Intestinal Research

Original Article

IBD

Changes in the clinical course and prognosis of ulcerative colitis in Chinese populations: a retrospective cohort study: Xinyu Liu, Qingfan Yang, Na Diao, Jian Tang, Zicheng Huang, Xiang Gao, Kang Chao; Intest Res 2024;22(3):357-368. Published online May 7, 2024; DOI: https://doi.org/10.5217/ir.2023.00106

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Background/Aims
Data on the natural course of Chinese patients with ulcerative colitis (UC) was lacking. This study aimed to evaluate the natural history and prognosis of patients with UC in the past 15 years in China.
Methods
This cohort study included patients with UC in a tertiary hospital in southern China from 2007 to 2021 (cohort I: 2007–2011, cohort II: 2012–2016, cohort III: 2017–2021). Patients’ clinical characteristics and natural history were analyzed retrospectively.
Results
Of 1,139 included patients, 683 patients presented with proctitis or left-sided colitis at diagnosis and 38.5% of them (263/683) developed proximal disease extension. Fifty-eight percent of patients experienced relapse, chronic continuous and intermittent active course. Five patients (0.4%) developed colorectal tumors/dysplasia. The overall surgery rate was 8.6%, and the rates were 14.2%, 7.8%, and 8.0% in the 3 cohorts, respectively (P= 0.059). Average time from diagnosis to surgery decreased from cohorts I to III (144 months vs. 36 months, P< 0.001), so did the use of glucocorticoids (58.2% vs. 43.5%, P< 0.001) and immunosuppressants (14.1% vs. 13.4%, P= 0.016), and days of hospitalization (13 days vs. 9 days, P< 0.001). Biologics were used more frequently during the first year (0.8%, 2.1%, and 13.7% for cohorts I to III, respectively; P< 0.001). The rate of mucosal healing increased over time.
Conclusions
In Chinese UC patients, one-third of patients experienced proximal disease extension. The rates of malignancy and mortality were low. More biologics were used, while use of immunosuppressants and glucocorticoids were reduced over time. Early biologics use seemed to promote mucosal healing, but the rate of colectomy has not dramatically decreased.

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The effects of biologics on ulcerative colitis–related colectomy rate: results of a 22-year study
Nur Beyza Tukek, Oguz Kagan Bakkaloglu, Gozde Sen, İbrahim Hatemi, Aykut Ferhat Celik, Yusuf Ziya Erzin
Scandinavian Journal of Gastroenterology.2025; 60(6): 548. CrossRef

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Review

Microbiota

Gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis: a review: Sung Wook Hwang, Min Kyu Kim, Mi-Na Kweon; Intest Res 2023;21(4):433-442. Published online August 29, 2023; DOI: https://doi.org/10.5217/ir.2023.00019

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Immune checkpoint inhibitors have dramatically revolutionized the therapeutic landscape for patients with advanced malignancies. Recently, convincing evidence has shown meaningful influence of gut microbiome on human immune system. With the complex link between gut microbiome, host immunity and cancer, the variations in the gut microbiota may influence the efficacy of immune checkpoint inhibitors. Indeed, some bacterial species have been reported to be predictive for cancer outcome in patients treated with immune checkpoint inhibitors. Although immune checkpoint inhibitors are currently proven to be an effective anti-tumor treatment, they can induce a distinct form of toxicity, termed immune-related adverse events. Immune-related colitis is one of the common toxicities from immune checkpoint inhibitors, and it might preclude the cancer therapy in severe or refractory cases. The manipulation of gut microbiome by fecal microbiota transplantation or probiotics administration has been suggested as one of the methods to enhance anti-tumor effects and decrease the risk of immune-related colitis. Here we review the role of gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis to provide a new insight for better anti-cancer therapy.

Citations

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Incidence and risk factors of immune checkpoint inhibitor-induced colitis in Korean patients with cancer
Tae Kyun Kim, Hyun Seok Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2025; 40(1): 49. CrossRef
Hidden Partner of Immunity: Microbiome as an Innovative Companion in Immunotherapy
Pyoseung Kim, Sunggeun Joe, Heeyoung Kim, Hyejeong Jeong, Sunghwan Park, Jihwan Song, Wondong Kim, Yong Gu Lee
International Journal of Molecular Sciences.2025; 26(2): 856. CrossRef
Effect of Probiotics on Improving Intestinal Mucosal Permeability and Inflammation after Surgery
Min-Jae Kim, Young Ju Lee, Zahid Hussain, Hyojin Park
Gut and Liver.2025; 19(2): 207. CrossRef
Advances in Genitourinary Tumor Genomics and Immunotherapy
Jasmine Vohra, Gabriela Barbosa, Lívia Bitencourt Pascoal, Leonardo O. Reis
Genes.2025; 16(6): 667. CrossRef
Date yogurt supplemented with Lactobacillus rhamnosus (ATCC 53103) encapsulated in wild sage (Salvia macrosiphon) mucilage and sodium alginate by extrusion: The survival and viability against the gastrointestinal condition, cold storage, heat, and salt wi
Mahsa Abbasi Saadi, Seyed Saeed Sekhavatizadeh, Hassan Barzegar, Behrooz Alizadeh Behbahani, Mohammad Amin Mehrnia
Food Science & Nutrition.2024; 12(10): 7630. CrossRef
Toxicity in the era of immune checkpoint inhibitor therapy
Synat Keam, Naimah Turner, Fernanda G. Kugeratski, Rene Rico, Jocelynn Colunga-Minutti, Rayansh Poojary, Sayan Alekseev, Anisha B. Patel, Yuanteng Jeff Li, Ajay Sheshadri, Monica E. Loghin, Karin Woodman, Ashley E. Aaroe, Sarah Hamidi, Priyanka Chandrasek
Frontiers in Immunology.2024;[Epub] CrossRef
Endoscopic findings of immune checkpoint inhibitor-related gastrointestinal adverse events
Min Kyu Kim, Sung Wook Hwang
Clinical Endoscopy.2024; 57(6): 725. CrossRef
Causality between gut microbiota, immune cells, and breast cancer: Mendelian randomization analysis
Rui Lv, Danyan Wang, Tengyue Wang, Rongqun Li, Aiwen Zhuang
Medicine.2024; 103(49): e40815. CrossRef

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Original Articles

IBD

Performing colonoscopy before steroid induction is associated with shorter steroid use in patients with ulcerative colitis: Taku Kobayashi, Eri Udagawa, Lisa Hirose, Toshifumi Hibi; Intest Res 2023;21(2):205-215. Published online December 15, 2022; DOI: https://doi.org/10.5217/ir.2021.00164

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Background/Aims
Risks of long-term steroid use in patients with ulcerative colitis (UC) outweigh the benefits, thus dosing should be tapered once a response is achieved. Colonoscopy is a key technique for assessing disease severity and optimizing treatment involving steroids. This retrospective longitudinal cohort study of patients with UC explored factors associated with the duration of systemic steroid use.
Methods
The Japan Medical Data Center database, an employer-based insurance claims database, was used to select individuals initiating prednisolone, with a prescription issued between January 1, 2010, and January 31, 2018. The study included adults with a confirmed diagnosis of UC, who had received ≥1 year of continuous treatment with 5-aminosalicylic acid, biologics, or thiopurine. Factors associated with prednisolone duration were assessed using a multivariate regression model.
Results
Median duration of prednisolone treatment was 98 days, and colonoscopy was performed ≤1 month before or at the first prescription of prednisolone (index date) in 32.8% of patients (607/1,853). Shorter durations of prednisolone treatment were associated with colonoscopy ≤1 month before or at the index date and higher prednisolone dose at index date, with incidence rate ratios (IRRs) of 0.776 (95% confidence interval [CI], 0.682–0.884; P<0.001) and 0.998 (95% CI, 0.996–1.000; P=0.018), respectively. Charlson Comorbidity Index scores of 1 and ≥2 predicted longer prednisolone treatment (IRR, 1.332; 95% CI, 1.174–1.511; P<0.001 and IRR, 1.599; 95% CI, 1.357–1.885; P<0.001, respectively).
Conclusions
Performing colonoscopy before or at the time of initiating steroid was associated with a shorter duration of steroid use in patients with UC.

Citations

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Quercus infectoria galls mitigates colitis in mice through alleviating mucosal barrier impairment and suppressing inflammatory factors
Yan Ding, Jiao-Jiao Bai, Sabahat Ablimit, Muyassar Yasen, Arfidin Anwar, Kudelaidi Kuerban, Mubarak Iminjan, Guo-Qiang Zhang
Journal of Ethnopharmacology.2025; 343: 119487. CrossRef
Main active components of Sishen Wan may modulate T cells-related proinflammatory cytokines via alleviating mitochondrial damage caused by oxidative stress in dextran sulphate sodium-induced ulcerative colitis
Ke Li, Weiguang Lv, Boning Zhang, Shengnan Han, Jing Han, Yu Zhang, Wei Wang, Weiyu Zang, Anqi Yang, Hongjia Wang, Chenggang Zhang
Chinese Journal of Analytical Chemistry.2025; : 100562. CrossRef

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IBD

Drug therapy and monitoring for inflammatory bowel disease: a multinational questionnaire investigation in Asia: Chenwen Cai, Juntao Lu, Lijie Lai, Dongjuan Song, Jun Shen, Jinlu Tong, Qing Zheng, Kaichun Wu, Jiaming Qian, Zhihua Ran; Intest Res 2022;20(2):213-223. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2021.00031

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Background/Aims
The incidence and prevalence of inflammatory bowel disease (IBD) is rising in Asia recently. The study aimed to obtain a comprehensive understanding of the current status of drug therapy and monitoring for IBD in Asia.
Methods
A questionnaire investigation on drug therapy and monitoring for IBD was conducted right before the 6th Annual Meeting of Asian Organization for Crohn’s & Colitis. Questionnaires were provided to Asian physicians to fill out via emails between March and May 2018.
Results
In total, responses of 166 physicians from 129 medical centers were included for analysis. Among the surveyed regions, the most average number of IBD specialist gastroenterologists and nurses was 4.8 per center in Taiwan and 2.5 per center in Mainland China, respectively. 5-Aminosalicylic acid/sulfasalazine (99.4%) was the most preferred first-line choice for mild-moderate ulcerative colitis (UC), meanwhile corticosteroid (83.7%) was widely applied for severe UC. The first-line medication for Crohn’s disease (CD) markedly varied as corticosteroid (68.1%) was the most favored in Mainland China, Japan, and South Korea, followed by infliximab (52.4%) and azathioprine (47.0%). Step-up strategy was preferred in mild-moderate UC (96.4%), while 51.8% of the physicians selected top-down treatment for CD. Only 25.9% and 17.5% of the physicians could test blood concentration of infliximab and antibody to infliximab in their hospitals, respectively.
Conclusions
The current status of drug therapy and monitoring for IBD in Asia possesses commonalities as well as differences. Asian recommendations, IBD specialist teams and practice of therapeutic drug monitoring are required to improve IBD management in Asia.

Citations

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Expression and role of CTHRC1 in inflammatory bowel disease in children
Heng Tang, Xiang Gao, Zhaofang Wu, Jia Chen, Li Chen, Xiang Du
Cytotechnology.2025;[Epub] CrossRef
Importance of STAT3 signaling in preeclampsia (Review)
Daniela Marzioni, Federica Piani, Nicoletta Di Simone, Stefano Giannubilo, Andrea Ciavattini, Giovanni Tossetta
International Journal of Molecular Medicine.2025;[Epub] CrossRef
Optimizing Infliximab Use in Real-World Inflammatory Bowel Disease: Insights from a Population Pharmacokinetic Model Integrating Intravenous and Subcutaneous Formulations
Sung Hoon Jung, Sang-Bum Kang
Gut and Liver.2025; 19(3): 299. CrossRef
New genetic biomarkers predicting 5-aminosalicylate-induced adverse events in patients with inflammatory bowel diseases
Jihye Park, I. Seul Park, Ji Hyung Kim, Jung Hyun Ji, Soo Jung Park, Jae Jun Park, Tae Il Kim, Seung Won Kim, Jae Hee Cheon
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
Primary surgery versus pharmacotherapy for newly diagnosed ileocecal Crohn’s disease: a hospital-based cohort study
Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
The Korean Journal of Internal Medicine.2024; 39(5): 759. CrossRef
Signal detection and analysis of sulfasalazine adverse reaction events based on the US FDA adverse event reporting database
Yikuan Du, Lingzhi Zhang, Liang Shi, Zhuoming Guo, Ziyi Luo, Ye Zheng, Yu Zeng, Yin Huang, Jiawen Luo, Xiaochun Guo, Mianda Hu, Yuhong Chen, Jinfeng Zhu, Yi Liu, Chun Yang
Expert Opinion on Drug Safety.2024; : 1. CrossRef
Impact of Concomitant 5-Aminosalicylic Acid Therapy on Vedolizumab Efficacy and Safety in Inflammatory Bowel Disease: Post Hoc Analyses of Clinical Trial Data
Ryan C Ungaro, Harisha Kadali, Wenwen Zhang, Shashi Adsul, Walter Reinisch
Journal of Crohn's and Colitis.2023; 17(12): 1949. CrossRef

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Inflammatory Bowel Diseases

Is there a correlation between infliximab trough levels and the development of adverse events in patients with inflammatory bowel disease?: Eirini Theodoraki, Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou, Evangelia Legaki, Maria Gazouli, Ioannis E. Koutroubakis; Intest Res 2021;19(4):461-467. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00042

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Background/Aims
The measurement of infliximab trough levels (IFX-TLs) in patients with inflammatory bowel disease (IBD) is performed to optimize treatment. However, the association between the development of adverse events (AEs) and IFX-TLs has not been sufficiently studied thus far. To investigate the possible association of IFX-TLs with AEs in Greek patients with IBD receiving maintenance treatment with IFX.
Methods
A retrospective analysis of the registry data of the Gastroenterology Department of the University Hospital of Heraklion, from IBD patients with at least one available IFX-TL measurement during the years 2016 to 2017 was conducted. AEs reported 4 months before and 4 months after the measured IFX-TLs were recorded. The IFX-TLs of patients with or without AEs were compared.
Results
Of a total of 83 IBD patients (61 Crohn’s disease [73%]; 52 men [63%]; mean age ± standard deviation, 43.3 ± 16.0 years), 147 measurements of IFX-TLs were available (median 4.69 μg/ mL [1.32–9.16]), and 99 AEs (67.3%, 14 severe) were registered. The median IFX-TL of patients with AEs was 5.79 μg/mL (1.36– 10.25), higher than the median IFX-TL of patients without AEs (3.40 μg/mL [1.30–5.92]), but the difference was not significant (P= 0.97). The presence of infections or dermatologic reactions was not correlated with IFX-TLs. There was no difference in the prevalence of the total AEs (66.7% vs. 73.3%, P= 0.77) or in the analysis of AEs by group between patients with IFX-TLs ≥ 15 μg/ mL and patients with IFX-TLs < 15 μg/mL.
Conclusions
IFX-TLs are not significantly associated with the development of AEs in IBD patients receiving maintenance treatment with IFX.

Citations

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Identifying risk factors of anti‐TNF induced skin lesions and other adverse events in paediatric patients with inflammatory bowel disease
Karen van Hoeve, Debby Thomas, Tom Hillary, Ilse Hoffman, Erwin Dreesen
Journal of Pediatric Gastroenterology and Nutrition.2024; 78(1): 95. CrossRef
Pharmacogenetics in personalized treatment in pediatric patients with inflammatory bowel disease (IBD)
Daniela Kosorínová, Pavlína Suchá, Zuzana Havlíčeková, Marek Pršo, Pavol Dvoran, Peter Bánovčin
Česko-slovenská pediatrie.2024; 79(4): 213. CrossRef
Comparison of the Pharmacokinetics of CT-P13 Between Crohn’s Disease and Ulcerative Colitis
Eun Soo Kim, Sung Kook Kim, Dong Il Park, Hyo Jong Kim, Yoo Jin Lee, Ja Seol Koo, Eun Sun Kim, Hyuk Yoon, Ji Hyun Lee, Ji Won Kim, Sung Jae Shin, Hyung Wook Kim, Hyun-Soo Kim, Young Sook Park, You Sun Kim, Tae Oh Kim, Jun Lee, Chang Hwan Choi, Dong Soo Ha
Journal of Clinical Gastroenterology.2023; 57(6): 601. CrossRef
Effect of antinuclear antibodies on pharmacokinetics of anti-TNF therapy in patients with inflammatory bowel disease
Eirini Theodoraki, Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou, Nikolaos-Panagiotis Andreou, Maria Gazouli, Ioannis E. Koutroubakis
International Journal of Colorectal Disease.2022; 37(3): 639. CrossRef
Can Anti-Tumor Necrosis Factor Agents Be Discontinued in Patients with Inflammatory Bowel Disease?
Jihye Park, Jae Hee Cheon
Gut and Liver.2021; 15(5): 641. 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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IBD

Randomized, crossover questionnaire survey of acceptabilities of controlled-release mesalazine tablets and granules in ulcerative colitis patients: Keiji Yagisawa, Taku Kobayashi, Ryo Ozaki, Shinji Okabayashi, Takahiko Toyonaga, Miki Miura, Mari Hayashida, Eiko Saito, Masaru Nakano, Hajime Matsubara, Tadakazu Hisamatsu, Toshifumi Hibi; Intest Res 2019;17(1):87-93. Published online December 14, 2018; DOI: https://doi.org/10.5217/ir.2018.00078; Correction in: Intest Res 2020;18(3):343

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Background/Aims
Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazine increases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilities of these formulations may influence patient adherence; however, they have not been compared to date. This study aimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossover questionnaire survey.
Methods
UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group took either 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6 to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analog scale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed.
Results
A total of 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found the tablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2 formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence rate was slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was not significant (P=0.139).
Conclusions
CR mesalazine granules are more acceptable than tablets, and may therefore be a better option for long-term medication.

Citations

Citations to this article as recorded by

Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
Filiz Akyüz, Yoon Kyo An, Jakob Begun, Satimai Aniwan, Huu Hoang Bui, Webber Chan, Chang Hwan Choi, Nazeer Chopdat, Susan J Connor, Devendra Desai, Emma Flanagan, Taku Kobayashi, Allen Yu-Hung Lai, Rupert W Leong, Alex Hwong-Ruey Leow, Wai Keung Leung, Ju
Intestinal Research.2025; 23(1): 37. CrossRef
Non-Adherence Rate to Oral Mesalamine in Ulcerative Colitis Patients: A Systematic Review with Meta-Analysis
Cristiano Pagnini, Elisabetta Antonelli, Barbara Scrivo, Maria Cappello, Marco Soncini, Roberto Vassallo, Giammarco Mocci, Maria Carla Di Paolo
Journal of Personalized Medicine.2025; 15(4): 123. CrossRef
Shared decision-making improves adherence to mesalamine in ulcerative colitis: A prospective, multicenter, non-interventional cohort study in Germany
Wolfgang Kruis, Petra Jessen, Julia Morgenstern, Birgitta Reimers, Nike Müller-Grage, Bernd Bokemeyer
World Journal of Gastroenterology.2025;[Epub] CrossRef
Continuing or stopping 5‐aminosalicylates in patients with inflammatory bowel disease on anti‐TNF therapy: A nationwide population‐based study
Jeongkuk Seo, Seonok Kim, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Ye‐Jee Kim, Byong Duk Ye
Alimentary Pharmacology & Therapeutics.2024; 60(3): 389. CrossRef
A review on taste masked multiparticulate dosage forms for paediatric
Khater AL-Japairai, Samah Hamed Almurisi, Abd Almonem Doolaanea, Syed Mahmood, Fawaz Alheibshy, Ahmed Alobaida, Nadiya Abdul-Halim, Bappaditya Chatterjee
International Journal of Pharmaceutics.2023; 632: 122571. CrossRef
Medication Formulation Preference of Mild and Moderate Ulcerative Colitis Patients: a European Survey
Xavier Hébuterne, Stephan R Vavricka, Helen C Thorne, Lara MacKenzie-Smith, Raphaël Laoun, Johan Burisch
Inflammatory Intestinal Diseases.2023; 8(1): 41. CrossRef
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Xinyi Guo, Changxing Liu, Yahui Huang, Naeem Jan
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
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Natsuko Ishida, Yurina Tokumoto, Yukio Suga, Moeko Noguchi-Shinohara, Chiemi Abe, Sohshi Yuki-Nozaki, Ayaka Mori, Mai Horimoto, Koji Hayashi, Kazuo Iwasa, Masami Yokogawa, Mai Ishimiya, Hiroyuki Nakamura, Kiyonobu Komai, Ryo Matsushita, Junko Ishizaki, Ma
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You Sun Kim
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Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef
Association of Self-Reported Medication Adherence with Potentially Inappropriate Medications in Elderly Patients: A Cross-Sectional Pilot Study
Motoyasu Miyazaki, Masanobu Uchiyama, Yoshihiko Nakamura, Koichi Matsuo, Chika Ono, Miwa Goto, Ayako Unoki, Akio Nakashima, Osamu Imakyure
International Journal of Environmental Research and Public Health.2020; 17(16): 5940. CrossRef
Mesalazine granule formulation improves clinical data in Crohn's disease compared with tablet formulation
Satoshi Tamura, Natsuki Ishida, Takahiro Miyazu, Shunya Onoue, Shinya Tani, Mihoko Yamade, Yasushi Hamaya, Moriya Iwaizumi, Satoshi Osawa, Takahisa Furuta, Ken Sugimoto
Scientific Reports.2020;[Epub] CrossRef

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IBD

Medication non-adherence in inflammatory bowel diseases is associated with disability: Jonathan Perry, Andy Chen, Viraj Kariyawasam, Glen Collins, Chee Choong, Wei Ling Teh, Nikola Mitrev, Friedbert Kohler, Rupert Wing Loong Leong; Intest Res 2018;16(4):571-578. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00033

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Background/Aims
Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term consequences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily functional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence.
Methods
Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability: <3.5) and Beliefs about Medicines Questionnaire (high necessity/concerns: ≥16). The primary outcome was the association between medication non-adherence and disability. Secondary outcomes were the predictors of these outcomes.
Results
A total of 173 subjects on IBD maintenance medications were recruited (98 Crohn’s disease, 75 ulcerative colitis: median IBD-DI, –5.0; interquartile range [IQR], –14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P<0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (–16.0 vs. –2.0, P<0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P<0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50–9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14–6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11–5.92; P=0.028).
Conclusions
Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability.

Citations

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Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
Filiz Akyüz, Yoon Kyo An, Jakob Begun, Satimai Aniwan, Huu Hoang Bui, Webber Chan, Chang Hwan Choi, Nazeer Chopdat, Susan J Connor, Devendra Desai, Emma Flanagan, Taku Kobayashi, Allen Yu-Hung Lai, Rupert W Leong, Alex Hwong-Ruey Leow, Wai Keung Leung, Ju
Intestinal Research.2025; 23(1): 37. CrossRef
Understanding Medication Nonadherence in Crohn’s Disease Patients: A Qualitative Evaluation
Robert E Brady, Jessica K Salwen-Deremer, Natalie C Tunnell, Michael W Winter
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Attitudes to medication and effects of IBD nursing service among patients with inflammatory bowel disease in Taiwan
Chen‐Ta Yang, Tsui‐Chun Hsu, Yang‐Yuan Chen, Siou‐Ping Huang, Hsu‐Heng Yen
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COMPLIANCE AND QUALITY OF LIFE OF PATIENTS WITH INFLAMMATORY BOWEL DISEASES
R.J. JAMOLOVA, D.K. MUKHABBATOV, D.T. RAKHMONOV, S.G. ALI-ZADE
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High refill-adherence to adalimumab is associated with low disease activity in patients with inflammatory bowel disease
Esma H. San, Angelique Egberts, Caroline W. Th. van Dijck - van Boetzelaer, Rachel L. West, Erwin C. Vasbinder
European Journal of Clinical Pharmacology.2024; 80(7): 1089. CrossRef
MMX mesalamine in ulcerative colitis: Major advantages towards classical mesalamine formulations
Ferdinando D'Amico, Francesca Lusetti, Laurent Peyrin-Biroulet, Silvio Danese
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Caterina Mercuri, Maria Catone, Vincenzo Bosco, Assunta Guillari, Teresa Rea, Patrizia Doldo, Silvio Simeone
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Filippo Vernia, Giorgia Burrelli Scotti, Raffaele Borghini, Mario Muselli, Stefano Necozione, Giovanni Moretta, Lorenza Scurti, Giuseppe Donato
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Laura Frank, Kelly Lambert
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Fen Xu, Jingjing Xing, Mingna Fan, Zhiping Zhu, Yan Chen, Wen Hu, Yunxian Zhou
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Yanfang Liu, Choo Hua Goh, Hong Qiu, Kuan-Chih Huang, Hsingwen Chung, Carine Saadoun
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IBD

Evaluation of the drug-induced lymphocyte stimulation test for diagnosing mesalazine allergy: Daisuke Saito, Mari Hayashida, Taro Sato, Shintaro Minowa, Osamu Ikezaki, Tatsuya Mitsui, Miki Miura, Akihito Sakuraba, Tadakazu Hisamatsu; Intest Res 2018;16(2):273-281. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.273

Abstract PDF PubReader ePub

Background/Aims

Mesalazine is an effective drug for treating ulcerative colitis (UC), but causes allergic symptoms in a few cases. Therefore, the objective of this study was to evaluate the usefulness of the drug-induced lymphocyte stimulation test (DLST) for the diagnosis of mesalazine allergy.

Methods

Patients with UC treated with mesalazine with or without a history of associated adverse events (AEs) were enrolled at Kyorin University Hospital from July 2016 to April 2017.

Results

The DLST was performed in 104 patients with UC, of which 24 had a history of AEs due to mesalazine treatment. The control value of DLST was 337.4±296.3 counts per minute (cpm) in the AE⁺ group and 408.0±371.9 cpm in the AE⁻ group. The measured value of DLST was 578.8±424.7 cpm in the AE⁺ group and 476.5±471.8 cpm in the AE⁻ group. The stimulation index (SI) was 243.9%±291.1% in the AE⁺ group and 119.8%±53.0% in the AE⁻ group. The SI value and DLST positivity were significantly higher in the AE⁺ group than in the AE⁻ group (P=0.030 and P=0.029, respectively). The test sensitivity and specificity were 0.240 and 0.805, respectively, and the false-positive and false-negative rate was 0.195 and 0.760, respectively.

Conclusions

The DLST for mesalazine showed low sensitivity and high specificity, suggesting that it may be useful for the definitive diagnosis of allergy to mesalazine.

Citations

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Evaluation of Xpert MTB/RIF assay performance in the diagnosis of abdominal tuberculosis: Suraj Kumar, Sawan Bopanna, Saurabh Kedia, Pratap Mouli, Rajan Dhingra, Rajesh Padhan, Mikashmi Kohli, Jigyasa Chaubey, Rohini Sharma, Prasenjit Das, S Dattagupta, Govind Makharia, SK Sharma, Vineet Ahuja; Intest Res 2017;15(2):187-194. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.187

Abstract PDF PubReader ePub

Background/Aims

The use of genetic probes for the diagnosis of pulmonary tuberculosis (TB) has been well described. However, the role of these assays in the diagnosis of intestinal tuberculosis is unclear. We therefore assessed the diagnostic utility of the Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay, and estimated the prevalence of multidrug-resistant (MDR) TB in the Indian population.

Methods

Of 99 patients recruited, 37 had intestinal TB; two control groups comprised 43 with Crohn's disease (CD) and 19 with irritable bowel syndrome. Colonoscopy was performed before starting any therapy; mucosal biopsies were subjected to histopathology, acid-fast bacilli staining, Lowenstein-Jensen culture, and nucleic acid amplification testing using the Xpert MTB/RIF assay. Patients were followed up for 6 months to confirm the diagnosis and response to therapy. A composite reference standard was used for diagnosis of TB and assessment of the diagnostic utility of the Xpert MTB/RIF assay.

Results

Of 37 intestinal TB patients, the Xpert MTB/RIF assay was positive in three of 37 (8.1%), but none had MDR-TB. The sensitivity, specificity, positive predictive value, and negative predictive value of the Xpert MTB/RIF assay was 8.1%, 100%, 100%, and, 64.2%, respectively.

Conclusions

The Xpert MTB/RIF assay has low sensitivity but high specificity for intestinal TB, and may be helpful in endemic tuberculosis areas, when clinicians are faced with difficulty differentiating TB and CD. Based on the Xpert MTB/RIF assay, the prevalence of intestinal MDR-TB is low in the Indian population.

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Case Report

Metronidazole-induced encephalopathy in a patient with Crohn's disease: Jihye Kim, Jaeyoung Chun, Jae Yong Park, Seung Wook Hong, Joo Young Lee, Jin Woo Kang, Seongjun Hwang, Sang-Bae Ko, Jong Pil Im, Joo Sung Kim; Intest Res 2017;15(1):124-129. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.124

Abstract PDF PubReader ePub

Metronidazole is a widely used antibiotic for the treatment of anaerobic bacterial infections. Metronidazole-induced encephalopathy (MIEP) is a rare but potentially reversible disease. The mechanism of MIEP remains unclear, and differences in the neurotoxic effects of oral versus intravenous (IV) metronidazole administration have not yet been determined. We report the case of a Crohn's disease (CD) patient who experienced encephalopathy immediately after a single IV dose of metronidazole following long-term exposure to the oral form of the drug. The 64-year-old man with intractable CD experienced a sudden change in mental status, aphasia, and muscle weakness after IV administration of metronidazole. He had previously taken metronidazole orally for 13 years and received intermittent IV metronidazole treatments for CD exacerbation. Brain magnetic resonance imaging (MRI) showed high-intensity signals in the bilateral medial thalamus and the midbrain and pontine tegmentum on fluid-attenuated inversion recovery images. After discontinuation of metronidazole, the high-intensity brain MRI signals resolved and the patient's mental status dramatically improved; however, the patient exhibited mild cognitive dysfunction 2 months after the onset of encephalopathy.

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Review

Natural Product-Derived Drugs for the Treatment of Inflammatory Bowel Diseases: Young-Eun Joo; Intest Res 2014;12(2):103-109. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.103

Abstract PDF PubReader

Natural products have been used as drugs for millennia, and the therapeutic potential of natural products has been studied for more than a century. Since the mid-1880s, approximately 60% of drugs have originated from natural products. Recently, the importance of using natural products has increased, as has interest in discovering efficient new drugs. Natural drugs are desirable for the treatment of inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease. This review discusses the discovery and development of drugs derived from natural products for the treatment of inflammatory bowel diseases.

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