1,721,256 research outputs found
Commentary: adjunct antibiotic combination therapy for ulcerative colitis - is it time to investigate Fusobacterium varium?
No full text
Anti-TNF's for Postoperative Recurrence in Crohn's Disease: The If's and How's
No full textRecurrence of Crohn’s disease (CD) is extremely frequent after surgery and its prevention remains a
fundamental problem in the medical management of these patients. As of today, none of the medications traditionally used
to treat the spontaneous disease (i.e. mesalamine, steroids, immunosuppressives and antibiotics) has shown a clear benefit.
Recent data, coming from our center and from a small RCT do indicate that infliximab is extremely effective in
preventing this complication in the large majority of patients. While additional, larger studies may be desirable, the
strength and consistency of the available data suggest that future trials may merely confirm these observations. A number
of issues however remain to be solved and include the long term strategy in patients treated for years with infliximab,
whether treating early endoscopic lesions may be as effective as preventing them and whether immuno-soppressives
should be used together with infliximab. A thorough understanding of the mechanisms by which infliximab appears so
effective in the postoperative setting may provide us with essential information regarding patients’ management and,
ultimately, highlight the molecular mechanisms at the very basis of Crohn’s disease
Review article: causative factors and the clinical management of patients with Crohn's disease who lose response to anti-TNF-alpha therapy
No full textBackground The addition of antitumour necrosis factor-alpha (TNF-alpha) agents to the therapeutic armamentarium against Crohn's disease has been a revolution in its management. However, approximately 25 to 40% of patients who initially benefit from anti-TNF-alpha treatment develop intolerable adverse events or loose their response during maintenance therapy. Aim To summarise the current knowledge on the mechanisms underlying loss of response in these patients and the therapeutic strategies available to counteract this clinical challenge. Method A literature search using PubMed, MedLine and Embase databases has been performed. Results Anti-infliximab antibodies formation and autoantibodies (ANA, anti-DNA and other autoantibodies) have been associated with loss of response. Individual differences in drug metabolism may contribute to loss of response. Smoking may be a risk factor for loss of response. Dose escalation, reduction of infusion intervals and switch to other anti-TNF-alpha agents are effective as rescue strategies. Conclusions Loss of response appears to result from different causes not fully established by now. Optimization of therapies, or switch to other anti-TNF-alpha, are currently the best studied strategies in case of loss of response, and can be successful in 40-60% of patients who lose response. Aliment Pharmacol Ther 2011; 34: 1-1
Methylene Blue Orally Administered Tablets (Mb MMx (R)) Is Effective in Detecting Intraepithelial Dysplasia in Patients With Long Standing Ulcerative Colitis: Results From an Open Label Trial
No full text
- …
