Disease Monitoring in Inflammatory Bowel Disease: Evolving Principles and Possibilities

Plevris, Nikolas; Lees, Charlie W.

doi:10.1053/j.gastro.2022.01.024

Cited by 61 publications

(42 citation statements)

References 162 publications

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“…Many of the monitoring tools are intrusive to patients, expensive to perform, and carry a significant administrative burden on health care teams. As such, not all patients should be monitored with the same intensity [21]. In this present study, the clinical activity and CRP monitoring occurred more frequently in the first 3 months and less after 6 months, but FCAL measurement occurred less in the first 3 months and increased frequency at 6-9 months after starting adalimumab therapy.…”

Section: Clinical Outcomes Of Patients With Objective Monitoringmentioning

confidence: 51%

Adherence to Objective Therapeutic Monitoring and Outcomes in Patients with Inflammatory Bowel Disease with Adalimumab Treatment. A Real-world Prospective Study

Wetwittayakhlang

Golovics

Khoury

et al. 2022

JGLD

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Background and Aims: Objective monitoring and effective early treatment using a treat-to-target approach are key to improving therapeutic outcomes in IBD patients. This study aimed to assess adherence to objective monitoring (clinical, biomarkers, and endoscopy) and its impact on clinical outcomes. Methods: A prospective, multicenter study included consecutive IBD patients starting on adalimumab therapy between January 2019 and December 2020. Disease activity, assessed by the Harvey-Bradshaw index (HBI), partial Mayo, C-reactive protein (CRP), fecal calprotectin (FCAL), and endoscopy were evaluated at adalimumab initiation and 3, 6, 9 and 12 months. Therapeutic drug monitoring, changes in treatment, drug sustainability, and clinical outcomes were assessed. Results: 104 IBD patients were enrolled (78.8% CD, median age 34.3 years, disease duration 9 years). During the 12 months follow-up, high adherence to clinical activity assessment was observed in both CD (81.3%- 87.7%) and UC patients (76.5-90.9%). CRP measurement decreased over time in both CD (37.3%-54.9%) and UC (29.4%-50.0%). The adherence to serial FCAL monitoring was low in CD (22.7-31.3%) and UC patients (17.6-56.0%). UC patients had higher adherence to early endoscopic assessment (<6 months) compared to CD patients (40.9% vs. 21.5%). Adherence to early combined clinical and biomarkers resulted in earlier dose optimization in CD and UC (log-rank<0.001), but drug sustainability was not different. The patients with early combined adherence had a significantly higher clinical remission rate at 1 year compared to non-adherence (70.2% vs. 29.8%, p=0.007) but no significant difference in UC patients. Conclusions: The adherence to early objective monitoring with combined clinical and biomarkers assessment in IBD patients starting adalimumab therapy led to dose optimization and improved 1-year clinical remission in CD but did not change drug sustainability and clinical remission in UC.

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Section: Clinical Outcomes Of Patients With Objective Monitoringmentioning

confidence: 51%

Adherence to Objective Therapeutic Monitoring and Outcomes in Patients with Inflammatory Bowel Disease with Adalimumab Treatment. A Real-world Prospective Study

Wetwittayakhlang

Golovics

Khoury

et al. 2022

JGLD

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“…Al establecer el tratamiento se debe acordar con el paciente cómo realizar el monitoreo para lograr los objetivos planteados, vinculados a evitar complicaciones y lograr una adecuada calidad de vida ("tratamiento por objetivos"). 4,5 El objetivo de esta revisión es presentar una actualización de las herramientas disponibles para un manejo óptimo del paciente con EII, desde el diagnóstico, la estadificación del riesgo, el monitoreo del tratamiento y la evolución de la enfermedad.…”

Section: Current Strategies In the Diagnosis And Follow-up Of Inflamm...unclassified

Estrategias actuales en el diagnóstico y seguimiento de las enfermedades inflamatorias intestinales

Sobrero¹,

Etchevers²

2022

ACTA

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Las enfermedades inflamatorias intestinales son entidades crónicas con manifestaciones y evolución heterogéneas, por lo que constituyen un desafío diagnóstico y terapéutico. En los últimos años se han producido cambios trascendentales en el manejo de las enfermedades inflamatorias intestinales, de la mano del mayor conocimiento de su inmunofisiopatología y evolución a largo plazo. A diferencia de otras enfermedades, la clínica no es soberana y debemos respaldarnos en parámetros más certeros de inflamación para la toma de decisiones. Con el advenimiento de nuevas herramientas bioquímicas, de imágenes y endoscópicas, el enfoque actual está dirigido a lograr un menor retraso en el diagnóstico y un monitoreo estrecho de la curación mucosa como una de las metas fundamentales asociada a una evolución favorable. El objetivo de esta revisión es actualizar los nuevos conceptos respecto a estrategias diagnósticas y de monitoreo en las enfermedades inflamatorias intestinales.

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“…IBD is a group of idiopathic, chronic inflammatory disorders of the gastrointestinal tract which includes two major forms, ulcerative colitis (UC) and Crohn’s disease (CD) ( Windsor and Kaplan, 2019 ; Bisgaard et al, 2022 ; Plevris and Lees, 2022 ). It is renowned that chronic inflammation in intestinal tract is an important feature of both UC and CD.…”

Section: Introductionmentioning

confidence: 99%

Targeting pathophysiological changes using biomaterials-based drug delivery systems: A key to managing inflammatory bowel disease

et al. 2022

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Inflammatory bowel disease (IBD) is a gastrointestinal disorder, affecting about several million people worldwide. Current treatments fail to adequately control some clinical symptoms in IBD patients, which can adversely impact the patient’s quality of life. Hence, the development of new treatments for IBD is needed. Due to their unique properties such as biocompatibility and sustained release of a drug, biomaterials-based drug delivery systems can be regarded as promising candidates for IBD treatment. It is noteworthy that considering the pathophysiological changes occurred in the gastrointestinal tract of IBD patients, especially changes in pH, surface charge, the concentration of reactive oxygen species, and the expression of some biomolecules at the inflamed colon, can help in the rational design of biomaterials-based drug delivery systems for efficient management of IBD. Here, we discuss about targeting these pathophysiological changes using biomaterials-based drug delivery systems, which can provide important clues to establish a strategic roadmap for future studies.

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Disease Monitoring in Inflammatory Bowel Disease: Evolving Principles and Possibilities

Cited by 61 publications

References 162 publications

Adherence to Objective Therapeutic Monitoring and Outcomes in Patients with Inflammatory Bowel Disease with Adalimumab Treatment. A Real-world Prospective Study

Adherence to Objective Therapeutic Monitoring and Outcomes in Patients with Inflammatory Bowel Disease with Adalimumab Treatment. A Real-world Prospective Study

Estrategias actuales en el diagnóstico y seguimiento de las enfermedades inflamatorias intestinales

Targeting pathophysiological changes using biomaterials-based drug delivery systems: A key to managing inflammatory bowel disease

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