Medical Therapy for Inflammatory Bowel Disease

Grevenitis, Panayiotis; Thomas, Arul; Lodhia, Nilesh

doi:10.1016/j.suc.2015.08.004

Cited by 34 publications

(35 citation statements)

References 140 publications

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“…Different types of immunosuppressant drugs are used alone or in combination to first induce and then maintain remission (Grevenitis et al . ). Previously, treatment response was defined by clinical response alone, but there is now evidence that achieving mucosal healing is important to reduce relapse rates in IBD patients (Dave & Loftus ).…”

Section: Canine Chronic Enteropathy – Is It the Same As The Human Dismentioning

confidence: 97%

“…Current research is investigating whether more aggressive immunosuppression early in the disease course improves outcome (Grevenitis et al . ). In contrast, the majority of dogs will not require any treatment other than dietary modification.…”

Section: Canine Chronic Enteropathy – Is It the Same As The Human Dismentioning

confidence: 97%

“…Firstly, medical therapy is central to the management of the human conditions and is aimed at controlling the inflammation. Different types of immunosuppressant drugs are used alone or in combination to first induce and then maintain remission (Grevenitis et al . 2015 ).…”

mentioning

confidence: 99%

“…Previously, treatment response was defined by clinical response alone, but there is now evidence that achieving mucosal healing is important to reduce relapse rates in IBD patients (Dave & Loftus 2012 ). Current research is investigating whether more aggressive immunosuppression early in the disease course improves outcome (Grevenitis et al . 2015 ).…”

mentioning

confidence: 99%

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Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?

Dandrieux

2016

J of Small Animal Practice

145

246

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The aim of this review is to discuss why "chronic enteropathy" might be a better term than "inflammatory bowel disease" in dogs, because the treatment and outcome of the disease is very different from that of inflammatory bowel disease in humans. The effect of food, antibiotics and immunosuppressant drugs on chronic enteropathy will be reviewed. New treatments under investigation will also be introduced. Although there are several studies evaluating treatment of chronic enteropathy in dogs, the quality and quantity of evidence supporting individual therapies remains scarce and more work is needed to improve management of this disease. Finally, new findings about dogs with chronic enteropathy complicated by protein-losing enteropathy will be discussed. Although prognosis for these dogs is poor, recent data might help improve their treatment.

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Section: Canine Chronic Enteropathy – Is It the Same As The Human Dismentioning

confidence: 97%

Section: Canine Chronic Enteropathy – Is It the Same As The Human Dismentioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?

Dandrieux

2016

J of Small Animal Practice

145

246

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“…Advances in therapeutics have increased the number of treatment options, expanding the armamentarium from broad conventional immunomodulator therapy to targeted biologics and small molecules including monoclonal antibodies to tumor necrosis factor α (anti-TNF) and gut-specific mucosal integrins. 2, 3 However, this has also resulted in care for IBD becoming increasingly complex and specialized with evolution towards therapeutic paradigms that suggest better outcomes with adoption of upfront biologic therapy early on in disease course and in combination with a conventional immunomodulators. 4, 5 …”

Section: Introductionmentioning

confidence: 99%

Distance to Specialist Care and Disease Outcomes in Inflammatory Bowel Disease

Conway

Tan

Andrews

et al. 2017

Inflammatory Bowel Diseases

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Introduction Optimal treatment of inflammatory bowel disease requires specialized health care. Patients frequently travel long distances to obtain care for inflammatory bowel disease, which may hinder regular care and affect outcomes adversely. Methods This study included patients with established CD or UC receiving care at a single referral center between January 2005 and August 2016. Distance to our healthcare center from the zip code of residence was determined for each patient and classified into quartiles. Our primary outcome was need for IBD-related surgery with secondary outcomes being need for biologic and immunomodulator therapy. Logistic regression models adjusting for relevant covariates examined the independent association between travel distance and patient outcomes. Results Our study included 2,136 patients with IBD (1,197 CD, 939 UC) among just over half were women (52%) and the mean age was 41 years. The mean distance from our hospital was 2.5 miles, 8.8 miles, 22.0 miles, and 50.8 miles for the first (most proximal) through fourth (most distant) respectively. We observed a statistically significant and meaningful higher risk among patients in the most distant quartile in the need for immunomodulator use (OR 1.69, 95% CI 1.29–2.22), biological therapy (OR 2.19, 95% CI 1.69–2.85) and surgery (OR 2.44, 95% CI 1.80 – 3.32). Differences remained significant on multivariable analysis and by type of IBD. Conclusion Greater distance to referral healthcare center was associated with increased risk for needing IBD-related surgery in patients with Crohn’s disease or ulcerative colitis.

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Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators

Connolly

Goldstone

2017

Int J Colorectal Dis

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This study highlights the potential for HSIL to extend into the rectum either as a contiguous patch or isolated islands and the need for heightened surveillance in patients with extensive anal canal HSIL treated with immunodulator therapy. HSIL identified at the limit of the anoscope should be investigated further with colonoscopy, and argon plasma coagulation (APC) ablation can serve as an effective treatment option. Patients are at risk for stricture, but it is unclear what role the UC or the ablation played in stricture formation.

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Medical Therapy for Inflammatory Bowel Disease

Cited by 34 publications

References 140 publications

Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?

Inflammatory bowel disease versus chronic enteropathy in dogs: are they one and the same?

Distance to Specialist Care and Disease Outcomes in Inflammatory Bowel Disease

Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators

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