Intestinal Research

Original Articles

IBD

Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study: Seung Yong Shin, Soo Jung Park, Young Kim, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-Ho Kim, Do Hyun Kim, Dennis Teng, Jong-Hwa Kim, Wonyong Kim, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):350-360. Published online July 23, 2021; DOI: https://doi.org/10.5217/ir.2021.00049

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Background/Aims
This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC).
Methods
A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score.
Results
A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients.
Conclusions
ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

Citations

Citations to this article as recorded by

Prospective Observational Evaluation of the Time-Dependency of Adalimumab Immunogenicity and Drug Concentration in Ulcerative Colitis Patients: the POETIC II Study
Sivan Harnik, Chaya M Abitbol, Ola Haj Natour, Miri Yavzori, Ella Fudim, Orit Picard, Timna Naftali, Efrat Broide, Ayal Hirsch, Limor Selinger, Eyal Shachar, Doron Yablecovitch, Ahmad Albshesh, Daniel Coscas, Uri Kopylov, Rami Eliakim, Shomron Ben-Horin,
Journal of Crohn's and Colitis.2024; 18(3): 341. CrossRef
Rapidly achieving clinical remission in ulcerative colitis indicates better endoscopic and histological outcomes
Rirong Chen, Yizhe Tie, Yongle Huang, Xi Zhang, Zhirong Zeng, Minhu Chen, Li Li, Shenghong Zhang
United European Gastroenterology Journal.2024; 12(4): 459. CrossRef
Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
Health Science Reports.2024;[Epub] CrossRef
Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
Gut Pathogens.2024;[Epub] CrossRef
Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis: Evidence from a systematic literature review
Peter M. Irving, Peter Hur, Raju Gautam, Xiang Guo, Severine Vermeire
Journal of Managed Care & Specialty Pharmacy.2024; 30(9): 1026. CrossRef
Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
Intestinal Research.2023; 21(1): 61. CrossRef
Changes in fecal metabolic and lipidomic features by anti-TNF treatment and prediction of clinical remission in patients with ulcerative colitis
Seok-Young Kim, Seung Yong Shin, Soo Jung Park, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-
Therapeutic Advances in Gastroenterology.2023; 16: 175628482311681. CrossRef
Reviewing not Homer’s Iliad, but “Kai Bao Ben Cao”: indigo dye—the past, present, and future
Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
Intestinal Research.2023; 21(2): 174. CrossRef
Precision medicine and drug optimization in adult inflammatory bowel disease patients
Sophie Vieujean, Edouard Louis
Therapeutic Advances in Gastroenterology.2023; 16: 175628482311733. CrossRef
Real-world effectiveness and safety of adalimumab in Korean patients with intestinal Behcet’s disease: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter study
Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
The Korean Journal of Internal Medicine.2023; 38(5): 661. CrossRef
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
Prediction of Clinical Remission with Adalimumab Therapy in Patients with Ulcerative Colitis by Fourier Transform–Infrared Spectroscopy Coupled with Machine Learning Algorithms
Seok-Young Kim, Seung Yong Shin, Maham Saeed, Ji Eun Ryu, Jung-Seop Kim, Junyoung Ahn, Youngmi Jung, Jung Min Moon, Chang Hwan Choi, Hyung-Kyoon Choi
Metabolites.2023; 14(1): 2. CrossRef
Association of C-reactive Protein and Partial Mayo Score With Response to Tofacitinib Induction Therapy: Results From the Ulcerative Colitis Clinical Program
Marla C Dubinsky, Fernando Magro, Flavio Steinwurz, David P Hudesman, Jami A Kinnucan, Ryan C Ungaro, Markus F Neurath, Nicole Kulisek, Jerome Paulissen, Chinyu Su, Dario Ponce de Leon, Miguel Regueiro
Inflammatory Bowel Diseases.2022;[Epub] CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
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
Gut and Liver.2022; 16(5): 764. CrossRef
Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef

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15 Crossref

Inflammatory Bowel Diseases

Efficacy and safety of ustekinumab in East Asian patients with moderately to severely active ulcerative colitis: a subpopulation analysis of global phase 3 induction and maintenance studies (UNIFI): Tadakazu Hisamatsu, Hyo Jong Kim, Satoshi Motoya, Yasuo Suzuki, Yoshifumi Ohnishi, Noriyuki Fujii, Nobuko Matsushima, Richuan Zheng, Colleen W. Marano; Intest Res 2021;19(4):386-397. Published online December 1, 2020; DOI: https://doi.org/10.5217/ir.2020.00080

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Background/Aims
We aimed to evaluate the efficacy and safety of ustekinumab (UST) in the East-Asian population with moderate to severely active ulcerative colitis (UC).
Methods
This sub-analysis was conducted on data from East-Asian patients included in the UNIFI program (NCT02407236). UNIFI consisted of two double-blind, placebo-controlled trials: an 8-week induction study and a 44-week randomized withdrawal maintenance study.
Results
Of 133 East-Asian patients (Japanese: 107, Korean: 26) who underwent randomization, 131 completed induction study and 111 entered maintenance study. In the maintenance study, 78 patients were randomized. Patients who received UST 130 mg and UST 6 mg/kg showed numerically higher clinical remission at week 8 in the induction study (5/44 [11.4%] and 5/45 [11.1%], respectively) compared with those who received placebo (0/44, 0%). The proportion of patients achieved clinical remission at week 44 was numerically higher in the UST 90 mg q12w group (10/21, 47.6%), but similar in the UST 90 mg q8w group (5/26, 19.2%) compared to placebo (7/31, 22.6%). Serious adverse events were reported in 1 patient in UST 130 mg group, but no patient in UST 6 mg/kg group through week 8 in the induction study, and 1 patient in UST 90 mg q12w group and 5 patients in the UST 90 mg q8w group in the maintenance study. No deaths were reported in East-Asian patients throughout the study.
Conclusions
UST induction and maintenance treatments were effective in East-Asian patients with moderate to severe UC; the efficacy and safety profiles were consistent with the overall population.

Citations

Citations to this article as recorded by

Systematic Review and Meta-analysis: The Association Between Serum Ustekinumab Trough Concentrations and Treatment Response in Inflammatory Bowel Disease
Abhinav Vasudevan, Vivek Tharayil, Laura H Raffals, David H Bruining, Michelle Becker, Mohammad Hassan Murad, Edward V Loftus
Inflammatory Bowel Diseases.2024; 30(4): 660. CrossRef
Machine learning using clinical data at baseline predicts the medium-term efficacy of ustekinumab in patients with ulcerative colitis
Hiromu Morikubo, Ryuta Tojima, Tsubasa Maeda, Katsuyoshi Matsuoka, Minoru Matsuura, Jun Miyoshi, Satoshi Tamura, Tadakazu Hisamatsu
Scientific Reports.2024;[Epub] CrossRef
Hepatic Steatosis but Not Fibrosis Is Independently Associated with Poor Outcomes in Patients with Inflammatory Bowel Disease
Hye Kyung Hyun, Hye Won Lee, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
Gut and Liver.2024; 18(2): 294. CrossRef
Machine Learning for Predicting Biologic Agent Efficacy in Ulcerative Colitis: An Analysis for Generalizability and Combination with Computational Models
Philippe Pinton
Diagnostics.2024; 14(13): 1324. CrossRef
One-year Safety and Effectiveness of Ustekinumab in Patients With Crohn’s Disease: The K-STAR Study
Chang Kyun Lee, Won Moon, Jaeyoung Chun, Eun Soo Kim, Hyung Wook Kim, Hyuk Yoon, Hyun Soo Kim, Yoo Jin Lee, Chang Hwan Choi, Yunho Jung, Sung Chul Park, Geun Am Song, Jong Hun Lee, Eun Suk Jung, Youngdoe Kim, Su Young Jung, Jong Min Choi, Byong Duk Ye
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Intestinal Research.2023; 21(2): 252. CrossRef
A critical review of ustekinumab for the treatment of active ulcerative colitis in adults
Sophie Vieujean, Edouard Louis, Silvio Danese, Laurent Peyrin-Biroulet
Expert Review of Gastroenterology & Hepatology.2023; 17(5): 413. CrossRef
Reviewing not Homer’s Iliad, but “Kai Bao Ben Cao”: indigo dye—the past, present, and future
Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
Intestinal Research.2023; 21(2): 174. CrossRef
Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim
Intestinal Research.2023; 21(2): 244. CrossRef
The Risk of Tuberculosis in Patients With Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab in Korea
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
Japanese pediatric patient with moderately active ulcerative colitis successfully treated with ustekinumab
Toshihiko Kakiuchi, Masato Yoshiura
Medicine.2022; 101(7): e28873. CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Antitumor necrosis factor treatment in patients with inflammatory bowel disease does not promote psoriasis development: A meta-analysis
Yu Kyung Jun, Joo Young Park, Seong-Joon Koh, Hyunsun Park, Hyoun Woo Kang, Jong Pil Im, Joo Sung Kim
Medicine.2022; 101(27): e29872. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
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
Gut and Liver.2022; 16(5): 764. CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef
Natural history of inflammatory bowel disease: a comparison between the East and the West
Eun Mi Song, Suk-Kyun Yang
Intestinal Research.2022; 20(4): 418. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef

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Inflammatory Bowel Diseases

Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis: Shin Ju Oh, Ga Young Shin, Hosim Soh, Jae Gon Lee, Jong Pil Im, Chang Soo Eun, Kang-Moon Lee, Dong Il Park, Dong Soo Han, Hyo Jong Kim, Chang Kyun Lee; Intest Res 2021;19(3):323-331. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00039

Abstract PDF PubReader ePub

Background/Aims
Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort.
Methods
We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit.
Results
A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities.
Conclusions
Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC.

Citations

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Factors Associated With Response to Rescue Therapy in Acute Severe Ulcerative Colitis
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American Journal of Gastroenterology.2024; 119(7): 1365. CrossRef
Emergency subtotal colectomy rates in relation to anti-TNF therapy in inflammatory bowel disease patients: comparison of retrospective cohorts
Saman Sajjadi, Rebecca Svensson Neufert, Emilia Ruhr, Sebastian Tryggmo, Jan Marsal, Pamela Buchwald
Scandinavian Journal of Gastroenterology.2023; 58(1): 15. CrossRef
The role and prospect of tofacitinib in patients with ulcerative colitis
Jun Lee
Intestinal Research.2023; 21(1): 168. CrossRef
Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Intestinal Research.2023; 21(2): 252. CrossRef
Rescue Therapies for Steroid-refractory Acute Severe Ulcerative Colitis: A Review
Javier P Gisbert, María José García, María Chaparro
Journal of Crohn's and Colitis.2023; 17(6): 972. CrossRef
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Humza Awan, Urooj Fatima, Ryan Eaw, Naomi Knox, Laith Alrubaiy
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Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
Intestinal Research.2023; 21(2): 174. CrossRef
Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim
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Eun Jin Yoo, Sang-Hoon Cho, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Yonsei Medical Journal.2023; 64(9): 541. CrossRef
CURRENT STATUS, PROBLEMS AND PROSPECTS OF ULCERATIVE COLITIS MEDICAL CORRECTION (LITERATURE REVIEW)
T. O. Briukhanova, O. A. Nakonechna, O. V Babenko
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Eun Soo Kim, Kyeong Ok Kim, Byung Ik Jang, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Joon Seop Lee, Sung Kook Kim, Yun Jin Jung, Sang-Bum Kang, Manasi Agrawal, Ryan Ungaro, Jean-Frederic Colombel
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Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
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Commentary

IBD

A new opportunity for innovative inflammatory bowel disease research: the moderate-to-severe ulcerative colitis in Korea (MOSAIK) cohort study: Chang Kyun Lee, Kang-Moon Lee, Dong Il Park, Sung-Ae Jung, Yoon Tae Jeen, Young Sook Park, Hyo Jong Kim, the MOSAIK study group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2019;17(1):1-5. Published online January 25, 2019; DOI: https://doi.org/10.5217/ir.2019.00005

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Clinical importance of weight gain and associated factors in patients with moderate to severe ulcerative colitis: results from the MOSAIK cohort in Korea
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BMC Gastroenterology.2023;[Epub] CrossRef
Infliximab versus Adalimumab: Can We Choose the Right One for the Right Patients with Ulcerative Colitis?
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Early course of newly diagnosed moderate‐to‐severe ulcerative colitis in Korea: Results from a hospital‐based inception cohort study (MOSAIK)
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Yonsei Medical Journal.2020; 61(10): 891. CrossRef

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Corrigenda and Errata

Corrigendum: Tofacitinib induction and maintenance therapy in East Asian patients with active ulcerative colitis: subgroup analyses from three phase 3 multinational studies: Satoshi Motoya, Mamoru Watanabe, Hyo Jong Kim, Young Ho Kim, Dong Soo Han, Hirotoshi Yuasa, Junichi Tabira, Naoki Isogawa, Shoko Arai, Isao Kawaguchi, Toshifumi Hibi; Intest Res 2018;16(3):499-501. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.499

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Citations

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Two cases in which tofacitinib effectively treated both ulcerative colitis and alopecia areata
Oki Kikuchi, Daisuke Saito, Miki Miura, Haruka Wada, Ryo Ozaki, Sotaro Tokunaga, Shintaro Minowa, Masahiro Fukuyama, Tatsuya Mitsui, Akihito Sakuraba, Mari Hayashida, Jun Miyoshi, Minoru Matsuura, Manabu Ohyama, Tadakazu Hisamatsu
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Original Article

IBD

Tofacitinib induction and maintenance therapy in East Asian patients with active ulcerative colitis: subgroup analyses from three phase 3 multinational studies: Satoshi Motoya, Mamoru Watanabe, Hyo Jong Kim, Young Ho Kim, Dong Soo Han, Hirotoshi Yuasa, Junichi Tabira, Naoki Isogawa, Shoko Arai, Isao Kawaguchi, Toshifumi Hibi; Intest Res 2018;16(2):233-245. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.233

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

Tofacitinib is an oral, small-molecule Janus kinase inhibitor being investigated for ulcerative colitis (UC). In OCTAVE Induction 1 and 2, patients with moderately to severely active UC received placebo or tofacitinib 10 mg twice daily (BID) for 8 weeks. Clinical responders in OCTAVE Induction were re-randomized to 52 weeks' therapy with placebo, tofacitinib 5 mg BID, or tofacitinib 10 mg BID.

Methods

We conducted post-hoc efficacy and safety analyses of East Asian patients in OCTAVE Induction 1 and 2 and OCTAVE Sustain.

Results

A total of 121 East Asian (Japan, Korea, and Taiwan) patients were randomized in OCTAVE Induction 1 and 2 (placebo, n=26; tofacitinib 10 mg BID, n=95), and 63 in OCTAVE Sustain (placebo, n=20; tofacitinib 5 mg BID, n=22; tofacitinib 10 mg BID, n=21). At week 8 of OCTAVE Induction 1 and 2, 18.9% of patients (18/95) achieved remission with tofacitinib 10 mg BID versus 3.8% (1/26) with placebo. In OCTAVE Sustain, the week 52 remission rates were 45.5% (10/22), 47.6% (10/21), and 15.0% (3/20) with 5 mg BID, 10 mg BID, and placebo, respectively. Adverse event rates were similar between groups in OCTAVE Induction and numerically higher with tofacitinib in OCTAVE Sustain. Serious adverse event rates were similar across groups in all studies. Infections were numerically more frequent with tofacitinib than placebo. Increases in serum lipid levels were observed with tofacitinib.

Conclusions

In East Asian patients with UC, tofacitinib demonstrated numerically greater efficacy versus placebo as induction and maintenance therapy, with a safety profile consistent with the global study population. ClinicalTrials.gov: NCT01465763; NCT01458951; NCT01458574.

Citations

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Therapeutic Advances in Gastroenterology.2023; 16: 175628482311541. CrossRef
Factors predicting clinical and endoscopic remission with placebo therapy in East Asian patients with ulcerative colitis: a systematic review and meta-analysis
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José M. Serra López-Matencio, Alberto Morell Baladrón, Santos Castañeda
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Ferdinando D’Amico, Tommaso Lorenzo Parigi, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
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Inhibitors of the Janus Kinases
Elisabetta Antonelli, Gabriele Torti, Gabrio Bassotti
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20 Web of Science
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Special Review

IBD

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment: Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang; Intest Res 2018;16(1):4-16. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.4

Abstract PDF PubReader ePub

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

Citations

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Risk of Tuberculosis and Hepatitis B Reactivation in Patients With Crohn’s Disease on Ustekinumab: A Nationwide Real-World Study
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Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
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Ten missteps in the management of inflammatory bowel disease in Asia: An expert report by the Asian Pacific Association of Gastroenterology Working Group on Inflammatory Bowel Disease
Vineet Ahuja, Ida Hilmi, Byong Duk Ye, Khoon Lin Ling, Siew C. Ng, Rupert W. Leong, Peeyush Kumar, Xin Hui Khoo, Govind K. Makharia, Jose Sollano, Pises Pisespongsa, Nazri Mustaffa, Rupa Banerjee, Alex Hwong‐Ruey Leow, Raja Affendi Raja Ali, Sai Wei Chuah
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Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
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Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients
Flora Maria Lorenzo Fortes, Raquel Rocha, Genoile Oliveira Santana
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Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy
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Miliary Tuberculosis in a Patient With Ulcerative Colitis Treated With Tofacitinib
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ACG Case Reports Journal.2023; 10(6): e01066. CrossRef
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SAGE Open Medical Case Reports.2023;[Epub] CrossRef
The safety of vedolizumab in a patient with Crohn’s disease who developed anti-TNF-alpha agent associated latent tuberculosis infection reactivation: A case report
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Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
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Frequency of Positive Conversion of Interferon-Gamma Release Assay Results Among Patients With Inflammatory Bowel Disease Treated With Non-tumor Necrosis Factor Inhibitors
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Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang
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Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study
Haruhiko Ogata, Takashi Hagiwara, Takeshi Kawaberi, Mariko Kobayashi, Toshifumi Hibi
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Targeted versus universal tuberculosis chemoprophylaxis in 1968 patients with inflammatory bowel disease receiving anti‐TNF therapy in a tuberculosis endemic region
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Comparison of outcomes of continuation/discontinuation of 5-aminosalicylic acid after initiation of anti-tumor necrosis factor-alpha therapy in patients with inflammatory bowel disease
Youn I Choi, Tae Jun Kim, Dong Kyun Park, Jun-won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim
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High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India
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9,563 View
204 Download
28 Web of Science
28 Crossref

Special Review: Consensus on TB in IBD

IBD

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management: Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang; Intest Res 2018;16(1):17-25. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.17

Abstract PDF PubReader ePub

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

Citations

Citations to this article as recorded by

Risk of Tuberculosis and Hepatitis B Reactivation in Patients With Crohn’s Disease on Ustekinumab: A Nationwide Real-World Study
Rongbei Liu, Zhilun Li, Lingna Ye, Jing Hu, Jian Tang, Baili Chen, Xiuli Chen, Bei Tan, Yubei Gu, Chen Xie, Chunhui Ouyang, Xiaomei Song, Fan Li, Yanyun Fan, Haixia Ren, Liangru Zhu, Min Chen, Wenyu Jiang, Qian Cao
Inflammatory Bowel Diseases.2024; 30(1): 45. 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
Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
Intestinal Research.2023; 21(1): 61. CrossRef
Miliary Tuberculosis in a Patient With Ulcerative Colitis Treated With Tofacitinib
Shruti Verma, Arshdeep Singh, Chandan Kakkar, Ashish Tripathi, Vandana Midha, Ajit Sood
ACG Case Reports Journal.2023; 10(6): e01066. CrossRef
IBD barriers across the continents – East Asia
Joyce Wing Yan Mak, Agnes Hiu Yan Ho, Siew Chien Ng
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Development of Spinal Tuberculosis in an Adolescent With Crohn's Disease After Infliximab Therapy: A Case Report With Literature Review
Jae Hoon Jung, Sujin Choi, Youra Kang, Dae-Chul Cho, So Mi Lee, Tae In Park, Byung-Ho Choe, Dongsub Kim, Ben Kang
Frontiers in Pediatrics.2022;[Epub] CrossRef
A case of paradoxical response during anti-tuberculosis treatment in a patient with ulcerative colitis
Shuhei Hosomi, Naoko Sugita, Atsushi Kanamori, Masaki Ominami, Koji Otani, Noriko Kamata, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Yasuhiro Fujiwara
Clinical Journal of Gastroenterology.2022; 15(3): 592. CrossRef
Prophylactic Antitubercular Therapy Is Associated With Accelerated Disease Progression in Patients With Crohn's Disease Receiving Anti-TNF Therapy: A Retrospective Multicenter Study
Fen Liu, Jian Tang, Lingna Ye, Jinyu Tan, Yun Qiu, Fan Hu, Jinshen He, Baili Chen, Yao He, Zhirong Zeng, Ren Mao, Qian Cao, Xiang Gao, Minhu Chen
Clinical and Translational Gastroenterology.2022; 13(6): e00493. CrossRef
Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab
Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang
Yeungnam University Journal of Medicine.2021; 38(3): 251. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef
Anti-tumor Necrosis Factor Agents and Tuberculosis in Inflammatory Bowel Disease
Yunho Jung
The Korean Journal of Gastroenterology.2020; 75(1): 1. CrossRef
Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy
Jihye Kim, Jong Pil Im, Jae-Joon Yim, Chang Kyun Lee, Dong Il Park, Chang Soo Eun, Sung-Ae Jung, Jeong Eun Shin, Kang-Moon Lee, Jae Hee Cheon
The Korean Journal of Gastroenterology.2020; 75(1): 29. CrossRef
Preoperative hypoalbuminemia is an independent risk factor for postoperative complications in Crohn's disease patients with normal BMI: A cohort study
Xiaolong Ge, Huaying Liu, Shasha Tang, Yan Wu, Yipeng Pan, Wei Liu, Weilin Qi, Lingna Ye, Qian Cao, Wei Zhou
International Journal of Surgery.2020; 79: 294. CrossRef
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Rupa Banerjee, Raja Affendi Raja Ali, Shu Chen Wei, Shashi Adsul
Gut and Liver.2020; 14(6): 685. CrossRef
Comparison of outcomes of continuation/discontinuation of 5-aminosalicylic acid after initiation of anti-tumor necrosis factor-alpha therapy in patients with inflammatory bowel disease
Youn I Choi, Tae Jun Kim, Dong Kyun Park, Jun-won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim
International Journal of Colorectal Disease.2019; 34(10): 1713. CrossRef
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Susan V. Lynch, Siew C. Ng, Fergus Shanahan, Herbert Tilg
Nature Reviews Gastroenterology & Hepatology.2019; 16(11): 656. CrossRef
Multidrug-resistant Disseminated Tuberculosis Related to Infliximab in a Patient with Ulcerative Colitis and Negative Evaluation for Latent Tuberculosis
Yu Kyung Jun, Jaeyoung Chun, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
The Korean Journal of Gastroenterology.2019; 74(3): 168. CrossRef
Evidence-based consensus on opportunistic infections in inflammatory bowel disease (republication)

Intestinal Research.2018; 16(2): 178. CrossRef
A rare case of disseminated histoplasmosis in a patient with Crohn’s disease on immunosuppressive treatment
Bhavesh Bhut, Akshay Kulkarni, Varnika Rai, Vinita Agrawal, Abhai Verma, Manoj Jain, Rungmei S K Marak, Ajai Kumar Dixit, Uday C Ghoshal
Indian Journal of Gastroenterology.2018; 37(5): 472. CrossRef
High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India
Ashish Agarwal, Saurabh Kedia, Saransh Jain, Vipin Gupta, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Venigalla Pratap Mouli, Rajan Dhingra, Govind Makharia, Vineet Ahuja
Intestinal Research.2018; 16(4): 588. CrossRef

6,858 View
176 Download
17 Web of Science
20 Crossref

Case Report

Crohn's disease and smoldering multiple myeloma: a case report and literature review: So Young Park, Jae Min Kim, Hyun Joon Kang, Minje Kim, Jae Joon Han, Chi Hoon Maeng, Sun Kyung Baek, Hwi-Joong Yoon, Si-Young Kim, Hyo Jong Kim; Intest Res 2017;15(2):249-254. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.249

Abstract PDF PubReader ePub

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that presents with abdominal pain, weight loss, and diarrhea. Although the etiology has not been fully elucidated, both environmental and genetic causes are known to be involved. In chronic inflammatory conditions such as IBD, B lymphocytes are chronically stimulated, and they induce monoclonal expansion of plasma cells, sometimes resulting in monoclonal gammopathy of undetermined significance. Immunomodulators that are commonly used to control inflammation, such as tumor necrosis factor-α (TNF-α) blockers could increase the possibility of hematologic malignancy. The pathogenesis of multiple myeloma in association with TNF-α inhibitor therapy is attributed to decreased apoptosis of plasma cell populations. Here, we describe a case of a 36-year-old male patient who was diagnosed with immunoglobulin A subtype smoldering multiple myeloma during the treatment for CD with infliximab and adalimumab. We report this case along with a review of the literature on cases of multiple myeloma that occurred in conjunction with CD.

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CROHN'S DISEASE AND MULTIPLE MYELOMA: A CLINICAL CASE AND LITERATURE REVIEW
O. V. Taratina, P. A. Makarchuk, L. L. Vysotskaya
Koloproktologia.2019; 18(3(69)): 84. CrossRef

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Original Article

Polymorphisms in PRKCDBP, a Transcriptional Target of TNF-α, Are Associated With Inflammatory Bowel Disease in Korean: Jung-Wook Kim, Chang Kyun Lee, Hyo Jong Kim, Jae-Jun Shim, Jae Young Jang, Seok Ho Dong, Byung-Ho Kim, Young Woon Chang, Sung-Gil Chi; Intest Res 2015;13(3):242-249. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.242

Abstract PDF PubReader

Background/Aims

Emerging data indicate that polymorphic sequence variations in the tumor necrosis factor alpha (TNF-α) gene may affect its production, and be associated with the risk of inflammatory bowel disease (IBD). PRKCDBP is a putative tumor suppressor gene and a transcriptional target of TNF-α. The aim of this case-control study is to explore the possible association of single nucleotide polymorphisms (SNPs) in PRKCDBP with the development of IBD in Koreans.

Methods

Genotyping analysis of four SNPs of PRKCDBP [rs35301211 (G210A), rs11544766 (G237C), rs12294600 (C797T), and rs1051992 (T507C)] was performed on 170 ulcerative colitis (UC),131 Crohn's disease (CD) patients, and 100 unrelated healthy controls using polymerase chain reaction and restriction fragment length polymorphism.

Results

Heterozygous configuration of three SNPs (G210A, G237C, and C797T) was very rare in both patients and healthy controls. However, allele frequencies of the T507C SNP showed a significant difference between UC patients and controls (P=0.037). The CC genotype of the T507C SNP was identified in 46.6% (61 of 131) of CD and 49.4% (84 of 170) of UC patients, but only in 33.0% (33 of 100) of healthy controls. Furthermore, CC homozygosity was more prevalent than TC heterozygosity in both CD and UC patients versus controls (P=0.016; gender-adjusted odds ratio [aOR], 2.16; 95% confidence interval [CI], 1.16-4.04 and P=0.009; aOR, 2.09; 95% CI, 1.193.64; respectively)

Conclusions

Our results suggest that the T507C SNP in PRKCDBP, a TNF-α-inducible gene, might be associated with susceptibility to IBD (particularly UC) development in Koreans.

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Comprehensive analysis of key host gene-microbe networks in the cecum tissues of the obese rabbits induced by a high-fat diet
Yanhong Li, Xiaolan Qi, Qinrong Wang, Yan He, Zhupeng Li, Xi Cen, Limin Wei
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
IL-32 gamma reduces lung tumor development through upregulation of TIMP-3 overexpression and hypomethylation
Jaesuk Yun, Mi Hee Park, Dong Ju Son, Kyung Tak Nam, Dae Bong Moon, Jung Heun Ju, Ok Kyung Hwang, Jeong Soon Choi, Tae Hoon Kim, Young Suk Jung, Dae Yeon Hwang, Sang Bae Han, Do-Young Yoon, Jin Tae Hong
Cell Death & Disease.2018;[Epub] CrossRef
The Correlation of Serum IL-12B Expression With Disease Activity in Patients With Inflammatory Bowel Disease
Hye Won Lee, Sook Hee Chung, Chang Mo Moon, Xiumei Che, Seung Won Kim, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Medicine.2016; 95(23): e3772. CrossRef

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Case Reports

A Case of Cholangiocarcinoma and Colorectal Cancer Diagnosed Simultaneously in a Patient with Ulcerative Colitis and Concurrent Primary Sclerosing Cholangitis: Eun Yeong Kim, Hyo Jong Kim, Chang Kyun Lee, Choul Ki Park, Hee Jae Hyun, Yeon Ju Kim, Kyung Yup Kim; Intest Res 2012;10(4):392-396. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.392

Abstract PDF

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) accompanied by a risk to develop colorectal dysplasia and cancer. Primary sclerosing cholangitis (PSC) is strongly associated with UC and there are some distinguishing clinical features between UC patients with PSC (UC-PSC) and UC patients without PSC. The most important feature is that UC patients with concomitant PSC are at a significantly increased risk of developing colorectal dysplasia or cancer. Furthermore, it has been suggested that patients with UC and PSC are also at an increased risk of cholangiocarcinoma. We report a case of cholangiocarcinoma and colorectal cancer diagnosed simultaneously in a patient with UC and concurrent PSC. He was diagnosed with UC and PSC 13 years ago and had been treated irregularly. Surveillance colonoscopy and biopsies were performed and one of the biopsied specimen confirmed adenocarcinoma. He underwent abdominal computed tomography (CT) because of the abnormal liver function test and the CT showed cholangiocarcinoma. To the best of our knowledge, this is the first case report of a UC-PSC with cholangiocarcinoma and colorectal cancer at the same time in Korea. (Intest Res 2012;10:392-396)

Citations

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Colon Cancer Screening and Surveillance in Inflammatory Bowel Disease
Song I Bae, You Sun Kim
Clinical Endoscopy.2014; 47(6): 509. CrossRef

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1 Crossref

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome in a Patient on Sulfasalazine for Ulcerative Colitis: Kyung Hwan Kang, Chang Kyun Lee, Hyo Jong Kim, Jaejun Shim, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang; Intest Res 2012;10(4):383-387. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.383

Abstract PDF: Drug rash with eosinophilia and systemic symptoms (DRESS) is a life-threatening systemic drug reaction characterized by fever, rash, hematological abnormalities, lymphadenopathy, and multiple internal organ involvement. Unfortunately, a long latency period as well as clinicians' unawareness of the disease entity often results in a delay of prompt diagnosis and treatment in clinical practice. A search of the literature revealed only few reports on DRESS in patients with inflammatory bowel diseases. The pathogenesis of the disease is not clearly understood, although several possible mechanisms, such as drug detoxification, slow acetylation, and reactivation of human herpes viruses, have been proposed in its development. Here, we present a rare case of DRESS associated with viral reactivation and defects in drug metabolism in a 22-year-old man who had been on sulfasalazine for 6 weeks to treat ulcerative colitis. (Intest Res 2012;10:383-387)

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Original Articles

Predictors of Steroid Treatment Failure and Validation of Previous Models for Severe Attacks of Ulcerative Colitis: Jung-Wook Kim, Hyo Jong Kim, Chang Kyun Lee, Hyuck Kim, A Ri Shin, Kyung Hwan Kang, Min Kyoung Kim, Hyun Jin Park, Hoe Hoon Chung, Eun Jung Hwang; Intest Res 2012;10(3):251-264. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.251

Abstract PDF

Background/Aims
Some clinical and laboratory parameter are predictors to determine steroid treatment failure in patients acute severe ulcerative colitis. We aimed to validate previous models in the Korean patients. Methods: This study was conducted retrospectively with 70 patients who were diagnosed with severe ulcerative colitis (UC) between January 2001 and June 2011. The rate of treatment failure was investigated using predictors or numerical scoring systems from prior studies. Results: Twelve (17.2%) patients failed to respond to steroid therapy. The logistic regression analysis revealed that stool frequency on the fifth day and colonic dilatation were the only independent predictive factors related to treatment failure. Formulated numerical risk scores based on mean stool frequency, colonic dilatation, and hypoalbuminemia were significantly higher in the non-responding group than those in the responding group (P＜0.001). Using another scoring system (stool frequency on the third day＋1.4×C-reactive protein [CRP]), treatment failure rate was significantly higher in the group in which the score was ＞8 than in the group with a score ＜8 (30.8% vs. 8.6%, P=0.042). Lastly, treatment failure rate was higher in the group (stool frequency ＞8 plus CRP ＞4.5 mg/dL or bloody stool plus CRP ＞4.3 mg/dL) than those of the other group at the third day (40% vs. 7.3%, P=0.004; 33.3% vs. 5.2%, P=0.014, respectively). Conclusions: Stool frequency and CRP level were the meaningful parameters among the predictors for steroid treatment response. Furthermore, several predictive models for steroid treatment failure in western countries seem to be of value for use in the Korean population. (Intest Res 2012;10: 0-264)

Citations

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Short- and Long-Term Outcomes of Acute Severe Ulcerative Colitis in Korea
Ho-Su Lee, Suk-Kyun Yang, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Hyo Jeong Lee, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim
Inflammatory Bowel Diseases.2015; 21(8): 1825. CrossRef

2,255 View
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1 Crossref

Efficacy of Infliximab Rescue Therapy in Hospitalized Patients with Steroid-Refractory Ulcerative Colitis: Single Center Experience: Jun Hyung Cho, Chang Kyun Lee, Hyo Jong Kim, Jae Jun Shim, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang; Intest Res 2012;10(2):152-160. Published online April 30, 2012; DOI: https://doi.org/10.5217/ir.2012.10.2.152

Abstract PDF

Background/Aims
In hospitalized patients with acute steroid-refractory UC, infliximab has been demonstrated to be one of the medical rescue therapies to avoid colectomy. We report the result of a retrospective observational study to find the efficacy and safety of infliximab as a rescue therapy in our hospital. Methods: Between January 2007 and January 2010, 9 hospitalized patients with steroid-refractory UC were selected to receive three infusions of infliximab (5 mg/kg), at weeks 0, 2, and 6. Efficacy of treatment was evaluated at 8 weeks after the first infliximab infusion and at the end of follow-up period. Adverse events related to infliximab rescue therapy were also collected. Results: Seven patients (77.8%) had completed 3 infusions of infliximab and achieved clinical response at 8 weeks after the first infliximab infusion. Clinical remission rate and the rate of mucosal healing at 8 weeks were 57.1% (4/7) and 71.4% (5/7), respectively. They were followed up for median time of 24.9 months (19.5-53.6 months). One patient underwent emergency colectomy at weeks 2, due to colon perforation, while another patient had discontinued infliximab treatment at weeks 4, because of Clostridium difficile-associated colitis. Finally, colectomy was avoided in 77.8% (7/9) of cases. There was no mortality. Conclusions: Rescue therapy with infliximab has sustained clinical benefit in 88.9% of our hospitalized patients with acute steroid-refractory UC. Future prospective and long-term follow-up trials with a large number of patients are needed to confirm the efficacy and safety of the treatment. (Intest Res 2012;10: 0-160)

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Differences in the Prognosis according to the Periods of Diagnosis in Ulcerative Colitis
Hyun Beom Chae, Yoon Suk Jung, Dong Il Park, Chang Kyun Lee, Kyu Chan Huh, Jeong Eun Shin, Jae Hak Kim, You Sun Kim, Yunho Jung, Sung Ae Jung, Hyun Ju Song, Hyun Joo Jang, Sung Noh Hong, Young-Ho Kim
The Korean Journal of Gastroenterology.2014; 64(2): 93. CrossRef

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Special Reviews

Korean Guidelines for Post-polypectomy Colonoscopic Surveillance: Dong-Hoon Yang, Sung Noh Hong, Young-Ho Kim, Sung Pil Hong, Sung Jae Shin, Seong-Eun Kim, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):89-109. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.89

Abstract PDF

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available. (Intest Res 2012;10:89-109)

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A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
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Risk of advanced colorectal neoplasm by the proposed combined United States and United Kingdom risk stratification guidelines
Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
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Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2018; 88(4): 715. CrossRef
Number of advanced adenomas on index colonoscopy: Important risk factor for metachronous advanced colorectal neoplasia
Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Digestive and Liver Disease.2018; 50(6): 568. CrossRef
Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis
Soon Young Kim, Tae Il Kim
Intestinal Research.2018; 16(3): 358. CrossRef
Do Serrated Polyps Increase the Risk of Colorectal Cancer Development?
Su Hwan Kim, Ji Won Kim
The Korean Journal of Gastroenterology.2016; 67(3): 161. CrossRef
Metabolic syndrome is a risk factor for adenoma occurrence at surveillance colonoscopy
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Medicine.2016; 95(32): e4454. CrossRef
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Kyeong Ok Kim
Intestinal Research.2014; 12(1): 83. CrossRef
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Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef

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Korean Guidelines for Colorectal Cancer Screening and Polyp Detection: Bo In Lee, Sung Pil Hong, Seong-Eun Kim, Se Hyung Kim, Hyun-Soo Kim, Sung Noh Hong, Dong-Hoon Yang, Sung Jae Shin, Suck-Ho Lee, Young-Ho Kim, Dong Il Park, Hyun Jung Kim, Suk-Kyun Yang, Hyo Jong Kim, Hae Jeong Jeon, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):67-88. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.67

Abstract PDF

Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods. Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations. (Intest Res 2012;10:67-88)

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Marta Maes‐Carballo, Manuel García‐García, Yolanda Gómez‐Fandiño, Carlos Roberto Estrada‐López, Andrés Iglesias‐Álvarez, Aurora Bueno‐Cavanillas, Khalid Saeed Khan
European Journal of Cancer Care.2022;[Epub] CrossRef
Syndecan-2 Methylation as a New Biomarker for Early Detection of Colorectal Neoplasm
Ji Hyun Kim, Sung Chul Park
Gut and Liver.2018; 12(5): 479. CrossRef
Association between dietary fat intake and colorectal adenoma in korean adults
Jeehyun Kim, Seung-Won Oh, Young-Sun Kim, Hyuktae Kwon, Hee-Kyung Joh, Ji-Eun Lee, Danbee Park, Jae-Hong Park, Ah-Ryoung Ko, Ye-Ji Kim
Medicine.2017; 96(1): e5759. CrossRef
Anaphylactic Shock Caused by Ingestion of Polyethylene Glycol
Sun Hee Lee, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Il Hyun Baek, Jung Won Jeon, Jun Uk Lim, Jung Lok Lee, Hyae Min Lee, Young-Hak Cho
Intestinal Research.2015; 13(1): 90. CrossRef
Fasting serum insulin levels and insulin resistance are associated with colorectal adenoma in Koreans
Eun Hee Kim, Hong‐Kyu Kim, Sung Jin Bae, Hye‐Sook Chang, Hye Won Park, Mi Young Do, Kyung‐Jo Kim, Chang Hee Jung, Woo Je Lee, Joong‐Yeol Park, Jaewon Choe
Journal of Diabetes Investigation.2014; 5(3): 297. CrossRef
Correlation between Adenoma Detection Rate and Advanced Adenoma Detection Rate
Shin Yeoung Lee, Nam Hee Kim, Hyun Beom Chae, Ki Joong Han, Tae Hoon Lee, Choel Min Jang, Kyung Mo Yoo, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Dong Il Park
The Korean Journal of Gastroenterology.2014; 64(1): 18. CrossRef
Difference in Adenoma Detection Rates according to Colonoscopic Withdrawal Times and the Level of Expertise
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The Korean Journal of Gastroenterology.2014; 64(5): 278. CrossRef

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Korean Guidelines for Colonoscopic Polypectomy: Suck-Ho Lee, Sung Jae Shin, Dong Il Park, Seong-Eun Kim, Sung Pil Hong, Sung Noh Hong, Dong-Hoon Yang, Bo In Lee, Young-Ho Kim, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):110-124. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.110

Abstract PDF

There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action. (Intest Res 2012;10:110-124)

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Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus Intramucosal Carcinoma
Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef

2,543 View
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1 Crossref

Original Articles

A Korean National Survey for Treatment Modality in Colon Polypectomy: Sung Jae Shin, Suck-Ho Lee, Dong Il Park, Sung Noh Hong, Seong-Eun Kim, Dong-Hoon Yang, Sung Pil Hong, Bo In Lee, Hyun Soo Kim, Young-Ho Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Multi-Society Task Force for the Guidelines for Colorectal Polyp Screening, Surveillance and Managem; Intest Res 2011;9(3):196-205. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.196

Abstract PDF

Background/Aims
There are no evidence-based, procedural guidelines to appropriately perform a colon polypectomy. Thus, we investigated the treatment modality for colon polypectomy in Korea, using a web-based e-mail survey. Methods: A questionnaire of preferred treatment modality for colon polypectomy was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who performed colonoscopies as a screening or surveillance program nationwide. Among 425 colonoscopists who were sent the e-mail, 263 replied. We analysed data from 252 colonoscopists who had performed colon polypectomies. Results: The stopping time for antiplatelet and anticoagulation therapy before a colon polypectomy had a tendency to increase and the restarting time for these drugs was delayed as polyp size increased. Colonoscopists preferred cold biopsy removal for polyps <5 mm in size and a hot snare polypectomy after injecting normal saline and epinephrine mixture for polyps ≥5 mm in size. More than half of colonoscopists preferred observation rather than additional procedures for adenomas with incomplete resection. In contrast, most colonoscopists recommended additional procedures, such as endoscopic mucosal resection, endoscopic submucosal dissection or surgery for an advanced adenoma with incomplete resection. The most preferred prophylactic treatment for immediate postpolypectomy bleeding washemoclipping. Conclusions: Various treatment modalities were used for a colon polypectomy because there are few guidelines for performing a colon polypectomy based on a critical review of the available data. Further well-designed, prospective studies are needed to develop evidence-based guidelines for colon polypectomy. (Intest Res 2011;9:196- 205)

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A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Cold polypectomy techniques for small and diminutive colorectal polyps: a systematic review and network meta-analysis of randomized controlled trials
Mohamed Abuelazm, Ahmed K. Awad, Islam Mohamed, Abdelrahman Mahmoud, Hosam Shaikhkhalil, Nour Shaheen, Omar Abdelwahab, Ahmed M. Afifi, Basel Abdelazeem, Mohamed O. Othman
Current Medical Research and Opinion.2023; 39(10): 1329. CrossRef
Risk of post-polypectomy bleeding after endoscopic mucosal resection in patients receiving antiplatelet medication: comparison between the continue and hold groups
Sang Hyun Park, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Surgical Endoscopy.2022; 36(9): 6410. CrossRef
Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study
Dong-Hoon Yang, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Panida Piyachaturawat, Thida Soe, Zhiqin Wong, Jeong-Sik Byeon
Gut and Liver.2021; 15(3): 391. CrossRef
Comparative efficacy of cold polypectomy techniques for diminutive colorectal polyps: a systematic review and network meta-analysis
Yoon Suk Jung, Chan Hyuk Park, Eunwoo Nam, Chang Soo Eun, Dong Il Park, Dong Soo Han
Surgical Endoscopy.2018; 32(3): 1149. CrossRef
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Jun Lee
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6 Crossref

A Survey for Post-polypectomy Surveillance: Sung Noh Hong, Dong-Hoon Yang, Young-Ho Kim, Seong-Eun Kim, Sung Jae Shin, Sung Pil Hong, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Multi-Society Task Force for the Guidelines for Colorectal Polyp Screening, Surveillance and Managem; Intest Res 2011;9(2):118-128. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.118

Abstract PDF

Background/Aims
There is a paucity of information on postpolypectomy surveillance currently practiced in Korea. Thus, we investigated the present state of postpolypectomy surveillance in Korea using a web-based survey. Methods: A multiple choice questionnaire was used to determine the preferred surveillance modality, the colonoscopic surveillance interval used in 11 case scenarios, and clinical factors influencing surveillance intervals. The form was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians involved in a colonoscopy surveillance program. Of 425 colonoscopists contacted, 263 replied (response rate, 62%). Of the respondents, 94% were internists and 54% practiced in tertiary referral hospitals. Results: All respondents chose colonoscopy as a preferred surveillance modality following polyp removal. Colonoscopy at 3 years was the most frequent answer after removal of 1 or 2 tubular adenoma(s) ＜1 cm in size, while 1 year was the most frequent answer after removal of an advanced adenoma or ≥3 adenomas, and 6 months was the most frequent choice after removal of adenoma with high-grade dysplasia or a sessile polyp ≥2 cm. The agreement rate for the time of first surveillance between preferred guideline recommendations and respondent answers was in the low range at 14-43%. Conclusions: A significant disagreement exists between current postpolypectomy surveillance practices of Korean colonoscopists and preferred guideline recommendations. This discrepancy may be due to the fact that the guidelines do not reflect recent studies and the specific medical environment in Korea. Thus, there is a need to develop new evidence-based Korean guidelines for postpolypectomy surveillance. (Intest Res 2011;9:118-128)

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A survey of current practices in post-polypectomy surveillance in Korea
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A Survey of Colonoscopic Surveillance After Polypectomy
Dae Kyung Sohn
Annals of Coloproctology.2014; 30(2): 88. CrossRef
Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus Intramucosal Carcinoma
Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef
A Korean National Survey for Colorectal Cancer Screening and Polyp Diagnosis Methods Using Web-based Survey
Seong-Eun Kim, Sung Pil Hong, Hyun-Soo Kim, Bo In Lee, Se Hyung Kim, Sung Noh Hong, Dong-Hoon Yang, Suck Ho Lee, Sung Jae Shin, Dong Il Park, Young-Ho Kim, Suk-Kyun Yang, Hyo Jong Kim
The Korean Journal of Gastroenterology.2012; 60(1): 26. CrossRef

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Case Reports

Two Cases of Crohn's Disease Presented with Hematochezia in Patients with Hemophilia: Jae Hyun Park, Hyo Jong Kim, Seong Dong Sohn, Young Hwangbo, Jaejun Shim, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Rin Chang; Intest Res 2011;9(1):35-39. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.35

Abstract PDF: The etiology of Crohn's disease, which is a chronic inflammatory condition that potentially involves any location of the alimentary tract from the mouth to the anus, is unknown. However, there is strong evidence that vascular damage could play a role in the pathogenesis of Crohn's disease. Crohn's disease is mediated by multifocal gastrointestinal infarctions, which occur at an early stage in the disease process. Persistent activation of coagulation in patients with Crohn's disease has been shown. In contrast, hemophilia is an inherited disorder of coagulation. The deficiencies of clotting factors usually involve occult or overt bleeding. The pathogenic mechanisms of Crohn's disease and hemophilia are incompatible. An association between Crohn's disease and hemophilia has not been reported in Korea. We managed 21- and 33-year-old men with Crohn's disease associated with hemophilia, who presented with hematochezia. (Intest Res 2011;9: 9-39)

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Pseudo-Obstruction of Jejunum due to AA Amyloidosis Associated with Latent Syphilis: Young Hwangbo, Hyo Jong Kim, Jae Yeon Lee, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Rin Chang; Intest Res 2010;8(2):195-199. Published online December 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.2.195

Abstract PDF: Amyloidosis uncommonly presents with intestinal pseudo-obstruction. According to previous reports, patients with primary AL amyloidosis presented with a chronic process with symtom duration of more than 1 year, but patients with secondary AA amyloidosis presented as an acute illness, usually less than 10 weeks. Localized gastrointestinal amyloidosis limited to the jejunum, without involvement of stomach, duodenum, colon, or rectum, is very rare. Imaging studies in small intestinal amyloidosis generally show a symmetrical uniform appearance. AA amyloidosis with acute-phase reactant serum amyloid A protein is associated with inflammatory, infectious or neoplastic disorders. To our knowledge, no case of amyloidosis associated with latent syphilis has been reported to date. We present a case of a 56-year-old man who presented with clinical and radiographic features of a small bowel obstruction and obscure gastrointestinal bleeding. Investigations including laparoscopy and other laboratory dataled to a diagnosis of pseudo-obstruction of the jejunum due to AA amyloidosis associated with latent syphilis. After appropriate treatment for latent syphilis, abdominal symptoms had been disappeared, but jejunal dilatation was still present two years later. (Intest Res 2010;8:195-199)

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Original Article

Change of Circulating Leptin, Adiponectin, Resistin, and Visfatin Level after Treatment of Patients with Active Inflammatory Bowel Disease: Young Hwangbo, Hyo Jong Kim, Jaejun Shim, Jae Young Jang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang; Intest Res 2010;8(2):151-161. Published online December 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.2.151

Abstract PDF

Background/Aims
The aim of this study was to evaluate the change in circulating levels of adipokines, including leptin, adiponectin, resistin, and visfatin, after induction therapy of patients with active inflammatory bowel disease (IBD). Methods: We prospectively evaluated 20 patients with Crohn's disease (CD) and 14 patients with ulcerative colitis (UC) who received induction therapy. The disease activity, body mass index (BMI), and C-reactive protein (CRP) and serum adipolines levels were checked before treatment and 10 weeks after treatment. Results: After induction therapy, significant reduction of disease activity was noted in patients with CD (CD activity index, 267.9±73.7 vs. 50.8±36.5, P＜0.001) and patients with UC (Mayo score, 9.8±2.2 vs. 1.4±1.6, P＜0.001). The mean serum leptin, adiponectin, resistin, and visfatin levels were 4.0±2.7 ng/mL and 4.4±2.3 ng/mL (P=0.323), 27.0±20.5 Ռg/mL and 33.8±26.5Ռg/mL (P=0.084), 9.0±4.0 ng/mL and 10.2±3.2 ng/mL (P=0.108), and 4.6±3.7 ng/mL and 2.5±4.1 ng/mL (P=0.046) before and after infliximab treatment, respectively. No significant correlation between the changes in BMI, CRP level, or the clinical indices of activity and alterations of the measured adipokines was demonstrated. Conclusions: The serum levels of leptin, adiponectin, and resistin showed no significant alterations, whereas the serum visfatin level decreased significantly after induction therapy, suggesting a possible pro-inflammatory property of visfatin and a role as a marker of successful therapy of IBD. (Intest Res 2010;8:151-161)

Citations

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Circulating Ghrelin Levels and Obestatin/Ghrelin Ratio as a Marker of Activity in Ulcerative Colitis
Ja Young Jung, Ji Bong Jeong, Ji Won Kim, Su Hwan Kim, Seong-Joon Koh, Byeong Gwan Kim, Kook Lae Lee
Intestinal Research.2015; 13(1): 68. CrossRef

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Review

Prevention of Post-operative Recurrence in Crohn's Disease: Hyo Jong Kim; Intest Res 2008;6(1):1-7. Published online June 30, 2008

Abstract PDF: At one year after a first resection in patients with Crohn's disease, up to 80% of patients show endoscopically-determined recurrence of disease, 10-20% have a clinical relapse and 5% have to undergo surgery again. However, there are currently no guidelines for the postoperative maintenance therapy for patients with Crohn's disease, and considerable uncertainty remains as to the efficacy of the various postoperative treatments. New lesions can be visualized endoscopically within weeks to months after performing ileal resection and creating an ileocolonic anastomosis in the neoterminal ileum. The evolution of these lesions mimics the natural history of ileal Crohn's disease at the onset. If we are able to prevent the recurrence of early lesions, then we will probably interrupt the natural course of this disease. Since there is a lag time of months to years between the development of recurrent lesions in the bowel and the recurrence of symptoms, we recommend performing endoscopy of the bowel 6 months after the initial operation to assess the severity of recurrence, and the strategy for further treatment should be based on this assessment. The development of explicit criteria for the appropriateness of various postoperative treatment regimens is needed to aid physicians when they making the clinical decisions in this context. (Intest Res 2008;6:1-7)

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Original Article

Clinical Significance of Screening Colonoscopy in Elderly: A KASID Multi-center Study: Sung Geun Park, Dong Il Park, Young-Ho Kim, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2008;6(1):25-30. Published online June 30, 2008

Abstract PDF: Background/Aims
Currently, screening colonscopy is widely performed in the medical field. The initial time of screening is recommended at an age of 50 years, but the age to cease screening is unknown. Accordingly, we have investigated the diagnostic yield of colonoscopy according to indications in the elderly, and we evaluated if screening colonoscopy is useful in the elderly. Methods: We recruited asymptomatic individuals undergoing screening colonoscopy according to age (2830 subjects aged 50-74 years and 111 subjects ≥75 years-old), The colonoscopy findings of the study subjects were compared. In addition, colonoscopy findings of asymptomatic subjects more than 75 years-old were compared with the findings of symptomatic subjects with the same age. Results: The yield for overall neoplasia and advanced adenoma was higher in the group of subjects ≥75 years-old than in the 50-74 years age group (overall adenoma: 49.54% versus 24.98%, p＜0.001; advanced adenoma: 16.2% versus 8.23%, p=0.003). The overall frequency of neoplasms was higher in asymptomatic subjects ≥75 years-old than in symptomatic subjects ≥75 years-old (49.54% versus 28.19%, p＜0.001). Conclusions: The prevalence of advanced adenoma increased with age. Screening colonoscopy was still significantly effective in elderly subjects ≥75 years-old. The lack of a decline in the frequency of adenoma, including advanced adenoma, justifies continuing screening colonoscopy in the elderly. (Intest Res 2008;6:25-30)

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Case Report

A Case of Sigmoidorectal Intussusception after Self-Expandable Colonic Stent Placement: Chang Kyun Lee, Hyo Jong Kim, Jae Young Jang, Seok Ho Dong, Byung-Ho Kim, Young Woon Chang, Rin Chang, Hyoung Jung Kim, Kil Yeon Lee; Intest Res 2008;6(1):70-75. Published online June 30, 2008

Abstract PDF: Self-expandable metallic stents are widely used to relieve acute colorectal obstruction that's secondary to malignancy. They are utilized for both palliation and preoperative decompression prior to colorectal surgery. Although stents have been documented as a relatively safe therapeutic modality, procedure-related complications such as perforation, bleeding, stent reobstruction and migration can occur during or after colonic stent placement. Therefore, clinicians must be aware of the various complications associated with colonic stent placement. We present here a very rare case of sigmoidorectal intussusception that developed after fluoroscopic placement of a self-expandable metallic stent for preoperative decompression of sigmoid colon cancer. We misdiagnosed the intussusception as a distal stent migration on the plain radiography. On the sigmoidoscopic examination to evaluate the unrelieved colonic obstruction, we diagnosed a sigmoidorectal intussusception of the stent-implanted malignant tumor. The patient was successfully treated by laparoscopic partial reduction, followed by a curative anterior resection. This case demonstrates that careful examination must be done in cases of unrelieved colonic obstruction with suspicious stent migration, and intussusception must be considered as a rare complication of self-expandable metallic stent placement in the colon. (Intest Res 2008;6:70-75)

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Original Articles

Molecular Characterization of hSRBC, a Candidate Tumor Suppressor Gene anda Upstream Regulator of p53 in Human Colon Cancer: Wan Jung Kim, Hyo Jong Kim, Sung-Gil Chi, Jin Oh Kim, Joo Young Cho, Chan Sup Shim; Intest Res 2007;5(2):131-143. Published online December 30, 2007

Abstract PDF: Background/Aims
hSRBC [human Serum deprivation response (sdr)-Related gene product that Binds to c-kinase] was identified using PKCδ or BRCA1 as a probe and located at 11p15.5-p15.4 region. Expression of hSRBC protein was also decreased in a number of breast, lung, and ovarian cancer cell lines, suggesting that hSRBC might be a putative tumor suppressor gene. Methods: The expression status of hSRBC was analyzed in 50 primary colon tumors and their adjacent 50 normal tissues, and 20 colon cancer cell lines. Transcript and protein expression of hSRBC was studied by quantitative RT-PCR and Western blot, respectively. siRNA-mediated knockdown of hSRBC expression was utilized to investigate its association with p53. Results: The mRNA expression of hSRBC was decreased in 60% (12/20) of colon cancer cell lines and 44% (22/50) of patient's colon cancer tissues. Expression of hSRBC mRNA was significantly decreased in tumors compared to non-cancerous cells, while genomic level of hSRBC was not decreased in tumors. hSRBC expression was increased by 5-aza-2’-deoxycytidine treatment and hypermethylation of CpG sites was strongly associated with decreased expression. Ectopic transfection of hSRBC suppressed RKO cell count and hSRBC knockdown by siRNA augmented HCT116 cell numbers. Flow cytometry showed G1 arrest and apoptosis of colon cancer cells by restoration of hSRBC expression in RKO cells. Both basal and etoposide-mediated p53 expression was decreased when hSRBC expression was knockdowned with siRNA. Conclusions: hSRBC expression is frequently decreased by promoter CpG site hypermethylation. hSRBC down-regulates p53 expression in G1 phase and might be a novel upstream regulator of p53. (Intest Res 2007;5:131-143)

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Factors Affecting the Efficacy of Tegaserod in Patients with Chronic Constipation: Hwang Choi, Sang Heon Yoon, Won Chul Lee, Joo Sung Kim, Dong Kyung Chang, Yoon Tae Jeen, Jin Oh Kim, Dong Soo Han, Hyo Jong Kim, Sang Yong Seol, Won Ho Kim, Suk Kyun Yang, Jin Ho Kim; Intest Res 2007;5(2):170-176. Published online December 30, 2007

Abstract PDF: Background/Aims
The effect of tegaserod has been found to differ for Caucasian and black patients. The aims of this study were to demonstrate the efficacy of tegaserod on bowel habits and to investigate the factors affecting the efficacy of tegaserod in Korean patients suffering from chronic constipation (CC). Methods: This was an open-label, multi-center, observational study. Analysis of covariance with repeated measures was used to determine the overall effect of treatment and was used to determine the changes in the number of complete spontaneous bowel movements (CSBM) from baseline during the 8-week treatment period. Demographic and baseline characteristics were compared between responders (3 or more CSBM at 8-weeks) and non-responders by the use of multivariate analysis. Results: A total of 1,798 patients were included in the study. Tegaserod treatment resulted in a significant increase in the mean number of CSBM per week over weeks 2-8 from baseline levels (from 1.0 to 3.1 CSBM per week, p＜0.0001). Tegaserod treatment was more effective for female patients, younger patients (age less than 65 years), patients with a high Bristol score at baseline, and patients with a short duration of constipation symptoms. Conclusions: Treatment with tegaserod improved bowel movements and more effective in female patients, patients under the age of 65 years, patients with a high Bristol score at baseline, and patients with a short duration of constipation symptoms. (Intest Res 2007;5:170-176)

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Promoter CpG Hypermethylation and Downregulation of Caveolin Expression in Human Colon Cancers: Nam Hoon Kim, Hyo Jong Kim, Sung Gil Chi, Young Soo Moon; Intest Res 2007;5(1):60-72. Published online June 30, 2007

Abstract PDF: Background/Aims
Abnormal reduction of caveolins has been found in many human cancers while its overexpression also correlates with increased metastatic progression of some tumors. To elucidate the possible implication of caveolin abnormality in human colon tumorigenesis, the expression and mutational status of caveolins was explored. Methods: We investigated 11 human colon cancer cell lines, 49 primary carcinoma tissues, and its matched normal colonic tissues. Both mRNA and protein levels of caveolins (cav-1, cav-2) were evaluated by quantitative RT-PCR and immunoblotting. Effect of cav-1 expression on tumor growth was tested using cell counting and colony formation assay. Cav-1 expression was restored in nonexpressing cells, whereas cav-1 expression was inhibited by siRNA-mediated knockdown in expressing cells. Methylation status of 38 CpG sites was evaluated by bisulfite DNA sequencing. Results: Low expression of cav-1 transcript was found in 54.5% of cancer cell lines, whereas 45.5% of those showed strong expression. Expression level of cav-1 protein was very low in majority of cancer cell lines except two cell lines. Approximately 47% and 10% of primary carcinomas exhibited significant reduction and elevation in cav-1 expression, respectively. Cav-2 expression also showed down- and up-regulation in 28% and 3% of primary tumors, respectively. Cav-1 transcript was re-expressed in nonexpressing cells by 5-aza-dC treatment. Restoration of cav-1 inhibited growth of cav-1-negative cells and reduced phospho-Erk level, whereas ectopic overexpression of cav-1 further stimulated cav-1-expressing cells and activated p53 and p21. Conclusions: Caveolin undergoes epigenetic silencing in a considerable proportion of human colon cancers by aberrant promoter CpG hypermethylation. Also, cav-1 acts two opposite functions as a growth suppressor or growth stimulator in colon cancers. (Intest Res 2007;5:60-72)

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Review

TLR Signaling in Intestinal Epithelial Tolerance of Commensals: Sang Kil Lee, Hyo Jong Kim; Intest Res 2005;3(2):91-95. Published online December 30, 2005

Abstract PDF: Toll-like receptors (TLR) is emerging as a key mediator of innate host defense in the intestinal mucosa, crucially involved in maintaining mucosal as well as commensal homeostasis. Through spatial and functional localization of TLR, the normal gut maintains a state of controlled inflammation, By contrast, patients with inflammatory bowel disease (IBD) demonstrated inflammation in response to the normal flora. Recent observations suggest new (patho-) physiologic mechanisms of how functional versus dysfunctional TLR pathways may oppose or favor IBD. A better understanding of the delicate regulation of TLR in the gut may lead to improved treatment for enteric infections and IBD. (Intestinal Research 2005;3:91-95)

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Original Article

Clinical Value of Distal Colon Polyps for Prediction of Advanced Proximal Neoplasia: The KASID Prospective Multicenter Study: Bora Keum, Yoon Tae Jeen, Jai Hyun Choi, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2005;3(2):121-126. Published online December 30, 2005

Abstract PDF: Backgroud/Aims: Proximal lesion without distal finding is weak point in colon cancer screening. Clinical significance of distal finding for advanced proximal neoplasia (APN) is uncertain. Aims of this study were to assess distal finding for prediction of APN. Methods: Asymptomatic 826 adults (age≥50) were collected in KASID prospective study, who underwent colonoscopy and polypectomy. Polyps located distal to splenic flexure were defined as distal polyps. Age, gender, size, appearance, histology of distal polyps were analyzed as risk factor of APN (adenoma≥10 mm or villous histology or high grade dysplasia or invasive cancer). Sensitivity and positive predictive value of distal polyp on APN were assessed. Results: APN were found in 98 patients and 45 (45.9%) patients of them were not associated with any distal findings. Risk factors of APN were male, size of distal polyp and advanced distal polyp. Sensitivity of distal polyp size≥10 mm on APN was 38.8% and advanced distal polyp also 38.8%. Positive predictive value of distal polyp size≥10 mm and advanced distal polyp were 13.3%, 14.4% respectively. Conclusions: Although distal colon findings were helpful to predict APN in asymptomatic 50 years of age or order patients screening, more careful examination is required considering APN without distal polyps. (Intestinal Research 2005;3:121-126)

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