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Calderón P, Núñez P, Nos P, Quera R. Personalised therapy in inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:763-770. [PMID: 38101615 DOI: 10.1016/j.gastrohep.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
Inflammatory bowel diseases (IBD), with ulcerative colitis and Crohn's disease being their most common presentations, comprise a spectrum of diverse disease phenotypes, exhibiting variable behaviors ranging from an indolent course to aggressive phenotypes that impact quality of life of these patients. The last two decades have been marked by the development of new medications (biological therapy and novel small molecules) with diverse mechanisms of action, which have revolutionized the management of IBD, thereby enhancing the quality of life for these patients. This landscape of multiple therapeutic options underscores the need to define which medication will benefit each patient the most and at what speed it should be started. The objective of this review is to present personalized approaches for patients with IBD, thus contributing to therapeutic management.
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Affiliation(s)
- Paula Calderón
- Programa de Enfermedad Inflamatoria Intestinal, Centro de Enfermedades Digestivas, Clínica Universidad de Los Andes, Santiago, Chile
| | - Paulina Núñez
- Programa de Enfermedad Inflamatoria Intestinal, Centro de Enfermedades Digestivas, Clínica Universidad de Los Andes, Santiago, Chile; Sección de Gastroenterología, Departamento de Medicina Interna, Universidad de los Andes, Santiago, Chile; Hospital San Juan de Dios, Facultad de Medicina Occidente, Universidad de Chile, Santiago, Chile
| | - Pilar Nos
- Servicio de Aparato Digestivo en Hospital Universitari y Politécnic la Fe de Valencia, Valencia, España
| | - Rodrigo Quera
- Programa de Enfermedad Inflamatoria Intestinal, Centro de Enfermedades Digestivas, Clínica Universidad de Los Andes, Santiago, Chile; Sección de Gastroenterología, Departamento de Medicina Interna, Universidad de los Andes, Santiago, Chile.
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2
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Massironi S, Furfaro F, Bencardino S, Allocca M, Danese S. Immunity in digestive diseases: new drugs for inflammatory bowel disease treatment-insights from Phase II and III trials. J Gastroenterol 2024:10.1007/s00535-024-02130-x. [PMID: 38980426 DOI: 10.1007/s00535-024-02130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), continues to challenge treatment paradigms. Advancements in therapeutic options have been have been driven by Phase 2 and 3 clinical trials of new drug classes, particularly sphingosine-1-phosphate (S1P) modulators and interleukin-23 (IL-23) inhibitors. METHODS This review synthesizes findings from Phase 2 and 3 clinical trials conducted up to early 2024, focusing on the impact of S1P modulators and IL-23 inhibitors on IBD management. Drugs such as ozanimod, etrasimod, risankizumab, mirikizumab, guselkumab, and brasikumab were evaluated for their efficacy and safety profiles. RESULTS S1P modulators, such as ozanimod and etrasimod, effectively regulate immune cell trafficking to reduce inflammation and several trials highlight their clinical effectiveness in both inducing and maintaining remission in IBD, highlighting its long-term safety and sustained therapeutic effects. Additionally, IL-23 inhibitors including risankizumab, mirikizumab, and guselkumab, which disrupt key inflammatory cytokine pathways, have already shown significant effectiveness in inducing and maintaining remission in both CD and UC, with favorable safety profiles across multiple studies, suggesting their potential as critical components in managing IBD. CONCLUSIONS The clinical trials indicate that both S1P modulators and IL-23 inhibitors offer promising therapeutic benefits and maintain strong safety profiles, positioning them as potential cornerstone treatments for IBD. Despite these advancements, further exploration into long-term safety and the development of personalized treatment strategies is essential for maximizing clinical outcomes.
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Affiliation(s)
- Sara Massironi
- Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 3, Monza, Italy.
| | - Federica Furfaro
- Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sarah Bencardino
- Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Mariangela Allocca
- Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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3
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Tiwari A. Upadacitinib in Crohn's disease: needs more insight. Expert Opin Pharmacother 2024; 25:1105-1106. [PMID: 38873701 DOI: 10.1080/14656566.2024.2369198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Affiliation(s)
- Avinash Tiwari
- Department of Gastroenterology, Regency Hospital Ltd, Kanpur, India
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D'Amico F, Lusetti F, Peyrin-Biroulet L, Danese S. MMX mesalamine in ulcerative colitis: Major advantages towards classical mesalamine formulations. Dig Liver Dis 2024:S1590-8658(24)00713-8. [PMID: 38705783 DOI: 10.1016/j.dld.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/27/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024]
Abstract
Medical therapy is the cornerstone of ulcerative colitis (UC) management and aims to induce and maintain remission. In case of mild-to-moderate UC, mesalamine (5-ASA) is the first-line option. 5-ASA requires local release at the level of the inflamed mucosa to exert its therapeutic action. While rectal preparations are useful in distal colitis, in cases of UC of at least rectosigmoid extent, guidelines suggest the association of oral and rectal 5-ASA. Mesalamine with Multi Matrix System® technology (MMX mesalamine) is an oral, high-strength (1.2 g/tablet), once-daily formulation of 5-ASA, designed to provide delayed and prolonged release throughout the entire colon. Clinical trials demonstrated a strong efficacy in inducing and maintaining clinical and endoscopic remission in active mild-to-moderate UC. The efficacy is related to specific colonic drug-delivery, to its high-dosage and once-daily administration, thus improving patients' adherence and outcomes. The specific colonic-delivery is also associated with very low rates of systemic absorption and adverse events (AEs). With this comprehensive review we aimed to summarize current knowledge on MMX mesalamine in mild-to-moderate UC, in terms of clinical pharmacology, efficacy and safety, also compared to other 5-ASA products. In addition we provided an expert opinion on the topic, examining the implications on clinical practice.
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Affiliation(s)
- Ferdinando D'Amico
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Lusetti
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy; Gastroenterology Unit, Foundation Policlinico San Matteo IRCCS, University of Pavia, Pavia, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France, Inserm, NGERE, University of Lorraine, F-54000 Nancy, France; INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France; FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France; Groupe Hospitalier privé Ambroise Paré - Hartmann, Paris IBD center, 92200 Neuilly sur Seine, France; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy.
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5
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Dignass A, Esters P, Flauaus C. Upadacitinib in Crohn's disease. Expert Opin Pharmacother 2024; 25:359-370. [PMID: 38512115 DOI: 10.1080/14656566.2024.2333964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/19/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The small molecule and oral selective and reversible Janus kinase (JAK) inhibitor upadacitinib has been approved for the treatment of moderate to severe active Crohn's disease (CD) in adult patients since April 2023 by EMA/FDA. AREAS COVERED The approval is based on the two induction studies a maintenance study showing that upadacitinib induction and maintenance therapy was superior to placebo. The approval of upadacitinib in CD expands the therapeutic armamentarium for the management of inflammatory bowel diseases (IBD). Upadacitinib is the first and only JAK inhibitor approved in patients with CD and provides a novel mechanism of action and the first advanced oral treatment option for patients with CD. Upadacitinib is approved for the treatment of other immunologically mediated disorders, including ulcerative colitis, rheumatoid arthritis, psoriasis arthritis, axial spondylarthritis, ankylosing spondylitis, and atopic dermatitis. Treatment of atopic dermatitis has been approved from the age of 12 years. EXPERT OPINION Upadacitinib may cause relevant changes of our current treatment algorithms for Crohn's disease. Further real-world studies and head-to-head comparisons are needed to position upadacitinib in our current treatment algorithms for CD.
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Affiliation(s)
- Axel Dignass
- Department of Medicine I, Agaplesion Markus Hospital, Frankfurt/Main, Germany
| | - Philip Esters
- Department of Medicine I, Agaplesion Markus Hospital, Frankfurt/Main, Germany
| | - Cathrin Flauaus
- AbbVie Deutschland GmbH & Co. KG, Medical Immunology, Wiesbaden, Germany
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6
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Polydorides AD. Assessment and Significance of Histologic Activity in Crohn's Disease. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00196-4. [PMID: 38365093 DOI: 10.1016/j.cgh.2024.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Alexandros D Polydorides
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Vitello A, Maida M, Shahini E, Macaluso FS, Orlando A, Grova M, Ramai D, Serviddio G, Facciorusso A. Current Approaches for Monitoring of Patients with Inflammatory Bowel Diseases: A Narrative Review. J Clin Med 2024; 13:1008. [PMID: 38398321 PMCID: PMC10888591 DOI: 10.3390/jcm13041008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Patients with inflammatory bowel diseases (IBD) require proactive monitoring both during the active phase to evaluate therapeutic response and during the remission phase to evaluate relapse or colorectal cancer surveillance. However, monitoring may vary between patients with ulcerative colitis (UC) and Crohn's disease (CD), with distinct tools and intervals. METHODS This narrative review aims to focus on modern approaches to IBD monitoring, considering international guidelines and expert consensus. RESULTS The most recent European diagnostic guidelines advocate a combination of clinical, laboratory, endoscopic, and radiological parameters to evaluate the disease course of patients with IBD. Unfortunately, the conventional symptom-based therapeutic approach does not improve long-term outcomes and there is no single ideal biomarker available. Endoscopy plays a key role in evaluating response to therapy as well as monitoring disease activity. Recently, bedside intestinal ultrasound (IUS) has gained increasing interest and diffusion as it appears to offer several advantages including the monitoring of therapeutic response. CONCLUSION In light of growing clinical advances, we present a schematic evidence-based monitoring algorithm that can be easily applied in clinical practice which combines all major monitoring modalities, including noninvasive tools such as IUS and video-capsule endoscopy.
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Affiliation(s)
- Alessandro Vitello
- Gastroenterology and Endoscopy Unit, S. Elia Hospital, 93100 Caltanissetta, Italy; (A.V.); (M.M.)
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia Hospital, 93100 Caltanissetta, Italy; (A.V.); (M.M.)
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Enna ‘Kore’, 94100 Enna, Italy
| | - Endrit Shahini
- Gastroenterology Unit, National Institute of Gastroenterology-IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
| | - Fabio Salvatore Macaluso
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Mauro Grova
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Daryl Ramai
- Division of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 84132, USA;
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
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Villanacci V, Bugatti M, Zini S, Del Sordo R, Bassotti G. Letter: The importance of histological assessment-a further stride in STRIDE. Aliment Pharmacol Ther 2023; 58:1244-1245. [PMID: 37986602 DOI: 10.1111/apt.17717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
LINKED CONTENTThis article is linked to Dignass et al papers. To view these articles, visit https://doi.org/10.1111/apt.17622 and https://doi.org/10.1111/apt.17763
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Affiliation(s)
- Vincenzo Villanacci
- Institute of Pathology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Mattia Bugatti
- Institute of Pathology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Stefania Zini
- Institute of Pathology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Rachele Del Sordo
- Department of Medicine and Surgery, Section of Anatomic Pathology and Histology, Medical School, University of Perugia, Perugia, Italy
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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9
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Dignass A, Rath S, Kleindienst T, Stallmach A. Letter: The importance of histological assessment-a further stride in STRIDE. Authors' reply. Aliment Pharmacol Ther 2023; 58:1246-1247. [PMID: 37986590 DOI: 10.1111/apt.17763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
LINKED CONTENTThis article is linked to Dignass et al papers. To view these articles, visit https://doi.org/10.1111/apt.17622 and https://doi.org/10.1111/apt.17717
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Affiliation(s)
- Axel Dignass
- Department of Medicine I, Agaplesion Markus Hospital, Frankfurt/Main, Germany
| | - Stefan Rath
- Department of Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Thomas Kleindienst
- Department of Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Andreas Stallmach
- Department of Medicine IV, Jena University Hospital, Jena, Jena, Germany
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Matsumoto T, Imai K, Goda Y, Fujimitsu Y, Kajioka T, Kihara H, Funaki Y, Imaki S, Ueno M. Questionnaire Survey for Inflammatory Bowel Disease Patients in Japan; A Web-Based Japan, Crohn's Disease, Ulcerative Colitis, Patients Survey. CROHN'S & COLITIS 360 2023; 5:otad069. [PMID: 38028953 PMCID: PMC10676197 DOI: 10.1093/crocol/otad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background/Aims The prevalence of inflammatory bowel disease (IBD) in Japan has been increasing. We aimed to clarify the symptoms of patients with IBD in Japan using an internet-based questionnaire survey. Methods Overall, 805 patients with IBD were asked to complete an internet-based questionnaire addressing their history of disturbances in daily activities, prevalence of fecal urgency, incontinence, and treatment preferences. Results Responses were obtained from 447 patients with IBD (mean age: 54 years; 70% were men), comprising 363 patients with ulcerative colitis (UC), and 84 with Crohn's disease (CD). Notably, 16% of patients with UC and 35% with CD took over 1 year until the diagnosis of IBD, and 5% of patients with CD visited more than 5 medical institutions. Patients with CD were more likely to experience disturbances in their diet, work, travel, and outings than those with UC. Fecal urgency and incontinence were significantly more frequent in patients with CD than in those with UC (72% vs. 44%, and 50% vs. 26%, respectively). In contrast, 26% of the men and 37% of women with IBD had constipation. Acid reflux, sleep disorders, and depressive symptoms were present in approximately 30% of the patients. Oral administration was preferred. Conclusions Patients with IBD in Japan experience more severe disturbances in their daily activities, and these are more severe in those with CD than those with UC. In addition to fecal urgency and incontinence, care is required for constipation, acid reflux, sleep disorders, and depressive symptoms.
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Affiliation(s)
- Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Keita Imai
- Department of IBD Strategy, EA Pharma Co., Ltd., Tokyo, Japan
| | - Yuki Goda
- Department of IBD Strategy, EA Pharma Co., Ltd., Tokyo, Japan
| | - Yuki Fujimitsu
- Department of IBD Strategy, EA Pharma Co., Ltd., Tokyo, Japan
| | | | - Hideaki Kihara
- Department of IBD Strategy, EA Pharma Co., Ltd., Tokyo, Japan
| | - Yuji Funaki
- Department of Integrated Marketing, EA Pharma Co., Ltd., Tokyo, Japan
| | - Shigeru Imaki
- Department of Corporate Communication, EA Pharma Co., Ltd., Tokyo, Japan
| | - Masato Ueno
- Department of IBD Strategy, EA Pharma Co., Ltd., Tokyo, Japan
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West J, Tan K, Devi J, Macrae F, Christensen B, Segal JP. Benefits and Challenges of Treat-to-Target in Inflammatory Bowel Disease. J Clin Med 2023; 12:6292. [PMID: 37834936 PMCID: PMC10573216 DOI: 10.3390/jcm12196292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
There is notable disparity between symptomatology and disease activity in a significant proportion of patients with inflammatory bowel disease (IBD), and escalation of treatment based on symptoms alone can fail to significantly alter the course of disease. The STRIDE-II position statement, published in 2021 by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative of the International Organisation for the Study of IBD (IOIBD) provides the most current recommendations for a treat-to-target (T2T) approach in IBD. Despite the benefits offered by a T2T approach in IBD, there are numerous drawbacks and current limitations to its widespread implementation in real-world clinical practice. Owing to the lack of a standardised definition of MH, outcome data are heterogeneous and limit the comparability of existing data. Further, studies investigating the likelihood of achieving MH with a T2T approach are limited and largely retrospective. Evidence of the real-world feasibility of tight monitoring is currently minimal and demonstrates sub-optimal adherence among patients. Further, the few studies on the acceptability and uptake of a T2T approach in real-world practice demonstrate the need for increased acceptability on both patients' and clinicians' behalf. Real-world applicability is further limited by the need for repeated endoscopic assessments of MH as well as a lack of guidance on how to incorporate the various treatment targets into therapeutic decision-making. We aim to review the benefits and challenges of the T2T approach and to discuss potential solutions to further patient care.
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Affiliation(s)
- Jack West
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia
| | - Katrina Tan
- Department of Gastroenterology, Northern Health, Epping, Melbourne 3076, Australia
| | - Jalpa Devi
- Department of Gastroenterology, Washington University in Saint Louis, St. Louis, MI 63110, USA
| | - Finlay Macrae
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia
- The University of Melbourne, Parkville, Melbourne 3010, Australia
| | - Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia
- The University of Melbourne, Parkville, Melbourne 3010, Australia
| | - Jonathan P. Segal
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia
- The University of Melbourne, Parkville, Melbourne 3010, Australia
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12
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Imbrizi M, Magro F, Coy CSR. Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years. Pharmaceuticals (Basel) 2023; 16:1272. [PMID: 37765080 PMCID: PMC10537095 DOI: 10.3390/ph16091272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Inflammatory Bowel Diseases had their first peak in incidence in countries in North America, Europe, and Oceania and are currently experiencing a new acceleration in incidence, especially in Latin America and Asia. Despite technological advances, 90 years after the development of the first molecule for the treatment of IBD, we still do not have drugs that promote disease remission in a generalized way. We carried out a narrative review on therapeutic advances in the treatment of IBD, the mechanisms of action, and the challenges facing the therapeutic goals in the treatment of IBD. Salicylates are still used in the treatment of Ulcerative Colitis. Corticosteroids have an indication restricted to the period of therapeutic induction due to frequent adverse events, while technologies with less systemic action have been developed. Most immunomodulators showed a late onset of action, requiring a differentiated initial strategy to control the disease. New therapeutic perspectives emerged with biological therapy, initially with anti-TNF, followed by anti-integrins and anti-interleukins. Despite the different mechanisms of action, there are similarities between the general rates of effectiveness. These similar results were also evidenced in JAK inhibitors and S1p modulators, the last therapeutic classes approved for the treatment of IBD.
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Affiliation(s)
- Marcello Imbrizi
- Department of Surgery, Faculty of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas 13083-970, SP, Brazil
| | - Fernando Magro
- Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Claudio Saddy Rodrigues Coy
- Department of Surgery, Faculty of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas 13083-970, SP, Brazil
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13
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Kedia S, Ahuja V. Editorial: If STRIDE-II is the hammer, then Crohn's disease and ulcerative colitis are not the same nails. Aliment Pharmacol Ther 2023; 58:632-633. [PMID: 37632280 DOI: 10.1111/apt.17640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
LINKED CONTENTThis article is linked to Dignass et al papers. To view these articles, visit https://doi.org/10.1111/apt.17622 and https://doi.org/10.1111/apt.17656
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Affiliation(s)
- Saurabh Kedia
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Vineet Ahuja
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
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14
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Dignass A, Rath S, Kleindienst T, Stallmach A. Editorial: If STRIDE-II is the hammer, then Crohn's disease and ulcerative colitis are not the same nails-Authors' reply. Aliment Pharmacol Ther 2023; 58:634-635. [PMID: 37632281 DOI: 10.1111/apt.17656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
LINKED CONTENTThis article is linked to Dignass et al papers. To view these articles, visit https://doi.org/10.1111/apt.17622 and https://doi.org/10.1111/apt.17640
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Affiliation(s)
- Axel Dignass
- Department of Medicine I, Agaplesion Markus Hospital, Frankfurt/Main, Germany
| | - Stefan Rath
- Department of Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Thomas Kleindienst
- Department of Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
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