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Original Article
- IBD
- Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
- Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood
- Intest Res 2025;23(2):144-156. Published online November 11, 2024
- DOI: https://doi.org/10.5217/ir.2024.00068
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Abstract
PDF
Supplementary Material
PubReader
ePub - Background/Aims
Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC.
Methods
Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed.
Results
We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples.
Conclusions
FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission. -
Citations
Citations to this article as recorded by
- Beyond mucosal healing: fecal calprotectin and the path toward histologic remission in ulcerative colitis
Yehyun Park
Intestinal Research.2025; 23(2): 115. CrossRef
- Beyond mucosal healing: fecal calprotectin and the path toward histologic remission in ulcerative colitis
- 1,474 View
- 146 Download
- 1 Crossref
Review
- IBD
- Use of thiopurines in inflammatory bowel disease: an update
- Arshdeep Singh, Ramit Mahajan, Saurabh Kedia, Amit Kumar Dutta, Abhinav Anand, Charles N. Bernstein, Devendra Desai, C. Ganesh Pai, Govind Makharia, Harsh Vardhan Tevethia, Joyce WY Mak, Kirandeep Kaur, Kiran Peddi, Mukesh Kumar Ranjan, Perttu Arkkila, Rakesh Kochhar, Rupa Banerjee, Saroj Kant Sinha, Siew Chien Ng, Stephen Hanauer, Suhang Verma, Usha Dutta, Vandana Midha, Varun Mehta, Vineet Ahuja, Ajit Sood
- Intest Res 2022;20(1):11-30. Published online April 15, 2021
- DOI: https://doi.org/10.5217/ir.2020.00155
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Abstract
PDFPubReaderePub
- Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.
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Citations
Citations to this article as recorded by- Pharmacogenomic Assessment of Genes Implicated in Thiopurine Metabolism and Toxicity in a UK Cohort of Pediatric Patients With Inflammatory Bowel Disease
Tracy Coelho, Guo Cheng, Sophie Lewis, James J Ashton, Farah Barakat, Kouros C T Driscoll, Adebola E Sholeye-Bolaji, Akshay Batra, Nadeem A Afzal, Robert M Beattie, Sarah Ennis
Inflammatory Bowel Diseases.2025; 31(2): 362. CrossRef - Immunogenicity of Therapeutic Antibodies Used for Inflammatory Bowel Disease: Treatment and Clinical Considerations
Ole Haagen Nielsen, Alexander Hammerhøj, Mark Andrew Ainsworth, John Gubatan, Geert D’Haens
Drugs.2025; 85(1): 67. CrossRef - Comparison of Effects on 6-Thioguanine Nucleotides According to Mesalazine Formulation in Pediatric Patients with Ulcerative Colitis
Hansol Kim, Yoon Zi Kim, Seon Young Kim, Yon Ho Choe, Mi Jin Kim
Clinical Therapeutics.2025; 47(3): 196. CrossRef - Thiopurine S-methyltransferase – An important intersection of drug-drug interactions in thiopurine treatment
Dunja Urbančič, Marko Jukič, Alenka Šmid, Stanislav Gobec, Janez Jazbec, Irena Mlinarič-Raščan
Biomedicine & Pharmacotherapy.2025; 184: 117893. CrossRef - Effectiveness and safety of thiopurines in inflammatory bowel disease patients with NUDT15 polymorphism: a real-world retrospective study
Abhirup Chatterjee, Prateek Bhatia, Saroj K Sinha, Anupam K Singh, Harshal S Mandavdhare, Jimil Shah, Vaneet Jearth, Arpit Sasani, Aravind Sekar, Minu Singh, Usha Dutta, Vishal Sharma
Expert Review of Clinical Pharmacology.2025; 18(3): 175. CrossRef - Cutting Edge: A Comprehensive Guide to Colorectal Cancer Surgery in Inflammatory Bowel Diseases
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Journal of Mind and Medical Sciences.2025; 12(1): 6. CrossRef - Perspectives in clinical research on Azathioprine for steroid-dependent ulcerative colitis
Yuan-Ting Qu, Jia-Yuan Ding, Wei Pan, Fang-Rui Liu, Ai-Lian Dong
Frontiers in Medicine.2025;[Epub] CrossRef - Therapeutic Drug Monitoring of Thiopurines in Patients With Inflammatory Bowel Disease: Observations From Daily Practice
Mila Lovrić, Kristina Dukić, Silvija Čuković-Čavka, Lana Ganoci, Nada Božina, Vladimir Trkulja
Therapeutic Drug Monitoring.2025;[Epub] CrossRef - Medical Management of Inflammatory Bowel Disease
Shahrose Rahman, Ranish K. Patel, Elisa Boden, Vassiliki Liana Tsikitis
Surgical Clinics of North America.2024; 104(3): 657. CrossRef - Tofacitinib Versus Oral Prednisolone for Induction of Remission in Moderately Active Ulcerative Colitis [ORCHID]: A Prospective, Open-Label, Randomized, Pilot Study
Arshdeep Singh, Vandana Midha, Kirandeep Kaur, Ramit Mahajan, Dharmatma Singh, Ramandeep Kaur, Aditya Kohli, Avantika Chawla, Kriti Sood, Namita Bansal, Ajit Sood
Journal of Crohn's and Colitis.2024; 18(2): 300. CrossRef - Differential molecular mechanisms of substrate recognition by selenium methyltransferases, INMT and TPMT, in selenium detoxification and excretion
Yasunori Fukumoto, Rin Kyono, Yuka Shibukawa, Yu-ki Tanaka, Noriyuki Suzuki, Yasumitsu Ogra
Journal of Biological Chemistry.2024; 300(2): 105599. CrossRef - Factors Associated with Reaching Mid-Parental Height in Patients Diagnosed with Inflammatory Bowel Disease in Childhood and Adolescent Period
So Yoon Choi, Sujin Choi, Byung-Ho Choe, Jae Hong Park, Kwang-Hae Choi, Hae Jeong Lee, Ji Sook Park, Ji-Hyun Seo, Jae Young Kim, Hyo-Jeong Jang, Suk Jin Hong, Eun Young Kim, Yeoun Joo Lee, Ben Kang
Gut and Liver.2024; 18(1): 106. CrossRef - Tofacitinib in Acute Severe Ulcerative Colitis (TACOS): A Randomized Controlled Trial
Arshdeep Singh, Manjeet Kumar Goyal, Vandana Midha, Ramit Mahajan, Kirandeep Kaur, Yogesh Kumar Gupta, Dharmatma Singh, Namita Bansal, Ramandeep Kaur, Shivam Kalra, Omesh Goyal, Varun Mehta, Ajit Sood
American Journal of Gastroenterology.2024; 119(7): 1365. CrossRef - Effectiveness of Tofacitinib in Ulcerative Proctitis Compared to Left Sided Colitis and Pancolitis
Arshdeep Singh, Ramit Mahajan, Vandana Midha, Kirandeep Kaur, Dharmatma Singh, Ramandeep Kaur, Shreya Garg, Kirti Arora, Namita Bansal, Ajit Sood
Digestive Diseases and Sciences.2024; 69(4): 1389. CrossRef - Uphill battle: Innovation of thiopurine therapy in global inflammatory bowel disease care
Ahmed B. Bayoumy, Chris J. J. Mulder, Azhar R. Ansari, Murray L. Barclay, Tim Florin, Marianne Kiszka-Kanowitz, Luc Derijks, Vishal Sharma, Nanne K. H. de Boer
Indian Journal of Gastroenterology.2024; 43(1): 36. CrossRef - The drug-survival of low-dose thioguanine in patients with inflammatory bowel disease: a retrospective observational study
Helena Gensmyr-Singer, Mårten Werner, Pontus Karling
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Thiopurine Metabolite Shunting in Late Pregnancy Increases the Risk of Intrahepatic Cholestasis of Pregnancy in Women With Inflammatory Bowel Disease, and Can be Managed With Split Dosing
Ralley Prentice, Emma Flanagan, Emily Wright, Lani Prideaux, William Connell, Miles Sparrow, Peter De Cruz, Mark Lust, Winita Hardikar, Rimma Goldberg, Sara Vogrin, Kirsten Palmer, Alyson Ross, Megan Burns, Tessa Greeve, Sally Bell
Journal of Crohn's and Colitis.2024; 18(7): 1081. CrossRef - Optimal Treatment Approaches to Intestinal Behçet's Disease Complicated by Myelodysplastic Syndrome: The KASID and KSBD Multicenter Study
Jung-Bin Park, So Jung Han, Seung Bum Lee, Dong Hyun Kim, Jae Hee Cheon, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Soo Jung Park, Sang Hyoung Park
Yonsei Medical Journal.2024; 65(5): 265. CrossRef - Application of Drug Repurposing Approach for Therapeutic Intervention
of Inflammatory Bowel Disease
Mohammad Aadil Bhat, Iqra Usman, Suneela Dhaneshwar
Current Reviews in Clinical and Experimental Pharmacology.2024; 19(3): 234. CrossRef - Selecting first-line advanced therapy for ulcerative colitis: A clinical application of personalized medicine
Mariam S. Mukhtar, Mahmoud H. Mosli
Saudi Journal of Gastroenterology.2024; 30(3): 126. CrossRef - Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef - Differences in the risk of clinical failure between thiopurine and methotrexate in bio-naïve patients with Crohn’s disease: a Korean nationwide population-based study
Yu Kyung Jun, Eunjeong Ji, Hye Ran Yang, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Low risk of malignancies with thiopurines in an Indian cohort of patients with Inflammatory bowel disease
Arshdeep Singh, Vandana Midha, Ajit Sood
Indian Journal of Gastroenterology.2024;[Epub] CrossRef - Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef - Reply: Predicting Adverse Events to Thiopurines in IBD: Are We a Step Closer?
Tracy Coelho, Guo Cheng, Fernando Vazquez Lopez, James J Ashton, Robert M Beattie, Sarah Ennis
Inflammatory Bowel Diseases.2024; 30(10): 1928. CrossRef - Safety and Effectiveness of Thiopurines and Small Molecules in Elderly Patients with Inflammatory Bowel Diseases
Aleksandra Strigáč, Miłosz Caban, Ewa Małecka-Wojciesko, Renata Talar-Wojnarowska
Journal of Clinical Medicine.2024; 13(16): 4678. CrossRef - Saudi consensus guidance for the diagnosis and management of inflammatory bowel disease in children and adolescents
Omar I. Saadah, Turki AlAmeel, Ahmed Al Sarkhy, Mohammed Hasosah, Abdulrahman Al-Hussaini, Majid A. Almadi, Badr Al-Bawardy, Talal A. Altuwaijri, Mohammed AlEdreesi, Shakir A. Bakkari, Othman R. Alharbi, Nahla A. Azzam, Abdulelah Almutairdi, Khalidah A. A
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef - Harnessing a Safe Novel Lipid Nanoparticle: Targeted Oral Delivery to Colonic Epithelial and Macrophage Cells in a Colitis Mouse Model
Rabeya Jafrin Mow, Michal Pawel Kuczma, Xiaodi Shi, Sridhar Mani, Didier Merlin, Chunhua Yang
Nanomaterials.2024; 14(22): 1800. CrossRef - Personalization of thiopurine therapy: Current recommendations and future perspectives
Dunja Urbančič, Flaka Pasha, Alenka Šmid, Irena Mlinarič-Raščan
Acta Pharmaceutica.2024; 74(3): 355. CrossRef - Navigating the pharmacotherapeutic management of comorbid inflammatory bowel disease and primary sclerosing cholangitis
Brigid Pinnuck, Kate D. Lynch
Expert Opinion on Pharmacotherapy.2024; 25(13): 1835. CrossRef - Ulcerative colitis: molecular insights and intervention therapy
Yuqing Liang, Yang Li, Chehao Lee, Ziwei Yu, Chongli Chen, Chao Liang
Molecular Biomedicine.2024;[Epub] CrossRef - Drug Interaction-Informed Approaches to Inflammatory Bowel Disease Management
Kyeong-Ryoon Lee, Aneela Gulnaz, Yoon-Jee Chae
Pharmaceutics.2024; 16(11): 1431. CrossRef - Dramatic Changes in Thiopurine Metabolite Levels in a Patient With Inflammatory Bowel Disease Treated With Tirzepatide for Weight Loss
Jeremy A. Klein, Joëlle St-Pierre, David Choi, Jacqueline Lopez, David T. Rubin
ACG Case Reports Journal.2024; 11(11): e01544. CrossRef - Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?
Shailesh Perdalkar, Pooja Basthi Mohan, Balaji Musunuri, Siddheesh Rajpurohit, Shiran Shetty, Krishnamurthy Bhat, Cannanore Ganesh Pai
International Immunopharmacology.2023; 116: 109597. CrossRef - Effectiveness and safety of thioguanine as a maintenance therapy of inflammatory bowel disease: Systematic review, meta-analysis and meta-regression
Anuraag Jena, Pardhu B Neelam, Harshavardhan Telaprolu, Uday Kiran Mangipudi, Usha Dutta, Shaji Sebastian, Vishal Sharma
Clinics and Research in Hepatology and Gastroenterology.2023; 47(7): 102155. CrossRef - Impact of Crohn’s Disease on the Survival of Patients with Small-Bowel Adenocarcinoma in Korea: A Bicenter Cohort Study
Kyuwon Kim, Kookhwan Choi, Sung Wook Hwang, Jong Pil Im, Byong Duk Ye, Joo Sung Kim, Kyu Joo Park, Suk-Kyun Yang, Seong-Joon Koh, Sang Hyoung Park
Gut and Liver.2023; 17(4): 581. CrossRef - Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
Intestinal Research.2023; 21(3): 353. CrossRef - The Management of Inflammatory Bowel Disease during Reproductive Years: An Updated Narrative Review
Nariman Hossein-Javaheri, Michael Youssef, Yaanu Jeyakumar, Vivian Huang, Parul Tandon
Reproductive Medicine.2023; 4(3): 180. CrossRef - Long‐term safety and effectiveness of azathioprine in the management of inflammatory bowel disease: A real‐world experience
Rohan V Yewale, Balakrishnan S Ramakrishna, Babu Vinish Doraisamy, Pandurangan Basumani, Jayanthi Venkataraman, Kayalvizhi Jayaraman, Ananthavadivelu Murali, Karunakaran Premkumar, Akkim Sathish Kumar
JGH Open.2023; 7(9): 599. CrossRef - Effectiveness and tolerability of methotrexate monotherapy in Crohn’s disease patients: a multicenter observational study
Jihye Park, Jaeyoung Chun, Soo Jung Park, Jae Jun Park, Tae Il Kim, Hyuk Yoon, Jae Hee Cheon
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef -
Oral Lingzhi or Reishi Medicinal Mushroom Ganoderma lucidum (Agaricomycetes) Spore Powder Ameliorates Murine Colitis by Inhibiting Key Kinases Phosphorylation in MAPK Pathway
Yingying Zhao, Liangchen Zhu
International Journal of Medicinal Mushrooms.2023; 25(10): 39. CrossRef - Enhancing cancer therapy: The potential of mercaptopurine-based nanomaterials for targeted drug delivery
Mehrab Pourmadadi, Arsalan Rahmani Ghohrodi, Zeinab Savari, Ehsan Talebi, Iman Ahamdi, Abbas Rahdar, Sadanand Pandey
Next Nanotechnology.2023; 2: 100018. CrossRef - Thiopurine exposure during pregnancy is not associated with anemia in infants born to mothers with IBD
Fiona Yeaman, Amelie Stritzke, Verena Kuret, Nastaran Sharifi, Cynthia H Seow, Amy Metcalfe, Yvette Leung
Crohn's & Colitis 360.2023;[Epub] CrossRef - Reviewing the potential of probiotics, prebiotics and synbiotics: advancements in treatment of ulcerative colitis
Apurva Jadhav, Suresh Jagtap, Suresh Vyavahare, Archana Sharbidre, Bipinraj Kunchiraman
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef - Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
Journal of Personalized Medicine.2022; 12(3): 507. CrossRef - Use of Azathioprine in Ulcerative Colitis: A Comprehensive Review
Bipadabhanjan Mallick, Sarthak Malik
Cureus.2022;[Epub] CrossRef - Ulcerative Colitis in Adulthood and in Older Patients: Same Disease, Same Outcome, Same Risks?
Walter Fries, Maria Giulia Demarzo, Giuseppe Navarra, Anna Viola
Drugs & Aging.2022; 39(6): 441. 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 - Prevention of postoperative recurrence in Crohn’s disease: the never-ending story
Jung-Bin Park, Sang Hyoung Park
Intestinal Research.2022; 20(3): 279. CrossRef - Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. 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 - Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. 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 - A report on the potential of Rac1/pSTAT3 protein levels in T lymphocytes to assess the pharmacodynamic effect of thiopurine therapy in Inflammatory Bowel Disease patients
Debbie S. Deben, Rob H. Creemers, Arjan J. van Adrichem, Roosmarie Drent, Audrey H. H. Merry, Mathie P. G. Leers, Adriaan A. van Bodegraven, Dennis R. Wong
Scientific Reports.2022;[Epub] CrossRef - Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo
Alexander Keith Turbayne, Miles Patrick Sparrow
Digestive Diseases and Sciences.2022; 67(12): 5382. CrossRef - NUDT15Genotyping in Thiopurine Drug Therapy
Jong Kwon Lee, Rihwa Choi, Soo-Youn Lee
Laboratory Medicine Online.2022; 12(4): 217. CrossRef - Personalized medicine to implementation science: Thiopurines set for the leap
Vishal Sharma, Saurabh Kedia, Vineet Ahuja
JGH Open.2022; 6(10): 651. CrossRef - Immunomodulators: still having a role?
Jeffery M Venner, Charles N Bernstein
Gastroenterology Report.2022;[Epub] CrossRef - Treatment of inflammatory bowel diseases: focusing on 5-aminosalicylates and immunomodulators
You Sun Kim
Journal of the Korean Medical Association.2021; 64(9): 596. CrossRef - Is the Long-term Disease Course of Elderly-Onset Ulcerative Colitis Different from That of Non-Elderly-Onset Ulcerative Colitis?
Jin Wook Lee, Eun Soo Kim
Gut and Liver.2021; 15(5): 639. 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 - Current status and future perspectives on the use of therapeutic drug monitoring of thiopurine metabolites in patients with inflammatory bowel disease
Debbie S. Deben, Dennis R. Wong, Adriaan A. van Bodegraven
Expert Opinion on Drug Metabolism & Toxicology.2021; 17(12): 1433. CrossRef
- Pharmacogenomic Assessment of Genes Implicated in Thiopurine Metabolism and Toxicity in a UK Cohort of Pediatric Patients With Inflammatory Bowel Disease
- 12,925 View
- 711 Download
- 62 Web of Science
- 62 Crossref
Original Articles
- IBD
- Maintaining infliximab induced clinical remission with azathioprine and 5-aminosalicylates in acute severe steroid-refractory ulcerative colitis has lower cost and high efficacy (MIRACLE): a multicenter study
- Ramit Mahajan, Arshdeep Singh, Saurabh Kedia, Kirandeep Kaur, Vandana Midha, Pabitra Sahu, Varun Mehta, Dharmatma Singh, Namita Bansal, Khushdeep Dharni, Sandeep Kaushal, Vineet Ahuja, Ajit Sood
- Intest Res 2022;20(1):64-71. Published online February 3, 2021
- DOI: https://doi.org/10.5217/ir.2020.00100
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Abstract
PDFPubReaderePub
- Background/Aims
Infliximab (IFX) has been used to induce and maintain remission in patients with severe steroid-refractory ulcerative colitis (UC). Long-term use of biologics in developing countries is limited by high cost and frequent side effects. An optimal maintenance strategy in these patients needs to be established.
Methods
A retrospective analysis of maintenance of clinical remission with combination of azathioprine (AZA) and 5-aminosalicylates (5-ASA) in patients with severe steroidrefractory UC where IFX (5 mg/kg intravenously at weeks 0, 2, 6) had been used only as an induction therapy was done at 2 centers in India. Primary outcome was the proportion of patients maintaining corticosteroid-free sustained clinical remission (SCR) at the end of study period. Rates of relapse and cost of therapy were also analyzed.
Results
Of the 137 patients who received rescue IFX induction therapy, 77 (56.2%) achieved clinical remission (mean age 34.81 ± 13.32 years, 68.83% males, median follow-up 4 years, range 3 months to 6 years) and were included. Cumulative corticosteroid-free SCR was maintained in 68%, 59%, 42%, and 35% patients at 1, 2, 4, and 6 years respectively. Sixty-seven relapses were observed in 33 patients. Majority of the relapses (45/67, 67.16%) occurred within first 2 years of follow-up. Two relapses were managed with re-induction with IFX, one required colectomy, whereas all other responded to repeat course(s) of corticosteroids. Annual per capita maintenance therapy with 5-ASA and AZA was cheaper by US$ 4,526 compared to maintaining remission with IFX.
Conclusions
Clinical remission achieved with IFX induction therapy in severe steroid-refractory UC can be sustained over long time with a combination of AZA and 5-ASA. -
Citations
Citations to this article as recorded by- Effect of Ornithine α-Ketoglutarate on Intestinal Microbiota and Serum Inflammatory Cytokines in Dextran Sulfate Sodium Induced Colitis
Tao Wang, Junquan Tian, Wenxuan Su, Fan Yang, Jie Yin, Qian Jiang, Yuying Li, Kang Yao, Tiejun Li, Yulong Yin
Nutrients.2023; 15(11): 2476. CrossRef - Management of Ulcerative Colitis: A Review of Indian Literature
Santhosh Rajendran, Ratnakar Kini, K. Muthukumaran, I. Shubha, A. Chezhian, R. Murali
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 127. 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 - 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 - Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo
Alexander Keith Turbayne, Miles Patrick Sparrow
Digestive Diseases and Sciences.2022; 67(12): 5382. CrossRef - Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
Gastroenterology.2022; 163(5): 1145. CrossRef - Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
Intestinal Research.2022; 20(4): 452. CrossRef - Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
Clinical Gastroenterology and Hepatology.2022; 20(11): 2421. 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
- Effect of Ornithine α-Ketoglutarate on Intestinal Microbiota and Serum Inflammatory Cytokines in Dextran Sulfate Sodium Induced Colitis
- 7,787 View
- 456 Download
- 7 Web of Science
- 9 Crossref
- Inflammatory Bowel Diseases
- Trends of inflammatory bowel disease at a tertiary care center in northern India
- Ajit Sood, Kirandeep Kaur, Arshdeep Singh, Vandana Midha, Ramit Mahajan, Namita Bansal, Varun Mehta, Dharmatma Singh
- Intest Res 2021;19(3):282-290. Published online August 18, 2020
- DOI: https://doi.org/10.5217/ir.2020.00010
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is increasingly being reported from India and other Asian countries. This study looks into the changing trends of IBD at a tertiary care center in north India over last two decades.
Methods
Retrospective analysis of a prospectively maintained database of patients diagnosed with IBD between January 1991 and December 2015 was conducted. The study period was divided into five times cohorts (1991–1995, 1996–2000, 2001–2005, 2006–2010, 2011–2015).
Results
During the study period, 2,467 patients (UC [n = 2,137, 86.6%], CD [n = 330, 13.3%], mean age 38.5 ± 13.3 years; 55.9% males) were registered. The proportion of patients with CD increased (ratio of UC to CD declined from 15.7:1 to 4:1). The mean age at diagnosis decreased for UC (45.7 ± 12.1 years in 1991–1995 vs. 37.6 ± 13.0 years in 2011–2015; P= 0.001) and remained consistent for CD (41.3 ± 13.6 years in 1996–2000 vs. 41.3 ± 16.9 years in 2011–2015, P= 0.86). Patients with proctitis in UC and isolated ileal disease in CD increased over the study period (P= 0.001 and P= 0.007, respectively). Inflammatory CD increased (P= 0.009) whereas stricturing CD decreased (P= 0.01) across all cohorts. There was a trend towards less severe presentation of both UC and CD. The use of thiopurines (P= 0.02) and biologics increased (P= 0.001) with no significant change in trends for requirements of surgery (P= 0.9).
Conclusions
Increasing prevalence of CD, younger age at diagnosis, diagnosis at an earlier and milder stage, greater use of thiopurines and biologics were observed. -
Citations
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Review
- Inflammatory bowel diseases
- Colitis and Crohn’s Foundation (India) consensus statements on use of 5-aminosalicylic acid in inflammatory bowel disease
- Ajit Sood, Vineet Ahuja, Vandana Midha, Saroj Kant Sinha, C. Ganesh Pai, Saurabh Kedia, Varun Mehta, Sawan Bopanna, Philip Abraham, Rupa Banerjee, Shobna Bhatia, Karmabir Chakravartty, Sunil Dadhich, Devendra Desai, Manisha Dwivedi, Bhabhadev Goswami, Kirandeep Kaur, Rajeev Khosla, Ajay Kumar, Ramit Mahajan, S. P. Misra, Kiran Peddi, Shivaram Prasad Singh, Arshdeep Singh
- Intest Res 2020;18(4):355-378. Published online July 13, 2020
- DOI: https://doi.org/10.5217/ir.2019.09176
-
Abstract
PDFPubReaderePub
- Despite several recent advances in therapy in inflammatory bowel disease (IBD), 5-aminosalicylic acid (5-ASA) therapy has retained its place especially in ulcerative colitis. This consensus on 5-ASA is obtained through a modified Delphi process, and includes guiding statements and recommendations based on literature evidence (randomized trials, and observational studies), clinical practice, and expert opinion on use of 5-ASA in IBD by Indian gastroenterologists. The aim is to aid practitioners in selecting appropriate treatment strategies and facilitate optimal use of 5-ASA in patients with IBD.
-
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Original Article
- Inflammatory Bowel Diseases
- Colitis and Crohn’s Foundation (India): a first nationwide inflammatory bowel disease registry
- Ajit Sood, Kirandeep Kaur, Ramit Mahajan, Vandana Midha, Arshdeep Singh, Sarit Sharma, Amarender Singh Puri, Bhabhadev Goswami, Devendra Desai, C. Ganesh Pai, Kiran Peddi, Mathew Philip, Rakesh Kochhar, Sandeep Nijhawan, Shobna Bhatia, N. Sridhara Rao
- Intest Res 2021;19(2):206-216. Published online July 13, 2020
- DOI: https://doi.org/10.5217/ir.2019.09169
-
Abstract
PDFPubReaderePub
- Background/Aims
The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.
Methods
A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.
Results
A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.
Conclusions
The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care. -
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Case Report
- Inflammatory bowel diseases
- Incidental benefits after fecal microbiota transplant for ulcerative colitis
- Ramit Mahajan, Vandana Midha, Arshdeep Singh, Varun Mehta, Yogesh Gupta, Kirandeep Kaur, Ritu Sudhakar, Anmol Singh Pannu, Dharmatma Singh, Ajit Sood
- Intest Res 2020;18(3):337-340. Published online April 22, 2020
- DOI: https://doi.org/10.5217/ir.2019.00108
-
Abstract
PDFPubReaderePub
- Gut dysbiosis can result in several diseases, including infections (Clostridium difficile infection and infectious gastroenteritis), autoimmune diseases (inflammatory bowel disease, diabetes, and allergic disorders), behavioral disorders and other conditions like metabolic syndrome and functional gastrointestinal disorders. Amongst various therapies targeting gut microbiome, fecal microbiota transplantation (FMT) is becoming a focus in the public media and peer reviewed literature. We have been using FMT for induction of remission in patients with moderate to severe active ulcerative colitis (UC) and also for subsequent maintenance of remission. Four cases reported incidental benefits while being treated with FMT for UC. These included weight loss (n=1), improvement in hair loss (n=1), amelioration of axial arthritis (n=1) and improvement in allergic rhinitis (n=1), thereby suggesting potential clinical applications of FMT in treating extraintestinal diseases associated with gut dysbiosis.
-
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Original Articles
- Inflammatory bowel diseases
- Exclusive enteral nutrition for induction of remission in anti-tumor necrosis factor refractory adult Crohn’s disease: the Indian experience
- Ajit Sood, Arshdeep Singh, Ritu Sudhakar, Vandana Midha, Ramit Mahajan, Varun Mehta, Yogesh Kumar Gupta, Kirandeep Kaur
- Intest Res 2020;18(2):184-191. Published online February 25, 2020
- DOI: https://doi.org/10.5217/ir.2019.00094
-
Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Exclusive enteral nutrition (EEN) is recommended for induction of remission in pediatric Crohn’s disease (CD). However, it is not currently recommended for inducing remission in adults. This report describes the use of 12-week EEN for induction of remission in anti-tumor necrosis factor (anti-TNF) refractory adult CD.
Methods
This is a retrospective analysis of adults with moderate to severe active (Crohn’s Disease Activity Index [CDAI] >220) anti-TNF refractory CD, who received EEN for 12 weeks between April 2018 and March 2019 at Dayanand Medical College and Hospital, Ludhiana, India. Primary outcomes included achievement of clinical remission and fistula healing at 12 weeks. Improvement in inflammatory markers and nutritional status were the secondary end points.
Results
Out of 23 patients who received anti-TNF agents, 7 (30.4%) were refractory and were offered EEN as a salvage therapy. Six patients (66.7% females, mean age 25.6±6.5 years) consented. Four patients (66.6%) achieved clinical remission (CDAI <150). Mean CDAI of patients decreased significantly after 12 weeks of EEN (388.8±74.8 vs. 160.0±25.2, P<0.001). Perianal fistulas showed clinical response (drainage decreased by >50%), though none achieved remission. Entero-enteric fistulae showed complete healing. Mean body mass index improved from 15.6±3.1 to 18.9±1.9 kg/m2 at week 12 (P=0.003). Hemoglobin and serum albumin also improved from 8.2±1.1 g/dL and 2.8±0.3 g/dL at baseline to 12.6±0.6 g/dL and 3.6±0.5 g/dL post-EEN respectively (P<0.001 and P=0.006 respectively).
Conclusions
EEN appears to be an effective and well tolerated therapy for induction of remission in anti-TNF refractory adult CD. More data from prospective trials with larger number of patients is required. -
Citations
Citations to this article as recorded by- Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
Hellen Kuo, Katrina Tognolini, Rumbidzai Mutsekwa, Dheeraj Shukla, Laura Willmann, Hadi Moattar, Alexander Dorrington, Naveed Ishaq, Maneesha Bhullar, John Edwards, Waled Mohsen, Pradeep Kakkadasam Ramaswamy
Frontline Gastroenterology.2025; 16(1): 3. CrossRef - Enteral Nutrition in Crohn’s Disease: A Comprehensive Review of Its Role in Induction and Maintenance of Remission and Perioperative Management in Adult Patients
André Bargas, Carolina Palmela, Luisa Glória
Nutrients.2025; 17(9): 1481. CrossRef - Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
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Daniela Kosorínová, Pavlína Suchá, Zuzana Havlíčeková, Marek Pršo, Pavol Dvoran, Peter Bánovčin
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Arshdeep Singh, Chandan Kakkar, Shreya Garg, Kirti Arora, Vandana Midha, Ramit Mahajan, Satpal Singh Virk, Narender Pal Jain, Dharmatma Singh, Kriti Sood, Ashish Tripathi, Dhruv Gupta, Ishita Gupta Kaushal, Ritu Dhawan Galhotra, Kavita Saggar, Ajit Sood
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Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
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Jihye Park, Jae Hee Cheon
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Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam
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Ji Young Chang, Jae Hee Cheon
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Tadakazu Hisamatsu
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- Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
- 7,861 View
- 187 Download
- 10 Web of Science
- 10 Crossref
- IBD
- Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis
- Ajit Sood, Ramit Mahajan, Garima Juyal, Vandana Midha, Charanpreet Singh Grewal, Varun Mehta, Arshdeep Singh, Mohan C Joshi, Vikram Narang, Kirandeep Kaur, Hasrat Sidhu
- Intest Res 2019;17(1):78-86. Published online November 20, 2018
- DOI: https://doi.org/10.5217/ir.2018.00089
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC.
Methods
This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT.
Results
Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation.
Conclusions
A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal. -
Citations
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steroid-dependent ulcerative colitis
Young-Seok Cho
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Kazuhiko Uchiyama, Yuji Naito, Tomohisa Takagi
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- 281 Download
- 43 Web of Science
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- Miscellaneous
- A simple phenotypic classification for celiac disease
- Ajit Sood, Vandana Midha, Govind Makharia, B. K. Thelma, Shivalingappa S Halli, Varun Mehta, Ramit Mahajan, Vikram Narang, Kriti Sood, Kirandeep Kaur
- Intest Res 2018;16(2):288-292. Published online April 30, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.2.288
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.
Methods Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.
Results After empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.
Conclusions APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.
-
Citations
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Arkadeep Dhali, Rick Maity, Hareesha Rishab Bharadwaj, Syed Hasham Ali, Muhammad Hamza Shah, David Surendran Sanders
Digestive and Liver Disease.2025;[Epub] CrossRef - Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India
Nidhya Ganesan, S. Shrinnivi, R. Shivani, R. K. Kartikayan
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Agnieszka Zubkiewicz-Kucharska, Tatiana Jamer, Joanna Chrzanowska, Katarzyna Akutko, Tomasz Pytrus, Andrzej Stawarski, Anna Noczyńska
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Vipin Gupta, Alka Singh, Rajesh Khadgawat, Ashish Agarwal, Asif Iqbal, Wajiha Mehtab, P.K. Chaturvedi, Vineet Ahuja, Govind K. Makharia
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- Analyzing the landscape of coeliac crisis in adult and paediatric populations: A systematic review and meta-analysis
- 6,496 View
- 109 Download
- 4 Web of Science
- 5 Crossref
- IBD
- Efficacy and safety of the adalimumab biosimilar Exemptia as induction therapy in moderate-to-severe ulcerative colitis
- Vandana Midha, Ramit Mahajan, Varun Mehta, Vikram Narang, Arshdeep Singh, Kirandeep Kaur, Ajit Sood
- Intest Res 2018;16(1):83-89. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.83
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Data on the efficacy and safety of the adalimumab biosimilar Exemptia are limited.
Methods Patients with moderate-to-severe active steroid-refractory ulcerative colitis (UC) treated at Dayanand Medical College and Hospital, India were offered cyclosporine A, biologicals or biosimilars, or surgery. A retrospective analysis was conducted on patients who were treated with the adalimumab biosimilar, Exemptia. These patients were administered an induction dosing schedule of 160 mg Exemptia at week 0, 80 mg at week 2, and then 40 mg every other week from week 4 to 8. The clinical response and remission were assessed at week 8 using Mayo score.
Results A total of 29 patients (62.1% male; mean age, 34.9 ± 9.7 years) with moderate-to-severe steroid-refractory active UC (mean disease duration, 6.3±5.1 years; pancolitis in 9 patients [31.1%]; left-sided colitis in 20 patients [68.9%]) were treated with the Exemptia induction dosing schedule. The mean Mayo score at presentation was 8.2±1.4. At week 8, clinical response was observed in 7 patients (24.1%), whereas clinical remission was observed only in 1 patient (3.5%). Among the non-responders (n=21), 4 patients required colectomy, 1 died, 1 was lost to follow-up, 10 were offered fecal microbiota transplant, 3 were administered infliximab, and 2 patients were administered cyclosporine and tacrolimus, respectively. Four patients (13.8%) developed extrapulmonary tuberculosis.
Conclusions The adalimumab biosimilar Exemptia has limited efficacy for the attainment of clinical response and remission in moderate-to-severe steroid-refractory UC, with a significant risk of acquisition or reactivation of tuberculosis in developing countries such as India.
-
Citations
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Yuto Yamada, Yuta Ohno, Takashi Niwa, Hiroko Kato‐Hayashi, Hideki Hayashi, Takashi Ibuka, Hiroshi Araki, Tadashi Sugiyama, Masahito Shimizu, Akio Suzuki
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Nagesh Kamat, Saurabh Kedia, Uday C. Ghoshal, Abhimanyu Nehra, Govind Makharia, Ajit Sood, Vandana Midha, Varun Gupta, Gourdas Choudhuri, Vineet Ahuja
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Marjorie Argollo, Gionata Fiorino, Daniela Gilardi, Federica Furfaro, Giulia Roda, Laura Loy, Mariangela Allocca, Laurent Peyrin-Biroulet, Silvio Danese
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- 7,145 View
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- 11 Crossref
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