Rates of Intestinal Resection and Colectomy in Inflammatory Bowel Disease Patients After Initiation of Biologics: A Cohort Study

Khoudari, George; Mansoor, Emad; Click, Benjamin; Alkhayyat, Motasem; Saleh, Mohannad Abou; Sinh, Preetika; Katz, Jeffry; Cooper, Gregory S.; Regueiro, Miguel

doi:10.1016/j.cgh.2020.10.008

Cited by 48 publications

(30 citation statements)

References 46 publications

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“…Biologics, such as anti‐TNFs and vedolizumab have dramatically changed the management of ulcerative colitis (UC) 1‐4 . However, these current therapies are limited by a lack of effectiveness, as only one‐third of treated patients achieves long‐term remission 5‐7 …”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of ustekinumab maintenance therapy in 103 patients with ulcerative colitis: a GETAID cohort study

Fuméry¹,

Filippi²,

Abitbol³

et al. 2021

Aliment Pharmacol Ther

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Summary Background Phase III trials have demonstrated the efficacy and safety of ustekinumab in ulcerative colitis (UC), but few real‐life long‐term data are currently available. Aims To assess the real‐world effectiveness and safety of ustekinumab in patients with UC. Methods From January to September 2019, all consecutive patients with active UC treated with ustekinumab in a GETAID centre were included. Patients were evaluated at week 52. Remission was defined as a partial Mayo Clinic score ≤2. Results We included 103 patients with UC (62 men; mean age: 41.2 ± 16.2 years; 52% pancolitis E3) with an insufficient response to immunosuppressants, anti‐TNFs and/or vedolizumab. At week 52, 45 (44%) patients had discontinued ustekinumab mainly due to lack of effectiveness (n = 41). The cumulative probabilities of ustekinumab persistence were 96.1%, 81.6%, 71.7% and 58.4% after 3, 6, 9 and 12 months respectively. The overall steroid‐free clinical remission rate at week 52 was 32% of whom 71% had subscores of null for rectal bleeding and stool frequency. Ten patients underwent colectomy within a median of 6.7 [4.3‐10.6] months. Adverse effects were observed in 15 (16.9%) patients; 4 (4.5%) were severe, including one patient who died from a myocardial infarction. Conclusion After 52 weeks, over one‐half of patients with refractory UC were still treated by ustekinumab and one‐third were in steroid‐free clinical remission.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of ustekinumab maintenance therapy in 103 patients with ulcerative colitis: a GETAID cohort study

Fuméry¹,

Filippi²,

Abitbol³

et al. 2021

Aliment Pharmacol Ther

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“…In addition, SNOMED-CT allows for more concepts to be coded per clinical document compared to ICD making it more accurate in terms of documenting diagnoses and pertinent patient information. It is important to highlight that Explorys has been validated previously as a database (59) and in different specialties including gastroenterology (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)60,61).…”

Section: Discussionmentioning

confidence: 99%

“…To keep patients' information confidentiality, Explorys rounds cell counts to the nearest 10. Explorys database has been validated previously in multiple fields including surgery and gastroenterology (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Databasementioning

confidence: 99%

Epidemiology of gallbladder cancer in the Unites States: a population-based study

Alkhayyat¹,

Saleh²,

Qapaja³

et al. 2021

Chin Clin Oncol

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Background: Gallbladder cancer (GBC) is the most common neoplasm of the biliary tract with the lowest rates of survival. Most GBCs are adenocarcinomas that arise from the epithelial lining of the gallbladder. There are limited data in the literature regarding the epidemiology of GBC. Using a large database, we aim to describe the epidemiology using a US population database. Methods: A multi-institutional database (Explorys Inc., Cleveland, OH, USA) was surveyed. A cohort of patients with a primary malignant neoplasm of gallbladder between 1999-2019 was identified. The prevalence rate was calculated and age-, race-, and sex-based distributions were described. Multivariate analysis was done to evaluate underlying associations. Results: Of the 56,197,690 individuals in the database, 4,790 individuals with GBC were identified with a prevalence rate of 8.5 per 100,000. Asian race has the highest prevalence of GBC (13.6/100,000). Patients with GBC were also more likely to be smokers, have a history of alcohol abuse, obesity, diabetes, cholelithiasis, chronic cholecystitis, primary sclerosing cholangitis (PSC), and chronic viral hepatitis. Conclusions: This is one of the largest US population studies to date evaluating the epidemiology of GBC. The 20-year period prevalence rate of GBC was 8.5 per 100,000. Patients with GBC were more likely to be elderly, females, obese, diabetic, and have chronic hepatobiliary disorders.

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“…Identifying UC patients most at risk for developing CDI may be helpful to clinicians so that strategies to minimise future infection can be implemented 17,18 . CDI is a major cause of morbidity and mortality in UC patients and has been shown to be associated with an increased risk of colectomy, post‐operative complications and death 19‐23 . Therefore, preventing CDI in UC patients is an important area of study and finding ways to identify children at risk of developing CDI would be a valuable first step.…”

Section: Discussionmentioning

confidence: 99%

Decreased secondary faecal bile acids in children with ulcerative colitis and Clostridioides difficile infection

Rotondo-Trivette

Wang

Gayer

et al. 2021

Aliment Pharmacol Ther

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Summary Background Patients with ulcerative colitis (UC) have an increased risk of Clostridioides difficile infection (CDI). There is a well‐documented relationship between bile acids and CDI. Aims To evaluate faecal bile acid profiles and gut microbial changes associated with CDI in children with UC. Methods This study was conducted at Children's Hospital Los Angeles. Faecal bile acids and gut microbial genes related to bile acid metabolism were measured in 29 healthy children, 23 children with mild to moderate UC without prior CDI (UC group), 16 children with mild to moderate UC with prior CDI (UC+CDI group) and 10 children without UC with prior CDI (CDI group). Results Secondary faecal bile acids, especially lithocholic acid (3.296 vs 10.793, P ≤ 0.001) and ursodeoxycholic acid (7.414 vs 10.617, P ≤ 0.0001), were significantly lower in children with UC+CDI when compared to UC alone. Secondary faecal bile acids can predict disease status between these groups with 84.6% accuracy. Additionally, gut microbial genes coding for bile salt hydrolase, 7α‐hydroxysteroid dehydrogenase and 7α/β‐dehydroxylation were all diminished in children with UC+CDI compared to children with UC alone. Conclusions Bile acids can distinguish between children with UC based on their prior CDI status. Bile acid profile changes can be explained by gut microbial genes encoding for bile salt hydrolase, 7α‐hydroxysteroid dehydrogenase and 7α/β‐dehydroxylation. Bile acid profiles may be helpful as biomarkers to identify UC children who have had CDI and may serve as future therapeutic targets.

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Rates of Intestinal Resection and Colectomy in Inflammatory Bowel Disease Patients After Initiation of Biologics: A Cohort Study

Cited by 48 publications

References 46 publications

Effectiveness and safety of ustekinumab maintenance therapy in 103 patients with ulcerative colitis: a GETAID cohort study

Effectiveness and safety of ustekinumab maintenance therapy in 103 patients with ulcerative colitis: a GETAID cohort study

Epidemiology of gallbladder cancer in the Unites States: a population-based study

Decreased secondary faecal bile acids in children with ulcerative colitis and Clostridioides difficile infection

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