The Asia‐Pacific consensus on ulcerative colitis

Ooi, Choon Jin; Fock, Kwong Ming; Makharia, Govind; Goh, Khean Lee; Ling, Khoon Lin; Hilmi, Ida; Lim, Wee Chian; Kelvin, Thia; Gibson, Peter R.; Gearry, Richard B.; Ouyang, Qi; Sollano, José D.; Manatsathit, Sathaporn; Rerknimitr, Rungsun; Shu, Wei; Leung, Wai K.; Silva, H. Janaka De; Leong, Rupert W.

doi:10.1111/j.1440-1746.2010.06241.x

Cited by 141 publications

(106 citation statements)

References 180 publications

(449 reference statements)

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“…Despite the CMV seroprevalence being high in East Asia [23,24], the rate of physicians who investigate CMV reactivation in patients with severe or refractory UC varied among these countries from 0 to 100%, and this may have been due to the current situation in which no conclusion has been reached regarding whether CMV infection in IBD patients is nonpathogenic colonization or a pathogenic disease requiring antiviral treatment [3,25,26]. Moreover, various diagnostic methods are used in these countries because no gold standard diagnostic method for CMV infection and disease has been sufficiently established.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there are treatment options that are characteristic of this region and not generally used in the West, such as leukocyte apheresis in Japan and medical herbs in China. Considering these differences, the IBD management consensus was formulated in the Asia-Pacific region in 2005 and 2010 [2,3]. In addition, there are original diagnostic criteria, guidelines and consensus in China, Korea and Japan, and various differences in the diagnosis and treatment of IBD among East Asian countries [4,5,6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

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A Questionnaire-Based Survey on the Diagnosis and Management of Inflammatory Bowel Disease in East Asian Countries in 2012

et al. 2014

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Background and Aim: The prevalence and incidence of inflammatory bowel disease (IBD) are lower in East Asia than in Western countries; however, marked increases have recently been reported. The clinical diagnosis and medical management of IBD in East Asia differ from those in Western countries. A questionnaire-based survey was performed to gather physicians' current opinions on IBD in different East Asian countries. Methods: Representative International Gastrointestinal Consensus Symposium (IGICS) committee members provided a questionnaire to physicians in each East Asian country studied. The questionnaire mainly focused on the diagnosis and management of IBD. Results: There were 19 respondents from Japan, 10 from South Korea, 9 from the Philippines, 6 from China and 4 from Indonesia. Colonoscopy (100%) and histopathology (63%) were commonly used for the diagnosis in ulcerative colitis (UC). Conventional small bowel enteroclysis was still the most common diagnostic tool for assessing small bowel lesions in Crohn's disease (CD) in East Asia. The percentage of physicians who investigated the reactivation of Cytomegalovirus in severe or refractory patients with UC ranged from 0% in the Philippines and Indonesia to 100% in Japan and Korea. Most physicians in Korea, the Philippines, China and Indonesia chose thiopurines or anti-TNF therapy as the second-line treatment in severe refractory UC, whereas Japanese physicians preferred to use tacrolimus or leukocyte apheresis. Physicians in the Philippines and Indonesia preferred to use oral 5-aminosalicylic acid for newly diagnosed severe ileocecal CD. In contrast, Korean physicians chose oral steroids and most physicians in China and Japan preferred to use anti-TNF. Nutritional therapy to induce or maintain remission in patients with CD was commonly used in Indonesia, Japan and China. Targeted biopsies by conventional colonoscopy were the most preferred strategy for cancer surveillance in long-standing UC over random biopsies in this region. Conclusions: The present survey found that current diagnostic approaches and clinical management of IBD vary within East Asian countries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Questionnaire-Based Survey on the Diagnosis and Management of Inflammatory Bowel Disease in East Asian Countries in 2012

et al. 2014

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“…Recently, a Korean group also discovered a single nucleotide polymorphism in NUDT15 , which may partially explain the higher incidence of thiopurine-induced leukopenia in Asians [37]. In view of this, recommendations suggest the use of a lower starting dose of thiopurines in Asian patients and advocate the testing of TPMT and thiopurine metabolites [38], which are unfortunately not widely available in many Asia-Pacific regions.…”

Section: Treatment and Managementmentioning

confidence: 99%

“…In the East, various countries have developed their own guidelines tailored for different patient needs. These include the Japanese guidelines [56], KASID (Korean) guidelines [57,58], the Asia-Pacific consensus on UC and CD [38,59,60], and the Hong Kong Inflammatory Bowel Disease Society use of biologics consensus [61]. Broadly speaking, many of these guidelines are consistent with specific differences pertaining to each country such as the availability of drugs, the local risk of infections, regional standard clinical practice, local evidence, and opinions of regional experts.…”

Section: Guidelinesmentioning

confidence: 99%

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Lui

2016

Inflamm Intest Dis

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Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease with unknown etiology. It is likely caused by a complex interplay between genetic, immunologic and environmental factors. Although IBD is still relatively uncommon in Asia, a multitude of studies have shown that it is an emerging disease around the world. Recent insights have highlighted both the similarities and differences amongst Asian and Western IBD patients. Summary: The annual incidence of IBD in the East is still low compared with the West, but there are differences between different regions of Asia. Time trend studies have shown that the incidence of IBD is on the rise. Some notable differences in the clinical manifestations of IBD between the East and West have also been noted. ‘Westernization' of lifestyle may encompass various social and environmental changes that account for the emergence of IBD in our population, although genetics also plays a role in disease pathogenesis. Diagnosis and treatment challenges include limited access to medical care in certain areas, limited availability and high cost of medications, lack of insurance reimbursement, paucity of multidisciplinary teams for the management of complicated IBD cases, and a high prevalence of endemic infections. Currently, the risk of colorectal cancer is lower in the East than in the West, but cancer rates will likely approach that of the West in the future as the prevalence of IBD continues to rise. Key Messages: Measures to improve access to diagnostic tools, increase the availability of medication, and provide adequate multidisciplinary care for IBD patients will become increasingly important in Asia. Differences between the East and West will provide a unique opportunity for global collaboration in basic and clinical research to further our understanding of the disease entity and also provide more locoregional data to healthcare providers and policymakers to make informed decisions and policy changes when tackling the rising burden of IBD in Asia.

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“…Although evidence-based clinical practice guidelines are available worldwide including Asia [1,2,3,4,5,6], diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) may vary among countries in terms of the availability of modalities, affordability of health care resource, health care policy and cultural background. This may be applied to different countries in Eastern Asia.…”

Section: Introductionmentioning

confidence: 99%

Asian Perspectives on Diagnostic and Therapeutic Strategies in Inflammatory Bowel Disease: Report and Analysis of a Survey with Questionnaires

et al. 2017

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Background: Diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) vary among countries in terms of availability of modalities, affordability of health care resource, health care policy and cultural background. This may be the case in different countries in Eastern Asia. The aim of this study was to determine and understand the differences in diagnostic and therapeutic strategies of IBD between Japan and the rest of Asian countries (ROA). Methods: Questionnaires with regard to clinical practice in IBD were distributed to members of the International Gastroenterology Consensus Symposium Study Group. The responders were allowed to select multiple items for each question, as multiple modalities are frequently utilized in the diagnosis and the management of IBD. Dependency and independency of selected items for each question were evaluated by the Bayesian network analysis. Results: The selected diagnostic modalities were not very different between Japan and ROA, except for those related to small bowel investigations. Balloon-assisted enteroscopy and small bowel follow through are frequently used in Japan, while CT/MR enterography is popular in ROA. Therapeutic modalities for IBD depend on availability of such modalities in clinical practice. As far as modalities commonly available in both regions are concerned, there seemed to be similarity in the selection of each therapeutic modality. However, evaluation of dependency of separate therapeutic modalities by Bayesian network analysis disclosed some difference in therapeutic strategies between Japan and ROA. Conclusion: Although selected modalities showed some similarity, Bayesian network analysis elicited certain differences in the clinical approaches combining multiple modalities in various aspects of IBD between Japan and ROA.

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The Asia‐Pacific consensus on ulcerative colitis

Cited by 141 publications

References 180 publications

A Questionnaire-Based Survey on the Diagnosis and Management of Inflammatory Bowel Disease in East Asian Countries in 2012

A Questionnaire-Based Survey on the Diagnosis and Management of Inflammatory Bowel Disease in East Asian Countries in 2012

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Asian Perspectives on Diagnostic and Therapeutic Strategies in Inflammatory Bowel Disease: Report and Analysis of a Survey with Questionnaires

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