Intestinal Research

Real-world use of biologics during the first year of treatment for newly diagnosed Crohn’s disease in Japan: a claims analysis from 2010 to 2021: Jun Miyoshi, Annabelle Yoon, Minoru Matsuura, Tadakazu Hisamatsu; Received June 5, 2024 Accepted October 5, 2024 Published online January 23, 2025; DOI: https://doi.org/10.5217/ir.2024.00082 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Crohn’s disease (CD) leads to bowel damage and disability if suboptimally treated. We investigated firstyear treatment decisions and real-world use of biologics in patients with CD in Japan.
Methods
In this retrospective observational study (2010–2021) from the JMDC claims database, patients with a new diagnosis of CD (no CD claims record within 12 months before index) who received ≥ 1 pre-defined treatment were grouped by use of biologics and systemic corticosteroids (SCS) within the first year of diagnosis.
Results
Of 823 patients included, 470 (57.1%) were prescribed biologics and 353 (42.9%) were not; 77.6% were male, 75.7% had adult-onset CD, and median age was 24 years. Patients prescribed biologics were younger (median: 23 years vs. 28 years) and more had perianal lesions (43.0% vs. 22.9%) than those not prescribed biologics; 64.9% (95% confidence interval, 60.4%–69.2%) received a top-down treatment approach (no SCS before biologics). Factors significantly associated with a top-down treatment approach were male sex, perianal lesions, no use of immunomodulators, and use of anti-tumor necrosis factor therapies. The proportion of patients receiving SCS before biologics (step-up approach) increased after 2018, with a shift from prednisolone to budesonide from 2016. Persistence with first biologics decreased over time, with no differences between biologic types.
Conclusions
Use of biologics for treatment of CD within the first year of diagnosis in Japan has remained stable over the past decade. However, there was a shift to a step-up treatment approach, with an increase in use of SCS before biologics over time.

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IBD

First aid with color atlas for the use of intestinal ultrasound for inflammatory bowel disease in daily clinical practice: Jun Miyoshi, Hiromu Morikubo, Hiromi Yonezawa, Hideaki Mori, Tadakazu Hisamatsu; Intest Res 2023;21(2):177-188. Published online April 28, 2023; DOI: https://doi.org/10.5217/ir.2023.00003

Intestinal ultrasound (IUS) is a promising modality for the management of inflammatory bowel disease (IBD) and has the potential to particularly contribute in monitoring disease activity, an advantage crucial for optimizing the therapeutic strategy. While many IBD physicians appreciate and are interested in the use of IUS for IBD, currently only a limited number of facilities can employ this examination in daily clinical practice. A lack of guidance is one of the major barriers to introducing this procedure. Standardized protocols and assessment criteria are needed such that IUS for IBD can be considered a feasible, reliable examination in clinical practice, and multicenter clinical studies can be conducted for further clinical evidence of the application of IUS in IBD for best patient care. In this article, we provide an overview of how to start IUS for IBD and introduce basic procedures. Furthermore, IUS images from our practice are provided as a color atlas for understanding sonographic findings and scoring systems. We anticipate this “first aid” article will be helpful to promote IUS for IBD in daily practice.

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Determination of optimal cutoff value of ulcerative colitis intestinal ultrasound index to estimate endoscopic improvement in ulcerative colitis
Haruka Komatsu, Hiromu Morikubo, Yoko Kimura, Chihiro Moue, Hiromi Yonezawa, Minoru Matsuura, Jun Miyoshi, Tadakazu Hisamatsu
Journal of Gastroenterology.2025; 60(2): 166. CrossRef
Bildgebung bei chronisch-entzündlichen Darmerkrankungen
Christoph F. Dietrich, Kathleen Möller
Die Innere Medizin.2025; 66(1): 40. CrossRef
Recent Advances in Molecular Targeted Therapy for Inflammatory Bowel Disease
Tadakazu Hisamatsu, Jun Miyoshi, Minoru Matsuura
Internal Medicine.2025;[Epub] CrossRef
A combination of bowel wall thickness and submucosa index is useful for estimating endoscopic improvement in ulcerative colitis: external validation of the Kyorin Ultrasound Criterion
Haruka Komatsu, Hiromu Morikubo, Yoko Kimura, Chihiro Moue, Hiromi Yonezawa, Minoru Matsuura, Jun Miyoshi, Tadakazu Hisamatsu
Journal of Gastroenterology.2024; 59(3): 209. CrossRef
Early Sonographic Improvement Predicts Clinical Remission and Mucosal Healing With Molecular-Targeted Drugs in Ulcerative Colitis
Yoko Kimura, Jun Miyoshi, Hiromu Morikubo, Haruka Komatsu, Chihiro Moue, Hiromi Yonezawa, Minoru Matsuura, Tadakazu Hisamatsu
Gastro Hep Advances.2024; 3(6): 703. 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

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IBD

5-Aminosalicylic acid aggravates colitis mimicking exacerbation of ulcerative colitis: Jun Miyoshi, Katsuyoshi Matsuoka, Atsushi Yoshida, Makoto Naganuma, Tadakazu Hisamatsu, Tomoharu Yajima, Nagamu Inoue, Susumu Okamoto, Yasushi Iwao, Haruhiko Ogata, Fumiaki Ueno, Toshifumi Hibi, Takanori Kanai; Intest Res 2018;16(4):635-640. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00015

Abstract PDF PubReader ePub

Ulcerative colitis (UC) is one of the major clinical phenotypes of inflammatory bowel diseases. Although 5-aminosalicylic acid (5-ASA) is widely used for UC and its efficacy and safety have been demonstrated, a few patients paradoxically develop a severe exacerbation of colitis by 5-ASA administration. It is crucial to know clinical features including endoscopic findings in this condition for making a correct diagnosis and a prompt decision to withdraw the medication. Here, we report case series with UC exacerbated by 5-ASA. Medical records of 8 UC patients experiencing an exacerbation of colitis after induction of 5-ASA that was improved by the withdrawal of 5-ASA but also re-aggravated by dose increase or re-administration of 5-ASA were reviewed. The patients were newly diagnosed with UC, started 5-ASA and developed an exacerbation in approximately 2 to 3 weeks. They did not appear to have systemic allergic reactions. Seven of the 8 patients had a high fever. Three of 5 patients who undertook total colonoscopy showed right-side-dominant colitis. These findings suggest clinical characteristics in this condition. Further assessment of clinical and endoscopic features in more cases is necessary for establishing diagnostic criteria and understanding underlying mechanisms in those cases where 5-ASA aggravates the colitis.

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Secondary loss‐of‐response associated with intolerance to Janus kinase inhibitor in a boy with ulcerative colitis
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Microbial Pathogenesis.2024; 197: 107053. CrossRef
Risk factors for intolerance of oral 5‐aminosalicylic acid preparations in pediatric ulcerative colitis
Naoki Abe, Naomi Iwata, Ryuhei Yasuoka, Daisuke Nishida, Asami Oohara, Haruna Nakaseko, Shiro Sugiura, Shinji Kawabe
Pediatrics International.2023;[Epub] CrossRef
Significance of 5-Aminosalicylic Acid Intolerance in the Clinical Management of Ulcerative Colitis
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