Risks and benefits of biologic therapy for inflammatory bowel diseases

D’Haens, Geert R.

doi:10.1136/gut.2006.103564

Cited by 76 publications

(50 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the most important side effects of the therapy are increased risk for infections and development of malignancies (8,9). However, in clinical practice, acute infusion reactions are the most frequent cause that limits the use of this biologic therapy in children (10).…”

Section: Introductionmentioning

confidence: 99%

Prevention of acute adverse events related to infliximab infusions in pediatric patients

Lahdenne¹,

Wikström²,

Aalto³

et al. 2010

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. To study whether premedication with an oral antifebrile agent (acetaminophen) and antihistamine (cetirizine) could decrease the frequency of acute infusion reactions in pediatric patients. Methods. All pediatric patients scheduled for infliximab infusions at the Helsinki University Central Hospital, a tertiary care center, were prospectively introduced to a standard oral premedication of acetaminophen (20 mg/kg) and cetirizine (10 mg) prior to infliximab infusions for a period of 1 year. All acute adverse events related to infliximab infusions given according to the guidelines of pediatric rheumatologists or gastroenterologists were registered for this time period and retrospectively during the preceding year. Results. During the study period, infliximab infusions with premedication were given to 64 pediatric patients (48 with rheumatic disease and l6 with inflammatory bowel disease, mean age 13 years, n ‫؍‬ 34 boys, and n ‫؍‬ 30 girls). Infliximab was introduced to 14 children; the rest were on maintenance therapy. Twelve infusion reactions, 4 mild and 8 severe, were observed in 8 (12.5%) of the 64 subjects, and in 1 subject 4 times. During the preceding year, 60 pediatric patients had received infliximab infusions without premedication. In this latter group, infusion reactions occurred in 5 children (8.3%; P > 0.05). The presentation of an acute infusion reaction was not related to the sex or diagnosis of the patient. Conclusion. In pediatric patients, acute infusion reactions related to infliximab could not be prevented with premedication with oral acetaminophen and cetirizine.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevention of acute adverse events related to infliximab infusions in pediatric patients

Lahdenne¹,

Wikström²,

Aalto³

et al. 2010

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…There were no reports of lymphoma development or tuberculosis, but a serious opportunistic infection of the oligodendrocytes by the JC virus called progressive multifocal leukoencephalopathy was reported in 3 out of 3,819 patients treated with the monoclonalantibody natalizumab with, among them, 1 in a Crohn’s disease patient [83, 85]. At present, there is no useful screening strategy available to screen for or to prevent JC virus infection and treatment is available for patients with multiple sclerosis under strict surveillance [53]. …”

Section: Treatment Adverse Eventsmentioning

confidence: 99%

“…Infections requiring antimicrobial agents are seen in 32% of patients, but severe infections in only 4% of the patients in clinical trials [53]. Opportunistic infections, particularly tuberculosis reactivation, have been described within the first 3 months after initiation of therapy, leading to recommendations for tuberculosis screening (purified protein derivative skin test and chest X-ray) prior to infliximab treatment [54].…”

Section: Treatment Adverse Eventsmentioning

confidence: 99%

See 1 more Smart Citation

Drug Safety in Crohn’s Disease Therapy

et al. 2007

View full text Add to dashboard Cite

The management of Crohn’s disease usually consists of a succession of short-term acute phase treatments followed by a long-term maintenance therapy. Above all the most frequent adverse events and the data on the long-term safety of the therapeutic arsenal available to the physician will be taken into consideration. The drugs described in this article include 5-ASA compounds, antibiotics (metronidazole, ciprofloxacin and rifaximin), corticosteroids (budesonide, prednisone and equivalents), thiopurines (azathioprine and 6-mercaptopurine), methotrexate, anti-tumor necrosis factor inhibitors (infliximab, adalimumab, certolizumab), natalizumab, anticalcineurin inhibitors (cyclosporine, tacrolimus) and mycophenolate mofetil.

show abstract

“…The chimeric monoclonal antibody infliximab and the human monoclonal antibody adalimumab have proven similar therapeutic efficacy in patients with IBD and have therefore both been approved for the induction and maintenance of remission in IBD patients in most parts of Europe [2,3]. However, about 50% of IBD patients do not respond to treatment with an anti-TNF antibody and there are no reliable predictors for therapeutic success [4,5]. Moreover, anti-TNF therapy may induce severe side effects (opportunistic infections, allergic reactions, skin disorders and lupus-like autoimmunity) and result in a high economic burden, with costs equaling nearly EUR 25,000/patient per year [6].…”

Section: Introductionmentioning

confidence: 99%

Physiological Intermolecular Modification Spectroscopy for the Prediction of Response to Anti-Tumor Necrosis Factor Therapy in Patients with Inflammatory Bowel Diseases

Eftekhari

Glaubitz

Atreya

2014

Dig Dis

View full text Add to dashboard Cite

Background/Aims: Anti-tumor necrosis factor (TNF) antibodies have clinical efficiency only in a subgroup of patients with inflammatory bowel diseases (IBD). Prediction of clinical response is a critical clinical problem. Physiological intermolecular modification spectroscopy (PIMS) is a label-free technology performed in physiological conditions. PIMS enables real-time monitoring of dynamic molecular resonance of entire proteins and macromolecules of an individual. The aim of this study was to explore the capacity of PIMS to discriminate IBD patients regarding response to anti-TNF treatment. Methods: Protein extracts of peripheral blood mononuclear cells (PBMC) from 30 outpatients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) and treated with infliximab were subjected to PIMS analysis in a blinded transversal study. Total protein from each patient's PBMCs was challenged with infliximab. Dynamic changes in macromolecular interaction were registered while the temperature rose from -37 to 37°C. Individual macromolecular volume and molecular elasticity were determined for each patient. Results: Clinical data revealed that 67% of UC and 79% of CD patients responded to infliximab therapy during the 3-month study period based on their respective clinical activity score. These results confirm that PIMS data predicted response to anti-TNF therapy with an accuracy of 96%. Conclusion: PIMS stratified IBD patients into two groups, responders and nonresponders, which correlated with the clinical efficacy of anti-TNF therapy. PIMS seems to be a powerful technology to adapt IBD treatment to the individual patient. Further studies with PIMS might enable to predict clinical response to biological treatment in IBD patients before the therapy is initiated.

show abstract

Risks and benefits of biologic therapy for inflammatory bowel diseases

Cited by 76 publications

References 42 publications

Prevention of acute adverse events related to infliximab infusions in pediatric patients

Prevention of acute adverse events related to infliximab infusions in pediatric patients

Drug Safety in Crohn’s Disease Therapy

Physiological Intermolecular Modification Spectroscopy for the Prediction of Response to Anti-Tumor Necrosis Factor Therapy in Patients with Inflammatory Bowel Diseases

Contact Info

Product

Resources

About