Intestinal Research

Original Articles

Inflammatory bowel diseases

Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease: Yue Zhao, Baili Chen, Yao He, Shenghong Zhang, Yun Qiu, Rui Feng, Hongsheng Yang, Zhirong Zeng, Shomron Ben-Horin, Minhu Chen, Ren Mao; Intest Res 2020;18(2):200-209. Published online March 31, 2020; DOI: https://doi.org/10.5217/ir.2019.00103

Background/Aims
Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD.
Methods
This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay.
Results
The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients.
Conclusions
Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Citations

Citations to this article as recorded by

Efficacy and Tolerance of Thalidomide in Patients With Very Early Onset Inflammatory Bowel Disease
Matteo Bramuzzo, Fabiola Giudici, Serena Arrigo, Paolo Lionetti, Giovanna Zuin, Claudio Romano, Francesco Graziano, Simona Faraci, Patrizia Alvisi, Sara Signa, Luca Scarallo, Stefano Martelossi, Grazia Di Leo
Inflammatory Bowel Diseases.2024; 30(1): 20. CrossRef
Inhibin B and antiMüllerian hormone as surrogate markers of fertility in male and female Crohn’s disease patients: a case-control study
Ana Gutiérrez, Roser Muñoz-Pérez, Pedro Zapater, Cristina Mira, Andrés Rodríguez, Laura Sempere-Robles, María Eugenia Torregrosa, Rocio Alfayate, Violeta Moreno-Torres, Lorena Bernal, Olivia Belén-Galipienso, Jose Ignacio Cameo, Paula Sirera, Belen Herrer
Frontiers in Medicine.2024;[Epub] CrossRef
Factors associated with decreased ovarian reserve in Crohn's disease: A systematic review and meta‐analysis
Arthur Foulon, Nicolas Richard, Camille Guichard, Clara Yzet, Coraline Breuval, Jean Gondry, Rosalie Cabry‐Goubet, Audrey Michaud, Mathurin Fumery
Acta Obstetricia et Gynecologica Scandinavica.2024; 103(9): 1714. CrossRef
Serum anti-mullerian hormone, sex hormone, and nutrient levels in reproductive age women with celiac disease
Ailifeire Tuerxuntayi, Tian Shi, Beiyao Gao, Yan Feng, Ting Li, Wenjia Hui, Shenglong Xue, Feng Gao
Journal of Assisted Reproduction and Genetics.2024; 41(8): 2129. CrossRef
Inflammatory bowel disease can reduce ovarian reserve function in women: A systematic review and meta-analysis
Lin Guo, Yi Liu, Jiansheng Li, Quan Liu, Bing Liu, Xuewen Shi
Medicine.2023; 102(11): e33113. CrossRef
Inflammatory bowel disease in pregnancy and breastfeeding
Max N. Brondfield, Uma Mahadevan
Nature Reviews Gastroenterology & Hepatology.2023; 20(8): 504. CrossRef
Case report: A pregnant woman with Crohn disease who used ustekinumab to the 3rd trimester developed severe infection
Peng Guo, Wulan Cao
Medicine.2023; 102(48): e36253. CrossRef
Monitoring of Inflammatory Bowel Disease in Pregnancy: A Review of the Different Modalities
Reem Al-jabri, Panu Wetwittayakhlang, Peter L. Lakatos
Journal of Clinical Medicine.2023; 12(23): 7343. CrossRef
General review of pregnancy in inflammatory bowel disease
Elena Santos Pérez, Marta Calvo Moya
Revista Española de Enfermedades Digestivas.2022;[Epub] CrossRef
Inflammatory Bowel Disease and Reproductive Health: From Fertility to Pregnancy—A Narrative Review
Camilla Ronchetti, Federico Cirillo, Noemi Di Segni, Martina Cristodoro, Andrea Busnelli, Paolo Emanuele Levi-Setti
Nutrients.2022; 14(8): 1591. CrossRef
Ovarian reserve and IVF outcomes in patients with inflammatory bowel disease: A systematic review and meta-analysis
Honghao Sun, Jiao Jiao, Feng Tian, Qing Liu, Jiansu Bian, Rongmin Xu, Da Li, Xiuxia Wang, Hong Shu
eClinicalMedicine.2022; 50: 101517. CrossRef
Inflammatory Bowel Disease and Pregnancy
Eugenia Shmidt, Marla C. Dubinsky
American Journal of Gastroenterology.2022; 117(10S): 60. CrossRef
Reproductive Health in IBD Patients
Sanket Patel, Haleh Vaziri
Current Treatment Options in Gastroenterology.2021; 19(2): 237. CrossRef
Ovarian Reserve Assessed by the Anti-Mullerian Hormone and Reproductive Health Parameters in Women With Crohn´s Disease, a Case-Control Study
T. Koller, J. Kollerová, T. Hlavatý, B. Kadlečková, J. Payer
Physiological Research.2021; : S69. CrossRef
THE ROLE OF IMMUNOGLOBULIN A IN THE INFLAMMATORY PROCESS INVOLVING NEUTROPHILS
O.O. Prudnikov, I.M. Prudnikov, V.M. Tsyvkin, A.M. Smirnov, R.I. Yanchiy
Fiziolohichnyĭ zhurnal.2021; 67(5): 44. CrossRef
Update on Pregnancy in Patients with IBD
Rachel W. Winter, Sonia Friedman
Current Treatment Options in Gastroenterology.2020; 18(3): 423. CrossRef

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130 Download
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16 Crossref

IBD

The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases: Santosh Sanagapalli, Yanna Ko, Viraj Kariyawasam, Siew C Ng, Whitney Tang, Hithanadura Janaka de Silva, Minhu Chen, Kaichun Wu, Satimai Aniwan, Ka Kei Ng, David Ong, Qin Ouyang, Ida Hilmi, Marcellus Simadibrata, Pises Pisespongsa, Saranya Gopikrishna, Rupert W Leong; Intest Res 2018;16(3):409-415. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.409

Abstract PDF PubReader ePub

Background/Aims

To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort.

Methods

A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD.

Results

Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77–3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049).

Conclusions

In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.

Citations

Citations to this article as recorded by

Estrogen receptor actions in colitis
Erika L. Garcia-Villatoro, Clinton D. Allred
Essays in Biochemistry.2021; 65(6): 1003. CrossRef
Sex-based differences in inflammatory bowel diseases: a review
Sheila D. Rustgi, Maia Kayal, Shailja C. Shah
Therapeutic Advances in Gastroenterology.2020; 13: 175628482091504. CrossRef

7,287 View
103 Download
3 Web of Science
2 Crossref

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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Inflammatory Bowel Diseases.2024; 30(1): 45. CrossRef
(Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
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
Journal of Gastroenterology and Hepatology.2024; 39(8): 1500. 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
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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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Shruti Verma, Arshdeep Singh, Chandan Kakkar, Ashish Tripathi, Vandana Midha, Ajit Sood
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Pooja KC, Madhur Bhattarai, Subodh Adhikari, Prakriti Parajuli, Sujata Bhandari, Himal Bikram Bhattarai, Niraj Kumar Sharma, Shailendra Karki, Suryakiran Acharya, Bibhusan Basnet
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Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-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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Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab
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28 Web of Science
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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
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Jae Hoon Jung, Sujin Choi, Youra Kang, Dae-Chul Cho, So Mi Lee, Tae In Park, Byung-Ho Choe, Dongsub Kim, Ben Kang
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A case of paradoxical response during anti-tuberculosis treatment in a patient with ulcerative colitis
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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
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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
Biologics for the Management of Inflammatory Bowel Disease: A Review in Tuberculosis-Endemic Countries
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
Translating the gut microbiome: ready for the clinic?
Susan V. Lynch, Siew C. Ng, Fergus Shanahan, Herbert Tilg
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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

Original Articles

Surgical management of inflammatory bowel disease in China: a systematic review of two decades: Qiao Yu, Ren Mao, Lei Lian, Siew chien Ng, Shenghong Zhang, Zhihui Chen, Yanyan Zhang, Yun Qiu, Baili Chen, Yao He, Zhirong Zeng, Shomron Ben-Horin, Xinming Song, Minhu Chen; Intest Res 2016;14(4):322-332. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.322

Abstract PDF Supplementary Material PubReader

Background/Aims

The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China.

Methods

We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures.

Results

A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010.

Conclusions

The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.

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Diagnosis of inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2^nd Asian Organization for Crohn's and Colitis (AOCC) meeting in Seoul: Eun Soo Kim, Minhu Chen, Jun Lee, Chang-Kyun Lee, You Sun Kim; Intest Res 2016;14(3):224-230. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.224

Abstract PDF PubReader ePub

Background/Aims

As the number of Asian patients with inflammatory bowel disease (IBD) has increased recently, there is a growing need to improve IBD care in this region. This study is aimed at determining how Asian countries are currently dealing with their IBD patients in terms of diagnosis.

Methods

A questionnaire was designed by the organizing committee of Asian Organization for Crohn's and Colitis, for a multinational web-based survey conducted between March 2014 and May 2014.

Results

A total of 353 Asian medical doctors treating IBD patients responded to the survey (114 in China, 88 in Japan, 116 in Korea, and 35 in other Asian countries). Most of the respondents were gastroenterologists working in an academic teaching hospital. While most of the doctors from China, Japan, and Korea use their own national guidelines for IBD diagnosis, those from other Asian countries most commonly adopt the European Crohn's Colitis Organisation's guideline. Japanese doctors seldom adopt the Montreal classification for IBD. The most commonly used activity scoring system for ulcerative colitis is the Mayo score in all countries except China, whereas that for Crohn's disease (CD) is the Crohn's Disease Activity Index. The most available tool for small-bowel evaluation in CD patients differs across countries. Many physicians administer empirical anti-tuberculous medications before the diagnosis of CD.

Conclusions

The results of this survey demonstrate that Asian medical doctors have different diagnostic approaches for IBD. This knowledge would be important in establishing guidelines for improving the care of IBD patients in this region.

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Adalimumab induction and maintenance therapy achieve clinical remission and response in Chinese patients with Crohn's disease: Kai-Chun Wu, Zhi Hua Ran, Xiang Gao, Minhu Chen, Jie Zhong, Jian-Qiu Sheng, Michael A Kamm, Simon Travis, Kori Wallace, Nael M Mostafa, Marisa Shapiro, Yao Li, Roopal B Thakkar, Anne M Robinson; Intest Res 2016;14(2):152-163. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.152

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

This was a Phase 2 study (NCT02015793) to evaluate the pharmacokinetics, safety, and efficacy of adalimumab in Chinese patients with Crohn's disease (CD).

Methods

Thirty, adult Chinese patients with CD (CD Activity Index [CDAI] 220–450; high-sensitivity [hs]-C-reactive protein [CRP] ≥3 mg/L) received double-blind adalimumab 160/80 mg or 80/40 mg at weeks 0/2, followed by 40 mg at weeks 4 and 6. An open-label extension period occurred from weeks 8–26; patients received 40 mg adalimumab every other week. Serum adalimumab concentration and change from baseline in fecal calprotectin (FC) were measured during the double-blind period. Clinical remission (CDAI <150), response (decrease in CDAI ≥70 points from baseline), and change from baseline in hs-CRP were assessed through week 26. Nonresponder imputation was used for missing categorical data and last observation carried forward for missing hs-CRP/FC values. No formal hypothesis was tested. Adverse events were monitored.

Results

Mean adalimumab serum concentrations during the induction phase were 13.9–18.1 µg/mL (160/80 mg group) and 7.5−9.5 µg/mL (80/40 mg group). During the double-blind period, higher remission/response rates and greater reductions from baseline in hs-CRP and FC were observed with adalimumab 160/80 mg compared to that with 80/40 mg. Adverse event rates were similar among all treatment groups.

Conclusions

Adalimumab serum concentrations in Chinese patients with CD were comparable to those observed previously in Western and Japanese patients. Clinically meaningful remission rates and improvement in inflammatory markers were achieved with both dosing regimens; changes occurred rapidly with adalimumab 160/80 mg induction therapy. No new safety signals were reported.

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