Epidemiology and Natural History of Inflammatory Bowel Diseases

Cosnes, Jacques; Gower‐Rousseau, Corinne; Seksik, Philippe; Cortot, Antoine

doi:10.1053/j.gastro.2011.01.055

Cited by 1,773 publications

(1,310 citation statements)

References 166 publications

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“…5 Current incidence and prevalence rates of IBD are 8-14 per 100 000 persons and 120-200 per 100 000 persons, respectively. 6 Furthermore, there has been a recently described increase in the incidence of IBD in developed countries. 7 Experimental, genetic and clinical evidence indicates that IBD 'results from an inappropriate inflammatory response to intestinal microbes in a genetically susceptible host' .…”

Section: Inflammatory Bowel Disease (Ibd)mentioning

confidence: 99%

Hydroxylases as therapeutic targets in inflammatory bowel disease

Cummins

Doherty

Taylor

2013

Laboratory Investigation

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Inflammatory bowel disease (IBD) is a common and debilitating clinical disorder comprising ulcerative colitis and Crohn's disease. IBD occurs when inappropriate immunological activity in the intestinal mucosa results in epithelial barrier dysfunction leading to exposure of the mucosal immune system to luminal antigenic material. This in turn results in the cycles of inflammation and further barrier dysfunction which underlie disease progression. Although significant therapeutic advances have been made over the last decade, current immunosuppressive and anti-inflammatory treatments for IBD have significant limitations due to lack of treatment response in some patients and adverse effects, including increased risk of infection and malignancy. Recent studies using experimental models of IBD have identified that intracellular hydroxylases, a group of enzymes responsible for oxygen sensing and activation of adaptive transcriptional responses to hypoxia may represent a new class of therapeutic targets in IBD. Hydroxylase inhibitors are effective in ameliorating symptoms of colitis at least in part through the promotion of intestinal epithelial barrier function. The mechanism of this protection is due to activation of hypoxia-sensitive transcription factors, including the hypoxiainducible factor (HIF) and nuclear factor kappa-B (NF-kB), which activate specific epithelial barrier-protective transcriptional programs. In this review, the mechanism(s) of action and the therapeutic potential of small molecule hydroxylase inhibitors for the treatment of IBD will be discussed.

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Section: Inflammatory Bowel Disease (Ibd)mentioning

confidence: 99%

Hydroxylases as therapeutic targets in inflammatory bowel disease

Cummins

Doherty

Taylor

2013

Laboratory Investigation

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“…12 Whether this represents a true drug effect or simply a biased patient selection with a priori benign natural course of CD is debatable, as it is known that Crohn's colitis can remain uncomplicated for many years in the adult population. 24 In pediatric CD the disease course in general is less benign. However, whether there exists a similar perception among pediatric gastroenterologists and the extent to which the adult perception influences the pediatric one remains speculative.…”

Section: -Asa In CDmentioning

confidence: 99%

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Sokollik

Fournier

Rizzuti

et al. 2018

Journal of Clinical Gastroenterology

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Background: In ulcerative colitis (UC) 5-aminosalicylic acid (5-ASA) is recommended as primary therapy for mild to moderate disease. Topical 5-ASA has been proven especially effective. In Crohn’s disease (CD) the evidence for a beneficial role of 5-ASA is weak. We investigated the use of topical and systemic 5-ASA therapy in children and adolescents with inflammatory bowel disease. Materials and Methods: Data of patients younger than 18 years, registered between April 2008 and December 2015 in the Swiss Inflammatory Bowel Disease Cohort, were analyzed. Results: Three hundred twenty pediatric inflammatory bowel disease patients were included; 189 with CD and 131 with UC. Over one third of UC patients [51 (39%)] received topical 5-ASA therapy and 43 (33%) received combination therapy during their disease course. UC patients with left-sided colitis or proctitis were more likely to receive topical or combination therapy as compared with patients with pancolitis (P<0.001 and <0.001, respectively). An increase in the use of topical 5-ASA therapy in UC patients was noted over time from 5% to 38%. Forty-seven percent of CD patients were treated with oral 5-ASA during their disease course. The usage was stable over time at approximately 15% to 20%. Conclusions: In recent years a very positive trend showing an increase in topical 5-ASA therapy in children and adolescents with UC has been observed. However topical therapy is still used with relative low frequency, especially in patients with a more extensive disease. Conversely, despite weak evidence supporting 5-ASA use in CD patients it has been frequently prescribed. Physicians should continue to encourage their UC patients to use topical therapy.

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“…Th iopurine treatment is associated with a decreased risk of surgery in CD patients [61]. Recent reviews suggest that approximately 50% of all IBD patients are treated with a thiopurine [62,63].…”

Section: Thiopurinesmentioning

confidence: 99%

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

2017

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Tumor necrosis factor (TNF)-α inhibitors and thiopurines are among the most important classes of medications utilized in the clinical management of Crohn's disease and ulcerative colitis. A signifi cant proportion of patients loses response to these agents or develops adverse eff ects during the course of the treatment. Monitoring of drug levels and anti-drug antibodies (for TNF-α inhibitors) and metabolite levels (for thiopurines) can provide valuable insight into the possible etiology of unfavorable outcomes and allow for an appropriate management strategy for these patients. Th is review summarizes the current knowledge on the clinical implications of therapeutic drug monitoring in infl ammatory bowel disease patients treated with TNF-α inhibitors and thiopurines.

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Epidemiology and Natural History of Inflammatory Bowel Diseases

Cited by 1,773 publications

References 166 publications

Hydroxylases as therapeutic targets in inflammatory bowel disease

Hydroxylases as therapeutic targets in inflammatory bowel disease

The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

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