Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Tumour Necrosis Factor-Alpha Antagonist Therapy in Crohn’s Disease

Sadowski, Daniel C.; Bernstein, Çharles N.; Bitton, Alain; Croitoru, Ken; Fedorak, Richard N.; Griffiths, Anne M.

doi:10.1155/2009/201430

Cited by 34 publications

(23 citation statements)

References 159 publications

(163 reference statements)

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“…A larger number of such cases would enable more robust conclusions. Given that medical treatments aimed at complete mucosal healing are increasingly accepted as the standard treatment for CD (3456), stable or aggravated bowel inflammation after therapy is now becoming rarer, in contrast with past CD management that primarily focused on symptomatic control. Additionally, although this study included patients who received an array of different treatments as seen in typical clinical practice, the small sample prevented evaluation of any potential differences between different therapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

“…Conformity to actual clinical practice translates clinical relevance. Second, endoscopic complete remission is the present therapeutic goal in disease modifying therapies for CD (3456), so it is important to design a study to allow for a meaningful analysis of the diagnosis of endoscopic complete remission. Complete endoscopic remission in CD generally takes a long time to achieve; for example, the reported rates of complete remission for anti-TNF-α therapy were 19–30% after either 6 months or 1 year of treatment (252627).…”

Section: Methodsmentioning

confidence: 99%

“…Disease-modifying therapy for CD using biologics or immunosuppressive agents aims to achieve mucosal healing beyond symptomatic control (3456). This has created an increased need for imaging examinations to monitor treatment responses in a more objective quantitative manner.…”

Section: Introductionmentioning

confidence: 99%

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Diffusion-Weighted MR Enterography to Monitor Bowel Inflammation after Medical Therapy in Crohn's Disease: A Prospective Longitudinal Study

et al. 2017

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ObjectiveTo prospectively evaluate the performance of diffusion-weighted imaging (DWI) to monitor bowel inflammation after medical therapy for Crohn's disease (CD).Materials and MethodsBefore and following 1–2 years of medical therapy, between October 2012 and May 2015, 18 randomly selected adult CD patients (male:female, 13:5; mean age ± SD, 25.8 ± 7.9 years at the time of enrollment) prospectively underwent MR enterography (MRE) including DWI (b = 900 s/mm2) and ileocolonoscopy. Thirty-seven prospectively defined index lesions (one contiguous endoscopy-confirmed inflamed area chosen from each inflamed anatomical bowel segment; 1–4 index lesions per patient; median, 2 lesions) were assessed on pre- and post-treatment MRE and endoscopy. Visual assessment of treatment responses on DWI in 4 categories including complete remission and reduced, unchanged or increased inflammation, and measurements of changes in apparent diffusion coefficient (ΔADC), i.e., pre-treatment–post-treatment, were performed by 2 independent readers. Endoscopic findings and CD MRI activity index (CDMI) obtained using conventional MRE served as reference standards.ResultsΔADC significantly differed between improved (i.e., complete remission and reduced inflammation) and unimproved (i.e., unchanged or increased inflammation) lesions: mean ± SD (× 10-3 mm2/s) of -0.65 ± 0.58 vs. 0.06 ± 0.15 for reader 1 (p = 0.022) and -0.68 ± 0.56 vs. 0.10 ± 0.26 for reader 2 (p = 0.025). DWI accuracy for diagnosing complete remission or improved inflammation ranged from 76% (28/37) to 84% (31/37). A significant negative correlation was noted between ΔADC and ΔCDMI for both readers with correlation coefficients of -0.438 and -0.461, respectively (p < 0.05).ConclusionDWI is potentially a feasible tool to monitor quantitatively and qualitatively bowel inflammation of CD after medical treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Diffusion-Weighted MR Enterography to Monitor Bowel Inflammation after Medical Therapy in Crohn's Disease: A Prospective Longitudinal Study

et al. 2017

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“…L'ACG a subventionné la création et la diffusion de plusieurs guides de pratique clinique (5,(11)(12)(13)(14) depuis quelques années, qui ont été bien reçus et ont influé sur les soins en santé digestive. L'évolution de la FCPSD comme véhicule de collecte de fonds pour la recherche a un potentiel énorme pour les membres de l'ACG.…”

Section: Grande Orientationunclassified

Sommaire du plan stratégique 2004 de l’Association canadienne de gastroentérologie

Bridges¹,

Paterson²,

Sinclair³

et al. 2010

Canadian Journal of Gastroenterology

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“…The era of biologic therapy began with the realization that TNF has an integral role in the pathogenesis of CD [Schreiber et al 1999;Reinecker et al 1993;MacDonald et al 1990]. Monoclonal antibodies that bind to TNF have since become the cornerstone in the management of moderate to severe CD that is refractory to conventional treatment options [Bernstein et al 2010;Binion, 2010;Lichtenstein et al 2009;Sadowski et al 2009]. The benefits of anti-TNF therapy include reduced reliance or dependence on corticosteroid-based therapies and the avoidance of corticosteroid-associated adverse effects [D'Haens et al 2008;Colombel et al 2007;Hanauer et al 2002].…”

Section: Introductionmentioning

confidence: 99%

Certolizumab pegol for the treatment of Crohn’s disease

Schreiber

2011

Therap Adv Gastroenterol

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In this article we provide a contemporary overview of available clinical data on certolizumab pegol, a pegylated anti-tumor necrosis factor (TNF) alpha agent that comprises a uniquely small protein, and its emerging role as a therapy for Crohn's disease (CD). The results from a comprehensive clinical trial program suggest that certolizumab pegol offers rapid and sustained remission of moderate to severe CD. Certolizumab pegol is an effective and welltolerated therapy both in patients who have already received biologics and in patients who are anti-TNF naïve. Benefits of therapy include a stable dosing regimen, which allows for rapid induction of a clinical response followed by long-term maintenance of response and remission under one fixed dose. Treatment with certolizumab pegol has been shown to improve function and quality of life in patients with CD, and insights into the potential mechanisms by which certolizumab pegol effects a response in CD suggest that this agent may have the potential to slow or even modify disease progression. Early therapy is particularly effective and could help control CD progression and lessen the burden of disease on patients.

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Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Tumour Necrosis Factor-Alpha Antagonist Therapy in Crohn’s Disease

Cited by 34 publications

References 159 publications

Diffusion-Weighted MR Enterography to Monitor Bowel Inflammation after Medical Therapy in Crohn's Disease: A Prospective Longitudinal Study

Diffusion-Weighted MR Enterography to Monitor Bowel Inflammation after Medical Therapy in Crohn's Disease: A Prospective Longitudinal Study

Sommaire du plan stratégique 2004 de l’Association canadienne de gastroentérologie

Certolizumab pegol for the treatment of Crohn’s disease

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