Patient Understanding of the Risks and Benefits of Biologic Therapies in Inflammatory Bowel Disease

Martínez, Bibiana; Dailey, Francis; Almario, Christopher V.; Keller, Michelle S.; Desai, M P; Dupuy, Taylor; Mosadeghi, Sasan; Whitman, Cynthia B.; Lasch, Karen; Ursos, Lyann; Spiegel, Brennan M.

doi:10.1097/mib.0000000000001110

Cited by 56 publications

(34 citation statements)

References 24 publications

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“…Patients with IBD also have an increased risk of other diseases such as anemia [3], acute arterial events [4], and colorectal cancer [5]. The mainstays of IBD treatment include dietary, surgical, and medical approaches [6]; however, many patients are still reluctant to receive treatment due to the associated high costs, toxic effects, and long-term uncertainty [7]. New alternative medical strategies for IBD are thus desperately needed.…”

Section: Introductionmentioning

confidence: 99%

Dihydroartemisinin Regulates the Th/Treg Balance by Inducing Activated CD4+ T cell Apoptosis via Heme Oxygenase-1 Induction in Mouse Models of Inflammatory Bowel Disease

Yan

Wang

et al. 2019

Molecules

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Dihydroartemisinin (DHA) is a derivative of the herb Artemisia annua L. that has prominent immunomodulatory activity; however, its underlying mechanism remains elusive. Inflammatory bowel disease (IBD) is an idiopathic inflammatory condition characterized as an autoimmune disorder that includes dysfunctions in the T helper (Th)/T regulatory cell (Treg) balance, which normally plays pivotal roles in immune homeostasis. The aim of this study was to explore the potential of DHA to ameliorate IBD by restoring the Th/Treg cell balance. To this end, we established mouse models of colitis induced by oxazolone (OXA) and 2,4,6-trinitro-benzene sulfonic acid (TNBS). We then treated mice with DHA at 4, 8, or 16 mg/kg/day. DHA treatment ameliorated colitis signs and reduced lymphocyte infiltration and tissue fibrosis. Moreover, DHA decreased the numbers of Th1 and Th17 cells and Th9 and Th22 cells in TNBS- or OXA-induced colitis, respectively, and increased Tregs in both models. DHA (0.8 mg/mL) also inhibited activated CD4+ T lymphocytes, which was accompanied by apoptosis induction. Moreover, it promoted heme oxygenase-1 (HO-1) production in vitro and in vivo, concomitant with CD4+ T cell apoptosis and restoration of the Th/Treg balance, and these effects were blocked by treatment with the HO-1 inhibitor Sn-protoporphyrin IX. Overall, these results suggest that DHA is a novel and valuable candidate for IBD therapy or Th/Treg immunoregulation.

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Section: Introductionmentioning

confidence: 99%

Dihydroartemisinin Regulates the Th/Treg Balance by Inducing Activated CD4+ T cell Apoptosis via Heme Oxygenase-1 Induction in Mouse Models of Inflammatory Bowel Disease

Yan

Wang

et al. 2019

Molecules

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“…Social listening, or examining social media and forum posts, can reveal trends in public attitudes and behaviors about various health care topics. For example, our group has used social listening to examine patient beliefs about the use of opioid medications and their gastrointestinal side effects, public opinions about the use of virtual reality in health care, and patient beliefs about biologic medications in IBD [ 15 - 17 ]. Researchers have used social listening methods to examine e-cigarette attitudes and posts in the United States, estimate trends in influenza epidemics, and monitor the use and misuse of antidepressants [ 18 - 22 ].…”

Section: Introductionmentioning

confidence: 99%

Reproductive Health and Medication Concerns for Patients With Inflammatory Bowel Disease: Thematic and Quantitative Analysis Using Social Listening

et al. 2018

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BackgroundInflammatory bowel disease (IBD) affects many individuals of reproductive age. Most IBD medications are safe to use during pregnancy and breastfeeding; however, observational studies find that women with IBD have higher rates of voluntary childlessness due to fears about medication use during pregnancy. Understanding why and how individuals with IBD make decisions about medication adherence during important reproductive periods can help clinicians address patient fears about medication use.ObjectiveThe objective of this study was to gain a more thorough understanding of how individuals taking IBD medications during key reproductive periods make decisions about their medication use.MethodsWe collected posts from 3000 social media sites posted over a 3-year period and analyzed the posts using qualitative descriptive content analysis. The first level of analysis, open coding, identified individual concepts present in the social media posts. We subsequently created a codebook from significant or frequently occurring codes in the data. After creating the codebook, we reviewed the data and coded using our focused codes. We organized the focused codes into larger thematic categories.ResultsWe identified 7 main themes in 1818 social media posts. Individuals used social media to (1) seek advice about medication use related to reproductive health (13.92%, 252/1818); (2) express beliefs about the safety of IBD therapies (7.43%, 135/1818); (3) discuss personal experiences with medication use (16.72%, 304/1818); (4) articulate fears and anxieties about the safety of IBD therapies (11.55%, 210/1818); (5) discuss physician-patient relationships (3.14%, 57/1818); (6) address concerns around conception, infertility, and IBD medications (17.38%, 316/1818); and (7) talk about IBD symptoms during and after pregnancy and breastfeeding periods (11.33%, 206/1818).ConclusionsBeliefs around medication safety play an important role in whether individuals with IBD decide to take medications during pregnancy and breastfeeding. Having a better understanding about why patients stop or refuse to take certain medications during key reproductive periods may allow clinicians to address specific beliefs and attitudes during office visits.

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“…Treato, the NLP algorithm used for this study, includes resolution of patient-specific symptom terms but it was not implemented for FDA reporting. Martinez et al, also using the Treato system, performed manual coding of symptoms for qualitative analysis 43 . These two studies call into question the true efficacy of Treato to extract relevant symptoms.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of natural language processing and text mining of symptoms from electronic patient-authored text data

Dreisbach

Koleck

Bourne

et al. 2019

International Journal of Medical Informatics

178

108

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Objective: In this systematic review, we aim to synthesize the literature on the use of natural language processing (NLP) and text mining as they apply to symptom extraction and processing in electronic patient-authored text (ePAT). Materials and Methods: A comprehensive literature search of 1,964 articles from PubMed and EMBASE was narrowed to 21 eligible articles. Data related to purpose, text source, number of users and/or posts, evaluation metrics, and quality indicators were recorded. Results: Pain (n=18) and fatigue and sleep disturbance (n=18) were the most frequently evaluated symptom clinical content categories. Studies accessed ePAT from sources such as Twitter and online community forums or patient portals focused on diseases, including diabetes, cancer, and depression. Fifteen studies used NLP as a primary methodology. Studies reported *

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Patient Understanding of the Risks and Benefits of Biologic Therapies in Inflammatory Bowel Disease

Abstract: Social media reveals a wide range of themes governing patients' experience and choice with IBD biologics. The complexity of navigating their risk-benefit profiles suggests merit in creating online tailored decision tools to support IBD patients' decision-making with biologic therapies.

Cited by 56 publications

References 24 publications

Dihydroartemisinin Regulates the Th/Treg Balance by Inducing Activated CD4+ T cell Apoptosis via Heme Oxygenase-1 Induction in Mouse Models of Inflammatory Bowel Disease

Dihydroartemisinin Regulates the Th/Treg Balance by Inducing Activated CD4+ T cell Apoptosis via Heme Oxygenase-1 Induction in Mouse Models of Inflammatory Bowel Disease

Reproductive Health and Medication Concerns for Patients With Inflammatory Bowel Disease: Thematic and Quantitative Analysis Using Social Listening

A systematic review of natural language processing and text mining of symptoms from electronic patient-authored text data

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