The Experts below are selected from a list of 31605 Experts worldwide ranked by ideXlab platform
Jeanfrederic Colombel - One of the best experts 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
William J Sandborn - One of the best experts 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.
Simon Travis - One of the best experts 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.
P Umbertmillet - One of the best experts on this subject based on the ideXlab platform.
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nail psoriasis a retrospective study on the effectiveness of systemic treatments classical and Biological Therapy
Journal of The European Academy of Dermatology and Venereology, 2011Co-Authors: M Sanchezregana, J Solaortigosa, M Alsinagibert, M Vidalfernandez, P UmbertmilletAbstract:BACKGROUND: Nail psoriasis represents a challenge for specialists. There is no comparative study of systemic treatment's effectiveness at this site. OBJECTIVE: Evaluate the response of nail psoriasis to classical and Biological Therapy and to compare the effectiveness and safety of the different treatments. METHODS: We performed a retrospective study of 84 patients with moderate-severe psoriasis seen at our Department between January 2006 and January 2009. RESULTS: Psoriasis was severe in 53.4%. In 75% of cases, the fingernails were affected, and the mixed form was the most frequently subtype. The mean baseline scores on the PASI and the NAPSI were 23.12 and 14.7 respectively; the correlation between the two scores fell at weeks 12 and 24 but had risen again at week 48. The baseline NAPSI score tended to be lower in women and significantly higher in patients over 65 years of age, family history of psoriasis, severe psoriasis and nail matrix involvement. In our series, 58.3% received classical treatment (acitretin, methotrexate, cyclosporin, PUVA, NUVB, REPUVA, RENUVB) and 41.7% received Biological treatment (infliximab, efalizumab, etanercept, adalimumab).Significant reductions were found (P < 0.05) in the mean NAPSI scores at 12, 24 and 48 weeks with all the antipsoriatic agents except NUVB; significantly greater with cyclosporine (P < 0.01) and Biological as infliximab and adalimumab at 12 and 24 weeks (differences between treatments disappeared at 48 weeks). CONCLUSION: The response to treatment is slower in the nail lesions than in the skin lesions. The improvement of nail psoriasis is significant both with the classical treatments significantly higher in cyclosporin; and Biological treatment (infliximab and adalimumab at 12 and 24 weeks).
Bianca Maria Piraccini - One of the best experts on this subject based on the ideXlab platform.
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nail involvement as a negative prognostic factor in Biological Therapy for psoriasis a retrospective study
Journal of The European Academy of Dermatology and Venereology, 2017Co-Authors: Federico Bardazzi, Martina Lambertini, Marco Adriano Chessa, Michela Magnano, Annalisa Patrizi, Bianca Maria PiracciniAbstract:Background Psoriasis (Pso) has a strong impact on quality of life and a positive association has been reported between nail psoriasis (NP) and more severe disease, together with a longer duration of skin lesions. The treatment of NP represents a challenge and Biological Therapy can be recommended for severe disease. Objective The first end point of this retrospective study was to evaluate the time to achieve Psoriasis Area Severity Index (PASI) 75 in patients with and without NP treated with Biological Therapy. The second end point was to evaluate the efficacy of Biological Therapy to improve NP. Methods A total of 127 patients (88 men and 39 women) with moderate to severe Pso referring to our Service between 2007 and 2014 were included. Inclusion criteria were age ≥18 years and a 24 week treatment. The outcome variable was achievement of PASI 75 at 24 weeks with and without NP. All patients were treated with topical Therapy and one of four different Biological treatments: adalimumab (44.09%), etanercept (18.11%), infliximab (13.39%) and ustekinumab (24.41%). Physical examinations were performed every 4 weeks, and at each visit, the clinician assessed the PASI and Nail Psoriasis Severity Index (NAPSI). Results At multivariate Cox regression analysis, a smaller proportion of patients with NP achieved PASI 75 at 24 weeks than patients without NP when adjusted for the epidemiological, clinical features and Biological treatment received. With all Biological drugs, the NAPSI score began to improve already after 8 weeks (from 18.53 at week 0–2.83 at week 24). Conclusion Patients with NP reach PASI 75 more slowly than patients without NP. Clinicians should therefore consider that treatment with a Biological agent may require a longer period before reaching a satisfying therapeutical goal. Nevertheless, adalimumab, infliximab, ustekinumab and etanercept demonstrated their equal effectiveness in reducing the NAPSI score.