Guidelines for the management of ulcerative colitis. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Eder, Piotr; Łodyga, Michał; Gawron-Kiszka, Magdalena; Dobrowolska, Agnieszka; Gonciarz, Maciej; Hartleb, Marek; Kłopocka, Maria; Małecka-Wojciesko, Ewa; Radwan, Piotr; Reguła, Jarosław; Zagórowicz, Edyta; Banasiewicz, Tomasz; Durlik, Marek; Rydzewska, Grażyna

doi:10.5114/pg.2023.125882

Cited by 14 publications

(5 citation statements)

References 262 publications

(1,085 reference statements)

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“…Inclusion criteria were the receipt of biological treatment, age 60 years or over, and documentation of IBD diagnosis. The diagnoses of CD and UC were determined according to the endoscopic, radiological, and histological criteria [22,23]. The clinical history of IBD patients over 60 years of age was thoroughly analyzed.…”

Section: Methodsmentioning

confidence: 99%

Inflammatory Bowel Diseases in the Elderly: A Focus on Disease Characteristics and Biological Therapy Patterns

Talar-Wojnarowska,

Caban,

Jastrzębska

et al. 2024

JCM

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Background: The incidence of inflammatory bowel diseases (IBDs) in elderly patients is constantly increasing. It results from the combination of an aging population with compounding prevalence of IBD, as well as the growing burden of elderly-onset IBD. The clinical characteristics of elderly patients differ from young subjects with IBD due to the multimorbidity or polypharmacy, affecting the choice of adequate therapeutic options. The aim of this study was to determine the clinical aspects and biological therapy safety in elderly Polish IBD patients. Methods: We conducted a retrospective study aimed at describing the demographic, clinical, and management characteristics of IBD patients treated with a biological therapy in two referral centers within the National Drug Program in Poland. Results: Out of the entire group of 366 studied patients, 51 (13.9%) were aged over 60—32 with ulcerative colitis (UC) and 19 with Crohn’s disease (CD). The disease location was predominantly ileocolonic (57.89%) in patients with CD and pancolitis for patients with UC (56.25%). Most of the elderly IBD subjects were characterized by significant comorbidities, with Charlson Comorbidity Index (CCI) ≥ 1 in 66.67% patients. The probability of stopping biological therapy due to adverse events had the tendency to be higher in the CCI ≥ 1 group (20.58% vs. 5.88% in CCI = 0; p = 0.087). The main reasons for the therapy discontinuation included hypersensitivity reactions and liver enzyme abnormalities. Conclusions: In conclusion, our results underline the importance of assessing the comorbidity status instead of the age prior to initiating biological therapy, analyzing additional safety risks, and close monitoring in IBD patients with multiple comorbidities.

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Section: Methodsmentioning

confidence: 99%

Inflammatory Bowel Diseases in the Elderly: A Focus on Disease Characteristics and Biological Therapy Patterns

Talar-Wojnarowska,

Caban,

Jastrzębska

et al. 2024

JCM

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“…A personalized approach to the treatment of ulcerative colitis is recommended. At present, the applicable recommendations of the Polish Society of Gastroenterology include 49 detailed recommendations concerning diagnostics and treatment of ulcerative colitis in adults, both pharmacological and surgical [33].…”

Section: Description Of the State Of Knowledgementioning

confidence: 99%

Relationship between periodontal diseases and non-specific inflammatory bowel diseases – an overview. Part I

Goździewska,

Łyszczarz,

Kaczoruk

et al. 2024

Ann Agric Environ Med.

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Introduction andObjective. An increasing number of studies indicate that the oral cavity and gastrointestinal tract are interconnected and that there is a potential causal link between non-specific inflammatory bowel diseases (IBD) and oral diseases. Therefore, following the example of the brain-gut axis, the concept of the gum-gut axis has now been put forward. The aim of the review is to assess the literature confirming the existence of the recently proposed gum-gut axis and the resulting relationships between non-specific inflammatory bowel diseases and oral diseases, especially periodontal diseases. Review Methods. The review sums-up information concerning the relationship between periodontal diseases and nonspecific bowel diseases. A literature review was carried out by searching databases PubMed, Google Scholar, and Web of Science. Brief description of the state of knowledge. Previously, it was presumed that oral microflora and intestinal microflora remain separate. because it was considered that salivary microbes are killed by stomach and bile acids during translocation through the gastrointestinal tract. Presently, it has been confirmed that oral microorganisms have been found in the faeces of even healthy people. The comparison of oral and intestinal microbiomes of adults does not show full convergence; but pathogenic bacteria such as Klebsiella, Porphyromonas gingivalis and Fusobacterium nucleatum may act as the microbial bridge between periodontitis and IBD. Summary. Dysbiosis of oral microflora may disrupt the normal functioning of the immune system, in this way increasing the development of periodontitis which, in turn, increases the risk of IBD and other complex systemic pathological processes. The gum-gut axis plays a crucial role in these associations. Additional studies are necessary to specify the role of nutritional intervention concerning oral and intestinal microbiome for precise health management.

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“…Treatment of moderate to severe UC typically begins with oral or intravenous corticosteroids followed by 5-ASA, drugs from the thiopurine family followed by biological drugs such as infliximab [IFX] and vedolizumab [VDZ]. Extreme, unresponsive to treatment cases may require surgical intervention [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Disease Activity Indices in Predicting Short-Term Response to Biologics in Patients with Ulcerative Colitis

Romaniuk,

Franus,

Sobolewska-Włodarczyk

et al. 2024

JCM

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Background: The Mayo Score [MS], endoscopic Mayo Score [eMS] and the Ulcerative Colitis Index of Severity [UCEIS] are employed in the assessment of ulcerative colitis [UC] severity. This study compared the aforementioned indices in terms of predictory value for response to remission induction treatment with anti-TNF and anti-integrin biologics. Methods: A total of 38 patients were retrospectively evaluated in the study, 23 male and 15 female, aged 18–74 years old who had undergone a total of 53 biological therapy courses with either infliximab [IFX] or vedolizumab [VDZ] at the Department of Gastroenterology of the Medical University of Łódź. The clinical and endoscopic activity of UC was assessed at the outset of biological therapy and the 14th week remission induction assessment juncture. Results: The study analyzed 19 IFX and 34 VDZ treatment courses. The response rate of patients receiving IFX reached 73.67% and the response rate was 58.82% for VDZ. The mean MS, eMS and UCEIS improved among all patient groups: 8.316 ± 1.974 to 4.158 ± 2.218 (p < 0.05), 2.632 ± 0.597 to 1.790 ± 0.713 (p < 0.05) and 4.790 ± 1.745 to 3.000 ± 1.453 (p < 0.05) for IFX, 7.088 ± 2.234 to 3.618 ± 2.412 (p < 0.05), 2.706 ± 0.524 to 1.677 ± 1.065 (p < 0.05) and 4.235 ± 1.350 to 2.735 ± 1.880 (p < 0.05) for VDZ. Conclusions: The outcome assessment in induction treatment of UC includes clinical data and endoscopic evaluation. Severity of inflammatory lesion activity according to the eMS and UCEIS indices correlates with the overall disease presentation as evaluated with MS. The UCEIS provides an overall better predictor for biological induction treatment when compared with the eMS in both patient groups, particularly in those receiving VDZ. It provides a promising alternative to the eMS and can be employed for both initial disease severity assessment as well as for treatment response monitoring.

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Guidelines for the management of ulcerative colitis. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Cited by 14 publications

References 262 publications

Inflammatory Bowel Diseases in the Elderly: A Focus on Disease Characteristics and Biological Therapy Patterns

Inflammatory Bowel Diseases in the Elderly: A Focus on Disease Characteristics and Biological Therapy Patterns

Relationship between periodontal diseases and non-specific inflammatory bowel diseases – an overview. Part I

Clinical Utility of Disease Activity Indices in Predicting Short-Term Response to Biologics in Patients with Ulcerative Colitis

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