosalicylates and Corticosteroidsmentioning

confidence: 96%

New pathophysiological insights and modern treatment of IBD

2010

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Inflammatory bowel disease (IBD), which comprises two main types, namely, Crohn's disease and ulcerative colitis, affects approximately 3.6 million people in the USA and Europe, and an alarming rise in low-incidence areas, such as Asia, is currently being observed. In the last decade, spontaneous mutations in a diversity of genes have been identified, and these have helped to elucidate pathways that can lead to IBD. Animal studies have also increased our knowledge of the pathological dialogue between the intestinal microbiota and components of the innate and adaptive immune systems misdirecting the immune system to attack the colon. Present-day medical therapy of IBD consists of salicylates, corticosteroids, immunosuppressants and immunomodulators. However, their use may result in severe side effects and complications, such as an increased rate of malignancies or infectious diseases. In clinical practice, there is still a high frequency of incomplete or absent response to medical therapy, indicating a compelling need for new therapeutic strategies. This review summarizes current epidemiology, pathogenesis and diagnostic strategies in IBD. It also provides insight in today's differentiated clinical therapy and describes mechanisms of promising future medicinal approaches.

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Section: Aminosalicylates and Corticosteroidsmentioning

confidence: 96%

New pathophysiological insights and modern treatment of IBD

2010

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“…Instead, it may cause harm to the patient by compromising the immune system, thus increasing the risk of complications after surgery. 53,55,56 In steroid failures, early decision about the next step is mandatory being either cyclosporine or surgery. Cyclosporine is a Tcell inhibitor with a rapid onset of action, not suppressing the activity of other stem cells or bone marrow.…”

Section: Infectious Complicationsmentioning

confidence: 99%

Colectomy in Patients with Acute Colitis: A Systematic Review

Teeuwen

Stommel

Bremers

et al. 2009

Journal of Gastrointestinal Surgery

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Colectomy for acute colitis is complicated by considerable morbidity. The incidence of adverse outcome has substantially decreased over the last three decades, but further improvements are still required. The retrospective nature of the included studies allows for a considerable degree of selection bias that limits robust and clinically sound conclusions about both conventional and laparoscopic surgery.

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“…While placebo-controlled trials would be unethical in this setting, several studies have compared parenteral hydrocortisone with adrenocorticotropic hormone (ACTH; corticotropin) but variations in response between formulations failed to define an "optimal" approach between hydrocortisone and ACTH. Although the latter may have a small advantage for steroid-naïve patients [477], the majority of hospitalized patients will have been hospitalized as the result of the failure of outpatient corticosteroid treatment. In addition, ACTH has been associated with adrenal hemorrhage and is no longer marketed as a therapy in the United States.…”

Section: Parenteral Corticosteroidsmentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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Corticotropin versus hydrocortisone in the intravenous treatment of ulcerative colitis

Cited by 142 publications

References 10 publications

New pathophysiological insights and modern treatment of IBD

New pathophysiological insights and modern treatment of IBD

Colectomy in Patients with Acute Colitis: A Systematic Review

Inflammatory Bowel Disease

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