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Greeve T, Prentice RE, Shelton E, Boyapati R, Lever F, Bell SJ. Letter: Transperineal ultrasonography for ulcerative proctitis- Applicability in the pregnant population? Aliment Pharmacol Ther 2023; 58:834-835. [PMID: 37768296 DOI: 10.1111/apt.17669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
LINKED CONTENTThis article is linked to Sagami et al papers. To view these articles, visit https://doi.org/10.1111/apt.16817 and https://doi.org/10.1111/apt.17705
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Affiliation(s)
- Tessa Greeve
- Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Ralley E Prentice
- Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Edward Shelton
- Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
| | - Ray Boyapati
- Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Frauke Lever
- Department of Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia
| | - Sally J Bell
- Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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2
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Prentice RE, Wright EK, Flanagan E, Kamm MA, Goldberg R, Ross AL, Burns M, Bell SJ. Evaluation and management of ileal pouch-anal anastamosis (IPAA) complications in pregnancy, and the impacts of an IPAA on fertility. Eur J Gastroenterol Hepatol 2023; 35:609-612. [PMID: 36966753 DOI: 10.1097/meg.0000000000002538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) remains the preferred surgical option for medically refractory ulcerative colitis. Management of individuals with an IPAA prior to and during pregnancy presents challenges that can have serious consequences. Infertility, mechanical obstructive and inflammatory pouch complications are frequently encountered in pregnant women with an IPAA. Mechanical obstructions occur due to a variety of underlying aetiologies, including stricturing disease, adhesions and pouch twists. Conservative management of such obstructions often results in resolution of symptoms without a need for endoscopic or surgical intervention, although endoscopic decompression may be attempted in isolation or as a bridge to definitive surgical intervention. Parenteral nutrition, and early delivery, may also be necessary. Faecal calprotectin and intestinal ultrasound, both of which are accurate in pregnancy, are useful in the setting of suspected inflammatory pouch complications, in some circumstances allowing for avoidance of pouchoscopy. Penicillin-based antimicrobials can be considered first line in pregnancy for the management of pouchitis and pre-pouch ileitis, and biologics can be safely instituted in the setting of refractory disease or suspected Crohn's disease-like inflammation of the pouch or pre-pouch ileum. Pragmatism, clear patient communication and multidisciplinary discussion are essential in approaching pregnant women with complications of an IPAA, particularly given the lack of definitive evidence to guide therapeutic decisions.
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Affiliation(s)
- Ralley E Prentice
- Department of Gastroenterology, St Vincent's Hospital, Melbourne
- Department of Gastroenterology, Monash Health, Clayton, Victoria
- Monash University, Clayton
| | - Emily K Wright
- Department of Gastroenterology, St Vincent's Hospital, Melbourne
- University of Melbourne, Melbourne, Australia
| | - Emma Flanagan
- Department of Gastroenterology, St Vincent's Hospital, Melbourne
- University of Melbourne, Melbourne, Australia
| | - Michael A Kamm
- Department of Gastroenterology, St Vincent's Hospital, Melbourne
- University of Melbourne, Melbourne, Australia
| | - Rimma Goldberg
- Department of Gastroenterology, Monash Health, Clayton, Victoria
- Monash University, Clayton
| | - Alyson L Ross
- Department of Gastroenterology, St Vincent's Hospital, Melbourne
| | - Megan Burns
- Department of Gastroenterology, Monash Health, Clayton, Victoria
| | - Sally J Bell
- Department of Gastroenterology, Monash Health, Clayton, Victoria
- Monash University, Clayton
- University of Melbourne, Melbourne, Australia
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3
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Prentice RE, Wright EK, Flanagan E, Hunt RW, Moore GT, Nold-Petry CA, Bell SJ, Nold MF, Goldberg R. Review: The effect of in-utero exposure to maternal inflammatory bowel disease and immunomodulators on infant immune system development and function. Cell Mol Gastroenterol Hepatol 2023:S2352-345X(23)00042-5. [PMID: 36972763 DOI: 10.1016/j.jcmgh.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
Autoimmune and inflammatory disorders, including inflammatory bowel disease (IBD), commonly affect women of childbearing age, warranting the use of immunomodulatory agents at a time where pregnancy may be desired. In-utero exposure to pro-inflammatory mediators from maternal IBD, IBD-associated intestinal dysbiosis, and immunomodulatory drug use may impact neonatal immune system development during what is considered to be a critical period, with potential long-lasting impacts on susceptibility to disease. Both the innate and adaptative immune systems of the neonatal differ to that of the adult in terms of both cellular composition and sensitivity to antigenic and innate stimulation. The infant immune system gradually develops to more closely resemble that of the adult. Exposure to maternal inflammation in-utero may aberrantly impact this period of infant immune system development, with maternal autoimmune and inflammatory disorders shown to affect the physiologic changes in serum cytokine abundance observed during pregnancy. The maternal and neonatal intestinal microbiome greatly influence infant mucosal and peripheral immune system development, and thereby impact the susceptibility to short term inflammatory diseases, the adequacy of vaccine response and later life risk of atopic and inflammatory disorders. Maternal disease, mode of delivery, method of feeding, time of weaning to include solid foods in the diet and neonatal antibiotic exposure all influence the composition of the infant microbiome, and thereby infant immune system maturation. How exposure to specific immunosuppressive medications in-utero alters infant immune cell phenotype and response to stimulation has been explored, but with existing studies limited by the time at which samples are performed, heterogenicity in methods, and small sample size. Furthermore, the impact of more recently introduced biologic agents have not been explored. Evolving knowledge in this field may influence therapeutic preferences for individuals with IBD planning to conceive, particularly if substantive differences in the risk of infant infection and childhood immune disease are identified.
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Affiliation(s)
- Ralley E Prentice
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, AUS; Department of Gastroenterology, Monash Health, Melbourne, VIC, AUS; Department of Medicine, Monash University, Melbourne, VIC, AUS.
| | - Emily K Wright
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, AUS; Department of Medicine, University of Melbourne, Melbourne, VIC, AUS
| | - Emma Flanagan
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, AUS; Department of Medicine, University of Melbourne, Melbourne, VIC, AUS
| | - Rod W Hunt
- Department of Paediatrics, Monash University, Melbourne, VIC, AUS; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AUS; Monash Newborn, Monash Children's Hospital, Melbourne, VIC, AUS
| | - Gregory T Moore
- Department of Gastroenterology, Monash Health, Melbourne, VIC, AUS; Department of Medicine, Monash University, Melbourne, VIC, AUS
| | - Claudia A Nold-Petry
- Department of Paediatrics, Monash University, Melbourne, VIC, AUS; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AUS
| | - Sally J Bell
- Department of Gastroenterology, Monash Health, Melbourne, VIC, AUS; Department of Medicine, Monash University, Melbourne, VIC, AUS; Department of Medicine, University of Melbourne, Melbourne, VIC, AUS
| | - Marcel F Nold
- Department of Paediatrics, Monash University, Melbourne, VIC, AUS; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AUS; Monash Newborn, Monash Children's Hospital, Melbourne, VIC, AUS
| | - Rimma Goldberg
- Department of Gastroenterology, Monash Health, Melbourne, VIC, AUS; Department of Medicine, Monash University, Melbourne, VIC, AUS; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AUS.
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Christensen B, Prentice RE, Al-Ani AH, Zhang E, Bedell A, Rubin DT. Self-Reported Failure to Address Sexual Function in Patients With Inflammatory Bowel Disease by Gastroenterologists: Barriers and Areas for Improvement. Inflamm Bowel Dis 2022; 28:1465-1468. [PMID: 35286382 DOI: 10.1093/ibd/izac025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Indexed: 12/09/2022]
Affiliation(s)
- Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Ralley E Prentice
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia
| | - Aysha H Al-Ani
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Eva Zhang
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia
| | - Alyse Bedell
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA.,Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - David T Rubin
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA
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Prentice RE, Ross AL, Flanagan EK. Management of Pregnant Women with Inflammatory Bowel Disease and COVID-19-Balancing Risks of Delayed Treatment Recommencement. J Crohns Colitis 2022; 16:867. [PMID: 34888653 DOI: 10.1093/ecco-jcc/jjab214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Ralley E Prentice
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Department of Gastroenterology, Monash Health, Clayton, VIC, Australia
| | - Alyson L Ross
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Emma K Flanagan
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
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6
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Prentice RE, Wright EK, Flanagan E, Ross AL, Bell SJ. Vedolizumab safety in pregnancy: Extricating drug from disease-related effects. J Gastroenterol Hepatol 2021; 36:3247-3248. [PMID: 34330150 DOI: 10.1111/jgh.15636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/09/2022]
Affiliation(s)
- R E Prentice
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Department of Gastroenterology, Monash Health, Clayton, Victoria, Australia.,Faculty of Medicine, Monash University, Clayton, Victoria, Australia
| | - E K Wright
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - E Flanagan
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - A L Ross
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - S J Bell
- Department of Gastroenterology, Monash Health, Clayton, Victoria, Australia.,Faculty of Medicine, Monash University, Clayton, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
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7
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Prentice RE, Rentsch C, Al‐Ani AH, Zhang E, Johnson D, Halliday J, Bryant R, Begun J, Ward MG, Lewindon PJ, Connor SJ, Ghaly S, Christensen B. SARS-CoV-2 vaccination in patients with inflammatory bowel disease. GastroHep 2021; 3:212-228. [PMID: 34539248 PMCID: PMC8441891 DOI: 10.1002/ygh2.473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/25/2021] [Accepted: 05/29/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The current COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has drastically impacted societies worldwide. Vaccination against SARS-CoV-2 is expected to play a key role in the management of this pandemic. Inflammatory conditions such as inflammatory bowel disease (IBD) often require chronic immunosuppression, which can influence vaccination decisions. AIM This review article aims to describe the most commonly available SARS-CoV-2 vaccination vectors globally, assess the potential benefits and concerns of vaccination in the setting of immunosuppression and provide medical practitioners with guidance regarding SARS-CoV-2 vaccination in patients with IBD. METHODS All published Phase 1/2 and/or Phase 3 and 4 studies of SARS-CoV-2 vaccinations were reviewed. IBD international society position papers, safety registry data and media releases from pharmaceutical companies as well as administrative and medicines regulatory bodies were included. General vaccine evidence and recommendations in immunosuppressed patients were reviewed for context. Society position papers regarding special populations, including immunosuppressed, pregnant and breast-feeding individuals were also evaluated. Literature was critically analysed and summarised. RESULTS Vaccination against SARS-CoV-2 is supported in all adult, non-pregnant individuals with IBD without contraindication. There is the potential that vaccine efficacy may be reduced in those who are immunosuppressed; however, medical therapies should not be withheld in order to undertake vaccination. SARS-CoV-2 vaccines are safe, but data specific to immunosuppressed patients remain limited. CONCLUSIONS SARS-CoV-2 vaccination is essential from both an individual patient and community perspective and should be encouraged in patients with IBD. Recommendations must be continually updated as real-world and trial-based evidence emerges.
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Affiliation(s)
- Ralley E. Prentice
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Clarissa Rentsch
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Aysha H. Al‐Ani
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Eva Zhang
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Douglas Johnson
- Departments of Infectious Diseases and General MedicineThe Royal Melbourne HospitalMelbourneVICAustralia
- Department of MedicineRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | - John Halliday
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Robert Bryant
- Department of GastroenterologyThe Queen Elizabeth HospitalAdelaideAustralia
| | - Jacob Begun
- Department of GastroenterologyMater HospitalBrisbaneAustralia
| | - Mark G. Ward
- Department of GastroenterologyAlfred HealthMelbourneVICAustralia
- Monash UniversityMelbourneVICAustralia
| | - Peter J. Lewindon
- Department of GastroenterologyLady Cilento Children’s HospitalBrisbaneQLDAustralia
- Queensland Children’s Medical Research InstituteUniversity of QueenslandBrisbaneQLDAustralia
| | - Susan J. Connor
- Department of Gastroenterology & HepatologyLiverpool HospitalLiverpoolNSWAustralia
- South West Sydney Clinical SchoolUniversity of New South WalesSydneyNSWAustralia
- Ingham Institute of Applied Medical ResearchSydneyNSWAustralia
| | - Simon Ghaly
- Department of GastroenterologySt. Vincent’s Hospital SydneySydneyNSWAustralia
- St. Vincent’s Clinical SchoolUniversity of New South Wales SydneySydneyNSWAustralia
| | - Britt Christensen
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
- University of MelbourneMelbourneVICAustralia
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Prentice RE, Hollingsworth L, Middleton C, Wilson J. Letter: colorectal cancer surveillance in inflammatory bowel disease-a call for systematic reform. Aliment Pharmacol Ther 2021; 53:953-954. [PMID: 33745168 DOI: 10.1111/apt.16284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Ralley E Prentice
- Department of Gastroenterology, The Royal Hobart Hospital, Hobart, TAS, Australia.,Department of Gastroenterology, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Laura Hollingsworth
- Department of Gastroenterology, The Royal Hobart Hospital, Hobart, TAS, Australia
| | | | - Jarrad Wilson
- Department of Gastroenterology, The Royal Hobart Hospital, Hobart, TAS, Australia
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9
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Prentice RE, Al-Ani A, Christensen B. Managing COVID-19 in patients with inflammatory bowel disease: navigating unprecedented challenges. Intern Med J 2021; 51:284-287. [PMID: 33631857 PMCID: PMC8013000 DOI: 10.1111/imj.15190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023]
Abstract
The COVID‐19 pandemic has demanded a rapid adaptation in healthcare provision, including patients with inflammatory bowel disease (IBD). This viewpoint discusses some of the unique challenges in managing comorbid IBD and COVID‐10 experienced by our team at The Royal Melbourne Hospital, which was at the epicentre of the COVID‐19 ‘second‐wave’ surge in Melbourne.
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Affiliation(s)
- Ralley E Prentice
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Aysha Al-Ani
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Britt Christensen
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
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10
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Al‐Ani AH, Prentice RE, Rentsch C, Christensen B. Letter: SARS-CoV-2 infection in two inflammatory bowel disease patients treated with dual targeted therapy-Authors' reply. Aliment Pharmacol Ther 2021; 53:766-767. [PMID: 33599326 PMCID: PMC8013379 DOI: 10.1111/apt.16287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/20/2022]
Abstract
LINKED CONTENT This article is linked to Al‐Ani et al and Privitera et al papers. To view these articles, visit https://doi.org/10.1111/apt.15779 and https://doi.org/10.1111/apt.16297
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Affiliation(s)
- Aysha H. Al‐Ani
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Ralley E. Prentice
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Clarissa Rentsch
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Britt Christensen
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
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Prentice RE, Al-Ani AH, Bond K, Johnson D, Christensen B. Asymptomatic screening for SARS CoV-2 prior to commencement of biologic therapies in patients with inflammatory bowel disease - a potentially harmful practice. Dig Liver Dis 2020; 52:1250-1251. [PMID: 32928674 PMCID: PMC7450924 DOI: 10.1016/j.dld.2020.08.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/23/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Ralley E. Prentice
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Aysha H Al-Ani
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Katherine Bond
- Department of Infectious Diseases, The Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Doug Johnson
- Department of Infectious Diseases, The Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Britt Christensen
- Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Vic., Australia,Corresponding author
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12
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Prentice RE, Tjandra D, Garg M, Lubel JS, Fourlanos S, Johnson D, Al‐Ani A, Christensen B. Letter: ACE2, IBD and COVID-19-why IBD patients may be at reduced risk of COVID-19. Aliment Pharmacol Ther 2020; 52:1422-1423. [PMID: 33105980 PMCID: PMC7537250 DOI: 10.1111/apt.16063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
LINKED CONTENT This article is linked to Taxonera et al paper. To view this article, visit https://doi.org/10.1111/apt.15804
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Affiliation(s)
- Ralley E. Prentice
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Doug Tjandra
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Mayur Garg
- Department of GastroenterologyNorthern Hospital and University of MelbourneMelbourneVICAustralia
| | - John S. Lubel
- Department of GastroenterologyAlfred Hospital and Monash UniversityMelbourneVICAustralia
| | - Spiros Fourlanos
- Department of Diabetes and EndocrinologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Doug Johnson
- Victorian Infectious Diseases UnitThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Aysha Al‐Ani
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
| | - Britt Christensen
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVICAustralia
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13
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Prentice RE, Al‐Ani AH, Christensen B. Letter: Covid-19-re-initiating clinical services for chronic gastrointestinal diseases. How and when? Authors' reply. Aliment Pharmacol Ther 2020; 52:1416-1417. [PMID: 33105973 PMCID: PMC7537262 DOI: 10.1111/apt.16065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
LINKED CONTENT This article is linked to Al‐Ani et al and Britton et al papers. To view these articles, visit https://doi.org/10.1111/apt.15779 and https://doi.org/10.1111/apt.16061
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Affiliation(s)
- Ralley E. Prentice
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Aysha H. Al‐Ani
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Britt Christensen
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
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14
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Affiliation(s)
- Aysha H Al-Ani
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Ralley E Prentice
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, VIC, Australia,Corresponding author: Britt Christensen, MB BS, Royal Melbourne Hospital, Gastroenterology Department, 300 Grattan St, Parkville, VIC, Australia.
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15
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Al‐Ani AH, Prentice RE, Rentsch CA, Johnson D, Ardalan Z, Heerasing N, Garg M, Campbell S, Sasadeusz J, Macrae FA, Ng SC, Rubin DT, Christensen B. Review article: prevention, diagnosis and management of COVID-19 in the IBD patient. Aliment Pharmacol Ther 2020; 52:54-72. [PMID: 32348598 PMCID: PMC7267115 DOI: 10.1111/apt.15779] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The current COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune-based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID-19. AIM To summarise the scale of the COVID-19 pandemic, review unique concerns regarding IBD management and infection risk during the pandemic and assess COVID-19 management options and drug interactions in the IBD population. METHODS A literature review on IBD, SARS-CoV-2 and COVID-19 was undertaken and relevant literature was summarised and critically examined. RESULTS IBD patients do not appear to be more susceptible to SARS-CoV-2 infection and there is no evidence of an association between IBD therapies and increased risk of COVID-19. IBD medication adherence should be encouraged to prevent disease flare but where possible high-dose systemic corticosteroids should be avoided. Patients should exercise social distancing, optimise co-morbidities and be up to date with influenza and pneumococcal vaccines. If a patient develops COVID-19, immune suppressing medications should be withheld until infection resolution and if trial medications for COVID-19 are being considered, potential drug interactions should be checked. CONCLUSIONS IBD patient management presents a challenge in the current COVID-19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.
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Affiliation(s)
- Aysha H. Al‐Ani
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Ralley E. Prentice
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Clarissa A. Rentsch
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Doug Johnson
- Victorian Infectious Diseases UnitThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Zaid Ardalan
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Neel Heerasing
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Mayur Garg
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Sian Campbell
- Victorian Infectious Diseases UnitThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Joe Sasadeusz
- Victorian Infectious Diseases UnitThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Finlay A. Macrae
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
| | - Siew C. Ng
- Department of Medicine and TherapeuticsInstitute of Digestive DiseaseState Key Laboratory of Digestive DiseasesLi Ka Shing Institute of Health ScienceThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - David T. Rubin
- Inflammatory Bowel Disease CenterUniversity of Chicago MedicineChicagoILUSA
| | - Britt Christensen
- Department of GastroenterologyThe Royal Melbourne HospitalMelbourneVic.Australia
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