Therapies in Inflammatory Bowel Disease Patients with Extraintestinal Manifestations

Juillerat, Pascal; Manz, Markus G.; Sauter, Bernhard; Zeitz, Jonas; Vavricka, Stephan R.

doi:10.1159/000502816

Cited by 21 publications

(17 citation statements)

References 188 publications

(179 reference statements)

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“… 1 EIMs can have a major impact on patients’ quality of life and increase the morbidity and disability of patients with UC. 2 , 3 The presence of EIMs has previously been reported significantly to increase the risk of poor clinical outcomes, such as lower remission rates. 4 The clinical presentation of EIMs is diverse and typically can involve the following four organs: skin (erythema nodosum, pyoderma gangrenosum, psoriasis, aphthous stomatitis); joints (peripheral arthritis, axial arthropathy); hepatobiliary tract (primary sclerosing cholangitis); and eyes (uveitis and episcleritis).…”

Section: Introductionmentioning

confidence: 99%

Extraintestinal manifestations at baseline, and the effect of tofacitinib, in patients with moderate to severe ulcerative colitis

Rubin

Reinisch

Greuter

et al. 2021

Therap Adv Gastroenterol

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Introduction: Extraintestinal manifestations (EIMs) in patients with ulcerative colitis (UC) are common. Tofacitinib is an oral, small molecule Janus kinase inhibitor for the treatment of UC. We evaluated the efficacy of tofacitinib in patients with EIMs, and the impact of tofacitinib on EIMs in patients with UC in the OCTAVE clinical program. Methods: Data from two 8-week induction studies (OCTAVE Induction 1 and 2) and a 52-week maintenance study (OCTAVE Sustain) were analyzed. The effect of tofacitinib on efficacy outcomes stratified by EIM status, proportion of predefined prior and active EIMs at baseline, and change from baseline in EIMs were determined at the end of the treatment period (weeks 8 or 52), or at early termination. Results: At baseline of OCTAVE Induction 1 and 2, and OCTAVE Sustain, 27.0% and 9.0% of patients had a history of EIMs (prior or active), respectively. Patients treated with tofacitinib 10 mg twice daily (BID) achieved remission and had endoscopic improvement in all studies, irrespective of any history of EIMs. A greater proportion of patients had active peripheral arthritis at baseline of OCTAVE Induction 1 and 2 versus OCTAVE Sustain. In OCTAVE Induction 1 and 2, similar proportions of tofacitinib and placebo-treated patients with active peripheral arthritis experienced either no change (81.3% and 85.7%, respectively) or an improvement (15.6% and 14.3%, respectively). By week 52 of OCTAVE Sustain, improvements in active peripheral arthritis were only observed in tofacitinib-treated patients (16.7% and 33.3% with tofacitinib 5 and 10 mg BID, respectively). Conclusion: Any history of EIMs did not influence the efficacy of tofacitinib 10 mg BID for induction or maintenance of UC. The most common active EIM was peripheral arthritis, for which many patients in OCTAVE Induction 1 and 2, and OCTAVE Sustain, reported improvement or no change from baseline with tofacitinib treatment. Clinicaltrials.gov:NCT01465763 ; NCT01458951; NCT01458574

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Section: Introductionmentioning

confidence: 99%

Extraintestinal manifestations at baseline, and the effect of tofacitinib, in patients with moderate to severe ulcerative colitis

Rubin

Reinisch

Greuter

et al. 2021

Therap Adv Gastroenterol

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“…However, due to a low sensitivity and specificity, none of them has entered clinical routine. Besides this, serum biomarkers bear the risk of capturing ECM changes in other organs, since IBD is associated with extraintestinal manifestations, such as rheumatological, musculoskeletal, hepatological and dermatological manifestations; arthropathies and uveitis are also frequent [106]. Nevertheless, additional assessment of ECM changes provides a great potential tool in IBD diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

Golusda

Kühl

Siegmund

et al. 2021

Biology

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Work from the last years indicates that the extracellular matrix (ECM) plays a direct role in various cellular processes, including proliferation, migration and differentiation. Besides homeostatic processes, its regulatory function in inflammation becomes more and more evident. In inflammation, such as inflammatory bowel disease, the ECM composition is constantly remodeled, and this can result in a structuring of fistulizing disease course. Thus, tracking early ECM changes might bear the potential to predict the disease course. In this review, we provide an overview of relevant diagnostic methods, focusing on ECM changes.

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“…Besides this, serum biomarkers bear the risk of capturing ECM changes in other organs. Since, IBD is associated with extraintestinal manifestations like rheumatological, musculoskeletal, hepatological and dermatological manifestations but also arthropathies and uveitis are frequent 90 . Nevertheless, additional assessment of ECM changes provides a great potential tool in IBD diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

Golusda¹,

Kühl²,

Siegmund³

et al. 2021

Preprint

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Work from the last years indicate that the extracellular matrix (ECM) plays a direct role in vari-ous cellular processes including proliferation, migration and differentiation. Besides homeostat-ic processes, its regulatory function in inflammation becomes more and more evident. In in-flammation like inflammatory bowel disease, the ECM composition is constantly remodeled which can result in a structuring of fistulizing disease course. Thus, tracking early ECM changes might bear the potential to predict the disease course. In this review, we will provide an over-view of relevant diagnostic methods focusing on ECM changes.

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Therapies in Inflammatory Bowel Disease Patients with Extraintestinal Manifestations

Cited by 21 publications

References 188 publications

Extraintestinal manifestations at baseline, and the effect of tofacitinib, in patients with moderate to severe ulcerative colitis

Extraintestinal manifestations at baseline, and the effect of tofacitinib, in patients with moderate to severe ulcerative colitis

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

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