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Biological Therapy
The Experts below are selected from a list of 31605 Experts worldwide ranked by ideXlab platform
Jeanfrederic Colombel – 1st expert on this subject based on the ideXlab platform
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de escalation of immunomodulator and Biological Therapy in inflammatory bowel disease
The Lancet Gastroenterology & Hepatology, 2020Co-Authors: Thomas P Chapman, Catarina Frias Gomes, Edouard Louis, Jeanfrederic Colombel, Jack SatsangiAbstract:Summary Treatment strategies for inflammatory bowel disease (IBD) focus on the induction and long-term maintenance of deep remission to avoid complications of active disease and improve long-term outcomes. Medical therapies for IBD, notably the increasingly widespread use of Biological Therapy, are often effective at controlling disease, but these drugs are associated with substantial adverse events, which together with other factors—including increasing treatment costs and patient preferences—leads to concerns regarding indefinite use of medical Therapy. Consequently, the need to consider the safety and feasibility of drug de-escalation once IBD remission has been achieved is clear. Here, we review the current evidence surrounding de-escalation of immunomodulator and Biological Therapy in Crohn’s disease and ulcerative colitis. We discuss strategies for de-escalation, including the selection of patients who are appropriate for treatment de-escalation and the use of proactive drug monitoring, and review the evidence on subsequent optimal follow-up. We conclude by proposing an algorithm to guide de-escalation decisions, and highlight future perspectives, including the potential effect of emerging medication and personalised medicine for these diseases.
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the london position statement of the world congress of gastroenterology on Biological Therapy for ibd with the european crohn s and colitis organisation safety
The American Journal of Gastroenterology, 2011Co-Authors: Gert Van Assche, James D Lewis, Gary R Lichtenstein, Edward V Loftus, Qin Ouyang, Julian Panes, Corey A Siegel, William J Sandborn, Simon Travis, Jeanfrederic ColombelAbstract:The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn’s and Colitis Organisation: Safety
Simon Travis – 2nd expert on this subject based on the ideXlab platform
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the london position statement of the world congress of gastroenterology on Biological Therapy for ibd with the european crohn s and colitis organisation safety
The American Journal of Gastroenterology, 2011Co-Authors: Gert Van Assche, James D Lewis, Gary R Lichtenstein, Edward V Loftus, Qin Ouyang, Julian Panes, Corey A Siegel, William J Sandborn, Simon Travis, Jeanfrederic ColombelAbstract:The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn’s and Colitis Organisation: Safety
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the london position statement of the world congress of gastroenterology on Biological Therapy for ibd with the european crohn s and colitis organisation pregnancy and pediatrics
The American Journal of Gastroenterology, 2011Co-Authors: Uma Mahadevan, William J Sandborn, Simon Travis, S Cucchiara, Jeffrey S Hyams, Flavio Steinwurz, F Nuti, Jean Frederio ColombelAbstract:8 Women with infl ammatory bowel disease (IBD) have similar rates of fertility to the general population, but have an increased rate of adverse pregnancy outcomes compared with the general population, which may be worsened by disease activity. Infertility is increased in those undergoing ileal pouch – anal anastomosis. Anti-tumor necrosis factor Therapy in pregnancy is considered to be low risk and compatible with use during conception in men and women and during pregnancy in at least the fi rst two trimesters. Infl iximab (IFX) and certolizumab pegol are also compatible with breastfeeding, but safety data for adalimumab (ADA) are awaited. The safety of natalizumab during pregnancy is unknown. For children with Crohn ‘ s disease (CD), IFX is effective at inducing and maintaining remission. Episodic Therapy is not as effective as scheduled infusions. Disease duration in children does not appear to affect the effi cacy of IFX. IFX promotes growth in prepubertal and early pubertal Crohn ‘ s patients. It is also effective for the treatment of extraintestinal manifestations. ADA is effective for children with active CD and for maintaining remission, even if they have lost response to IFX, although there are fewer data. Vaccination of infants exposed to Biological Therapy in utero should be given at standard schedules during the fi rst 6 months of life, except for live-virus vaccines such as rotavirus. Inactivated vaccines may be safely administered to children with IBD, even when immunocompromised.
William J Sandborn – 3rd expert on this subject based on the ideXlab platform
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the london position statement of the world congress of gastroenterology on Biological Therapy for ibd with the european crohn s and colitis organisation safety
The American Journal of Gastroenterology, 2011Co-Authors: Gert Van Assche, James D Lewis, Gary R Lichtenstein, Edward V Loftus, Qin Ouyang, Julian Panes, Corey A Siegel, William J Sandborn, Simon Travis, Jeanfrederic ColombelAbstract:The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn’s and Colitis Organisation: Safety
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the london position statement of the world congress of gastroenterology on Biological Therapy for ibd with the european crohn s and colitis organisation pregnancy and pediatrics
The American Journal of Gastroenterology, 2011Co-Authors: Uma Mahadevan, William J Sandborn, Simon Travis, S Cucchiara, Jeffrey S Hyams, Flavio Steinwurz, F Nuti, Jean Frederio ColombelAbstract:8 Women with infl ammatory bowel disease (IBD) have similar rates of fertility to the general population, but have an increased rate of adverse pregnancy outcomes compared with the general population, which may be worsened by disease activity. Infertility is increased in those undergoing ileal pouch – anal anastomosis. Anti-tumor necrosis factor Therapy in pregnancy is considered to be low risk and compatible with use during conception in men and women and during pregnancy in at least the fi rst two trimesters. Infl iximab (IFX) and certolizumab pegol are also compatible with breastfeeding, but safety data for adalimumab (ADA) are awaited. The safety of natalizumab during pregnancy is unknown. For children with Crohn ‘ s disease (CD), IFX is effective at inducing and maintaining remission. Episodic Therapy is not as effective as scheduled infusions. Disease duration in children does not appear to affect the effi cacy of IFX. IFX promotes growth in prepubertal and early pubertal Crohn ‘ s patients. It is also effective for the treatment of extraintestinal manifestations. ADA is effective for children with active CD and for maintaining remission, even if they have lost response to IFX, although there are fewer data. Vaccination of infants exposed to Biological Therapy in utero should be given at standard schedules during the fi rst 6 months of life, except for live-virus vaccines such as rotavirus. Inactivated vaccines may be safely administered to children with IBD, even when immunocompromised.