Long-term outcome after admission for acute severe ulcerative colitis in Oxford: The 1992–1993 cohort

Bojic, Daniela; Radojičić, Zoran; Nedeljkovic-Protic, M; Alali, Mohammed; Jewell, D P; Travis, Simon

doi:10.1002/ibd.20843

Cited by 74 publications

(66 citation statements)

References 19 publications

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“…The colectomy rate at admission in our study was lower than that reported in the West, but matched the Asian data ( Table 3 ). The longterm colectomy rate in our study was 34%, which was lower than that reported by two earlier studies from Sweden (64%) [72] and Oxford (61%) [73] , but comparable to the recent studies from Oxford (40%) [70] , Hungary (25%) [74] , and South Korea (29%) [75] . These differences could be explained by an absence of immunomodulator use in the Swedish cohort, regional differences in the behaviour of disease (Asia vs. West), and the duration of follow-up.…”

Section: Long-term Disease Course and Treatmentcontrasting

confidence: 55%

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

2017

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Section: Long-term Disease Course and Treatmentcontrasting

confidence: 55%

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

2017

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“…The risk of the development of these complications is much lower in UC than in CD. In addition, the colectomy rate of acute severe UC is reported to be significantly lower in Korean patients [55] than in British patients [56,57] : 16.2 versus 29.4% during index hospitalization and 15.7 versus 50% during a median 10-year follow-up after discharge. Therefore, the strategy of discontinuing anti-TNF therapy after a certain period of remission and later reintroducing it on an on-demand basis may be worth evaluating in Asian patients with UC.…”

Section: Combination Therapy Versus Monotherapymentioning

confidence: 99%

Personalizing IBD Therapy: The Asian Perspective

Yang

2016

Dig Dis

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Background: All patients with inflammatory bowel disease (IBD) share common therapeutic goals, such as complete mucosal healing and improved long-term outcomes (e.g., reduction in hospitalization, surgery and mortality). However, because IBD patients have diverse features in terms of severity, phenotypes, clinical courses and responses to therapy, therapeutic options for achieving these goals differ among patients, from no therapy to early introduction of combination therapy with anti-TNF and immunosuppressive agents. Key Messages: By personalizing IBD therapy, we may be able to maximize management efficacy, minimize the risk of adverse events and ultimately decrease costs. The initial steps of personalized therapy involve the selection of the right patients by predicting the clinical course of IBD and the subsequent selection of the right therapy by predicting the response to therapy. The next step of personalized therapy involves the adjustment of therapy through therapeutic response evaluation and therapeutic drug monitoring. Notably, current recommendations on personalized IBD therapy are mainly based on results derived from Western populations. However, Asian patients with IBD are different from Western patients in many respects, including clinical characteristics, therapeutic response and prognosis, probably due to differences in environmental and genetic backgrounds. In addition, the healthcare systems and sociocultural backgrounds of Asian countries are not the same as those of Western countries. Therefore, personalized IBD therapy for Asians may differ from that for Westerners in some aspects. Conclusions: This review discusses the current progress of personalized IBD therapy and its application from the Asian perspective.

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“…Serological markers able to predict an aggressive course are antiglycan antibodies and antibacterial antibodies [2]. In UC, clinical, genetic and serological risk factors for more aggressive disease are extensive colitis, sclerosing cholangitis, the presence of extraintestinal manifestations, a young age, a nonsmoking status, systemic inflammation, no response to first-line therapy, no mucosal healing 1 year after diagnosis, HLA variants and antineutrophil cytoplasmic antibodies [11,12,13,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Risk Factors for Complicated Disease: How Reliable Are They?

Zallot

Peyrin–Biroulet²

2012

Dig Dis

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Crohn’s disease is a chronic, progressive, destructive disease. Complicated disease can be defined as the presence of bowel damage (stricture, abscess or fistula) and/or the need for surgery. Natural history studies provide invaluable data on the disease course. In population-based cohorts, half of all patients experienced an intestinal complication within 20 years after diagnosis and half of the patients required surgery within 10 years after diagnosis. In Olmsted County, the factors associated with the development of complications were the presence of ileal involvement and perianal disease. The extent of noncolonic disease, current smoking, male gender, penetrating disease behavior and early steroid use were significantly associated with major abdominal surgery. Overall, using various definitions of complicated disease, the predictors of a worse outcome in Crohn’s disease were: extensive small bowel disease, severe upper gastrointestinal disease, rectal disease, perianal lesions, early stricturing/penetrating disease, smoking and a young age at diagnosis. Aggressive ulcerative colitis was recently defined as a disease that is associated with a high relapse rate, the need for surgery, the development of colon cancer or the presence of extraintestinal manifestations. About one tenth of patients still require colectomy for ulcerative colitis at 5 years in the era of biologics. An average of 1.6% of patients with ulcerative colitis was diagnosed with colorectal cancer during 14 years of follow-up in population-based cohorts. A younger age at diagnosis and pancolitis were associated with a worse outcome in ulcerative colitis. The identification of clinical risk factors for complicated disease may be used in future disease-modification trials.

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Long-term outcome after admission for acute severe ulcerative colitis in Oxford: The 1992–1993 cohort

Cited by 74 publications

References 19 publications

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

Personalizing IBD Therapy: The Asian Perspective

Clinical Risk Factors for Complicated Disease: How Reliable Are They?

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