Intestinal Research

Volume 19(1); January 2021

Reviews

IBD

Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment: Shintaro Akiyama, Victoria Rai, David T. Rubin; Intest Res 2021;19(1):1-11. Published online November 5, 2020; DOI: https://doi.org/10.5217/ir.2020.00047

Patients with inflammatory bowel disease (IBD) occasionally need a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) because of medically refractory colitis or dysplasia/cancer. However, pouchitis may develop in up to 70% of patients after this procedure and significantly impair quality of life, more so if the inflammation becomes a chronic condition. About 10% of patients with IBD who develop pouchitis require pouch excision, and several risk factors of the failure have been reported. A phenotype that has features similar to Crohn’s disease may develop in a subset of ulcerative colitis patients following proctocolectomy with IPAA and is the most frequent reason for pouch failure. In this review, we discuss the diagnosis and prognosis of pouchitis, risk factors for pouchitis development, and treatment options for pouchitis, including the newer biological agents.

Citations

Citations to this article as recorded by

Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
DEN Open.2025;[Epub] CrossRef
Treatment of Antibiotic Refractory Chronic Pouchitis With JAK Inhibitors and S1P Receptor Modulators: An ECCO CONFER Multicentre Case Series
Davide Giuseppe Ribaldone, Giulia Testa, Bram Verstockt, Tamas Molnar, Edoardo Savarino, Carsten Schmidt, Sophie Vieujean, Niels Teich, Corina Meianu, Pascal Juillerat, Nathan Grellier, Triana Lobaton
Journal of Crohn's and Colitis.2024; 18(5): 720. CrossRef
Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study
Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya
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Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies
Alex L. Huang, Marnie Abeshouse, Katherine C. Lee, Emily Rinebold, Maia Kayal, Michael C. Plietz
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
Treatment of Chronic Pouchitis With JAK Inhibitors: Results from A Large Multicenter Database
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Inflammatory Bowel Diseases.2024;[Epub] CrossRef
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Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Jacob E Ollech, Nathaniel A Cohen, Cindy Traboulsi, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron Olortegui, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A Rubin,
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Mucosal Single-Cell Profiling of Crohn’s-Like Disease of the Pouch Reveals Unique Pathogenesis and Therapeutic Targets
Siyan Cao, Khai M. Nguyen, Kaiming Ma, Xiaotang Du, Xiuli Liu, Alina Ulezko Antonova, Richard P. Rood, Anas Gremida, Chien-Huan Chen, Alexandra Gutierrez, Deborah C. Rubin, Martin H. Gregory, Mate Gergely, Guadalupe Oliva Escudero, Katherine Huang, Natali
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A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
Crohn's & Colitis 360.2024;[Epub] CrossRef
Ileoanal Pouch–Related Fistulas: A Narrative Review
Sergio Bronze, Maia Kayal, Maria Manuela Estevinho, Sue Hahn, Sergey Khaitov, Jean-Frederic Colombel, Serre-Yu Wong
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
Complicaciones asociadas al reservorio ileal en colitis ulcerativa versus poliposis familiar adenomatosa: Impacto en la calidad de vida del paciente
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología.2023; 46(1): 39. CrossRef
Antibiotics in the pathogenesis of diabetes and inflammatory diseases of the gastrointestinal tract
Aline C. Fenneman, Melissa Weidner, Lea Ann Chen, Max Nieuwdorp, Martin J. Blaser
Nature Reviews Gastroenterology & Hepatology.2023; 20(2): 81. CrossRef
Treatment of Chronic Inflammatory Pouch Conditions With Tofacitinib: A Case Series From 2 Tertiary IBD Centers in the United States
Shintaro Akiyama, Nathaniel A Cohen, Maia Kayal, Marla C Dubinsky, Jean-Frederic Colombel, David T Rubin
Inflammatory Bowel Diseases.2023; 29(9): 1504. CrossRef
Ileal reservoir-associated complications in ulcerative colitis versus familial adenomatous polyposis: Impact on patient quality of life
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología (English Edition).2023; 46(1): 39. CrossRef
Effectiveness and safety of tofacitinib in patients with chronic pouchitis multirefractory to biologics
Mathieu Uzzan, Maria Nachury, Aurélien Amiot, Laurent Peyrin-Biroulet, Julien Kirchgesner, Yoram Bouhnik
Digestive and Liver Disease.2023; 55(8): 1158. CrossRef
Prioritization in inflammatory bowel disease therapy
Klaus R. Herrlinger, Eduard F. Stange
Expert Review of Gastroenterology & Hepatology.2023; 17(8): 753. CrossRef
Cannabis Improves Clinical Outcomes and Quality of Life in Patients With Chronic Pouchitis
Timna Naftali, Lihi Bar-Lev Schleider, Hen Kayless, Zohar Bromberg, Iris Dotan, Efrat Broide
ACG Case Reports Journal.2023; 10(8): e01131. CrossRef
Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study
Ronaldo Paolo Panganiban, Alyssa Tuan, Maxwell Hart, Mathew Pelton, Daniella Mikhail, Sarah Akhtar, Kaleb Bogale, Susan Deiling, Shouhao Zhou, Mathew D Coates, Gregory S Yochum, Walter Koltun
Crohn's & Colitis 360.2023;[Epub] CrossRef
Endoscopy of the Ileal Pouch Anal Anastomosis
Athos Bousvaros, Jill M. Zalieckas, Lori Zimmerman
Journal of Pediatric Gastroenterology & Nutrition.2023; 77(6): 691. CrossRef
Sampling and Reporting of Inflammatory Bowel Disease
Ian S. Brown, Cheng Liu, Gregory C. Miller
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Time to Revisit Disease Classification in Inflammatory Bowel Disease: Is the Current Classification of Inflammatory Bowel Disease Good Enough for Optimal Clinical Management?
Bram Verstockt, Brian Bressler, Helena Martinez-Lozano, Dermot McGovern, Mark S. Silverberg
Gastroenterology.2022; 162(5): 1370. CrossRef
Histopathology of Colectomy Specimens Predicts Endoscopic Pouch Phenotype in Patients with Ulcerative Colitis
Shintaro Akiyama, Jacob E. Ollech, Cindy Traboulsi, Victoria Rai, Laura R. Glick, Yangtian Yi, Joseph Runde, Andrea D. Olivas, Christopher R. Weber, Russell D. Cohen, Kinga B. Skowron Olortegui, Roger D. Hurst, Konstantin Umanskiy, Benjamin D. Shogan, Mic
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Network meta-analysis: efficacy of treatment for acute, chronic, and prevention of pouchitis in ulcerative colitis
Stephanie Poo, Danujan Sriranganathan, Jonathan P Segal
European Journal of Gastroenterology & Hepatology.2022; 34(5): 518. CrossRef
When pouches cannot empty: a cohort study of the symptoms this causes, the reasons it's happening, and the treatments needed
Emmeline Nugent, James M. Church
ANZ Journal of Surgery.2022; 92(12): 3237. CrossRef
Diagnostic and Management Considerations for the IPAA With Crohn’s Disease-Like Features
Shintaro Akiyama, Emma C. Dyer, David T. Rubin
Diseases of the Colon & Rectum.2022; 65(S1): S77. CrossRef
Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment
Sabrina L. Chen, Adam S. Faye, Shannon Chang
Current Treatment Options in Gastroenterology.2022; 20(4): 564. CrossRef
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
Dong-Hoon Yang
Journal of Digestive Cancer Reports.2021; 9(2): 50. CrossRef

10,252 View
466 Download
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27 Crossref

Cancer

Two intertwined compartments coexisting in sporadic conventional colon adenomas: Carlos A. Rubio; Intest Res 2021;19(1):12-20. Published online February 24, 2020; DOI: https://doi.org/10.5217/ir.2019.00133

Abstract PDF PubReader ePub

Sporadic conventional colon adenomas are microscopically built of 2 intertwined compartments: one on top, harboring the dysplastic tissue that defines their histo-biomolecular attributes, and the other below, composed of non-dysplastic crypts with corrupted shapes (CCS). The CCS of 306 colon adenomas revealed asymmetric, haphazardly-distributed proliferating cell-domains (PC). In contrast, the PC-domains in normal controls were symmetric, being limited to the lower thirds of the crypts. In 28% out of 501 sporadic conventional adenomas, foci of p53-upregulated dysplastic tissue were found. The CCS in 30% of 108 sporadic adenomas showed p53-upregulated single cells, suggesting mounting somatic mutations. No p53-upregulated cells were found in the crypts of controls. In polypoid adenomas, the mucosa of the stalk without dysplastic tissue on top disclosed CCS with asymmetrical PC-domains and single p53-upregulated cells. The latter observations suggested that CCS had developed prior to and not after the growth of the dysplastic tissue on top. CCS were also found below colon adenomas in carcinogen-treated rats. It is concluded that the 2 intertwined histo-biological compartments of sporadic conventional colon adenomas are probably interdependent components. These findings may open new directions aimed to uncover the link between the normal colonic mucosa and the histogenesis of, conventional adenomas.

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Calcium, Vitamin D, and Colorectal Cancer
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The Korean Journal of Gastroenterology.2023; 82(2): 47. CrossRef
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Carlos A Rubio, Peter T Schmidt
Journal of Clinical Pathology.2020; : jclinpath-2020-206694. CrossRef

5,954 View
144 Download
6 Web of Science
4 Crossref

IBD

Intestinal tuberculosis or Crohn’s disease: a review of the diagnostic models designed to differentiate between these two gastrointestinal diseases: Julajak Limsrivilai, Nonthalee Pausawasdi; Intest Res 2021;19(1):21-32. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.09142

Abstract PDF PubReader ePub

Differentiating Crohn’s disease (CD) from intestinal tuberculosis (ITB) is a diagnostic dilemma, particularly in regions where ITB is prevalent and CD incidence is increasing, because both diseases can present quite similarly, and diagnostic tests to identify Mycobacterium tuberculosis in tissue samples have rather poor sensitivity. Studies that were conducted to determine the factors that differentiate CD from ITB identified some significant characteristics, but none of those characteristics are exclusive to either ITB or CD. Many diagnostic models or scoring systems that use one to several diagnostic parameters have been proposed to help distinguish these two intestinal diseases. Early models consisted of parameters common to routine clinical practice, such as clinical features, and endoscopic and pathologic findings. The later models also include more advanced diagnostic parameters like high-resolution imaging and serological testing. However, the number and types of parameters differ among diagnostic models, and the systems used to calculate scoring also vary from model to model. Enhanced awareness and understanding of the currently available diagnostic models will help physicians determine which model(s) is/are most suitable for differentiating CD from ITB in their clinical practice.

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IBD

Endoscopic molecular imaging in inflammatory bowel disease: Nam Seok Ham, Seung-Jae Myung; Intest Res 2021;19(1):33-44. Published online April 20, 2020; DOI: https://doi.org/10.5217/ir.2019.09175

Abstract PDF PubReader ePub

Molecular imaging is a technique for imaging the processes occurring in a living body at a molecular level in real-time, combining molecular cell biology with advanced imaging technologies using molecular probes and fluorescence. Gastrointestinal endoscopic molecular imaging shows great promise for improving the identification of neoplasms, providing characterization for patient stratification and assessing the response to molecular targeted therapy. In inflammatory bowel disease, endoscopic molecular imaging can be used to assess disease severity and predict therapeutic response and prognosis. Endoscopic molecular imaging is also able to visualize dysplasia in the presence of background inflammation. Several preclinical and clinical trials have evaluated endoscopic molecular imaging; however, this area is just beginning to evolve, and many issues have not been solved yet. In the future, it is expected that endoscopic molecular imaging will be of increasing interest among clinicians as a new technology for the identification and evaluation of colorectal neoplasm and colitis-associated cancer.

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Original Articles

Inflammatory Bowel Diseases

Quality of life in inflammatory bowel diseases: it is not all about the bowel: Ronald Keller, Nazar Mazurak, Laura Fantasia, Stefano Fusco, Nisar P Malek, Jan Wehkamp, Paul Enck, Thomas Klag; Intest Res 2021;19(1):45-52. Published online February 27, 2020; DOI: https://doi.org/10.5217/ir.2019.00135

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD) are chronic diseases mostly affecting young patients. As they are diseases accompanying patients for their entire life, and the quality of life (QUOL) interacts with disease activity, improving QUOL should be one of the main goals of therapy. This study aims to identify factors contributing to good or impaired QUOL.
Methods
Questionnaires addressing health-related QUOL and other psychological and social features were positioned on our institutions’ webpage and on the webpage of the largest self-help group for IBD in Germany. Patients were subdivided according to their QUOL score with a cutoff of <60. We used the Short Inflammatory Bowel Disease Questionnaire, the Assessment of the Demand for Additional Psychological Treatment, and the Fear of Progression Questionnaire Short Form.
Results
High numbers of patients in both subgroups showed an impaired QUOL (87.34% in UC, 91.08% in CD). Active extraintestinal manifestations, smoking, high fear of progression and high demand for psychotherapy were associated with reduced QUOL. In addition, polypharmacological interventions did not result in a good QUOL, but ostomies are linked to improved QUOL especially in CD patients.
Conclusions
Scores used in clinical day-to-day-practice mainly focusing on somatic factors do not sufficiently address important aspects concerning QUOL. Most importantly, extraintestinal manifestations show a hitherto underestimated impact on QUOL.

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Inflammatory Bowel Diseases

Efficacy of biologic therapies for biologic-naïve Japanese patients with moderately to severely active ulcerative colitis: a network meta-analysis: Toshifumi Hibi, Isao Kamae, Philippe Pinton, Lyann Ursos, Ryuichi Iwakiri, Greg Hather, Haridarshan Patel; Intest Res 2021;19(1):53-61. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.09146

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Several biologic therapies are approved in Japan to treat moderately to severely active ulcerative colitis (UC), but there are no published comparative efficacy studies in a Japanese population. We compared the efficacy of biologics approved in Japan (adalimumab, infliximab, golimumab, and vedolizumab) for treating biologic-naïve patients with UC at their approved doses.
Methods
A targeted literature review identified 4 randomized controlled trials of biologics for UC in biologicnaïve Japanese patients. For each study, efficacy outcome data from induction (weeks 6–12) and maintenance (weeks 30–60) treatment were extracted for analysis. Treatment effects on clinical response, clinical remission, and mucosal healing relative to the average placebo results across all trials were estimated using network meta-analyses followed by transformation into probabilities and odds ratios (OR).
Results
At the end of induction, the likelihood of clinical response and clinical remission was highest with infliximab (OR: 2.12 and 2.35, respectively) and vedolizumab (OR: 2.10 and 2.32, respectively); the likelihood of mucosal healing was highest with infliximab (OR: 2.24) and adalimumab (OR: 1.86). During maintenance, the likelihood of clinical response and clinical remission was highest with vedolizumab (OR: 6.44 and 4.68, respectively) and golimumab (OR: 5.13 and 3.84, respectively); the likelihood of mucosal healing was significantly higher than placebo with all biologics.
Conclusions
All active treatments were efficacious compared with placebo. Infliximab and vedolizumab had the highest odds for induction of clinical response, remission, and mucosal healing. Golimumab and vedolizumab had numerically higher odds of achieving efficacy outcomes in the maintenance phase.

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Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
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Efficacy and Safety of Etrasimod in Patients with Ulcerative Colitis in Japan: Data from the Phase 3 ELEVATE UC 12 and ELEVATE UC 40 JAPAN Trials
Ken Takeuchi, Tadakazu Hisamatsu, Hiroshi Nakase, Katsuyoshi Matsuoka, Michael Keating, Hirotoshi Yuasa, Motoki Oe, Shoko Arai, Rafal Mazur, Toshifumi Hibi
Digestion.2024; : 1. CrossRef
The role and prospect of tofacitinib in patients with ulcerative colitis
Jun Lee
Intestinal Research.2023; 21(1): 168. CrossRef
Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
Intestinal Research.2023; 21(3): 353. CrossRef
Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
Ji Eun Baek, Sung Wook Hwang
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Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
Soo-Young Na
The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy
Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
Intestinal Research.2022; 20(1): 101. CrossRef
How to Choose the Biologic Therapy in a Bio-naïve Patient with Inflammatory Bowel Disease
Viviana Laredo, Carla J. Gargallo-Puyuelo, Fernando Gomollón
Journal of Clinical Medicine.2022; 11(3): 829. CrossRef
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Eun Ae Kang
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Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
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Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
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Gut and Liver.2022; 16(5): 736. CrossRef
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Seung Hwan Shin, Sang Hyoung Park
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Hyo Yeop Song, Geom Seog Seo
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BMC Gastroenterology.2021;[Epub] CrossRef

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Inflammatory Bowel Diseases

The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis: Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park; Intest Res 2021;19(1):62-70. Published online May 8, 2020; DOI: https://doi.org/10.5217/ir.2019.09156

Abstract PDF PubReader ePub

Background/Aims
Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can serve as biomarkers for diagnosing and assessing disease activity in ulcerative colitis (UC). We investigated their clinical significance in UC.
Methods
We analyzed 48 patients with UC who underwent measurement of fecal calprotectin (FC) and endoscopy and 96 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. The endoscopic activity was divided into 2 groups: group 1 (mild to moderate inflammation) and group 2 (severe inflammation) according to the Mayo endoscopic subscore in UC.
Results
To diagnose UC, the optimal cutoff of NLR and PLR was 2.26 (sensitivity 54.2%; specificity 90.6%; positive likelihood ratio 5.778, 95% confidence interval [CI] 2.944–11.339; area under the curve [AUC] 0.774, 95% CI, 0.690–0.859) and 179.8 (sensitivity 35.4%; specificity 90.6%; positive likelihood ratio 3.778, 95% CI 1.821–7.838; AUC 0.654, 95% CI 0.556–0.753), respectively. The optimal cutoff to differentiate group 1 and group 2 was 3.44, 175.9, and 453 µg/g for NLR, PLR, and FC, respectively (sensitivity, 63.6% vs. 90.9% vs. 81.8%; specificity, 81.1% vs. 78.4% vs. 73.0%; positive likelihood ratio, 3.364 vs. 4.205 vs. 3.027; AUC, 0.714 vs. 0.897 vs. 0.813). PLR had the highest AUC and positive likelihood ratio.
Conclusions
NLR and PLR help differentiate patients with UC from healthy controls. NLR, PLR, and FC indicate endoscopic activity and may reflect intestinal mucosal conditions.

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Seung Bum Lee, Hyun-Ki Kim, Sang Hyuk Park, Ji-Hun Lim, Sang Hyoung Park
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Anas Elgenidy, Omar Alomari, Tasbih Emad, Sara K. Kamal, Islam E. Al Ghanam, Aya Sherif, Mohammed Al-mahdi Al-kurdi, Abdallah A. Helal, Yusof Mohamed Omar, Mohamed Rafiek Ramadan
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LN Altunal, AS Ozel, C AK
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Ioan Sabin Poenariu, Lidia Boldeanu, Bogdan Silviu Ungureanu, Daniel Cosmin Caragea, Oana Mariana Cristea, Vlad Pădureanu, Isabela Siloși, Anca Marinela Ungureanu, Răzvan-Cristian Statie, Alina Elena Ciobanu, Dan Ionuț Gheonea, Eugen Osiac, Mihail Virgil
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Yiyi Xie, Tingting Zhuang, Ying Ping, Yingzhi Zhang, Xuchu Wang, Pan Yu, Xiuzhi Duan
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Natsuki Ishida, Satoru Takahashi, Yusuke Asai, Takahiro Miyazu, Satoshi Tamura, Shinya Tani, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Satoshi Osawa, Takahisa Furuta, Ken Sugimoto
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Inflammatory Bowel Diseases

Efficacy and safety of vedolizumab in ulcerative colitis in patients from Asian countries in the GEMINI 1 study: Choon Jin Ooi, Ida Normiha Hilmi, Hyo-Jong Kim, Umesh Jalihal, Deng-Chyang Wu, Dirk Demuth, Dirk Lindner, Shashi Adsul; Intest Res 2021;19(1):71-82. Published online September 4, 2020; DOI: https://doi.org/10.5217/ir.2019.09159

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The efficacy and safety of vedolizumab in moderate to severely active ulcerative colitis (UC) have been demonstrated in the GEMINI 1 study (NCT00783718). This post-hoc exploratory analysis sought to establish the efficacy and safety of vedolizumab in a subgroup of patients from Asian countries with UC from GEMINI 1.
Methods
Efficacy outcomes of interest were clinical response, clinical remission and mucosal healing at week 6 (induction phase); and clinical remission, durable clinical response, durable clinical remission, mucosal healing and glucocorticoid-free remission at week 52 (maintenance phase). Differences in outcome rates between vedolizumab and placebo in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) were assessed using descriptive analyses, and efficacy and safety compared between Asian and non-Asian countries.
Results
During induction, in Asian countries (n = 58), clinical response rates at week 6 with vedolizumab and placebo were 55.2% and 24.1%, respectively (difference 31.0%; 95% confidence interval: 7.2%–54.9%). In non-Asian countries (n = 316), response rates at week 6 with vedolizumab and placebo were 45.9% and 25.8%, respectively. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 8 weeks, vedolizumab administered every 4 weeks and placebo were 9.1%, 36.8%, and 31.6%, respectively; corresponding rates for mucosal healing were 45.5%, 47.4%, and 47.4%, respectively. Vedolizumab was well-tolerated; adverse event frequency was comparable in Asian and non-Asian countries.
Conclusions
In patients from Asian countries, the efficacy and safety of vedolizumab in treatment of UC were broadly consistent with that in the overall study population.

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Combination of vedolizumab and immunomodulators in ulcerative colitis
P Pinton
Journal of Gastroenterology and Hepatology.2021; 36(12): 3556. CrossRef
Adalimumab, Infliximab, and Vedolizumab in Treatment of Ulcerative Colitis: A Long-Term Retrospective Study in a Tertiary Referral Center
Ann-Lorie Gagnon, William Beauchesne, Laurence Tessier, Charles David, Djamal Berbiche, Alexandre Lavoie, Alban Michaud-Herbst, Karine Tremblay
Crohn's & Colitis 360.2021;[Epub] CrossRef
Vedolizumab in Inflammatory Bowel Disease: West versus East
Prasanta Debnath, Pravin M. Rathi
Inflammatory Intestinal Diseases.2021; 6(1): 1. CrossRef

6,287 View
241 Download
17 Web of Science
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Inflammatory Bowel Diseases

Efficacy and safety of vedolizumab in Crohn’s disease in patients from Asian countries in the GEMINI 2 study: Rupa Banerjee, Sai Wei Chuah, Ida Normiha Hilmi, Deng-Chyang Wu, Suk-Kyun Yang, Dirk Demuth, Dirk Lindner, Shashi Adsul; Intest Res 2021;19(1):83-94. Published online December 31, 2020; DOI: https://doi.org/10.5217/ir.2019.09160

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The efficacy and safety of vedolizumab in moderate-to-severely active Crohn’s disease (CD) were demonstrated in the GEMINI 2 study (NCT00783692). This post-hoc exploratory analysis aimed to assess the efficacy and safety of vedolizumab in the subgroup of patients from Asian countries.
Methods
During the induction phase (doses at day 1, 15), clinical remission, enhanced clinical response, and change in C-reactive protein at 6 weeks; during the maintenance phase, clinical remission, enhanced clinical response, glucocorticoid-free remission and durable clinical remission at 52 weeks, were the efficacy outcomes of interest. Efficacy and safety of vedolizumab compared to placebo were assessed in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) using descriptive analyses.
Results
During the induction phase, in Asian countries (n = 51), 14.7% of the vedolizumab-treated patients achieved clinical remission at week 6 compared to none with placebo (difference, 14.7%; 95% confidence interval, 15.8%–43.5%). In non-Asian countries (n = 317), the remission rate at week 6 with vedolizumab was 14.5%. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 4 weeks, vedolizumab administered every 8 weeks and placebo were 41.7%, 36.4%, and 0%, respectively; while enhanced clinical response rates were 41.7%, 63.6%, and 42.9%, respectively. During induction, 39.7% of patients with vedolizumab experienced an adverse event compared to 58.8% of patients with placebo, and vedolizumab was generally well-tolerated.
Conclusions
This post-hoc analysis demonstrates the treatment effect and safety of vedolizumab in moderateto-severely active CD in patients from Asian countries.

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Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients with Crohn’s disease and ulcerative colitis included in randomised controlled trials
Laurent Peyrin‐Biroulet, Perttu Arkkila, Alessandro Armuzzi, Silvio Danese, Marc Ferrante, Jordi Guardiola, Jørgen Jahnsen, Edouard Louis, Milan Lukáš, Walter Reinisch, Xavier Roblin, Philip J Smith, Taek Kwon, Jeeyoung Kim, Sangwook Yoon, Dong-Hyeon Kim
BMC Gastroenterology.2024;[Epub] CrossRef
A Review on Nanosystem-Based Delivery of Tofacitinib for Enhanced Treatment of Autoimmune Diseases and Inflammation
Thi-Thao-Linh Nguyen, Van-An Duong
BioNanoScience.2024; 14(2): 2048. CrossRef
Application of clinical decision support tools for predicting outcomes with vedolizumab therapy in patients with inflammatory bowel disease: A KASID multicentre study
Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun‐Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk‐Kyun Yang, Byong Duk Ye
Alimentary Pharmacology & Therapeutics.2024; 59(12): 1539. CrossRef
The treatment of inflammatory bowel disease with monoclonal antibodies in Asia
Yu Chen, Guolin Zhang, Yuewen Yang, Shuangshuang Zhang, Haozheng Jiang, Kang Tian, Arenbaoligao, Dapeng Chen
Biomedicine & Pharmacotherapy.2023; 157: 114081. CrossRef
Real-World Evidence of Effectiveness and Safety of Vedolizumab for Inflammatory Bowel Disease in Taiwan: A Prospective Nationwide Registry (VIOLET) Study
Wei-Chen Lin, Wei-Chen Tai, Chung-Hsin Chang, Chia-Hung Tu, I-Che Feng, Ming-Jium Shieh, Chen-Shuan Chung, Hsu-Heng Yen, Jen-Wei Chou, Jau-Min Wong, Yu-Hwa Liu, Tien-Yu Huang, Chiao-Hsiung Chuang, Tzung-Jiun Tsai, Feng-Fan Chiang, Chien-Yu Lu, Wen-Hung Hs
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Joo Kyung Kim, Jae Hee Cheon
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Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
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Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
Journal of Korean Medical Science.2022;[Epub] CrossRef
Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis
Laurent Peyrin-Biroulet, Perttu Arkkila, Alessandro Armuzzi, Silvio Danese, Jordi Guardiola, Jørgen Jahnsen, Charles Lees, Edouard Louis, Milan Lukáš, Walter Reinisch, Xavier Roblin, Minyoung Jang, Han Geul Byun, Dong-Hyeon Kim, Sung Jeong Lee, Raja Atrey
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Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
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Jung-Bin Park, Sang Hyoung Park
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Soo-Young Na, You Sun Kim
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Natural history of inflammatory bowel disease: a comparison between the East and the West
Eun Mi Song, Suk-Kyun Yang
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Hyo Yeop Song, Geom Seog Seo
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Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
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Inflammatory Bowel Diseases

Population pharmacokinetics of vedolizumab in Asian and non-Asian patients with ulcerative colitis and Crohn’s disease: Hiroyuki Okamoto, Nathanael L. Dirks, Maria Rosario, Tetsuharu Hori, Toshifumi Hibi; Intest Res 2021;19(1):95-105. Published online July 10, 2020; DOI: https://doi.org/10.5217/ir.2019.09167

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Vedolizumab is indicated for moderately-to-severely active ulcerative colitis (UC) and Crohn’s disease (CD). Because multiple factors may result in different pharmacokinetics and clinical efficacies, understanding determinants of vedolizumab clearance may enhance dose and treatment strategies. The aim was to characterize vedolizumab pharmacokinetics in Asian and non-Asian UC and CD patients.
Methods
Population pharmacokinetic analysis for repeated measures, using data from 5 studies, was conducted using nonlinear mixed-effects modeling. A Bayesian estimation approach in NONMEM 7.3 was utilized to leverage the predominantly sparse data available for this analysis with results from a prior population pharmacokinetic analysis of vedolizumab.
Results
Vedolizumab pharmacokinetics were described by a 2-compartment model with parallel linear and nonlinear elimination. Using reference covariate values, linear elimination half life of vedolizumab was 24.7 days for anti-vedolizumab antibody (AVA)-negative patients and 18.1 days for AVA-positive patients; linear clearance (CL_L) was 0.165 L/day for AVA-negative patients and 0.246 L/day for AVA-positive patients; central (V_c) and peripheral compartment volumes of distribution were 3.16 L and 1.84 L, respectively. Interindividual variabilities (percent coefficient of variation) were 30.8% for CL_L and 19% for V_c; interoccasion variability on CL_L was 20.3%; residual variance was 17.8%. For albumin, body weight and AVA, only extreme values were identified as potentially clinically important predictors of CL_L. The effect of race (Asian/non-Asian) and diagnosis (UC/CD) on CL_L was negligible and likely not of clinical importance.
Conclusions
Pharmacokinetic parameters were similar in Asian and non-Asian patients with moderately-to-severely active UC and CD. This analysis supports use of vedolizumab flat-fixed dosing in these patients. (Clinicaltrials.gov Identifiers: NCT00783718 (GEMINI 1); NCT00783692 (GEMINI 2). CCT 101; NCT02039505 and CCT-001; NCT02038920)

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Monitorización terapéutica de los fármacos biológicos en la enfermedad inflamatoria intestinal. Documento de Posicionamiento del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU)
Francisco Rodríguez-Moranta, Federico Argüelles-Arias, Joaquín Hinojosa del Val, Marisa Iborra Colomino, M. Dolores Martín-Arranz, Luis Menchén Viso, Fernando Muñoz Núñez, Elena Ricart Gómez, José Germán Sánchez-Hernández, Teresa Valdés-Delgado, Jordi Gua
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Combination of vedolizumab and immunomodulators in ulcerative colitis
P Pinton
Journal of Gastroenterology and Hepatology.2021; 36(12): 3556. CrossRef
Vedolizumab in Inflammatory Bowel Disease: West versus East
Prasanta Debnath, Pravin M. Rathi
Inflammatory Intestinal Diseases.2021; 6(1): 1. CrossRef

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Miscellaneous

Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver: Ashish Agarwal, Alka Singh, Wajiha Mehtab, Vipin Gupta, Ashish Chauhan, Mahendra Singh Rajput, Namrata Singh, Vineet Ahuja, Govind K. Makharia; Intest Res 2021;19(1):106-114. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.00136

Abstract PDF PubReader ePub

Background/Aims
Gluten-free diet has an excess of fats and simple sugars and puts patients with celiac disease at risk of metabolic complications including metabolic syndrome and fatty liver. We assessed prevalence of metabolic syndrome and fatty liver in two cohorts of celiac disease.
Methods
Study was done in 2 groups. In group 1, 54 treatment naïve patients with celiac disease were recruited. Of them, 44 returned after 1-year of gluten-free diet and were reassessed. In group 2, 130 celiac disease patients on gluten-free diet for ≥1 year were recruited. All patients were assessed for anthropometric and metabolic parameters and fatty liver. Metabolic syndrome was defined as per consensus definition for Asian Indians. Fatty liver was defined as controlled attenuation parameter value >263 decibels by FibroScan.
Results
In group 1, of 44 treatment naïve patients with celiac disease, metabolic syndrome was present in 5 patients (11.4%) at baseline and 9 (18.2%) after 1 year of gluten-free diet. Patients having fatty liver increased from 6 patients (14.3%) at baseline to 13 (29.5%) after 1year of gluten-free diet (P=0.002). In group 2, of 130 patients with celiac disease on gluten-free diet for a median duration of 4 years, 30 out of 114 (26.3%) and 30 out of 130 patients (23%) had metabolic syndrome and fatty liver, respectively.
Conclusions
Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver, which increases further with gluten-free diet. These patients should be assessed for nutritional and metabolic features and counseled about balanced diet and physical activity regularly.

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Brief Communication

IBD

Rapid prediction of 1-year efficacy of tofacitinib for treating refractory ulcerative colitis: Hiromichi Shimizu, Toshimitsu Fujii, Shuji Hibiya, Maiko Motobayashi, Kohei Suzuki, Kento Takenaka, Eiko Saito, Masakazu Nagahori, Kazuo Ohtsuka, Mamoru Watanabe; Intest Res 2021;19(1):115-118. Published online June 11, 2020; DOI: https://doi.org/10.5217/ir.2020.00030

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Citations

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Digestive and Liver Disease.2024; 56(4): 613. CrossRef
Continued JAK inhibitor treatment on the risk of recurrent herpes zoster reactivation in patients with immune-mediated inflammatory diseases: A nationwide population-based study in South Korea
Young-Eun Kim, Ye-Jee Kim, Dae Hyun Jeong, Seonok Kim, Min Jee Kim, Hyeon Hwa Kim, Kyung-Wook Jo, Sang Hyoung Park, Seokchan Hong
Seminars in Arthritis and Rheumatism.2024; 65: 152362. CrossRef
Preventing and managing cardiovascular events in patients with inflammatory bowel diseases treated with small-molecule drugs, an international Delphi consensus
Pablo A. Olivera, Axel Dignass, Marla C. Dubinsky, Giovanni Peretto, Paulo G. Kotze, Iris Dotan, Taku Kobayashi, Subrata Ghosh, Fernando Magro, Jose Rocha Faria-Neto, Britta Siegmund, Silvio Danese, Laurent Peyrin-Biroulet
Digestive and Liver Disease.2024; 56(8): 1270. CrossRef
Long-term efficacy and safety of tofacitinib in patients with ulcerative colitis: 3-year results from a real-world study
Hiromichi Shimizu, Yuko Aonuma, Shuji Hibiya, Ami Kawamoto, Kento Takenaka, Toshimitsu Fujii, Eiko Saito, Masakazu Nagahori, Kazuo Ohtsuka, Ryuichi Okamoto
Intestinal Research.2024; 22(3): 369. CrossRef
Safety and effectiveness of tofacitinib in Korean adult patients with ulcerative colitis: post-marketing surveillance study
Hyuk Yoon, Byong Duk Ye, Sang-Bum Kang, Kang-Moon Lee, Chang Hwan Choi, Joo-young Jo, Juwon Woo, Jae Hee Cheon
BMC Gastroenterology.2024;[Epub] CrossRef
Real-World Evidence of Tofacinitib in Ulcerative Colitis: Short-Term and Long-Term Effectiveness and Safety
María Chaparro, Diana Acosta, Cristina Rodríguez, Francisco Mesonero, Miren Vicuña, Manuel Barreiro-de Acosta, Agnès Fernández-Clotet, Álvaro Hernández Martínez, Maite Arroyo, Isabel Vera, Alexandra Ruiz-Cerulla, Beatriz Sicilia, M. José Cabello Tapia, Ca
American Journal of Gastroenterology.2023; 118(7): 1237. CrossRef
Real-life effectiveness and safety of tofacitinib treatment in patients with ulcerative colitis: a KASID multicenter cohort study
Seung Hwan Shin, Kyunghwan Oh, Sung Noh Hong, Jungbok Lee, Shin Ju Oh, Eun Soo Kim, Soo-Young Na, Sang-Bum Kang, Seong-Joon Koh, Ki Bae Bang, Sung-Ae Jung, Sung Hoon Jung, Kyeong Ok Kim, Sang Hyoung Park, Suk-Kyun Yang, Chang Hwan Choi, Byong Duk Ye
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Review article: Risk of cardiovascular events in patients with inflammatory bowel disease receiving small molecule drugs
Pablo A. Olivera, Juan S. Lasa, Giovanni Peretto, Stephane Zuily, Silvio Danese, Laurent Peyrin‐Biroulet
Alimentary Pharmacology & Therapeutics.2023; 57(11): 1231. CrossRef
Positioning of tofacitinib in treatment of ulcerative colitis: a global perspective
Shubhra Mishra, Anuraag Jena, Rinkalben Kakadiya, Vishal Sharma, Vineet Ahuja
Expert Review of Gastroenterology & Hepatology.2022; 16(8): 737. CrossRef
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Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
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Peter M. Irving, Yvette Leung, Marla C. Dubinsky
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Soo-Young Na, You Sun Kim
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Effectiveness and Safety of Tofacitinib for Ulcerative Colitis
Vikas Taneja, Mohammed El-Dallal, Zadid Haq, Kartikeya Tripathi, Hannah K. Systrom, Linda F. Wang, Hyder Said, Paul A. Bain, Youlian Zhou, Joseph D. Feuerstein
Journal of Clinical Gastroenterology.2022; 56(10): e323. CrossRef
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Laura A. Lucaciu, Nathan Constantine-Cooke, Nikolas Plevris, Spyros Siakavellas, Lauranne A.A.P. Derikx, Gareth-Rhys Jones, Charles W. Lees
Therapeutic Advances in Gastroenterology.2021;[Epub] CrossRef

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Case Report

Infection

Whipple disease mimicking inflammatory bowel disease: Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa; Intest Res 2021;19(1):119-125. Published online July 3, 2020; DOI: https://doi.org/10.5217/ir.2019.09177

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Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.

Citations

Citations to this article as recorded by

Through the Looking Glass: A Child With Arthralgia, Malaise and Weight Loss
Aline R. Verhage, Iris D. Nagtegaal, Cathelijne van der Feen, Tom F.W. Wolfs
Pediatric Infectious Disease Journal.2023; 42(7): 629. CrossRef
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Revista colombiana de Gastroenterología.2023; 38(1): 35. CrossRef
Whipple’s Disease with Colonic Involvement: A Rare Endoscopic Documentation
Verónica Gamelas, Ines Canha, João Pimentel, Sara Santos, Verónica Borges, Carlos Bernardes
GE - Portuguese Journal of Gastroenterology.2022; 29(6): 436. CrossRef
Whipple’s disease with normal duodenal histology diagnosed by ileal biopsy using balloon endoscopy
Hideki Mori, Chiaki Yakabi, Kiwamu Yonahara, Kazunao Hamahiga, Miyu Yoshimura, Masaki Sakihara, Kenji Ishihara, Kinya Azama, Takayuki Chinen, Osamu Zaha
Clinical Journal of Gastroenterology.2022; 15(4): 702. CrossRef

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