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[PMID]:28453766
[Au] Autor:Lim KJ; Lee SJ; Kim S; Lee SY; Lee MS; Park YA; Choi EJ; Lee EB; Jun HK; Cho JM; Lee S; Kwon KS; Lim BP; Jeon MS; Shin EC; Choi YS; Fudim E; Picard O; Yavzori M; Ben-Horin S; Chang SJ
[Ad] Endereço:R&D Division, Celltrion Inc., Incheon, Korea.
[Ti] Título:Comparable Immune Function Inhibition by the Infliximab Biosimilar CT-P13: Implications for Treatment of Inflammatory Bowel Disease.
[So] Source:J Crohns Colitis;11(5):593-602, 2017 May 01.
[Is] ISSN:1876-4479
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and Aims: CT-P13 is the first biosimilar monoclonal antibody to infliximab, and was recently approved in the European Union, Japan, Korea, and USA for all six indications of infliximab. However, studies directly assessing the biologic activity of CT-P13 versus inflximab in the context of inflammatory bowel disease [IBD] are still scanty. In the present study, we aimed to compare the biological activities of CT-P13 and infliximab with specific focus on intestinal cells so as to gain insight into the potential biosimilarity of these two agents for treatment of IBD. Methods: CT-P13 and infliximab were investigated and compared by in vitro experiments for their neutralisation ability of soluble tumour necrosis factor alpha [sTNFα] and membrane-bound tumour necrosis factor alpha [mTNFα], suppression of cytokine release by reverse signalling, induction of regulatory macrophages and wound healing, and antibody-dependent cell cytotoxicity [ADCC]. Results: CT-P13 showed similar biological activities to infliximab as gauged by neutralisation of soluble TNFα, as well as blockade of apoptosis and suppression of pro-inflammatory cytokines in intestinal Caco-2 cells. Infliximab and CT-P13 equally induced apoptosis and outside-to-inside signals through transmembrane TNFα [tmTNFα]. Moreover, regulatory macrophage induction and ensuing wound healing were similarly exerted by CT-P13 and infliximab. However, neither CT-P13 nor infliximab exerted any significant ADCC of ex vivo-stimulated peripheral blood monocytes or lamina propria mononuclear cells from IBD patients. Conclusions: These findings indicate that CT-P13 and infliximab exert highly similar biological activities in intestinal cells, and further support a mechanistic comparability of these two drugs in the treatment of IBD.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/farmacologia
Medicamentos Biossimilares/farmacologia
Fármacos Gastrointestinais/farmacologia
Doenças Inflamatórias Intestinais/tratamento farmacológico
Infliximab/farmacologia
Intestinos/efeitos dos fármacos
[Mh] Termos MeSH secundário: Anticorpos Monoclonais/uso terapêutico
Medicamentos Biossimilares/uso terapêutico
Células CACO-2/efeitos dos fármacos
Citocinas/metabolismo
Fármacos Gastrointestinais/uso terapêutico
Seres Humanos
Técnicas In Vitro
Infliximab/uso terapêutico
Intestinos/citologia
Intestinos/imunologia
Macrófagos/efeitos dos fármacos
Fator de Necrose Tumoral alfa/metabolismo
Cicatrização/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Biosimilar Pharmaceuticals); 0 (CT-P13); 0 (Cytokines); 0 (Gastrointestinal Agents); 0 (Tumor Necrosis Factor-alpha); B72HH48FLU (Infliximab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/ecco-jcc/jjw183


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[PMID]:28453755
[Au] Autor:Davidov Y; Ungar B; Bar-Yoseph H; Carter D; Haj-Natour O; Yavzori M; Chowers Y; Eliakim R; Ben-Horin S; Kopylov U
[Ad] Endereço:Department of Gastroenterology, Sheba Medical Center, Tel-Aviv, Israel.
[Ti] Título:Association of Induction Infliximab Levels With Clinical Response in Perianal Crohn's Disease.
[So] Source:J Crohns Colitis;11(5):549-555, 2017 May 01.
[Is] ISSN:1876-4479
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: The association of infliximab [IFX] trough levels with clinical and endoscopic outcomes in inflammatory bowel disease is well established. However, there is scarce data regarding the association of perianal fistula response with IFX. The aim of this study was to establish whether early induction infliximab levels and anti-infliximab antibodies [ATIs] are associated with perianal fistula response. Methods: Consecutive CD patients with perianal fistulae that were treated with IFX between 2008 and 2016 were included in the study. Response was defined as cessation or significant improvement of fistula drainage. Patients with unavailable IFX level or ATI measurements and/or missing clinical follow-up at Week 14 were excluded. Results: A total of 36 patients with perianal fistulae were included; 25/36 [69.4%] responded to treatment by Week 14. The median induction IFX levels at Weeks 2, 6 and 14 in the responders group at Week 14 were higher compared with those of the non-responders group [20/5.6 µg/mL, P = 0.0001; 13.3/2.55 µg/mL P = 0.0001; 4.1/0.14 µg/mL, P = 0.01]. On multivariate analysis, IFX leve at Weeks 2 and 6 were significantly associated with fistula response at Weeks 14 and 30. IFX drug levels of 9.25 µg/mL at Week 2 and 7.25 µg/mL at Week 6 were the best predictors of fistula response. Conclusion: High IFX trough levels during induction are associated with favorable fistula response to anti-TNF treatment. If validated in a larger prospective study, our findings may help guide anti-TNF treatment in patients with perianal CD, and suggest serum level-guided treatment escalation in non-responders or prompt changing of biologic treatment in non-responders.
[Mh] Termos MeSH primário: Doença de Crohn/tratamento farmacológico
Fármacos Gastrointestinais/uso terapêutico
Infliximab/uso terapêutico
Fístula Retal/etiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Doença de Crohn/complicações
Feminino
Fármacos Gastrointestinais/administração & dosagem
Fármacos Gastrointestinais/sangue
Seres Humanos
Infliximab/administração & dosagem
Infliximab/sangue
Masculino
Fístula Retal/tratamento farmacológico
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Gastrointestinal Agents); B72HH48FLU (Infliximab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/ecco-jcc/jjw182


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[PMID]:29364909
[Au] Autor:de Bruyn JR; Becker MA; Steenkamer J; Wildenberg ME; Meijer SL; Buskens CJ; Bemelman WA; Löwenberg M; Ponsioen CY; van den Brink GR; D'Haens GR
[Ad] Endereço:Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
[Ti] Título:Intestinal fibrosis is associated with lack of response to Infliximab therapy in Crohn's disease.
[So] Source:PLoS One;13(1):e0190999, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Overt fibrostenotic disease is a relative contraindication for anti-TNF therapy in Crohn's disease. We hypothesized that subclinical fibrosis may also contribute to an incomplete response to anti-TNF therapy before the onset of symptomatic stenosis. METHODS: In a previous trial, patients with ileocecal Crohn's disease were randomized to either immediate ileocecal resection or medical treatment with Infliximab. In case of insufficient response to Infliximab, the latter underwent secondary ileocecal resection. We compared specimens from those patients undergoing immediate resection (Infliximab naïve, n = 20) to those who failed Infliximab therapy (n = 20). RESULTS: Infliximab naïve and Infliximab failure patients had similar severity of inflammation when assessed by CRP levels (median 14 vs 9 mg/L) and histology (Geboes-D'Haens-score, median 10 vs 11 points). On immunohistochemistry, collagen-III and fibronectin depositions were increased in patients previously exposed to Infliximab compared to patients naïve to Infliximab. On mRNA level, procollagen peptidase showed significantly more mucosal mRNA expression in Crohn's disease patients who failed Infliximab. Infliximab responders showed no increase of this marker after 4 weeks of successful Infliximab treatment. DISCUSSION: Failure to Infliximab therapy is associated with subclinical fibrosis in Crohn's disease.
[Mh] Termos MeSH primário: Doença de Crohn/tratamento farmacológico
Fármacos Gastrointestinais/uso terapêutico
Infliximab/uso terapêutico
Enteropatias/complicações
[Mh] Termos MeSH secundário: Adulto
Doença de Crohn/complicações
Doença de Crohn/metabolismo
Proteínas da Matriz Extracelular/metabolismo
Feminino
Fibrose
Seres Humanos
Enteropatias/metabolismo
Enteropatias/patologia
Mucosa Intestinal/enzimologia
Masculino
Meia-Idade
Pró-Colágeno N-Endopeptidase/metabolismo
Reação em Cadeia da Polimerase Via Transcriptase Reversa
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Extracellular Matrix Proteins); 0 (Gastrointestinal Agents); B72HH48FLU (Infliximab); EC 3.4.24.14 (Procollagen N-Endopeptidase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190999


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[PMID]:29360138
[Au] Autor:Lawrie TA; Green JT; Beresford M; Wedlake L; Burden S; Davidson SE; Lal S; Henson CC; Andreyev HJN
[Ad] Endereço:Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group, 1st Floor Education Centre, Royal United Hospital, Combe Park, Bath, UK, BA1 3NG.
[Ti] Título:Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic cancers.
[So] Source:Cochrane Database Syst Rev;1:CD012529, 2018 Jan 23.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: An increasing number of people survive cancer but a significant proportion have gastrointestinal side effects as a result of radiotherapy (RT), which impairs their quality of life (QoL). OBJECTIVES: To determine which prophylactic interventions reduce the incidence, severity or both of adverse gastrointestinal effects among adults receiving radiotherapy to treat primary pelvic cancers. SEARCH METHODS: We conducted searches of CENTRAL, MEDLINE, and Embase in September 2016 and updated them on 2 November 2017. We also searched clinical trial registries. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of interventions to prevent adverse gastrointestinal effects of pelvic radiotherapy among adults receiving radiotherapy to treat primary pelvic cancers, including radiotherapy techniques, other aspects of radiotherapy delivery, pharmacological interventions and non-pharmacological interventions. Studies needed a sample size of 20 or more participants and needed to evaluate gastrointestinal toxicity outcomes. We excluded studies that evaluated dosimetric parameters only. We also excluded trials of interventions to treat acute gastrointestinal symptoms, trials of altered fractionation and dose escalation schedules, and trials of pre- versus postoperative radiotherapy regimens, to restrict the vast scope of the review. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodology. We used the random-effects statistical model for all meta-analyses, and the GRADE system to rate the certainty of the evidence. MAIN RESULTS: We included 92 RCTs involving more than 10,000 men and women undergoing pelvic radiotherapy. Trials involved 44 different interventions, including radiotherapy techniques (11 trials, 4 interventions/comparisons), other aspects of radiotherapy delivery (14 trials, 10 interventions), pharmacological interventions (38 trials, 16 interventions), and non-pharmacological interventions (29 trials, 13 interventions). Most studies (79/92) had design limitations. Thirteen studies had a low risk of bias, 50 studies had an unclear risk of bias and 29 studies had a high risk of bias. Main findings include the following:Radiotherapy techniques: Intensity-modulated radiotherapy (IMRT) versus 3D conformal RT (3DCRT) may reduce acute (risk ratio (RR) 0.48, 95% confidence interval (CI) 0.26 to 0.88; participants = 444; studies = 4; I = 77%; low-certainty evidence) and late gastrointestinal (GI) toxicity grade 2+ (RR 0.37, 95% CI 0.21 to 0.65; participants = 332; studies = 2; I = 0%; low-certainty evidence). Conformal RT (3DCRT or IMRT) versus conventional RT reduces acute GI toxicity grade 2+ (RR 0.57, 95% CI 0.40 to 0.82; participants = 307; studies = 2; I = 0%; high-certainty evidence) and probably leads to less late GI toxicity grade 2+ (RR 0.49, 95% CI 0.22 to 1.09; participants = 517; studies = 3; I = 44%; moderate-certainty evidence). When brachytherapy (BT) is used instead of external beam radiotherapy (EBRT) in early endometrial cancer, evidence indicates that it reduces acute GI toxicity (grade 2+) (RR 0.02, 95% CI 0.00 to 0.18; participants = 423; studies = 1; high-certainty evidence).Other aspects of radiotherapy delivery: There is probably little or no difference in acute GI toxicity grade 2+ with reduced radiation dose volume (RR 1.21, 95% CI 0.81 to 1.81; participants = 211; studies = 1; moderate-certainty evidence) and maybe no difference in late GI toxicity grade 2+ (RR 1.02, 95% CI 0.15 to 6.97; participants = 107; studies = 1; low-certainty evidence). Evening delivery of RT may reduce acute GI toxicity (diarrhoea) grade 2+ during RT compared with morning delivery of RT (RR 0.51, 95% CI 0.34 to 0.76; participants = 294; studies = 2; I = 0%; low-certainty evidence). There may be no difference in acute (RR 2.22, 95% CI 0.62 to 7.93, participants = 110; studies = 1) and late GI toxicity grade 2+ (RR 0.44, 95% CI 0.12 to 1.65; participants = 81; studies = 1) between a bladder volume preparation of 1080 mls and that of 540 mls (low-certainty evidence). Low-certainty evidence on balloon and hydrogel spacers suggests that these interventions for prostate cancer RT may make little or no difference to GI outcomes.Pharmacological interventions: Evidence for any beneficial effects of aminosalicylates, sucralfate, amifostine, corticosteroid enemas, bile acid sequestrants, famotidine and selenium is of a low or very low certainty. However, evidence on certain aminosalicylates (mesalazine, olsalazine), misoprostol suppositories, oral magnesium oxide and octreotide injections suggests that these agents may worsen GI symptoms, such as diarrhoea or rectal bleeding.Non-pharmacological interventions: Low-certainty evidence suggests that protein supplements (RR 0.23, 95% CI 0.07 to 0.74; participants = 74; studies = 1), dietary counselling (RR 0.04, 95% CI 0.00 to 0.60; participants = 74; studies = 1) and probiotics (RR 0.43, 95% CI 0.22 to 0.82; participants = 923; studies = 5; I = 91%) may reduce acute RT-related diarrhoea (grade 2+). Dietary counselling may also reduce diarrhoeal symptoms in the long term (at five years, RR 0.05, 95% CI 0.00 to 0.78; participants = 61; studies = 1). Low-certainty evidence from one study (108 participants) suggests that a high-fibre diet may have a beneficial effect on GI symptoms (mean difference (MD) 6.10, 95% CI 1.71 to 10.49) and quality of life (MD 20.50, 95% CI 9.97 to 31.03) at one year. High-certainty evidence indicates that glutamine supplements do not prevent RT-induced diarrhoea. Evidence on various other non-pharmacological interventions, such as green tea tablets, is lacking.Quality of life was rarely and inconsistently reported across included studies, and the available data were seldom adequate for meta-analysis. AUTHORS' CONCLUSIONS: Conformal radiotherapy techniques are an improvement on older radiotherapy techniques. IMRT may be better than 3DCRT in terms of GI toxicity, but the evidence to support this is uncertain. There is no high-quality evidence to support the use of any other prophylactic intervention evaluated. However, evidence on some potential interventions shows that they probably have no role to play in reducing RT-related GI toxicity. More RCTs are needed for interventions with limited evidence suggesting potential benefits.
[Mh] Termos MeSH primário: Trato Gastrointestinal/efeitos da radiação
Neoplasias Pélvicas/radioterapia
Lesões por Radiação/prevenção & controle
Radioterapia Conformacional/efeitos adversos
[Mh] Termos MeSH secundário: Diarreia/etiologia
Diarreia/prevenção & controle
Fármacos Gastrointestinais/uso terapêutico
Trato Gastrointestinal/efeitos dos fármacos
Seres Humanos
Efeito Placebo
Radioterapia de Intensidade Modulada/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Gastrointestinal Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012529.pub2


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[PMID]:29355546
[Au] Autor:Shen P; Zhang Z; He Y; Gu C; Zhu K; Li S; Li Y; Lu X; Liu J; Zhang N; Cao Y
[Ad] Endereço:College of Veterinary Medicine, Jilin University, Changchun 130062, People's Republic of China.
[Ti] Título:Magnolol treatment attenuates dextran sulphate sodium-induced murine experimental colitis by regulating inflammation and mucosal damage.
[So] Source:Life Sci;196:69-76, 2018 Mar 01.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Magnolol, the main and active ingredient of the Magnolia officinalis, has been widely used in traditional prescription to the human disorders. Magnolol has been proved to have several pharmacological properties including anti-bacterial, anti-oxidant and anti-inflammatory activities. However, the effects of magnolol on ulcerative colitis (UC) have not been reported. The aim of this study was to investigate the protective effects and mechanisms of magnolol on dextran sulphate sodium (DSS)-induced colitis in mice. The results showed that magnolol significantly alleviated DSS-induced body weight loss, disease activities index (DAI), colon length shortening and colonic pathological damage. In addition, magnolol restrained the expression of TNF-α, IL-1ß and IL-12 via the regulation of nuclear factor-κB (NF-κB) and Peroxisome proliferator-activated receptor-γ (PPAR-γ) pathways. Magnolol also enhanced the expression of ZO-1 and occludin in DSS-induced mice colonic tissues. These results showed that magnolol played protective effects on DSS-induced colitis and may be an alternative therapeutic reagent for colitis treatment.
[Mh] Termos MeSH primário: Compostos de Bifenilo/uso terapêutico
Colite Ulcerativa/induzido quimicamente
Colite Ulcerativa/tratamento farmacológico
Sulfato de Dextrana
Fármacos Gastrointestinais/uso terapêutico
Mucosa Intestinal/efeitos dos fármacos
Lignanas/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Ceco/microbiologia
Colite Ulcerativa/patologia
Colo/patologia
Citocinas/biossíntese
Inflamação/fisiopatologia
Inflamação/prevenção & controle
Mediadores da Inflamação
Mucosa Intestinal/patologia
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Ocludina/antagonistas & inibidores
Ocludina/biossíntese
PPAR gama/efeitos dos fármacos
Perda de Peso/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biphenyl Compounds); 0 (Cytokines); 0 (Gastrointestinal Agents); 0 (Inflammation Mediators); 0 (Lignans); 0 (Occludin); 0 (PPAR gamma); 001E35HGVF (magnolol); 9042-14-2 (Dextran Sulfate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180123
[St] Status:MEDLINE


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[PMID]:29173359
[Au] Autor:Al-Bayati I; Saadi M; Elhanafi S; McCallum RW
[Ad] Endereço:Department of Internal Medicine, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, El Paso, Texas.
[Ti] Título:Effectiveness of Bulking Agent (Solesta) Therapy in Fecal Incontinence in Patients Refractory to Conventional Therapies.
[So] Source:Am J Med Sci;354(5):476-479, 2017 11.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fecal incontinence is a problem that imposes considerable socioeconomic consequences. Despite many medical therapies, unmet needs remain. A new treatment option is a biocompatible bulking agent (Solesta) administered by submucosal injection in the distal rectum. The aims of this study are as follows: (1) To evaluate the efficacy and safety of this bulking agent in decreasing the severity of fecal incontinence (FI) and improving quality of life. (2) To obtain objective evidence of changes in anorectal physiology by high-resolution anorectal manometry pretreatment and posttreatment. MATERIALS AND METHODS: From January 2014 to June 2015, 17 patients who had failed medical therapy for FI received stabilized hyaluronate injected submucosally into the rectum under direct anoscopic visualization. The treatment was considered successful if patients achieved >50% reduction in FI events during monitoring for up to 12 months. RESULTS: After the first treatment session, 14 patients (82.3%) had a successful outcome. The remaining 3 patients received a second therapy 3 months later to achieve this result. At last follow-up, 7 of the 17 patients (41%) were having no FI events. The remaining patients had reduction in fecal accidents from a mean of 6.4/week baseline to 2.8/week during follow-up. CONCLUSIONS: Intrarectal injection of stabilized hyaluronate is effective for treating FI in patients who had failed standard medical treatments and is technically easy and safely performed as an outpatient procedure.
[Mh] Termos MeSH primário: Dextranos/administração & dosagem
Incontinência Fecal/tratamento farmacológico
Fármacos Gastrointestinais/administração & dosagem
Ácido Hialurônico/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Injeções Subcutâneas
Masculino
Meia-Idade
Reto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dextrans); 0 (Gastrointestinal Agents); 0 (dextranomer-hyaluronic acid copolymer); 9004-61-9 (Hyaluronic Acid)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:29384953
[Au] Autor:Taguchi H; Kanmura S; Maeda T; Iwaya H; Arima S; Sasaki F; Nasu Y; Tanoue S; Hashimoto S; Ido A
[Ad] Endereço:Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
[Ti] Título:Helicobacter pylori eradication improves the quality of life regardless of the treatment outcome: A multicenter prospective cohort study.
[So] Source:Medicine (Baltimore);96(52):e9507, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Helicobacter pylori (Hp) eradication is recommended for improving the quality of life (QOL) of patients with epigastric symptoms, especially reflux and dyspepsia. However, no reports have investigated the improvement of QOL after the eradication of Hp irrespective of epigastric symptoms. The aim of this study was to investigate the improvement in the QOL after the eradication of Hp irrespective of epigastric symptoms, and evaluate the factors associated with an improved QOL after the eradication of Hp.This prospective cohort study was performed at 15 referral institutions from September 2013 to December 2014. The patients' QOL and epigastric symptoms were evaluated before and after the eradication of Hp using the 8-item Short-Form Health Survey (SF-8) and the modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease, respectively.One hundred sixty-five of 184 Hp-infected patients underwent Hp eradication treatment. The treatment was successful in 82.4% (136/165) of the cases. One hundred sixty of the 165 Hp-infected patients were eligible for inclusion in the QOL analysis. In the indices of QOL on the SF-8, the scores on both the mental component summary (MCS) and the physical component summary (PCS) were found to have significantly improved after the eradication of Hp. However, the epigastric symptoms before the eradication of Hp were not correlated with either the MCS or PCS. A low QOL value before the eradication of Hp was the factor what was most strongly associated with the improvement in the QOL.The eradication of Hp improved the QOL, regardless of the outcome of the treatment, especially in patients who had an impaired QOL before the eradication.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Gastrite Atrófica/complicações
Fármacos Gastrointestinais/uso terapêutico
Infecções por Helicobacter/complicações
Infecções por Helicobacter/tratamento farmacológico
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/administração & dosagem
Emoções
Feminino
Gastrite Atrófica/fisiopatologia
Gastrite Atrófica/psicologia
Fármacos Gastrointestinais/administração & dosagem
Nível de Saúde
Helicobacter pylori
Seres Humanos
Relações Interpessoais
Masculino
Saúde Mental
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gastrointestinal Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009507


  8 / 8553 MEDLINE  
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[PMID]:29202588
[Au] Autor:van Hoeve K; Hoffman I; Vermeire S
[Ad] Endereço:a Department of Pediatric Gastroenterology , University Hospitals Leuven , Leuven , Belgium.
[Ti] Título:Therapeutic drug monitoring of anti-TNF therapy in children with inflammatory bowel disease.
[So] Source:Expert Opin Drug Saf;17(2):185-196, 2018 Feb.
[Is] ISSN:1744-764X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Although anti-TNF therapy has changed the scenery of pediatric inflammatory bowel diseases (IBD) immensely, there are still patients with an unfortunate outcome. Approximately one third of patients that initially respond to anti-TNF therapy will lose that response over time and need treatment optimization. Loss of response (LOR) is a big concern in IBD management and especially among pediatric patients where treatment options are more limited than in adults. In children it is even more important to sustain response with minimal toxicity. Therapeutic drug monitoring (TDM) is proposed as a tool to reach this goal. Areas covered: This review focuses on the importance of TDM of anti-TNF and the role TDM has in clinical practice of pediatric IBD. Expert opinion: Although TDM is not yet widely used in pediatric IBD, the available literature suggests it to be a promising tool, especially in patients with LOR to anti-TNF. There is increasing evidence that also in children, higher anti-TNF drug levels are associated with sustained response, and likewise low or undetectable trough levels increase the likelihood of LOR. TDM-based treat to target strategies are being designed in adult studies, but more prospective studies also in pediatric IBD populations looking at the role of proactive testing are needed.
[Mh] Termos MeSH primário: Monitoramento de Medicamentos/métodos
Doenças Inflamatórias Intestinais/tratamento farmacológico
Fator de Necrose Tumoral alfa/antagonistas & inibidores
[Mh] Termos MeSH secundário: Adulto
Criança
Fármacos Gastrointestinais/administração & dosagem
Fármacos Gastrointestinais/efeitos adversos
Fármacos Gastrointestinais/farmacologia
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Gastrointestinal Agents); 0 (Tumor Necrosis Factor-alpha)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1080/14740338.2018.1413090


  9 / 8553 MEDLINE  
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[PMID]:27777142
[Au] Autor:Fløisand Y; Lundin KEA; Lazarevic V; Kristiansen JD; Osnes LTN; Tjønnfjord GE; Reims HM; Gedde-Dahl T
[Ad] Endereço:Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: yfl70@me.com.
[Ti] Título:Targeting Integrin α4ß7 in Steroid-Refractory Intestinal Graft-versus-Host Disease.
[So] Source:Biol Blood Marrow Transplant;23(1):172-175, 2017 Jan.
[Is] ISSN:1523-6536
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Steroid refractory acute graft-versus-host-disease of the gut is a serious complication associated with high mortality after allogeneic stem cell transplantation. Treatment options are limited and not predictably effective. We describe the treatment of steroid-refractory acute graft-versus-host-disease with vedolizumab, an antibody directed against integrin α4ß7, in 6 patients. All patients responded, and 4 of 6 patients are alive with a median follow-up of 10 months.
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico
Doença Enxerto-Hospedeiro/tratamento farmacológico
Integrinas/efeitos dos fármacos
Enteropatias/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Feminino
Fármacos Gastrointestinais/uso terapêutico
Doença Enxerto-Hospedeiro/patologia
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Terapia de Salvação/métodos
Esteroides/uso terapêutico
Transplante Homólogo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (Gastrointestinal Agents); 0 (Integrins); 0 (Steroids); 0 (integrin alpha4beta7); 9RV78Q2002 (vedolizumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29369874
[Au] Autor:Aschenbrenner DS
[Ad] Endereço:Diane S. Aschenbrenner is an assistant professor at Notre Dame of Maryland University in Baltimore. She also coordinates Drug Watch: daschenbrenner@ndm.edu.
[Ti] Título:Excessive Dosing of Obeticholic Acid May Increase Risk of Liver Damage.
[So] Source:Am J Nurs;118(2):46, 2018 Feb.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doença Hepática Induzida por Substâncias e Drogas/etiologia
Ácido Quenodesoxicólico/análogos & derivados
Fármacos Gastrointestinais/efeitos adversos
[Mh] Termos MeSH secundário: Ácido Quenodesoxicólico/administração & dosagem
Ácido Quenodesoxicólico/efeitos adversos
Colangite/tratamento farmacológico
Relação Dose-Resposta a Droga
Fármacos Gastrointestinais/administração & dosagem
Seres Humanos
Estados Unidos
United States Food and Drug Administration
[Pt] Tipo de publicação:NEWS
[Nm] Nome de substância:
0 (Gastrointestinal Agents); 0462Z4S4OZ (obeticholic acid); 0GEI24LG0J (Chenodeoxycholic Acid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000530245.53335.c8



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