Figure 1 Sociodemographic, clinical and lifestyle characteristics of 78 patients with age-related cataract.
Background: Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) considered independent risk factors for the development of lactose maldigestion. Patients with these clinical conditions usually make restriction of dairy products believing they harm their clinical or because of health professionals indication. However, the assertion that this group of patients has lactose intolerance (LI) remains controversial. The aim of this study was to identify the frequency of LI in a group of IBD patients. Methods: IBD patients in outpatient treatment were appraised from August to November 2012. Hydrogen breath test (HBT) was used to diagnose lactose maldigestion. To this, the first sample of exhaled air was collected in fasting, followed by another sample, 1 hour after ingestion of 25g of lactose solution at 10%, and by other four consecutive samples every 30 minutes, totaling three hours of analysis. The HBT was considered positive if at least one sample increased more than 20ppm of hydrogen compared to baseline. LI was diagnosed by positive HBT associated with the presence of gastrointestinal disorders. Results: Eighty-three adult IBD patients were appraised, 49 UC patients and 34 CD patients. Most were female (61.4%) and were between 31 and 50 years old (62.7%). The frequency of LI was 31.3% in IBD patients. In UC patients, the frequency of LI was 28.6%, and among those CD patients, 35.3% were considered intolerant (p = 0.51). Of all LI patients, 80.8% were women (p = 0.01), 57.7% were between 31 and 50 years old and 46.2% were diagnosed less than 5 years before, however the last two data showed no statistically significant differences when comparing the groups with and without LI diagnosis (p = 0.76; p = 0.46; respectively). Of the 38 patients who had some restriction of dairy products, 60.5% were diagnosed negative for LI. Conclusions: LI was common in both UC and CD patients, however the most part of patients who restrict dairy products did not present LI. These findings emphasize the importance of investigating LI in IBD patients and of the individualization of dietary behaviors, so that unnecessary restrictions can be avoided. P206Is the IBD pre-endoscopic screening F-Calprotectin test more cost-effective than the usage of serologic markers in selected European markets?
BACKGROUND: Ulcerative colitis (UC) affects between 37 and 238 people per 100,000 in the United States. Golimumab (GLM), an anti-TNF therapy, was recently approved for the treatment of moderate to severe UC. Increasing concerns about the budgetary impact of biologic therapies has intensified the need to understand the cost implications of their use. The primary objective of this study was to assess the cost per unit of effectiveness and number needed to treat (NNT) of patients receiving maintenance therapy of GLM after achieving clinical response during an induction period. METHODS: A cost effectiveness model was developed using the results of the PURSUIT-Maintenance (PURSUIT-M) study, a 54 week Phase 3 randomized, placebo-controlled, double-blind maintenance study of the safety and efficacy of GLM among individuals who had not used biologic therapy previously. This analysis evaluated the placebo-adjusted cost per clinical response, clinical remission, and mucosal healing. Clinical response was measured as sustained clinical response through week 54. Clinical remission was measured at week 30 and week 54. Patients had to be in clinical remission at both time periods. Mucosal healing was measured at the same time points and manner as clinical remission. The number needed to treat (NNT) was calculated for each of these endpoints. The PURSUIT-M study included a GLM 100 mg and GLM 50 mg treatment arms. However, the 50 mg treatment arm was excluded since it is not the FDA-approved labeled dose. Medication costs were calculated by applying the July, 2013 wholesale acquisition costs based on the FDA-labeled dosing requirements. RESULTS: The cost per clinical response and NNT for clinical response of GLM was $184,690 and 6, respectively. The cost per remission and the NNT for patients in remission was $268,640, and 8, respectively. The cost per mucosal healing and NNT of mucosal healing was $213,617 and 7, respectively. CONCLUSIONS: This analysis revealed that the cost effectiveness of GLM for the maintenance therapy of UC ranged from $184,690 for clinical response to $268,640 for clinical remission. The NNT ranged from 6 to 8 for the endpoints studied. Further studies using real-world data may provide a better understanding of the cost effectiveness of anti-TNF therapies and allow comparisons among different medications.BACKGROUND: The influence of clinical features, such as duration and disease activity, complications, intestinal resection, and use of corticosteroids on bone mineral density (BMD) in ulcerative colitis (UC) patients is already defined. However, the association between BMD and nutritional factors is still controversial and poorly investigated. The aim of this study was to evaluate the anthropometric features, body composition and BMD in UC patients. METHODS: Cross-sectional study with 65 adult outpatients, recruited from 2 reference centers of inflammatory bowel disease, in the city of Salvador, Bahia, Brazil. Between September/2012 and March/2013, patients underwent to anthropometric evaluation (body ma...
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