To gain a better understanding of the effects of biologics, we evaluated clinical outcomes in patients with moderate to severe exacerbations of ulcerative colitis (UC). This retrospective, multicenter study retrieved the entire clinical courses of UC patients who began treatments between 2004 and 2018. All exacerbations and clinical parameters, including treatment details for exacerbations and both remission and re-exacerbation dates, were identified during the observation period. Two different endpoints, the cumulative incidence rates of surgical resection and re-exacerbation, were evaluated separately in moderate to severe exacerbation events. Among 1401 patients, 1626 exacerbation events were determined according to a partial Mayo score (remission: < 2, mild: 2–4, moderate: 5–7, and severe: > 7). During the observation period, as administration rates of biologics increased, both surgical resection and hospitalization rates decreased, for 959 moderate to severe exacerbation events. We confirmed that biologics significantly reduced the cumulative re-exacerbation rate in moderate to severe exacerbation events during the study period compared with suboptimal therapies (a 0.507-fold decreased risk according to COX regression analysis, P < 0.001). However, they had not enough impact in reducing the cumulative incidence rate of surgical resection in moderate to severe exacerbation events that were corticosteroid-refractory or dependent (a 0.878-fold decreased risk according to COX regression analysis, P = 0.606). Biologics may improve remission duration, but these agents had no significant impact in reducing the risk of surgical resection in moderate to severe active UC.
Background and aim: In recent years, the linked color imaging (LCI) system has been developed as a new endoscopic imaging modality 1. LCI uses band laser (wavelength 410 AE 10 nm) in addition to white-light laser. Therefore, the LCI mode helps emphasize vascular and surface structures and color differences while maintaining a bright vision. However, the utility of LCI for visualizing superficial nonampullary duodenal epithelial tumors (SNADETs) is unclear. Thus, the present study aimed to evaluate the visibility of LCI with SNADETs. Patients and methods: We retrospectively evaluated 44 SNADETs with 44 patients (M:F Z 31:13, mean age Z 66.0 AE 9.4). All lesions were examined with LASEREO system (FUJIFILM, Tokyo, Japan) and subsequently removed via endoscopic resection. Lesions background were as follows: mean tumor size (mm) (9.0 AE 6.0), location [bulb/2nd portion (oral side of papilla)/2nd portion (anal side of papilla)/3rd portion/4th portion Z 5/14/23/ 2], morphology (Is
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