Golimumab for ulcerative colitis: adding perspective to the pursuit

Limdi, Jimmy K.

doi:10.1136/flgastro-2017-100929

Cited by 6 publications

(8 citation statements)

References 11 publications

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“…Meanwhile, ‘point of care’ assays may be able to rapidly measure trough concentrations enabling efficacy through speedy and accurate dose optimisation 30 49. Reassuringly, TDM has been shown to be cost-effective compared with empiric dose escalation 24 34–36…”

Section: Discussionmentioning

confidence: 99%

“…TDM is typically performed in a reactive manner wherein serum levels are checked when there is a suspicion of loss of response with confirmed active disease 15–23 30. It has been shown to be cost-effective compared with empiric dose escalation 24 34–36. Proactive TDM on the other hand, is performed at predefined time-points, irrespective of symptoms and with the aim of preventing ‘under-dosing’ from triggering a flare of disease or indeed even to potentially de-escalate in case of ‘supra-therapeutic’ levels 26–30.…”

Section: Introductionmentioning

confidence: 99%

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UK National Survey of Gastroenterologists’ attitudes and barriers toward therapeutic drug monitoring of anti-TNF therapy in inflammatory bowel disease

Nigam

Nayeemuddin

Kontopantelis

et al. 2020

Frontline Gastroenterol

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BackgroundEvidence supports use of therapeutic drug monitoring (TDM) in improving efficacy and cost-effectiveness of anti-tumour necrosis factor (TNF) therapy in inflammatory bowel disease (IBD). Our objective was to assess attitudes and barriers towards TDM use with anti-TNF’s in the UK.MethodsA 17-question survey was distributed to members of the British Society of Gastroenterology by email.ResultsOf 243 respondents (51.6% male), 237 respondents met inclusion criteria. Of these, 46% were consultants (gastroenterologist, GI), 39.2% IBD nurse specialists (clinical nurse specialists, CNS), 14.8% registrars. TDM is used by 96.9% for secondary loss of response; 72.5% for primary non-response and 54.1% used TDM proactively. Barriers were time lag in receiving results (49.8%), lack of awareness of guidelines (46.4%) and cost (29.9%). Clinicians working at a teaching hospital (OR 2.6, 95% CI 0.71 to 9.8), IBD CNS and GI registrars (OR 2.6, 95% CI 0.7 to 10 and OR 1.5, 95% CI 0.3 to 7.2, respectively) were more likely to use TDM. Clinicians practising for >20 years (OR 4.1, 95% CI 0.4 to 41.8) and a large volume IBD practice (>50% IBD patients per month) were more likely to use TDM (OR 45.7, 95% CI 7.5 to 275). Proactive TDM, was more likely to be used in tertiary care (OR 2.25, 95% CI 0.84 to 6.1), IBD CNS (OR 1.2, 95% CI 0.7 to 2.1) and clinicians managing >50% IBD patients per month (OR 10.8, 95% CI 1.3 to 90.3). Clinicians with 5–9 years of experience in practice were more likely to use proactive TDM (OR 2.6 and CI 1.04 to 6.4).ConclusionValidation of point of care and lower cost assays, reduced time lag from test to result, lower cost of testing and dissemination of current recommendations may further optimise treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

UK National Survey of Gastroenterologists’ attitudes and barriers toward therapeutic drug monitoring of anti-TNF therapy in inflammatory bowel disease

Nigam

Nayeemuddin

Kontopantelis

et al. 2020

Frontline Gastroenterol

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“…Anti-TNFa antibodies, such as infliximab and adalimumab, have proven to be effective for the treatment of CD and ulcerative colitis (UC) in various controlled trials [9][10][11][12][13]. Recently, golimumab (a fully human monoclonal IgG1 antibody) was approved for moderately to severely active UC patients who have had an inadequate response to conventional therapies [14]. Although we are in the era of biologics, treatment with biologics is not all encompassing.…”

Section: The Pathophysiology and Treatment Of Ibd From The Perspectivmentioning

confidence: 99%

Treatment of inflammatory bowel disease from the immunological perspective

Nakase

2020

Immunological Medicine

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Since 1950, the number of patients with inflammatory bowel disease (IBD) in Japan has been increasing. Recent research data indicate that the pathophysiology of IBD involves abnormalities in disease susceptibility genes, environmental factors and intestinal bacteria. The elucidation of the mechanism of IBD has facilitated therapeutic development based on basic research data. In particular, the emergence of biologics has brought about a paradigm shift in the treatment of IBD. However, there are still IBD patients who are refractory to these biologics. IBD pathophysiology is extremely complex. Therefore, to address these clinical issues, further clinical and basic data are required. The bottom line of IBD drug therapy is still to use the most of recent treatments. Therefore, the physicians should be familiar with the modes of action (MOA) of the available drugs.

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“…Clinical remission was achieved at week 6 in 17.8% in both 200 mg/100 mg and 17.9% (400 mg/200 mg) vs placebo (6.4%, P < 0.0001)[ 211 , 212 ]. Real world studies also demonstrated similar effectiveness data[ 213 , 214 ].…”

Section: Management–active Ucmentioning

confidence: 59%

First United Arab Emirates consensus on diagnosis and management of inflammatory bowel diseases: A 2020 Delphi consensus

Alkhatry

Al‐Rifai

Annese

et al. 2020

WJG

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Ulcerative colitis and Crohn’s disease are the main entities of inflammatory bowel disease characterized by chronic remittent inflammation of the gastrointestinal tract. The incidence and prevalence are on the rise worldwide, and the heterogeneity between patients and within individuals over time is striking. The progressive advance in our understanding of the etiopathogenesis coupled with an unprecedented increase in therapeutic options have changed the management towards evidence-based interventions by clinicians with patients. This guideline was stimulated and supported by the Emirates Gastroenterology and Hepatology Society following a systematic review and a Delphi consensus process that provided evidence- and expert opinion-based recommendations. Comprehensive up-to-date guidance is provided regarding diagnosis, evaluation of disease severity, appropriate and timely use of different investigations, choice of appropriate therapy for induction and remission phase according to disease severity, and management of main complications.

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Golimumab for ulcerative colitis: adding perspective to the pursuit

Cited by 6 publications

References 11 publications

UK National Survey of Gastroenterologists’ attitudes and barriers toward therapeutic drug monitoring of anti-TNF therapy in inflammatory bowel disease

UK National Survey of Gastroenterologists’ attitudes and barriers toward therapeutic drug monitoring of anti-TNF therapy in inflammatory bowel disease

Treatment of inflammatory bowel disease from the immunological perspective

First United Arab Emirates consensus on diagnosis and management of inflammatory bowel diseases: A 2020 Delphi consensus

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