Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population

Baños, Fabián Juliao; Grillo‐Ardila, Carlos Fernando; Alfaro, Ignacio; Andara-Ramírez, M.T.; Avelar-Escobar, O.; Barahona-Garrido, J.; Bautista-Martínez, S.; Bosques-Padilla, Francisco; Paula, Juan A. De; Ernest-Suarez, Kenneth; Galiano, M.T.; Iade-Vergara, B.; Patricio-Ibañez,; Jara-Alba, M.L.; Kotze, Paulo Gustavo; Miranda-Ojeda, M.C.; Ortuño-Escalante, R.; Moreno, G. Otoya-; Piñol-Jiménez, F.N.; Ramos-Polo, I.C.; Sambuelli, Alicia M.; Toro, María Eugenia; Torres, Esther A.; Veitia-Velásquez, G.R.; Yamamoto‐Furusho, Jesús K.; Zaltman, Cyrla; Steinwurz, Flávio; Vallejo-Ortega, Maria Teresa; Torres-Castillo, J.I.; Hamon-Pinilla, C.; Calderon-Franco, C.H.; Escobar-Villegas, A.M.

doi:10.1016/j.rgmxen.2022.04.006

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…The infliximab administration follows the standard induction and maintenance protocol with 5 mg/kg infused at weeks 0, 2, and 6 and then every eight weeks. Although some studies [ 33 ] support the efficacy of infliximab dose escalation in patients with ASUC, the PANCCO Clinical Practice Guidelines recommend against the routine use of an intensified regimen [ 34 ].…”

Section: Medical Managementmentioning

confidence: 99%

Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches

Lauricella,

Brucchi,

Cavalcoli

et al. 2024

JPM

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Acute severe ulcerative colitis (ASUC) is a life-threatening medical emergency with considerable morbidity. Despite recent advances in medical IBD therapy, colectomy rates for ASUC remain high. A scoping review of published articles on ASUC was performed. We collected data, such as general information of the disease, diagnosis and initial assessment, and available medical and surgical treatments focusing on technical aspects of surgical approaches. The most relevant articles were considered in this scoping review. The management of ASUC is challenging; currently, personalized treatment for it is unavailable. Sequential medical therapy should be administrated, preferably in high-volume IBD centers with close patient monitoring and indication for surgery in those cases with persistent symptoms despite medical treatment, complications, and clinical worsening. A total colectomy with end ileostomy is typically performed in the acute setting. Managing rectal stump is challenging, and all individual and technical aspects should be considered. Conversely, when performing elective colectomy for ASUC, a staged surgical procedure is usually preferred, thus optimizing the patients’ status preoperatively and minimizing postoperative complications. The minimally invasive approach should be selected whenever technically feasible. Robotic versus laparoscopic ileal pouch–anal anastomosis (IPAA) has shown similar outcomes in terms of safety and postoperative morbidity. The transanal approach to ileal pouch–anal anastomosis (Ta-IPAA) is a recent technique for creating an ileal pouch–anal anastomosis via a transanal route. Early experiences suggest comparable short- and medium-term functional results of the transanal technique to those of traditional approaches. However, there is a need for additional comparative outcomes data and a better understanding of the ideal training and implementation pathways for this procedure. This manuscript predominantly explores the surgical treatment of ASUC. Additionally, it provides an overview of currently available medical treatment options that the surgeon should reasonably consider in a multidisciplinary setting.

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Section: Medical Managementmentioning

confidence: 99%

Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches

Lauricella,

Brucchi,

Cavalcoli

et al. 2024

JPM

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“…Additionally, it is worth mentioning the creation and publication of guidelines adapted to managing IBD patients from LATAM. [82][83][84][85]…”

Section: Access To Biological Therapies In Mexico Central America And...mentioning

confidence: 99%

IBD barriers across the continents: a continent-specific analysis: Latin America

Queiroz

Martins

Quaresma

et al. 2023

Therap Adv Gastroenterol

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Latin America (LATAM) is a large region comprising 47 countries and territories. Each one carries a different cultural and historical background, diverse political systems, and a particular approach to healthcare management. There is a lack of high-quality data on the epidemiology of inflammatory bowel diseases (IBD) in this region, including broad and detailed information about the penetration of biological and advanced therapies as treatment strategies. From an IBD perspective, patients experience, in general, fragmentations and inequities in the healthcare systems, with different and usually delayed access to qualified health services. This review explores the barriers to accessing IBD care throughout LATAM. The authors compiled data from multiple sources, such as studies focusing on epidemiology, biological penetration, and surgical rates. In addition, overall access to IBD treatments was assessed through a questionnaire distributed to physicians in LATAM via email and direct messaging to capture local perspectives.

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“…Mesalazine (5-aminosalicylate) is a well-established treatment for UC administered orally (tablets, capsules or sachets) or topically (liquid or foam suspensions, gels, suppositories). Currently, it is the standard of care for induction and maintenance of remission in patients with mild-to-moderate disease [3][4][5][6][7][8]. It is reported that mesalazine exerts extensive anti-inflammatory effects by inhibition of leukotriene and IL-1 production, impairment of TNFα and NF-κB transcription signaling, and acting as a free-radical scavenger [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…In some cases, mesalamine concentration is insufficient in the inflamed distal colon after oral administration. For this reason, topical therapy with mesalazine enema (1g/d) is recommend by practice guidelines as the preferred option to maintain remission in distal mild-to-moderate UC, particularly in proctitis and left-sided colitis [3,7]. Topical therapy can provide some advantages such as quicker response to treatment, lower dosing frequency, and less systemic absorption compared to oral therapy.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic and safety profiles of mesalazine enema in healthy Chinese subjects: A single- and multiple-dose study

Cao,

Wang,

Tang

et al. 2024

PLoS ONE

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Mesalazine is a well-established treatment for ulcerative colitis by oral or topical administration. However, the pharmacokinetic (PK) and safety profiles of mesalazine administered by an enema has not been clarified in Chinese population. We conducted an open-label study to assess the PK and safety profiles of mesalazine in 11 healthy Chinese subjects after receiving mesalazine enema (1 g/100 mL) once daily for 7 consecutive days. Blood and urine samples were collected for assay of mesalazine and N-acetyl mesalazine by liquid chromatography-tandem mass spectrometry. The PK and safety data were summarized using descriptive statistics. The mean (standard deviation) maximum plasma concentration (Cmax), area under plasma drug concentration-time curve from time 0 to the last measurable plasma concentration time point (AUC0-t) and elimination half-life (t1/2) of mesalazine were 1007.64 (369.00) ng/mL, 9608.59 (3533.08) h·ng/mL and 3.33 (1.99) h, respectively after the first dose administration. In multiple-dose study, the estimated accumulation factor of mesalazine was 1.09. The cumulative urinary excretion rate of parent and major metabolite of mesalazine was 27.77%. After the last doe administration, 2.21% of the administered dose was excreted as mesalazine and 24.47% as N-acetyl mesalazine in urine within 24 h. Overall, 9 adverse events (AEs) were reported in 4 of the 11 subjects (36.4%), including oral ulcer, toothache, upper respiratory tract infection (1 each) and laboratory abnormalities (6 cases). All AEs were mild and recovered spontaneously without treatment, and were not considered as related to mesalazine. Mesalazine enema (1 g/100 mL) was safe and well tolerated in healthy Chinese subjects. These findings support further clinical trials in Chinese patients. Trial registration: This trial was registered to Chinese Clinical Trial Registry (ChiCTR) at https://www.chictr.org.cn (registration number: ChiCTR2300073148).

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Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population

Cited by 3 publications

References 37 publications

Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches

Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches

IBD barriers across the continents: a continent-specific analysis: Latin America

Pharmacokinetic and safety profiles of mesalazine enema in healthy Chinese subjects: A single- and multiple-dose study

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