The Experts below are selected from a list of 207 Experts worldwide ranked by ideXlab platform
Bruce E. Sands - One of the best experts on this subject based on the ideXlab platform.
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The Role of TNFα in Ulcerative Colitis
Journal of clinical pharmacology, 2007Co-Authors: Bruce E. Sands, Gilaad G. KaplanAbstract:Standard of care for Ulcerative Colitis involves long-term pharmacotherapy or colectomy. Approximately 20% to 30% of patients eventually require a colectomy because patients either do not respond or cannot tolerate the currently available pharmacotherapies. Advances in our knowledge of the pathophysiology of Ulcerative Colitis have highlighted the importance of cytokines such as tumor necrosis factor alpha (TNFalpha) in the inflammatory process. TNFalpha is a proinflammatory mediator that plays an integral role in the pathogenesis of inflammatory bowel disease. In addition, mounting evidence indicates a genetic association between TNFalpha and Ulcerative Colitis. Furthermore, increased TNFalpha levels have been demonstrated in studies of patients with Ulcerative Colitis. TNFalpha is likely an important component in the pathophysiology of Ulcerative Colitis, and thus agents targeting TNFalpha in Ulcerative Colitis have been studied. Recent randomized controlled trials have confirmed that biologic anti-TNFalpha therapy is effective in Ulcerative Colitis. Soluble TNFalpha receptors or biologic agents that suppress or inhibit TNFalpha production may also show therapeutic promise.
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Biological therapies for Ulcerative Colitis.
Acta gastro-enterologica Belgica, 2001Co-Authors: Bruce E. SandsAbstract:Biological therapies are being increasingly investigated for the treatment of inflammatory bowel disease. However, a great deal more study has been devoted to studies of Crohn's disease rather than Ulcerative Colitis. Ulcerative Colitis, like Crohn's disease, represents an area of high clinical need, particularly for those patients who have disease inadequately responsive to corticosteroids and 5-aminosalicylates. The distinct anatomic distribution of inflammation in Ulcerative Colitis represents an important model for study, with the entire involved mucosa entirely accessible to endoscopy. In addition, there is an opportunity for local delivery of biologic agents in left-sided disease. Distinct pathogenetic factors in Ulcerative Colitis raise the possibility of therapies quite different from those used in Crohn's disease. This work describes the current state of knowledge regarding biological therapy in Ulcerative Colitis. The role of probiotic therapy, and studies of cytokine-directed therapies, therapies targeting adhesion and recruitment, and restitution and repair are described.
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Treatment of Ulcerative Colitis.
Current opinion in gastroenterology, 1999Co-Authors: Choon Jin Ooi, Bruce E. SandsAbstract:Advances in the treatment of Ulcerative Colitis have continued to focus on improved local delivery of existing agents, such as 5-aminosalicylate and corticosteroids, and on novel immunosuppressive agents. Although newer preparations of 5-aminosalicylate continue to provide incremental benefits in safety, tolerance, and efficacy, there is a growing understanding of the limits of benefit from increasing doses. Knowledge of the safety of these agents, particularly in regard to their use in pregnancy, continues to expand. Novel corticosteroids are used in much of the world for the treatment of Ulcerative Colitis, with the exception of the United States, with anticipated benefits in safety but little additional therapeutic benefit. Innovative use of oral emulsion preparations of cyclosporine has been reported in the treatment of Ulcerative Colitis and adds to the growing body of literature on the efficacy of cyclosporine in severe disease. Relatively limited experience with other immunosuppressive agents, such as tacrolimus, has been reported. The role of antibiotics in the treatment of Ulcerative Colitis has continued to present controversy.
Anders Ekbom - One of the best experts on this subject based on the ideXlab platform.
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appendectomy and protection against Ulcerative Colitis
The New England Journal of Medicine, 2001Co-Authors: Roland Andersson, Gunnar Olaison, Curt Tysk, Anders EkbomAbstract:Background: A history of appendectomy is rare in patients with Ulcerative Colitis. This suggests a protective effect of appendectomy or that appendicitis and Ulcerative Colitis are alternative infl ...
Stephen B. Hanauer - One of the best experts on this subject based on the ideXlab platform.
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Therapy of Ulcerative Colitis
Current opinion in gastroenterology, 2004Co-Authors: Stephen B. Hanauer, Miles P. SparrowAbstract:PURPOSE OF REVIEW The past year has brought forth several controversies regarding the treatment of Ulcerative Colitis along with several potentially important clinical advances. The aim of this review is to provide the practicing gastroenterologist with a summation of these recent developments, with particular emphasis on advances that have already moved toward acceptance into clinical practice. RECENT FINDINGS Controversies remain regarding the optimal formulations and doses of aminosalicylates. At the same time, the potential for chemoprotective effects in patients using maintenance therapy with mesalamine derivatives has been expanded. In addition, advances in biologic therapy for Crohn disease are beginning to be formally evaluated in Ulcerative Colitis, although the benefits of anti-tumor necrosis factor therapy in this condition remain to be established. Biologic therapies are beginning to be explored as adjunctive therapy for steroid-refractory Ulcerative Colitis, where trials of calcineurin inhibitors are also advancing clinical practice for this poor prognostic subgroup of patients. Finally, after surgery for Ulcerative Colitis, the treatment and prevention of pouchitis has become the one established indication for probiotic therapy. SUMMARY Despite some inroads into the medical therapy of Ulcerative Colitis, controversies remain regarding the optimal dosing and delivery systems of the most fundamental therapies, and how to optimize therapy for severe Ulcerative Colitis. Clinical research will continue to investigate new biologic agents that inhibit tumor necrosis factor and other pro-inflammatory cytokines, and ongoing trials with leukocyte apheresis are currently under way.
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Medical therapy for Ulcerative Colitis
Current opinion in gastroenterology, 2000Co-Authors: Stephen B. HanauerAbstract:Last year was not a banner year for developments in medical therapy for Ulcerative Colitis. In contrast to the expansion of therapies for Crohn disease, treatment for Ulcerative Colitis was evolutionary, at best, leading many patients to seek alternative medical approaches. Nevertheless, there have
Roland Andersson - One of the best experts on this subject based on the ideXlab platform.
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appendectomy and protection against Ulcerative Colitis
The New England Journal of Medicine, 2001Co-Authors: Roland Andersson, Gunnar Olaison, Curt Tysk, Anders EkbomAbstract:Background: A history of appendectomy is rare in patients with Ulcerative Colitis. This suggests a protective effect of appendectomy or that appendicitis and Ulcerative Colitis are alternative infl ...
Miles P. Sparrow - One of the best experts on this subject based on the ideXlab platform.
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Therapy of Ulcerative Colitis
Current opinion in gastroenterology, 2004Co-Authors: Stephen B. Hanauer, Miles P. SparrowAbstract:PURPOSE OF REVIEW The past year has brought forth several controversies regarding the treatment of Ulcerative Colitis along with several potentially important clinical advances. The aim of this review is to provide the practicing gastroenterologist with a summation of these recent developments, with particular emphasis on advances that have already moved toward acceptance into clinical practice. RECENT FINDINGS Controversies remain regarding the optimal formulations and doses of aminosalicylates. At the same time, the potential for chemoprotective effects in patients using maintenance therapy with mesalamine derivatives has been expanded. In addition, advances in biologic therapy for Crohn disease are beginning to be formally evaluated in Ulcerative Colitis, although the benefits of anti-tumor necrosis factor therapy in this condition remain to be established. Biologic therapies are beginning to be explored as adjunctive therapy for steroid-refractory Ulcerative Colitis, where trials of calcineurin inhibitors are also advancing clinical practice for this poor prognostic subgroup of patients. Finally, after surgery for Ulcerative Colitis, the treatment and prevention of pouchitis has become the one established indication for probiotic therapy. SUMMARY Despite some inroads into the medical therapy of Ulcerative Colitis, controversies remain regarding the optimal dosing and delivery systems of the most fundamental therapies, and how to optimize therapy for severe Ulcerative Colitis. Clinical research will continue to investigate new biologic agents that inhibit tumor necrosis factor and other pro-inflammatory cytokines, and ongoing trials with leukocyte apheresis are currently under way.
