Anti-tumor necrosis factor agents reduce corticosteroid use compared with azathioprine in patients with Crohn’s disease

Kane, Sunanda V.; Jaganathan, Srihari; Bedenbaugh, A.; Palmer, Liisa; Schwartz, David L.

doi:10.1185/03007995.2014.928273

Cited by 7 publications

(8 citation statements)

References 24 publications

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“…compared patients with inactive Crohn's disease to control subjects, they found elevated levels of tumor necrosis factor (TNF)‐α in the colonic mucosa of patients . This finding is in keeping with the success of infliximab (IFX) anti‐TNF‐α therapy for patients with refractory Crohn's disease . When Simoneau et al .…”

Section: Inflammation and Hyperparathyroidism Are Important Causes Ofmentioning

confidence: 71%

“…Although there is a body of strong evidence suggesting that inflammation causes the metabolic conversion of 25(OH)D to 1,25(OH) 2 D in the inflamed intestine of patients, thereby reducing the serum level of 25(OH)D, well‐designed clinical studies are still needed to conclusively establish the biological significance of the local production of 1,25(OH) 2 D in relationship to GI diseases. Also, it will be important to investigate whether, in addition to TNF‐α, other inflammatory cytokines also regulate the local conversion of 25(OH)D to 1,25(OH) 2 D in the inflamed GI system of patients and, if so, how significant this is to the development of disease or disease activity. The outcomes of such studies may perhaps lead to the identification of new biomarkers for hypovitaminosis D associated with GI syndromes and also novel drug targets.…”

Section: Future Researchmentioning

confidence: 99%

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Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Margulies

Kurian

Elliott

et al. 2015

J of Digest Diseases

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There is a very high prevalence of vitamin D deficiency, which is defined by a serum level of 25-hydroxyvitamin D [25(OH)D] of lower than 20 ng/mL, in all populations of the world. Unfortunately, the prevalence of vitamin D deficiency in patients with intestinal malabsorption syndromes, including cystic fibrosis (CF), celiac disease (CD), short bowel syndrome and inflammatory bowel disease (IBD), is higher than that in the general population, indicating the presence of disease-specific causative factors. In this review, we aimed to present clinical findings to highlight the roles of insufficient exposure to sunlight and inflammation in the development of vitamin D deficiency in patients with intestinal malabsorption syndromes. Furthermore, we aimed to present experimental evidence that supported a role of vitamin D deficiency in the pathogenesis of IBD. Finally, we reviewed clinical intervention strategies aiming to normalize vitamin D status in and even to improve the conditions of patients and to discuss certain issues that needed to be addressed in future research.

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Section: Inflammation and Hyperparathyroidism Are Important Causes Ofmentioning

confidence: 71%

Section: Future Researchmentioning

confidence: 99%

Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Margulies

Kurian

Elliott

et al. 2015

J of Digest Diseases

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“…It has been suggested that allogeneic stem cell transplantation may result in disease remission in such patients. 36 …”

Section: Profile Of Pediatric Patients Qualifying For Biologic Therapmentioning

confidence: 99%

Profile of infliximab in the treatment of pediatric Crohn’s disease

Kierkuś¹,

Szymańska²,

Oracz³

et al. 2015

PHMT

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In recent years, a novel biologic therapy with monoclonal antibodies against tumor necrosis factor-alpha has revolutionized the treatment of Crohn’s disease. Infliximab, the first biologic agent, has been demonstrated to considerably improve both clinical and endoscopic outcomes. In view of the growing popularity of infliximab in the management of Crohn’s disease, we review the profile of the agent in the treatment of this disease in a pediatric setting.

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“…The primary IBD treatment goal is long-lasting corticosteroid (CS)-free disease remission with a good HRQoL [5,7]. To reach this objective, therapy with non-biologic and biologic immunosuppressants (IS) is indicated in case of moderate to severe CD and UC [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Indicators of active disease and steroid dependency in patients with inflammatory bowel diseases not treated with biologics in a German real-world-setting

Bokemeyer

Ghiani

Fuchs³

et al. 2020

Int J Colorectal Dis

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Background and aims While a minority of inflammatory bowel disease (IBD) patients receives biologics in Germany, little is known about therapeutic needs of patients receiving non-biologic therapies. This study aimed to identify indicators of active disease/steroid dependency in patients with moderate to severe Crohn's disease (CD) and ulcerative colitis (UC) treated with conventional therapies and to describe health care resource use (HCRU)/cost. Methods CD/UC patients treated with immunosuppressants (IS) and/or systemic or locally acting oral corticosteroids (CS) were identified in German claims data (2013-2017) and followed for 12 months post-therapy start. Indicators of active disease/steroid dependency during follow-up period were (i) ≥ 2 prescriptions of CS (sensitivity ≥ 4) or (ii) ≥ 1 IBD-related surgery or (iii) > 7 days IBD-related hospitalization(s). Results Of 9871 included IBD patients (5170 CD, 4701 UC), 25.7%/19.9% (CD/UC) received ≥ 2 prescriptions of CS (sensitivity, 17.4%/15.7%) (i), 3.2% experienced IBD-related surgeries (ii), and 2.5% > 7 days of hospitalizations (iii). Altogether, 44.4% had indicators of active disease/steroid dependency (sensitivity, 23.9%). Among patients with active disease/steroid dependency, 78.0% received CS monotherapy at baseline. Of these, 89.6% received a CS monotherapy in the follow-up period, too. Proportionally, fewer patients with CS monotherapy (57.4%) than IS therapy (91.0%) visited a specialist. HCRU/cost per patient year was significantly higher in patients with than without active disease/steroid dependency. The manuscript, including related data, figures, and tables has not been previously published and the manuscript is not under consideration elsewhere.

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Anti-tumor necrosis factor agents reduce corticosteroid use compared with azathioprine in patients with Crohn’s disease

Abstract: Patients with Crohn's disease were able to avoid new prescriptions for corticosteroids at a statistically higher rate when treated with an anti-TNF agent. These results demonstrate that the anti-TNF agents are superior to azathioprine for minimizing exposure to corticosteroids.

Cited by 7 publications

References 24 publications

Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Profile of infliximab in the treatment of pediatric Crohn’s disease

Indicators of active disease and steroid dependency in patients with inflammatory bowel diseases not treated with biologics in a German real-world-setting

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Anti-tumor necrosis factor agents reduce corticosteroid use compared with azathioprine in patients with Crohn’s disease

Abstract: Patients with Crohn's disease were able to avoid new prescriptions for corticosteroids at a statistically higher rate when treated with an anti-TNF agent. These results demonstrate that the anti-TNF agents are superior to azathioprine for minimizing exposure to corticosteroids.

Cited by 7 publications

References 24 publications

Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Vitamin D deficiency in patients with intestinal malabsorption syndromes – think in and outside the gut

Profile of infliximab in the treatment of pediatric Crohn&rsquo;s disease

Indicators of active disease and steroid dependency in patients with inflammatory bowel diseases not treated with biologics in a German real-world-setting

Contact Info

Product

Resources

About

Profile of infliximab in the treatment of pediatric Crohn’s disease