Intestinal Research

Original Articles

Understanding fatigue among Japanese patients with inflammatory bowel disease: insights from international comparisons and meta-analysis: Makoto Tanaka, Momoko Takai, Sayaka Wakai, Kayoko Sakagami, Hiroaki Ito; Received September 13, 2024 Accepted November 17, 2024 Published online January 22, 2025; DOI: https://doi.org/10.5217/ir.2024.00145 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Fatigue is a common symptom in patients with inflammatory bowel disease (IBD). The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale has demonstrated reliability and validity in assessing fatigue in patients with IBD and is used worldwide. This study aimed to examine the current state of fatigue among Japanese patients with IBD using the FACIT-F scale and to compare these findings with data from global studies through a systematic review.
Methods
Data from 488 patients with IBD treated at a specialized IBD clinic were analyzed. Patient characteristics, such as sex, age, disease duration, disease activity, FACIT-F scores, and sleep duration, were collected. A literature search identified 8 studies that met our inclusion criteria for an international comparison. A meta-analysis was performed on the Fatigue Subscale (FS) scores of FACIT-F to estimate the pooled mean.
Results
The mean FACIT-F (FS) score in this study was 39.9 ± 8.6. Four variables were significantly associated with fatigue: low Emotional Well-Being subscale scores, sleep duration < 6 hours, albumin level below the reference value, and being unmarried. The meta-analysis revealed that the pooled mean score was 40.2 (95% confidence interval, 39.5–40.9), and between-study heterogeneity was moderate (I² = 41%).
Conclusions
The FACIT-F (FS) scores and related factors in Japanese patients with IBD demonstrated a similar trend to those in other countries. These findings can be used to identify patients in need of support and to consider interventions for modifiable factors. This study will help promote international collaborative research.

Citations

Citations to this article as recorded by

Sexual satisfaction and associated factors among patients with inflammatory bowel disease in Japan
Sayaka Wakai, Makoto Tanaka, Momoko Takai, Kayoko Sakagami, Hiroaki Ito
Japan Journal of Nursing Science.2025;[Epub] CrossRef

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Infection

Diagnostic performance of noninvasive tests for cytomegalovirus ileocolitis: a systematic review and meta-analysis: Thanaboon Chaemsupaphan, Onuma Sattayalertyanyong, Julajak Limsrivilai; Intest Res 2025;23(2):213-224. Published online January 14, 2025; DOI: https://doi.org/10.5217/ir.2024.00136

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Diagnosis of cytomegalovirus (CMV) ileocolitis traditionally requires colonoscopy with tissue biopsy. Due to potential complications in high-risk patients, there is growing interest in serum and stool tests for diagnosing this condition. We aimed to evaluate the diagnostic accuracy of these noninvasive tests compared to traditional gold standards.
Methods
Two independent reviewers performed a comprehensive search on MEDLINE and Embase from inception up to October 1, 2023. Prospective and retrospective studies evaluating the performance of serum CMV polymerase chain reaction (PCR), serum CMV antigen (Ag), and stool CMV PCR in diagnosing CMV ileocolitis were included. Tissue histopathology or tissue CMV PCR served as reference standards. Diagnostic performances of each serum and stool test were calculated based on a meta-analysis using random-effects model.
Results
A total of 30 studies, comprising 23 studies of serum CMV PCR, 9 of serum CMV Ag, and 7 of stool CMV PCR, were included. The pooled sensitivity, specificity, and area under summary receiver operating characteristic curves were 62% (95% confidence interval [CI], 51%–72%), 90% (95% CI, 79%–96%), and 0.81 for serum CMV PCR, 38% (95% CI, 26%–51%), 94% (95% CI, 70%–99%), and 0.56 for serum CMV Ag, and 53% (95% CI, 35%–70%), 91% (95% CI, 84%–95%), and 0.84 for stool CMV PCR.
Conclusions
Serum and stool tests cannot replace colonoscopy for diagnosing CMV ileocolitis due to their low sensitivities but may be useful when colonoscopy is not feasible. Positive results can aid diagnosis, given their high specificities. Serum and/or stool CMV PCR are preferred over CMV Ag.

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IBD

Vedolizumab for perianal fistulizing Crohn’s disease: systematic review and meta-analysis: Fares Ayoub, Matthew Odenwald, Dejan Micic, Sushila R. Dalal, Joel Pekow, Russell D. Cohen, David T. Rubin, Atsushi Sakuraba; Intest Res 2022;20(2):240-250. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00091

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Perianal fistulas are a debilitating manifestation of Crohn’s disease (CD). Despite the advent of anti-tumor necrosis factor (anti-TNF) therapy, the medical management of fistulizing CD continues to be challenged by unmet needs. We conducted a systematic review and meta-analysis of the effectiveness of vedolizumab for the management of perianal fistulizing CD.
Methods
A search of PubMed, EMBASE and the Cochrane Library was performed from inception to June 2020 for studies reporting rates of perianal fistula healing in CD patients treated with vedolizumab. The primary outcome of interest was complete healing of perianal fistulas and the secondary outcome was partial healing. The pooled fistula healing rates with 95% confidence intervals (CI) were calculated utilizing a random effects model.
Results
A total of 74 studies were initially identified, 4 of which met the inclusion criteria. A total of 198 patients with active perianal fistulas were included, 87% of whom had failed previous anti-TNF therapy. The pooled complete healing rate was 27.6% (95% CI, 18.9%–37.3%) with moderate heterogeneity (I2=49.4%) and the pooled partial healing rate was 34.9% (95% CI, 23.2%–47.7%) with high heterogeneity (I2=67.1%).
Conclusions
In a meta-analysis of 4 studies that included 198 patients with perianal fistulizing CD, the majority of whom had failed previous anti-TNF therapy, vedolizumab treatment led to healing of perianal fistulas in nearly one-third of the patients. The lack of high-quality data and significant study heterogeneity underscores the need for future prospective studies of fistula healing in patients receiving anti-integrin therapy.

Citations

Citations to this article as recorded by

How to Approach the Difficult Perineum in Crohn's Disease
Emily Rinebold, Alex L. Huang, Sue J. Hahn
Clinics in Colon and Rectal Surgery.2025; 38(02): 148. CrossRef
Fistula in Crohn’s disease: classification, pathogenesis, and treatment options
Kimia Basiji, Nesa Kazemifard, Maryam Farmani, Kasra Jahankhani, Shaghayegh Baradaran Ghavami, Amir Fallahnia, Hesameddin Eghlimi, Adil Mir
Tissue Barriers.2025;[Epub] CrossRef
Perianal Crohn's disease: the experience of taking a multiprofessional approach in a tertiary centre setting
Eathar Shakweh, Johncy Baby, Lisa Younge, Phil Tozer, Ailsa Hart
British Journal of Nursing.2025; 34(8): 406. CrossRef
ACG Clinical Guideline: Management of Crohn's Disease in Adults
Gary R. Lichtenstein, Edward V. Loftus, Anita Afzali, Millie D. Long, Edward L. Barnes, Kim L. Isaacs, Christina Y. Ha
American Journal of Gastroenterology.2025; 120(6): 1225. CrossRef
Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
Inflammatory Bowel Diseases.2024; 30(9): 1579. CrossRef
Choosing Therapy for Moderate to Severe Crohn’s Disease
Malcolm Irani, Bincy Abraham
Journal of the Canadian Association of Gastroenterology.2024; 7(1): 1. CrossRef
Perianal fistulizing Crohn’s disease: Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies
Jalpa Devi, David H. Ballard, Tina Aswani-Omprakash, Alyssa M. Parian, Parakkal Deepak
Indian Journal of Gastroenterology.2024; 43(1): 48. CrossRef
Clinical use of biologics for Crohn’s disease in adults: lessons learned from real-world studies
Antonio Tursi, Giammarco Mocci, Angelo Del Gaudio, Alfredo Papa
Expert Opinion on Biological Therapy.2024; 24(3): 171. CrossRef
Biologics, Small Molecules and More in Inflammatory Bowel Disease: The Present and the Future
Manish Manrai, Atul Abhishek Jha, Saurabh Dawra, Aditya Vikram Pachisia
Future Pharmacology.2024; 4(1): 279. CrossRef
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
The potential for medical therapies to address fistulizing Crohn’s disease: a state-of-the-art review
Mohammad Shehab, Davide De Marco, Peter L. Lakatos, Talat Bessissow
Expert Opinion on Biological Therapy.2024; 24(8): 733. CrossRef
A Crohn-betegég terápiás stratégiája
Klaudia Farkas, Hajnal Székely, Péter Bacsur, Balázs Bánky, Zsuzsa Bianka Élthes, László Harsányi, Katalin Edit Müllner, Ágnes Milassin, Károly Palatka, Patrícia Sarlós, Tamás Szamosi, Tamás Molnár, Pál Miheller
Orvosi Hetilap.2024; 165(Supplement): 1. CrossRef
Terápiás kihívások nehezen kezelhető, penetráló Crohn-betegségben – multidiszciplináris megoldás
Bernadett Farkas, Péter Bacsur, Emese Ivány, Anita Bálint, Mariann Rutka, Klaudia Farkas, Tamás Molnár
Orvosi Hetilap.2024; 165(32): 1252. CrossRef
Refractory Crohn’s Disease: Perspectives, Unmet Needs and Innovations
Luisa Bertin, Martina Crepaldi, Miriana Zanconato, Greta Lorenzon, Daria Maniero, Caterina De Barba, Erica Bonazzi, Sonia Facchin, Marco Scarpa, Cesare Ruffolo, Imerio Angriman, Andrea Buda, Fabiana Zingone, Edoardo Vincenzo Savarino, Brigida Barberio
Clinical and Experimental Gastroenterology.2024; Volume 17: 261. CrossRef
Is There a Best First Line Biological/Small Molecule in IBD: Are We Ready for Sequencing?
Gustavo Drügg Hahn, Petra Anna Golovics, Panu Wetwittayakhlang, Alex Al Khoury, Talat Bessissow, Peter Laszlo Lakatos
Biomedicines.2022; 10(4): 749. CrossRef
The Optimal Management of Fistulizing Crohn’s Disease: Evidence beyond Randomized Clinical Trials
Panu Wetwittayakhlang, Alex Al Khoury, Gustavo Drügg Hahn, Peter Laszlo Lakatos
Journal of Clinical Medicine.2022; 11(11): 3045. CrossRef
Management of Non-response and Loss of Response to Anti-tumor Necrosis Factor Therapy in Inflammatory Bowel Disease
Jan Marsal, Manuel Barreiro-de Acosta, Irina Blumenstein, Maria Cappello, Thomas Bazin, Shaji Sebastian
Frontiers in Medicine.2022;[Epub] CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef

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Inflammatory Bowel Diseases

Efficacy of biologic therapies for biologic-naïve Japanese patients with moderately to severely active ulcerative colitis: a network meta-analysis: Toshifumi Hibi, Isao Kamae, Philippe Pinton, Lyann Ursos, Ryuichi Iwakiri, Greg Hather, Haridarshan Patel; Intest Res 2021;19(1):53-61. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.09146

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Several biologic therapies are approved in Japan to treat moderately to severely active ulcerative colitis (UC), but there are no published comparative efficacy studies in a Japanese population. We compared the efficacy of biologics approved in Japan (adalimumab, infliximab, golimumab, and vedolizumab) for treating biologic-naïve patients with UC at their approved doses.
Methods
A targeted literature review identified 4 randomized controlled trials of biologics for UC in biologicnaïve Japanese patients. For each study, efficacy outcome data from induction (weeks 6–12) and maintenance (weeks 30–60) treatment were extracted for analysis. Treatment effects on clinical response, clinical remission, and mucosal healing relative to the average placebo results across all trials were estimated using network meta-analyses followed by transformation into probabilities and odds ratios (OR).
Results
At the end of induction, the likelihood of clinical response and clinical remission was highest with infliximab (OR: 2.12 and 2.35, respectively) and vedolizumab (OR: 2.10 and 2.32, respectively); the likelihood of mucosal healing was highest with infliximab (OR: 2.24) and adalimumab (OR: 1.86). During maintenance, the likelihood of clinical response and clinical remission was highest with vedolizumab (OR: 6.44 and 4.68, respectively) and golimumab (OR: 5.13 and 3.84, respectively); the likelihood of mucosal healing was significantly higher than placebo with all biologics.
Conclusions
All active treatments were efficacious compared with placebo. Infliximab and vedolizumab had the highest odds for induction of clinical response, remission, and mucosal healing. Golimumab and vedolizumab had numerically higher odds of achieving efficacy outcomes in the maintenance phase.

Citations

Citations to this article as recorded by

Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
Health Science Reports.2024;[Epub] CrossRef
Efficacy and Safety of Etrasimod in Patients with Ulcerative Colitis in Japan: Data from the Phase 3 ELEVATE UC 12 and ELEVATE UC 40 JAPAN Trials
Ken Takeuchi, Tadakazu Hisamatsu, Hiroshi Nakase, Katsuyoshi Matsuoka, Michael Keating, Hirotoshi Yuasa, Motoki Oe, Shoko Arai, Rafal Mazur, Toshifumi Hibi
Digestion.2024; : 1. CrossRef
Selection of anti-cytokine biologics by pretreatment levels of serum leucine-rich alpha-2 glycoprotein in patients with inflammatory bowel disease
Takahiro Amano, Takeo Yoshihara, Shinichiro Shinzaki, Yuko Sakakibara, Takuya Yamada, Naoto Osugi, Satoshi Hiyama, Yoko Murayama, Koji Nagaike, Hideharu Ogiyama, Toshio Yamaguchi, Yuki Arimoto, Ichizo Kobayashi, Shoichiro Kawai, Satoshi Egawa, Takashi Kiz
Scientific Reports.2024;[Epub] CrossRef
The role and prospect of tofacitinib in patients with ulcerative colitis
Jun Lee
Intestinal Research.2023; 21(1): 168. 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
Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
Ji Eun Baek, Sung Wook Hwang
Intestinal Research.2023; 21(3): 277. 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
Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy
Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
Intestinal Research.2022; 20(1): 101. CrossRef
How to Choose the Biologic Therapy in a Bio-naïve Patient with Inflammatory Bowel Disease
Viviana Laredo, Carla J. Gargallo-Puyuelo, Fernando Gomollón
Journal of Clinical Medicine.2022; 11(3): 829. 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
The Prognostic Value of Residual Nonrectal Inflammation in Ulcerative Colitis
Eun Ae Kang
Gut and Liver.2022; 16(3): 487. CrossRef
Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
The Korean Journal of Internal Medicine.2022; 37(6): 1140. 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
Latent and Active Tuberculosis Infection in Patients with Inflammatory Bowel Disease
Byung Chul Jin, Hee Jin Moon, Sang Wook Kim
The Korean Journal of Gastroenterology.2022; 80(2): 72. CrossRef
Improvement in Medication Adherence after Pharmacist Intervention Is Associated with Favorable Clinical Outcomes in Patients with Ulcerative Colitis
Jae Song Kim, Min Jung Geum, Eun Sun Son, Yun Mi Yu, Jae Hee Cheon, Kyeng Hee Kwon
Gut and Liver.2022; 16(5): 736. 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
Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies
Hyo Yeop Song, Geom Seog Seo
Journal of the Korean Medical Association.2021; 64(9): 605. CrossRef
Risk and characteristics of tuberculosis after anti-tumor necrosis factor therapy for inflammatory bowel disease: a hospital-based cohort study from Korea
Jae Yong Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Ho-Su Lee, Kyung-Wook Jo, Sang Hyoung Park
BMC Gastroenterology.2021;[Epub] CrossRef

9,753 View
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