Systematic Review

Narula, Neeraj; Michael, Fine; Colombel, Jean–Frédéric; Marshall, John K.; Reinisch, Walter

doi:10.1097/mib.0000000000000350

Cited by 74 publications

(28 citation statements)

References 53 publications

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“…Sequential therapy with infliximab and ciclosporin can be associated with profound immunosuppression and potentially risks serious adverse events and infections and is not recommended,246 247 although a recent review suggested that the risks were not excessive (on the basis of low-quality data) 248. In the ENEIDA registry sequential therapy was defined as treatment with the second agent (ciclosporin or infliximab) within 3 months after the steroid-refractory ASUC attack, and was used in 10% of those with long-term outcomes available 234.…”

Section: Ulcerative Colitismentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,721

1,816

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Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

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Section: Ulcerative Colitismentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,721

1,816

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“…Hence, while this study may further shift the trend towards operating earlier, it should be stressed that immediate operation is, in most instances, over-treatment as the great majority of patients respond to drugs and this attitude may lead to missed opportunities for bowel salvage. A third line of therapy has been reported to have acceptable results but the evidence in its favor is probably still outbalanced by the risks of not operating [164,165].…”

Section: Item 23mentioning

confidence: 99%

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): Crohn’s disease

et al. 2020

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The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a position statement of Italian colorectal surgeons to address the surgical aspects of Crohn's disease management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of Crohn's disease. The committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.

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“…A systematic review of ten studies, or 314 participants, showed sequential treatment with combinations of steroids, CsA or TAC, and IFX, led to ASUC patients achieving a response in 62% of cases and remission in 39%; colectomy rates were 28% at 3 months, but were as high as 42% at 12 months. Adverse events were encountered by 23% of patients, including serious infections in 7% and mortality in 1% [58]. This study highlights that the quality of the evidence available overall is low and consequently is unable to draw definite conclusion on appropriate sequence of therapies; we may be able to delay rather than prevent colectomies, but it has to be clearly balanced with the higher risks of adverse outcomes.…”

Section: "Third Line" Medical Therapy or Sequential Therapymentioning

confidence: 90%

Management of Acute Severe Colitis in the Era of Biologicals and Small Molecules

Verdon

Bessissow

Lakatos

2019

JCM

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Acute severe ulcerative colitis (ASUC) is a medical emergency which occurs in about 20%–30% of patients with ulcerative colitis during their lifetime, and does carry a mortality risk of 1%. The management of inflammatory bowel diseases has evolved with changes in objective patient monitoring, as well as the availability of new treatment options with the development of new biological and small molecules; however, data is limited regarding their use in the context of ASUC. This review aims to discuss the emerging data regarding biologicals and small molecules therapies in the context of ASUC.

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Systematic Review

Cited by 74 publications

References 53 publications

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): Crohn’s disease

Management of Acute Severe Colitis in the Era of Biologicals and Small Molecules

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