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Coe CL, Horst SN, Izzy MJ. Neurologic Toxicities Associated with Tumor Necrosis Factor Inhibitors and Calcineurin Inhibitors. Neurol Clin 2020; 38:937-951. [PMID: 33040870 DOI: 10.1016/j.ncl.2020.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The calcineurin inhibitors cyclosporine and tacrolimus are used for their immunosuppressive effects. Neurotoxic side effects include tremor, paresthesia, and headache. Rarer neurotoxicities include seizure, posterior reversible encephalopathy syndrome, and encephalopathy. Tacrolimus tends to be more neurotoxic than cyclosporine. Management of toxicities associated with calcineurin inhibitors includes dose reduction, switching between calcineurin inhibitors, or switching to a calcineurin-free regimen. Tumor necrosis factor (TNF) inhibitors are used in autoimmune diseases. Management of demyelinating conditions among patients treated with anti-TNF should follow standard of care and withdrawal of the anti-TNF. This drug class should be avoided in patients with a history of demyelinating conditions.
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Affiliation(s)
- Christopher L Coe
- Department of Medicine, Section of Hospital Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 37232, USA. https://twitter.com/ccoemd
| | - Sarah N Horst
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building, Suite 220, Nashville, TN 37232, USA. https://twitter.com/HorstIBDDoc
| | - Manhal J Izzy
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Transplant Hepatology, 1660 The Vanderbilt Clinic, Nashville, TN 37232, USA.
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2
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Chen C, Borrego ME, Roberts MH, Raisch DW. Comparison of post-marketing surveillance approaches regarding infections related to tumor necrosis factor inhibitors (TNFi’s) used in treatment of autoimmune diseases. Expert Opin Drug Saf 2019; 18:733-744. [DOI: 10.1080/14740338.2019.1630063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C. Chen
- College of Pharmacy, University of New Mexico, Albuquerque, NM, USA
| | - M. E. Borrego
- College of Pharmacy, University of New Mexico, Albuquerque, NM, USA
| | - M. H. Roberts
- College of Pharmacy, University of New Mexico, Albuquerque, NM, USA
| | - D. W. Raisch
- College of Pharmacy, University of New Mexico, Albuquerque, NM, USA
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Safety Profile of Certolizumab Pegol in Patients with Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-Analysis. Drug Saf 2015; 38:869-88. [DOI: 10.1007/s40264-015-0336-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Moon W, Pestana L, Becker B, Loftus EV, Hanson KA, Bruining DH, Tremaine WJ, Kane SV. Efficacy and safety of certolizumab pegol for Crohn's disease in clinical practice. Aliment Pharmacol Ther 2015; 42:428-40. [PMID: 26081839 DOI: 10.1111/apt.13288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/13/2015] [Accepted: 06/01/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Certolizumab pegol (CZP) is Food and Drug Administration (FDA)-approved to treat Crohn's disease (CD). However, the efficacy and safety of CZP outside clinical trials are not well established. AIM To report the efficacy, safety and predictors of response to CZP in CD patients treated during a 6-year period since FDA-approval at a tertiary care centre. METHODS All CD patients who received CZP at our institution between 2008 and 2013 were evaluated through retrospective medical record-based review of steroid-free complete response (SCR), loss of response and safety. RESULTS A total of 358 patients were included. One hundred twelve patients (31.3%) and 189 (52.8%) received CZP as their second and third biological agent, respectively. The probability of SCR at 26 week was 19.9% (95% CI, 15.9-24.5). The probability of survival free of loss of response at 2 year was 45.7% (95% CI, 32.5-59.5). A predictor of SCR was age at CD diagnosis of >40 years old (hazard ratio, HR relative to those <17, 4.69; 95% CI, 1.75-12.61). Negative predictors included present perianal fistula (HR, 0.39; 95% CI, 0.16-0.98) and prior primary nonresponse to adalimumab (ADA; HR relative to secondary loss of response, 0.18; 95% CI, 0.04-0.76). Twenty-three patients (6.4%) experienced serious adverse events and 19 patients (5.3%) discontinued CZP due to adverse events. CONCLUSIONS Certolizumab pegol was both effective and well tolerated for the treatment of Crohn's disease in this large tertiary care centre enriched with biologics-exposed patients. It may be more effective in patients without early-aged Crohn's disease diagnosis, prior primary nonresponse to adalimumab and present perianal fistula.
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Affiliation(s)
- W Moon
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.,Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - L Pestana
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - B Becker
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - E V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - K A Hanson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - D H Bruining
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - W J Tremaine
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S V Kane
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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Gilet H, Arnould B, Fofana F, Clerson P, Colombel JF, D’Hondt O, Faure P, Hagège H, Nachury M, Nahon S, Tucat G, Vandromme L, Cazala-Telinge I, Thibout E. Measuring patients' satisfaction with their anti-TNF treatment in severe Crohn's disease: scoring and psychometric validation of the Satisfaction for PAtients in Crohn's diseasE Questionnaire (SPACE-Q(©)). Patient Prefer Adherence 2014; 8:1671-81. [PMID: 25525343 PMCID: PMC4262217 DOI: 10.2147/ppa.s72004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Severe Crohn's disease management includes anti-tumor necrosis factor (anti-TNF) drugs that differ from early-stage treatments regarding efficacy, safety, and convenience. This study aimed to finalize and psychometrically validate the Satisfaction for PAtients in Crohn's diseasE Questionnaire (SPACE-Q(©)), developed to measure satisfaction with anti-TNF treatment in patients with severe Crohn's disease. METHODS A total of 279 patients with severe Crohn's disease receiving anti-TNF therapy completed the SPACE-Q 62-item pilot version at inclusion and 12 and 13 weeks after first anti-TNF injection. The final SPACE-Q scoring was defined using multitrait and regression analyses and clinical relevance considerations. Psychometric validation included clinical validity against Harvey-Bradshaw score, concurrent validity against Treatment Satisfaction Questionnaire for Medication (TSQM), internal consistency reliability, test-retest reliability, and responsiveness against the patient global impression of change (PGIC). RESULTS Quality of completion was good (55%-67% of patients completed all items). Four items were removed from the questionnaire. Eleven scores were defined within the final 58-item SPACE-Q: disease control; symptoms, anal symptoms, and quality of life transition scales; tolerability; convenience; expectation confirmation toward efficacy, side effects, and convenience; satisfaction with treatment; and motivation. Scores met standards for concurrent validity (correlation between SPACE-Q satisfaction with treatment and TSQM satisfaction scores =0.59), internal consistency reliability (Cronbach's α=0.67-0.93), test-retest reliability (intraclass correlations =0.62-0.91), and responsiveness (improvement in treatment experience assessed by the SPACE-Q for patients reporting improvement on the PGIC). Significantly different mean scores were observed between groups of patients with different Harvey-Bradshaw disease severity scores. CONCLUSION The SPACE-Q is a valid, reliable, and responsive instrument to measure satisfaction with anti-TNF treatment in patients with severe Crohn's disease and for use in future studies.
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Affiliation(s)
- Hélène Gilet
- HEOR and Strategic Market Access, Mapi, Lyon, France
| | | | | | | | | | | | | | - Hervé Hagège
- Centre Hospitalier Intercommunal, Créteil, France
| | | | - Stéphane Nahon
- Centre Hospitalier Intercommunal, Le Raincy Montfermeil, France
| | - Gilbert Tucat
- Gastroenterologist, Private Clinical Practice, Paris, France
| | - Luc Vandromme
- Gastroenterologist, Private Clinical Practice, Reims, France
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Augustine JM, Lee JK, Armstrong EP. Health outcomes and cost-effectiveness of certolizumab pegol in the treatment of Crohn's disease. Expert Rev Pharmacoecon Outcomes Res 2014; 14:599-609. [PMID: 25209304 DOI: 10.1586/14737167.2014.957680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Crohn's disease (CD) causes chronic inflammation of the gastrointestinal tract and leads to fluctuations between active disease and remission. Certolizumab pegol is one of the newer biological treatments for patients with moderate-to-severe CD. Certolizumab pegol was shown to be effective in CD patients achieving response and remission in both randomized and non-randomized studies, and is an alternative biological treatment for CD. The available data show that certolizumab pegol achieves similar therapeutic efficacy and health-related quality of life scores in CD patients as the other biological agents, but at a higher cost, if dose escalation of other biologics is not considered. Considering subcutaneous self-administration, and lower number and frequency of injections, patients may prefer certolizumab pegol over the other biological treatments.
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Affiliation(s)
- Jill M Augustine
- University of Arizona College of Pharmacy, 1295 N. Martin Ave. Tucson, AZ 85721-0202, USA
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Cohen LB, Nanau RM, Delzor F, Neuman MG. Biologic therapies in inflammatory bowel disease. Transl Res 2014; 163:533-56. [PMID: 24467968 DOI: 10.1016/j.trsl.2014.01.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 11/26/2013] [Accepted: 01/02/2014] [Indexed: 12/12/2022]
Abstract
Inflammatory bowel disease, including its 2 entities ulcerative colitis and Crohn's disease, is a chronic medical condition characterized by the destructive inflammation of the intestinal tract. Biologics represent a class of therapeutics with immune intervention potential. These agents block the proinflammatory cascade that triggers the activation and proliferation of T lymphocytes at the level of the intestine, therefore reestablishing the balance between the pro- and anti-inflammatory messages. All 7 biologics showing clinical benefits in inflammatory bowel disease are monoclonal antibodies. The following systematic review discusses the pharmacokinetics and efficacy of the tumor necrosis factor blockers infliximab, adalimumab, certolizumab pegol, and golimumab. In addition, we describe the α4 integrin inhibitors natalizumab and vedolizumab, which are directed against cell adhesion molecules, as well as the interleukin 12/23 blocker ustekinumab.
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Affiliation(s)
- Lawrence B Cohen
- Division of Gastroenterology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada; Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Radu M Nanau
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada
| | - Faustine Delzor
- In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada
| | - Manuela G Neuman
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada.
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Effects of infliximab retreatment after consecutive discontinuation of infliximab and adalimumab in refractory Crohn's disease. Inflamm Bowel Dis 2014; 20:251-8. [PMID: 24378599 DOI: 10.1097/01.mib.0000438248.14218.1d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Switches between anti-tumor necrosis factor agents in the treatment of Crohn's disease (CD) occur in case of treatment failure, intolerance, or patient preference. No data are currently available on the usefulness of a second infliximab treatment after earlier discontinuation and previous switch to an alternative anti-tumor necrosis factor agent. In this study, we evaluated the clinical benefit of infliximab retreatment in patients with CD after sequential use of both infliximab and adalimumab. METHODS Twenty-nine patients with CD who had received earlier treatments with sequential infliximab and adalimumab and were then restarted on infliximab were retrieved from a multicenter registry designed for the follow-up of adalimumab treatment for CD. Short-term and sustained effects of infliximab retreatment were evaluated retrospectively by reviewing clinical records. Follow-up was 18 months for all patients. RESULTS In 13/29 (45%) patients, infliximab was reintroduced at intensified dosing schedule (>5 mg/kg or <8 wk) for 23/29 (79%) of patients similar to the schedule who were on at time of previous discontinuation. During the second infliximab treatment course, dosing was further intensified in 11 out of 29 (38%) patients. After 18 months 18/29 (62%), patients were still on continued therapy of their second infliximab treatment. Infliximab was discontinued (after a median of 7 mo) in 11 out of 29 patients for loss of response (n = 7 [24%]), intolerance (n = 3 [10%]), or non-compliance (n = 1 [3%]). Use of induction schedule or concomitant immunomodulators were not significantly associated with treatment benefit. CONCLUSIONS The majority of patients with CD benefit from a second treatment with infliximab after previous treatment with infliximab and adalimumab, which offer a meaningful therapeutic option in often highly refractory patients.
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Renna S, Orlando A, Cottone M. Comparing medical treatments for Crohn's disease. J Comp Eff Res 2013; 2:135-49. [PMID: 24236556 DOI: 10.2217/cer.13.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The drugs available for inflammatory bowel disease are aminosalicylates, antibiotics, steroids, immunosuppressors and biologics. The effectiveness of these drugs has been evaluated in many randomized clinical trials, mainly versus placebo. Few studies have been conducted comparing the different drugs among themselves, owing to the methodological problems raised by comparative trials, such as sample size and blindness. This review focuses mainly on the randomized clinical trials that have compared different treatments. Of course comparisons are mainly between drugs used in a particular setting (mild, moderate and severe disease). However, on many occasions there is no homogeneity in these clinical settings, and therefore the results are difficult to interpret.
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Affiliation(s)
- Sara Renna
- DI.BI.MIS., Division of Internal Medicine "Villa Sofia-V. Cervello" Hospital, University of Palermo, Palermo, Italy
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Ferrante M, Vermeire S, Rutgeerts PJ. Drug safety evaluation of certolizumab pegol. Expert Opin Drug Saf 2013; 13:255-66. [PMID: 24156537 DOI: 10.1517/14740338.2014.851666] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The introduction of antibodies directed against tumor necrosis factor (anti-TNF) has dramatically changed our concept of treating both patients with Crohn's disease (CD) and patients with rheumatoid arthritis (RA). Subcutaneous injections with certolizumab pegol (CZP) have been shown efficacious for both CD and RA. In this review, the authors focus on the safety of CZP among other anti-TNF agents. AREAS COVERED A literature search till June 2013 was performed to identify all trials studying CZP in patients with CD and RA. In addition, abstracts of major congresses were assessed. The authors first focused on the mechanism of action of CZP, and evaluated the efficacy of this drug in both CD and RA. Next, they explored the available safety data on CZP, including infection and malignancy risk, injection site reactions, the development of antibodies against CZP, as well as its use during pregnancy. EXPERT OPINION Based on the provided literature, CZP seems to have a similar safety profile to other anti-TNF agents. However, in young females considering pregnancy, CZP may be advocated over other anti-TNF agents as it does not actively cross the placenta.
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Affiliation(s)
- Marc Ferrante
- University Hospitals Leuven, Department of Gastroenterology , Herestraat 49, B3000 Leuven , Belgium +32 16 34 42 25 ; +32 16 34 44 19 ;
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Ferrante M, Vermeire S, Rutgeerts P. Certolizumab pegol in the treatment of Crohn's disease. Expert Opin Biol Ther 2013; 13:595-605. [DOI: 10.1517/14712598.2013.777039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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12
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Ivens IA, Baumann A, McDonald TA, Humphries TJ, Michaels LA, Mathew P. PEGylated therapeutic proteins for haemophilia treatment: a review for haemophilia caregivers. Haemophilia 2012; 19:11-20. [DOI: 10.1111/j.1365-2516.2012.02931.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2012] [Indexed: 12/27/2022]
Affiliation(s)
- I. A. Ivens
- Bayer HealthCare Pharmaceuticals; San Francisco; CA; USA
| | | | - T. A. McDonald
- Bayer HealthCare Pharmaceuticals; San Francisco; CA; USA
| | | | - L. A. Michaels
- Bayer HealthCare Pharmaceuticals; San Francisco; CA; USA
| | - P. Mathew
- Bayer HealthCare Pharmaceuticals; San Francisco; CA; USA
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Evans AT, Lee SD. A review and expert opinion of the use of certolizumab for Crohn's disease. Expert Opin Biol Ther 2012; 12:363-70. [PMID: 22339409 DOI: 10.1517/14712598.2012.658770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Crohn's disease (CD) is a chronic, idiopathic, inflammatory bowel disease with no known cure. In those patients with moderate to severe disease, the result is often a clinically debilitating condition. In the last decade, one of the most significant developments in therapy has been a class of biological agents that neutralize TNFa. Certolizumab pegol (CZP) is the most recently FDA approved anti-TNF agent for the induction and maintenance of moderate to severely active Crohn's disease. AREAS COVERED The currently available evidence regarding the use of CZP in CD, the expected efficacy and possible adverse events associated with this population. EXPERT OPINION CZP is a TNFa inhibitor that is a safe and effective agent for treatment of CD. It has several unique features which make it useful in patients with moderate to severe disease.
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Affiliation(s)
- Ashley T Evans
- University of Washington, Medical Center, Gastroenterology, 1959 NE Pacific St, WA 98195, USA
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Blonski W, Buchner AM, Lichtenstein GR. Patient adherence and efficacy of certolizumab pegol in the management of Crohn's disease. CLINICAL MEDICINE INSIGHTS. GASTROENTEROLOGY 2012; 5:11-21. [PMID: 24833930 PMCID: PMC3987757 DOI: 10.4137/cgast.s7613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Treatment with Anti-Tumor Necrosis Factor (anti-TNF) therapy has become a mainstay of therapy for patients with CD who are unresponsive to conventional medical management. Currently there are three anti-TNFα antibodies that have been approved by the US Food and Drug Administration for the treatment of CD, namely infliximab, adalimumab and certolizumab pegol (CZP). Several double blind placebo controlled trials determined that CZP is effective as induction and maintenance treatment in adult patients with CD regardless of their prior exposure to other anti-TNFα antibodies. This review discusses the efficacy of CZP and adherence to therapy with anti-TNFα antibodies in patients with CD.
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Affiliation(s)
- Wojciech Blonski
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA. ; Department of Gastroenterology, Medical University, Wroclaw, Poland
| | - Anna M Buchner
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA
| | - Gary R Lichtenstein
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA
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