Intestinal Research

Takeshi Tomomasa

2 Articles

Inflammatory bowel diseases

Tacrolimus for ulcerative colitis in children: a multicenter survey in Japan: Tadahiro Yanagi, Kosuke Ushijima, Hidenobu Koga, Takeshi Tomomasa, Hitoshi Tajiri, Reiko Kunisaki, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Atsushi Yoden, Tomoki Aomatsu, Satoru Nagata, Keiichi Uchida, Yoshikazu Ohtsuka, Toshiaki Shimizu; Intest Res 2019;17(4):476-485. Published online August 31, 2019; DOI: https://doi.org/10.5217/ir.2019.00027

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Background/Aims
Tacrolimus is effective for refractory ulcerative colitis in adults, while data for children is sparse. We aimed to evaluate the effectiveness and safety of tacrolimus for induction and maintenance therapy in Japanese children with ulcerative colitis.
Methods
We retrospectively reviewed the multicenter survey data of 67 patients with ulcerative colitis aged < 17 years treated with tacrolimus between 2000 and 2012. Patients’ characteristics, disease activity, Pediatric Ulcerative Colitis Activity Index (PUCAI) score, initial oral tacrolimus dose, short-term (2-week) and long-term (1-year) outcomes, steroid-sparing effects, and adverse events were evaluated. Clinical remission was defined as a PUCAI score < 10; treatment response was defined as a PUCAI score reduction of ≥ 20 points compared with baseline.
Results
Patients included 35 boys and 32 girls (median [interquartile range] at admission: 13 [11–15] years). Thirty-nine patients were steroid-dependent and 26 were steroidrefractory; 20 had severe colitis and 43 had moderate colitis. The initial tacrolimus dose was 0.09 mg/kg/day (range, 0.05–0.12 mg/kg/day). The short-term clinical remission rate was 47.8%, and the clinical response rate was 37.3%. The mean prednisolone dose was reduced from 19.2 mg/day at tacrolimus initiation to 5.7 mg/day at week 8 (P< 0.001). The adverse event rate was 53.7%; 6 patients required discontinuation of tacrolimus therapy.
Conclusions
Tacrolimus was a safe and effective second-line induction therapy for steroid-dependent and steroid-refractory ulcerative colitis in Japanese children.

Citations

Citations to this article as recorded by

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Perseus V. Patel, Amy Zhang, Balu Bhasuran, Vignesh G. Ravindranath, Melvin B. Heyman, Sofia G. Verstraete, Atul J. Butte, Michael J. Rosen, Vivek A. Rudrapatna
Journal of Pediatric Gastroenterology and Nutrition.2024; 78(5): 1126. CrossRef
CXCR2 Activated JAK3/STAT3 Signaling Pathway Exacerbating Hepatotoxicity Associated with Tacrolimus
Xiao Chen, Ke Hu, Yue Zhang, Su-Mei He, Dong-Dong Wang
Drug Design, Development and Therapy.2024; Volume 18: 6331. CrossRef
Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef
Clinical outcome of ulcerative colitis with severe onset in children: a multicenter prospective cohort study
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Journal of Gastroenterology.2023; 58(5): 472. CrossRef
Oral Tacrolimus in Steroid Refractory and Dependent Pediatric Ulcerative Colitis—A Systematic Review and Meta-Analysis
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Journal of Pediatric Gastroenterology & Nutrition.2023; 77(2): 228. CrossRef
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Modern Rheumatology.2022; 32(4): 783. CrossRef
3D printed tacrolimus suppositories for the treatment of ulcerative colitis
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Asian Journal of Pharmaceutical Sciences.2021; 16(1): 110. CrossRef
Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?
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Intestinal Research.2021; 19(4): 357. CrossRef
Tacrolimus in pediatric ulcerative colitis: does it have a role?
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Intestinal Research.2019; 17(4): 441. CrossRef

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Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey: Takashi Ishige, Takeshi Tomomasa, Hitoshi Tajiri, Atsushi Yoden; Intest Res 2017;15(3):345-351. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.345

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<b>Background/Aims</b><br/>

Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices.

Methods

Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011.

Results

A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days.

Conclusions

EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.

Citations

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A kizárólagos enteralis táplálás hazai gyakorlata gyermekkori Crohn-betegségben
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Enteral Nutrition Prescription in Children and Adults with Inflammatory Bowel Diseases: Gaps in Current Gastroenterology Practice in Saudi Arabia
Sarah Ajabnoor, Atheer Attar, Noof BinJahlan, Nawal Almutairi, Shimaa Bashmail, Almoutaz Hashim, Alastair Forbes, Hani Jawa
Nutrients.2023; 15(1): 232. CrossRef
Implementation of exclusive enteral nutrition in pediatric patients with Crohn’s disease—results of a survey of CEDATA-GPGE reporting centers
Sarah Peters, Serdar Cantez, Jan De Laffolie
Molecular and Cellular Pediatrics.2022;[Epub] CrossRef
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Juan Luo, Yong-Mei Xie, Mei Wu, Jin-Gui Zhao, Liang-Liang Hu
Frontiers in Medicine.2022;[Epub] CrossRef
Elemental Diet Enriched with Amino Acids Alleviates Mucosal Inflammatory Response and Prevents Colonic Epithelial Barrier Dysfunction in Mice with DSS-Induced Chronic Colitis
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Journal of Immunology Research.2020; 2020: 1. CrossRef
Exclusive enteral nutrition in children with inflammatory bowel disease: Physician perspectives and practice
Shaun S C Ho, Andrew S Day
JGH Open.2019; 3(2): 148. CrossRef
Global Variation in Use of Enteral Nutrition for Pediatric Crohn Disease
Morgan Lawley, Jessica W. Wu, Victor M. Navas‐López, Hien Q. Huynh, Matthew W. Carroll, Min Chen, Pavel Medvedev, Andrew S. Day, Séamus Hussey, Rotem Sigall‐Boneh, Arie Levine, Eytan Wine
Journal of Pediatric Gastroenterology and Nutrition.2018;[Epub] CrossRef
Living on Liquids: Surviving and Thriving on Exclusive Enteral Nutrition
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American Journal of Gastroenterology.2017; 112(10): 1491. CrossRef

7,075 View
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