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Laboratory Assessment of Disease Activity in Pediatric Patients with Inflammatory Bowel Disease: What’s New? GASTROENTEROLOGY INSIGHTS 2020. [DOI: 10.3390/gastroent11020009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Laboratory tests are an integral part of both the diagnostic and follow-up algorithm of patients with inflammatory bowel disease (IBD). Their advantages over other non-invasive methods for assessing disease activity are greater objectivity than clinical activity indices and imaging studies. This review aims to analyze shortly the most common laboratory tests used to assess disease activity in pediatric patients with IBD. In addition to the conventional blood and serum markers that are not specific for gut inflammation, although routinely used, we also reviewed the established fecal markers such as calprotectin, lactoferrin, M2-pyruvate kinase, osteoprotegerin, HMGB1, chitinase 3-like 1, and the promising non-coding microRNA. In conclusion, neither marker is unique to the pediatric IBD. More clinical data are required to assess biomarkers’ full potential for diagnosis, management, and follow-up of pediatric IBD patients.
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Martínez-Feito A, Bravo-Gallego LY, Hernández-Breijo B, Diez J, García-Ramirez L, Jaquotot M, Plasencia-Rodríguez C, Nozal P, Mezcua A, Martín-Arranz MD, Pascual-Salcedo D. Infliximab concentrations in two non-switching cohorts of patients with inflammatory bowel disease: originator vs. biosimilar. Sci Rep 2020; 10:17099. [PMID: 33051546 PMCID: PMC7555902 DOI: 10.1038/s41598-020-74235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022] Open
Abstract
Biosimilars are replacing originator compounds due to their similar effectiveness, safety and pharmacokinetics. Our objective was to compare the differences in pharmacokinetics and clinical outcomes between the originator infliximab (Ifx) and the biosimilar CT-P13 in a patient cohort with inflammatory bowel disease (IBD). Our cohort study included 86 patients from a historical and a prospective cohort from the start of infliximab treatment to 22 weeks later. Serum infliximab, antidrug antibody levels and other serum biomarkers were measured at weeks 0, 2, 6, 14 and 22. Remission outcomes were evaluated at weeks 14 and 22. Drug levels were measured prospectively and analysed using MANOVA. Of the 86 patients, 44 (51%) and 42 (49%) were administered the originator and CT-P13, respectively. Originator trough levels were higher than the biosimilar trough levels (35 vs. 21, 20.1 vs. 11, 6.6 vs. 2.9 and 4.3 vs. 1.7 μg/mL at weeks 2, 6, 14 and 22, respectively). A post-hoc analysis demonstrated changes in mean serum drug levels over time (p < 0.001) and according to the drug employed (p = 0.001). At week 22, 13 (81%) patients administered the originator achieved clinical remission compared with 5 (19%) patients with the biosimilar (p = 0.02). None of the patients administered the originator withdrew from the treatment compared with 7 for the biosimilar. During the study, there were significant differences in serum infliximab levels between the originator and the CT-P13 in the patients with IBD. The clinical outcomes were influenced by the type of compound administered.
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Affiliation(s)
- Ana Martínez-Feito
- Immuno-Rheumatology Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain. .,Immunology Unit, La Paz University Hospital, Madrid, Spain.
| | - Luz Yadira Bravo-Gallego
- Immunology Unit, La Paz University Hospital, Madrid, Spain.,Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPAZ) and Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain
| | - Borja Hernández-Breijo
- Immuno-Rheumatology Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Jesús Diez
- Biostatistics Section, La Paz University Hospital, Madrid, Spain
| | - Laura García-Ramirez
- Unit of Inflammatory Bowel Disease, Gastroenterology Department. Innate Immunity Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Marta Jaquotot
- Unit of Inflammatory Bowel Disease, Gastroenterology Department. Innate Immunity Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | - Pilar Nozal
- Immunology Unit, La Paz University Hospital, Madrid, Spain
| | - Araceli Mezcua
- Immunology Unit, La Paz University Hospital, Madrid, Spain
| | - María Dolores Martín-Arranz
- Unit of Inflammatory Bowel Disease, Gastroenterology Department. Innate Immunity Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Dora Pascual-Salcedo
- Immuno-Rheumatology Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
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Smart Model to Distinguish Crohn’s Disease from Ulcerative Colitis. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9081650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Inflammatory bowel diseases (IBD) is a term referring to chronic and recurrent gastrointestinal disease. It includes Crohn’s disease (CD) and ulcerative colitis (UC). It is undeniable that presenting features may be unclear and do not enable differentiation between disease types. Therefore, additional information, obtained during the analysis, can definitely provide a potential way to differentiate between UC and CD. For that reason, finding the optimal logistic model for further analysis of collected medical data, is a main factor determining the further precisely defined decision class for each examined patient. In our study, 152 patients with CD or UC were included. The collected data concerned not only biochemical parameters of blood but also very subjective information, such as data from interviews. The built-in logistics model with very high precision was able to assign patients to the appropriate group (sensitivity = 0.84, specificity = 0.74, AUC = 0.93). This model indicates factors differentiating between CD and UC and indicated odds ratios calculated for significantly different variables in these two groups. All obtained parameters of the model were checked for statistically significant. The constructed model was able to be distinguish between ulcerative colitis and Crohn’s disease.
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Gürsoy G, Cimbek A, Acar Y, Erol B, Dal HC, Evrin N, Gungor A. Combined portal, splenic and mesenteric venous thrombosis in inactive ulcerative colitis with heterozygous mutation in MTHFR gene: A rare case of thrombophilia. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2011; 16:1500-6. [PMID: 22973354 PMCID: PMC3430070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 11/10/2011] [Indexed: 11/29/2022]
Abstract
Thrombophilia is a rare but potentially catastrophic phenomenon occurring in patients having tendency of thrombosis. It may lead to serious complications. The etiology of thrombophilia is thought to be multifactorial and related to both acquired and inherited factors. Inflammatory bowel disease is an acquired cause of thrombophilia. Thromboembolic events are seen during inflammatory bowel disease, especially during the active period of the disease. In inflammatory bowel disease, thrombus formation in portal, splenic and mesenteric veins are not common. Besides, the association of genetic disorders related to metabolism of homocysteine with inflammatory bowel disease has been evidenced, especially in Crohn disease and rarely in ulcerative colitis. We present a rare case of ulcerative colitis in association with combined portal, splenic and mesenteric vein thrombosis. The patient was recently diagnosed with the disease which was in the inactive period. Interestingly, our patient was also heterozygous for the mutation in methylenetetrahydrofolate reductase (MTHFR) gene.
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Affiliation(s)
- Gül Gürsoy
- Associate Professor, Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey,
Corresponding author: Gül Gürsoy E-mail:
| | - Ahmet Cimbek
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
| | - YaŞar Acar
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
| | - Birsen Erol
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
| | - Hayriye Cankar Dal
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
| | - Nuray Evrin
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
| | - Aslı Gungor
- Department of Internal Medicine, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey
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