6 research outputs found
Natural disease course of inflammatory bowel disease unclassified in a prospective European population-based inception cohort-the Epi-IBD cohort
No full textBackground: The precise diagnosis of inflammatory bowel disease (IBD) cannot always be established. Thus, a proportion of patients will be diagnosed as IBD Unclassified (IBDU). A significant proportion of these patients will remain unclassified throughout their disease course. Only very few population-based cohorts have investigated the disease course of IBDU. Methods: The Epi-IBD cohort is a prospective population-based cohort of 1289 unselected, uniformly diagnosed patients with IBD diagnosed in 2010 in centres from Western and Eastern European countries. Clinical data were captured prospectively throughout the follow-up period. The aim of the study was to investigate the disease course and prognosis of patients diagnosed with IBDU from diagnosis and during the first 5 years of follow-up. Results: A total of 112 (9%) patients were initially diagnosed with IBD). Patient characteristics are shown in Table 1. After 5 years of follow-up, 28 (25%) patients changed diagnosis to either ulcerative colitis (UC) (n = 20, 71%) or Crohn’s disease (CD) (n = 8, 29%) while 84 (7% of the total cohort) remained as IBDU. The median time to a definite IBD diagnosis was 7 months (range: 1–63) with no difference between those changing to UC or CD. A total of 17 (15%) patients were hospitalised for their IBD during follow-up after a median of 10 months (range: 0–63). Of those, 9 (45%) patients changed diagnosis to UC during follow-up, while no patient changing diagnosis to CD was hospitalised. 8 (7%) patients had surgery (7 colectomies, 1 resection) after a median of 19 months (range: 3–63). Most surgeries (n = 6, 75%) were performed in patients who changed diagnosis to UC, and 3 of those led to a definite diagnosis of UC where the other 3 were performed after the change of diagnosis. No patient changing diagnosis to CD had surgery. The cumulative exposure to medical treatments in IBDU patients including t[...]
Initial Disease Course and Treatment in an Inflammatory Bowel Disease Inception Cohort in Europe:The ECCO-EpiCom Cohort
No full textBACKGROUND: The EpiCom cohort is a prospective, population-based, inception cohort of inflammatory bowel disease (IBD) patients from 31 European centers covering a background population of 10.1 million. The aim of this study was to assess the 1-year outcome in the EpiCom cohort.METHODS: Patients were followed-up every third month during the first 12 (±3) months, and clinical data, demographics, disease activity, medical therapy, surgery, cancers, and deaths were collected and entered in a Web-based database (www.epicom-ecco.eu).RESULTS: In total, 1367 patients were included in the 1-year follow-up. In western Europe, 65 Crohn's disease (CD) (16%), 20 ulcerative colitis (UC) (4%), and 4 IBD unclassified (4%) patients underwent surgery, and in eastern Europe, 12 CD (12%) and 2 UC (1%) patients underwent surgery. Eighty-one CD (20%), 80 UC (14%), and 13 (9%) IBD unclassified patients were hospitalized in western Europe compared with 17 CD (16%) and 12 UC (8%) patients in eastern Europe. The cumulative probability of receiving immunomodulators was 57% for CD in western (median time to treatment 2 months) and 44% (1 month) in eastern Europe, and 21% (5 months) and 5% (6 months) for biological therapy, respectively. For UC patients, the cumulative probability was 22% (4 months) and 15% (3 months) for immunomodulators and 6% (3 months) and 1% (12 months) for biological therapy, respectively in the western and eastern Europe.DISCUSSION: In this cohort, immunological therapy was initiated within the first months of disease. Surgery and hospitalization rates did not differ between patients from eastern and western Europe, although more western European patients received biological agents and were comparable to previous population-based inception cohorts.</p
Occurrence of anaemia in the first year of inflammatory bowel disease in a European population-based inception cohort:An ECCO-EpiCom study
No full textBackground and aims: Anaemia is an important complication of inflammatory bowel disease (IBD). The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis in a European prospective population-based inception cohort.Methods: Newly diagnosed IBD patients were included and followed prospectively for one year in 29 European and 1 Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization.Results: A total of 1,871 patients (CD: 686, 88%; UC: 1,021, 87%; IBDU 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and overall, 49% of CD and 39% of UC patients had at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed.Conclusions: Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting.</p
Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study
No full textBackground Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends.
Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age ≥0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories.
Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0·7% (95% UI 0·7–0·9), corresponding to 56·8 million (95% UI 55·2–67·8) infections, on Jan 1, 2020. This number represents a decrease of 6·8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63·6 million (61·8–75·8) infections (0·9% [0·8–1·0] prevalence). By the end of 2020, an estimated 12·9 million (12·5–15·4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641000 (623000–765000) patients initiated treatment.
Interpretation At the beginning of 2020, there were an estimated 56·8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination
Occurrence of Anaemia in the First Year of Inflammatory Bowel Disease in a European Population-based Inception Cohort—An ECCO-EpiCom Study
No full textRisankizumab for Ulcerative Colitis Two Randomized Clinical Trials
No full textIMPORTANCE The clinical effects of risankizumab (a monoclonal antibody that selectively targets the p19 subunit of IL-23) for the treatment of ulcerative colitis are unknown. OBJECTIVE To evaluate the efficacy and safety of risankizumab when administered as an induction and a maintenance therapy for patients with ulcerative colitis. DESIGN, SETTING, AND PARTICIPANTS Two phase 3 randomized clinical trialswere conducted. The induction trial was conducted at 261 clinical centers (in 41 countries) and enrolled 977 patients from November 5, 2020, to August 4, 2022 (final follow-up on May 16, 2023). The maintenance trial was conducted at 238 clinical centers (in 37 countries) and enrolled 754 patients from August 28, 2018, to March 30, 2022 (final follow-up on April 11, 2023). Eligible patients had moderately to severely active ulcerative colitis; a history of intolerance or inadequate response to 1 or more conventional therapies, advanced therapies, or both types of therapies; and no prior exposure to risankizumab. INTERVENTIONS For the induction trial, patients were randomized 2:1 to receive 1200mg of risankizumab or placebo administered intravenously at weeks 0, 4, and 8. For the maintenance trial, patients with a clinical response (determined using the adapted Mayo score) after intravenous treatment with risankizumab were randomized 1:1:1 to receive subcutaneous treatment with 180mg or 360mg of risankizumab or placebo (no longer receiving risankizumab) every 8 weeks for 52 weeks. MAIN OUTCOMES AND MEASURES The primary outcomewas clinical remission (stool frequency score ≤1 and not greater than baseline, rectal bleeding score of 0, and endoscopic subscore ≤1 without friability) at week 12 for the induction trial and at week 52 for the maintenance trial. RESULTS Among the 975 patients analyzed in the induction trial (aged 42.1 [SD, 13.8] years; 586/973 [60.1%] were male; and 677 [69.6%] were White), the clinical remission rates at week 12 were 132/650 (20.3%) for 1200mg of risankizumab and 20/325 (6.2%) for placebo (adjusted between-group difference, 14.0% [95%CI, 10.0%-18.0%], P < .001). Among the 548 patients analyzed in the maintenance trial (aged 40.9 [SD, 14.0] years; 313 [57.1%] were male; and 407 [74.3%] were White), the clinical remission rates at week 52 were 72/179 (40.2%) for 180mg of risankizumab, 70/186 (37.6%) for 360mg of risankizumab, and 46/183 (25.1%) for placebo (adjusted between-group difference for 180mg of risankizumab vs placebo, 16.3%[97.5%CI, 6.1%-26.6%], P < .001; adjusted between-group difference for 360mg of risankizumab vs placebo, 14.2%[97.5%CI, 4.0%-24.5%], P = .002). No new safety risks were detected in the treatment groups. CONCLUSION AND RELEVANCE Compared with placebo, risankizumab improved clinical remission rates in an induction trial and in a maintenance trial for patients with moderately to severely active ulcerative colitis. Further study is needed to identify benefits beyond the 52-week follow-up.AbbVieDepartment of Hepato-Gastroenterology and Digestive Oncology University Hospital CHU of LiègeDepartment of Internal Medicine University Hospital Schleswig-Holstein Christian-Albrecht University of KielInflammatory Bowel Disease Unit Division of Gastroenterology and Hepatology University of CalgaryImelda GI Clinical Research Center Imelda General HospitalDepartment of Gastroenterology and Hepatology University Hospital ZurichHenry D. Janowitz Division of Gastroenterology Department of Medicine Icahn School of Medicine at Mount SinaiDepartment of Gastroenterology Royal London Hospital Barts Health NHS TrustDepartment of Gastroenterology and INSERM U1256 University Hospital of Nancy Lorraine UniversityDepartment of Gastroenterology Amsterdam University Medical CentersDepartment of Gastroenterology and Hepatology Kyorin University School of MedicineDepartment of Gastroenterology Infectiology and Rheumatology Charité - Universitaetsmedizin Berlin Freie Universität Berlin Humboldt-Universität zu BerlinState Key Laboratory of Cancer Biology National Clinical Research Center for Digestive Diseases Xijing Hospital of Digestive Diseases Fourth Military Medical UniversityDivision of Gastroenterology University of California, La JollaF. Widjaja Inflammatory Bowel Disease Institute Cedars Sinai Medical CenterIBD Center IRCCS Humanitas Research Hospital, RozzanoDepartment of Biomedical Sciences Humanitas University, Pieve EmanueleAbbVie IncAbbVie Deutschland GmbH and Co KGFirst Department of Medicine University Hospital Erlangen Friedrich-Alexander-University Erlangen-NürnbergDepartment of Gastroenterology and Hepatology University Hospitals Leuven KU LeuvenDivision of Gastroenterology and Hepatology Mayo Clinic College of Medicine and ScienceHospital Privado Universitario de Cordoba CordobaGEDYT Buenos AiresCEMIC Buenos AiresSanatorio 9 de Julio San Miguel de TucumanHospital Provincial Del Centenario RosarioLandeskrankenhaus Salzburg Universitätsklinikum der PMU (LKH) SalzburgMedizinische Universitat Wien ViennaAZ Delta RoeselareImeldaziekenhuis BonheidenCHC Groupe Sante - Clinique du MontLegia LiegeCliniques Universitaires Saint-Luc (UCLouvain), Brussels-CapitalUniversitair Ziekenhuis Leuven LeuvenCliniques Universitaires de Bruxelles Hopital Erasme, Brussels-CapitalCHU de Liege LiegeCHU UCL Namur - Site Godinne YvoirHospital de Clinicas de Porto Alegre Porto AlegreKaiser Hospital Clinica e Hospital Dia, Sao Jose Do Rio PretoHospital das Clinicas da Faculdade de Medicina de Ribeirao Preto USP Ribeirão PretoUPECLIN Unidade de Pesquisa Clinica da Faculdade de Medicina de Botucatu -BotucatuUMHAT Tsaritsa Joanna ISUL SofiaUMHAT Kaspela EOOD Plovdiv-CityFraser Clinical Trials IncLondon Health Sciences Centre University Hospital LondonRoyal Victoria Hospital McGill University Health CentreToronto Digestive Disease Associates Inc.CIUSSS de l'Est de l'Ile-de-Montreal Hopital Maisonneuve-RosemontAllen Whey Khye Lim Professional CorporationHotel Dieu de LevisScott Shulman Medicine Professional CorporationCovenant HealthHospital Guillermo Grant Benavente de Concepción ConcepciónHospital Las Higueras TalcahuanoComplejo Asistencial Dr. Sotero Del Rio SantiagoRenmin Hospital of Wuhan University, HubeiSir Run Run Shaw Hospital Zhejiang University School of Medicine, ZhejiangThe Second Affiliated Hospital of Zhejiang University School of Medicine, ZhejiangThe First Affiliated Hospital of Nanchang University, JiangxiThe Sixth Affiliated Hospital Sun Yat-sen University, GuangdongUnion Hospital Tongji Medical College Huazhong University of Science and Tec, HubeiThe First Affiliated Hospital of Anhui Medical University, AnhuiShengjing Hospital of China Medical University, LiaoningShanghai East Hospital ShanghaiTongji Hospital Tongji Medical College of HUST WuhanShanghai General Hospital ShanghaiRenji Hospital-Shanghai Jiao Tong University School of Medicine ShanghaiThe First Hospital of Jilin University, JilinTangdu Hospital of the Fourth Military Medical University, ShaanxiGeneral Hospital of Ningxia Medical University, Ningxia HuiWuxi People's Hospital, JiangsuJiangsu Province People's Hospital, JiangsuWest China Hospital Sichuan University, SichuanThe Second Xiangya Hospital of Central South University, HunanThe Second Hospital of Hebei Medical University, HebeiRuijin Hospital Shanghai Jiaotong University School of Medicine ShanghaiNanjing Drum Tower Hospital, JiangsuImat Oncomedica SA, COHospital Universitario San Vicente Fundacion, AntioquiaKlinicki Bolnicki Centar Osijek, SlavoniaKlinicki Bolnicki Centar Zagreb ZagrebKlinicki Bolnicki Centar Split SplitNemocnice Ceske Budejovice A.s. South BohemianFakultni Nemocnice Ostrava, Moravian-SilesianFakultni Nemocnice U Sv. Anny v Brne BrnoHepato-Gastroenterologie HK S.r.o. Hradec KraloveOdense Universitetshospital OdenseSjællands Universitetshospital Roskilde, ZealandBispebjerg and Frederiksberg Hospital CopenhagenClinical Research Center Faculty of Medicine Alexandria University AlexandriaAir Force Specialized Hospital CairoNational Liver Institute Monufia Governorate, Monufia GovernorateCHU Montpellier Hôpital Saint Eloi MontpellierClinique Jules Verne NantesCHU Amiens-Picardie AmiensCHU de Nice-Hopital l'Archet II NiceCHU Bordeaux Hopital Haut Leveque PessacCHRU de Nancy Hopitaux de Brabois Vandoeuvre-Les-NancyCHU de SAINT ETIENNE Hopital Nord Saint-Priest-En-JarezCentre Médico Chirurgical Ambroise Paré Hartmann, Neuilly-Sur-SeineUniversitatsklinikum Erlangen, BavariaGastroenterologische Gemeinschaftspraxis Minden, North Rhine-WestphaliaUniversitaetsklinikum FreiburgUniversitaetsklinikum Regensburg, BavariaUniversitaetsklinikum Ulm, Baden-WurttembergGastroenterologie Opernstrasse, HesseKlinikum Lueneburg, Lower SaxonyUniversitaetsklinikum Koln, North Rhine-WestphaliaGastroenterologische Spezialpraxis Am Wittenbergplatz BerlinPraxiszentrum fuer Gastroenterologie, North Rhine-WestphaliaUniversitatsklinikum Mannheim, Baden-WurttembergEUGASTRO GmbH, SaxonyUniversitaetsklinikum Schleswig-Holstein Campus Kiel, Schleswig-HolsteinMVZ fuer Gastroenterlogie Am Bayerischen Platz BerlinCharite Universitaetsklinikum Berlin Campus Benjamin Franklin BerlinDRK Kliniken Berlin Westend BerlinGeneral Hospital of Chest Diseases of Athens SOTIRIA, AtticaUniversity General Hospital of Heraklion PAGNI, CreteGeneral Hospital of Athens Ippokrateio, AtticaEvangelismos General Hospital, AtticaGeneral Hospital of Nikaia-Piraeus Agios Panteleimon, AtticaRabin Medical Center HaifaShaare Zedek Medical Center JerusalemHadassah Medical Center-Hebrew University JerusalemThe Chaim Sheba Medical Center, Tel AvivSoroka University Medical Center, SouthernASST Fatebenefratelli Sacco, LombardyIstituto Clinico Humanitas, LombardyUniversitario Campus Bio-Medico di Roma, LazioAzienda Ospedaliero-Universitaria di Modena ModenaAzienda Ospedaliera San Camillo Forlanini, LazioUOC Medicina Interna e Gastroenterologia, LazioIRCCS Ospedale Sacro Cuore Don Calabria Negrar di ValpolicellaOspedale Policlinico San Martino, LiguriaOspedale Sant Orsola Malpighi, Emilia-RomagnaMagna Graecia University of Catanzaro, CalabriaAzienda Ospedaliera Universitaria Policlinico Tor Vergata, LazioAzienda Ospendaliera per l'Emergenza Cannizzaro, SicilyASST Rhodense/Presidio Ospedaliero di Rho, LombardyASST Grande Ospedale Metropolitano Niguarda, LombardyYamagata University Hospital, TohokuKhloe Clinic Aoyama, Hyogo PrefectureShowa University Fujigaoka Hospital, Kanagawa PrefectureGokeikai Ofuna Chuo Hospital, KantoSaga University Hospital, KyushuTokyo Medical and Dental University Hospital, Bunkyo-KuSt. Luke's International Hospital, Chuo-KuFukuoka University Hospital, FukuokaOgaki Municipal Hospital, GifuMie University Hospital, MieWakayama Medical University Hospital, HonshuSapporo Medical University Hospital, HokkaidoHirosaki General Medical Center, TohokuKinshukai Infusion Clinic, KansaiTohoku University Hospital, TohokuHyogo Medical University Hospital, KansaiChiba University Hospital, KantoTokatsu Tsujinaka Hospital, ChibaKitasato University Kitasato Institute Hospital, Minato-Ku, TokaiNara Medical University Hospital, NaraSapporo Higashi Tokushukai Hospital, HokkaidoNational Hospital Organization Takasaki General Medical Center, KantoToho University Medical Center Sakura Hospital, ChibaNagasaki University Hospital, KyushuTokai University Hospital, KantoHokkaido P.W.F.A.C. Sapporo-Kosei General Hospital, HokkaidoMatsuda Hospital, ChubuMatsushima Clinic Colo-proctology Center, Kanagawa PrefectureNagoya University Hospital, ChubuShiga University of Medical Science Hospital, KansaiDaido Clinic, ChubuSameshima Hospital, KyushuSaiseikai Fukuoka General Hospital, KyushuFujita Health University Hospital, ChubuNHO Shizuoka Medical Center, ShizuokaHiroshima University Hospital, ChugokuNagoya City University Hospital, ChubuKyorin University Hospital, KantoThe Jikei University Hospital, KantoAichi Medical University Hospital, ChubuGifu University Hospital, ChubuHamamatsu University Hospital, ChubuKeio University Hospital, KantoTokai University Hachioji Hospital, KantoKanazawa University Hospital, ChubuFukuoka University Chikushi Hospital, KyushuKurume University Hospital, KyushuTsujinaka Hospital Kashiwanoha, KantoSapporo IBD Clinic, HokkaidoTokitokai Tokito Clinic, KantoNHO Fukuyama Medical Center, ChugokuJapanese Red Cross Wakayama Medical Center, HonshuTeikyo University Hospital, KantoYokkaichi Hazu Medical Center, KansaiSt. Marianna Medical University Hospital, KantoKitasato University Hospital, KantoVCA Poliklinika Aura RigaPauls Stradins Clinical University Hospital RigaHospital of Lithuanian University of Health Sciences Kaunas Clinics KaunasVilnius University Hospital Santaros Klinikos VilniusUnidad de Atencion Medica e Investigacion en Salud MeridaAcademisch Medisch Centrum AmsterdamElisabeth-TweeSteden Ziekenhuis, North BrabantWaikato Hospital, WaikatoChristchurch Hospital, CanterburyWellington Regional Medical Center, WellingtonHutt Hospital, WellingtonDunedin Hospital, OtagoNZOZ All-Medicus, SilesianWIP Warsaw IBD Point Profesor Kierkus, MasovianEndoskopia Sp. Z O.o., PomeranianGastromed Sp. Z O.o, Kuyavian-PomeranianNZOZ Vivamed Jadwiga Miecz, MasovianNarodowy Instytut Onkologii im Marii Skłodowskiej Curie Panstwowy Instytut Bada, MasovianH-T. Centrum Medyczne - Endoterapia, SilesianPanstwowy Instytut Medyczny MSWiA W Warszawie, MasovianVitamed Galaj i Cichomski Sp.j., Kuyavian-PomeranianCentrum Zdrowia MDM, MasovianCentro Hospitalar de Entre Douro e Vouga, NorteHospital da Senhora da Oliveira Guimaraes EPE, NorteCentro Hospitalar Universitario de Sao Joao EPE, NorteCentro Hospitalar de Tondela-Viseu, CentroCentro Hospitalar e Universitario de Coimbra EPE, CentroCentro Hospitalar Universitário Do Algarve EPE Hospital de Portimão, AlgarveFundeni Clinical Institute BucharestCabinet Particular Policlinic Algomed, TimisClinica Gastroenterologie Gastro Med Cluj Cluj-NapocaCity Clinical Hospital, #40 SestroretskArsvita Clinic KorolevKuzbass Regional Clinical Hospital, Kemerovo OblastInterdisctrict Multidisciplinary Hospital, Kabardino-Balkaria AnzoreyNational Medical Research Center of Coloproctology A. N. Ryzhikh, CentralImmanuel Kant Baltic Federal University, Kaliningrad OblastRegional Clinical Hospital #1, Tyumen OblastFirst Moscow State Medical University I.M. Sechenov, CentralUlyanovsk Regional Clinical Hospital, Ulyanovsk OblastGeneral Hospital Leskovac, Southern And Eastern SerbiaClinical Hospital Center Bezanijska Kosa BelgradeClinical Hospital Center Zvezdara BelgradeClinical Hospital Center Dr Dragisa Misovic - Dedinje BelgradeKL Ling Gastroenterology and Liver Clinic SingaporeFakultna Nemocnica S Poliklinikou F.D. Roosevelta Banska Bystrica BanskaFakultna Nemocnica S Poliklinikou Nove Zamky Nove, ZamkyKM Management Spol. S.r.o. NitraGASTRO I. S.r.o. PresovUniversity Medical Center Ljubljana LjubljanaSpoke Research Inc, Western CapeAllergy & Immunology (AIU), Western CapePrivate Practice - Dr MN Rajabally, Western CapeClinresco Centres, GautengFARMOVS (PTY) LTD, Free StateYonsei University Health System Severance Hospital SeoulYeungnam University Medical Center, YeongnamThe Catholic University of Korea Daejeon St. Mary's Hospital, HoseoCHA University Bundang Medical Center, Gyeonggi ProvinceInje University Haeundae Paik Hospital, YeongnamSamsung Medical Center SeoulThe Catholic University of Korea St. Vincent's Hospital, GyeonggiKangbuk Samsung Hospital SeoulPusan National University Hospital, YeongnamHospital Universitario Virgen Macarena, AndalusiaHospital Arquitecto Marcide Complejo Hospitalario Universitario de Ferrol, GaliciaHospital Universitario Miguel Servet, AragonHospital Alvaro Cunqueiro CHUVI, VigoHospital Universitario la Paz MadridHospital Universitario de Cabuenes, AsturiasHospital Universitario Puerta de Hierro Majadahonda, MajadahondaDanderyds Sjukhus AB, Uppland, SodermanlandUniversitatsspital ZurichInselspital - Universitätsspital BernTaichung Veterans General Hospital TaichungChina Medical University Hospital TaichungLinkou Chang Gung Memorial Hospital TaoyuanChung Shan Medical University Hospital TaichungNational Taiwan University Hospital Taipei CityGastro Health & Nutrition - VictoriaClin Res Inst of Michigan LLCGastro OneVirginia Mason Medical CenterSisli Etfal Training & Research Hospital, SisliIstanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, MarmaraAnkara University Medical Faculty AnkaraKyiv City Clinical Hospital No.18 KyivMedical Center OK Clinic International Institute of Clinical Research LLC KyivCNE Regional Clinical Hospital of Ivano-Frankivsk RC Ivano-FrankivskRoyal Devon University Healthcare NHS Foundation Trust, DevonUniversity Hospital Southampton NHS Foundation Trust, HampshireBarnsley Hospital NHS Foundation Trust, Yorkshire/HumberCambridge University Hospitals NHS Foundation Trust, CambridgeshireKing's College Hospital NHS Foundation Trust LondonBarts Health NHS Trust LondonSt George's University Hospitals NHS Foundation Trust TootingThe Newcastle Upon Tyne Hospitals NHS Foundation Trust, Tyne And WearLiverpool University Hospitals NHS Foundation Trust, MerseysideUniversity of PennsylvaniaLouisiana Research Center LLCYale Univ Digestive DiseasesMassachusetts General Hospital Crohn's and Colitis CenterGastroenterology Associates, P.A. of GreenvilleUCSF Center for Colitis and Crohn's DiseaseDM Clinical Research/SouthwestUC San Diego Health System, La JollaSouthern Star Research Institute LLCThe Ohio State UniversityVanderbilt University Medical CenterThe University of Chicago Medical CenterSouth Florida Research Ph I-IV Inc.DiGiovanna Institute for Medical Education & Research NorthTyler Research Institute LLCAdvanced Research Institute IncGreat Lakes Gastroenterology Research LLCMedical Research Center of CTSouthern California Res. Ctr.University of Michigan Comprehensive Cancer Center Michigan MedicineUnited Medical DoctorsBaylor College of Medicine Baylor Medical CenterNola Research Works LLCTexas Digestive Disease ConsultantsUniv Kansas Med CtrUniversity of MiamiEndoscopic Research Inc.Atrium Health Carolinas Medical CenterMayo Clinic - RochesterClinical Associates in Research Therapeutics of America LLCOptimed Research Ltd.Cedars-Sinai Medical Center-West HollywoodCtr for Advanced GastroenterolVilo Research Group IncPeak Gastroenterology Associates PCGastroenterology Group NaplesCentex Studies Inc. - HoustonDHAT Research InstitutePlains Clinical Research Center LLCGastroenterology Associates of Central Georgia LLCDigestive Disease Associates LTDGI AllianceColumbia Univ Medical CenterLenox Hill HospitalUPECLIN Unidade de Pesquisa Clinica da Faculdade de Medicina de Botucatu -Botucat
