Next generation of small molecules in inflammatory bowel disease

Introduction Inflammatory bowel disease (IBD) encompasses two major entities: ulcerative colitis (UC) and Crohn's disease (CD).1 Both are chronic, progressive, disabling conditions that require lifelong medical treatment in most cases. IBD has a major impact on the patient's health-related quality of life,2 and the treatment-related costs place a significant burden on healthcare systems.3 Historically, the medical management of IBD has been based on the use of several small-molecule drugs (SMDs), including corticosteroids, immunomodulators (such as azathioprine, 6-mercaptopurine and methotrexate) and aminosalicylates.4 The introduction of biologic anti-tumour necrosis factor-α (TNF-α) agents in the first few years of this century has revolutionised the clinical management of IBD. In parallel, treatment goals have shifted from symptomatic control towards more objective endpoints (such as mucosal healing and deep remission) associated with better long-term outcomes.5 6 Over the past 20 years, drug...
Source: Gut - Category: Gastroenterology Authors: Tags: Crohn's disease, Ulcerative colitis Leading article Source Type: research

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Source: Clinical Epidemiology - Category: Epidemiology Tags: Clinical Epidemiology Source Type: research
Abstract Inflammatory bowel disease (IBD) is a chronic, elusive disorder resulting in relapsing inflammation of intestine with incompletely elucidated etiology, whose two representative forms are ulcerative colitis (UC) and Crohn's disease (CD). Accumulating researches have revealed that the individual genetic susceptibility, environmental risk elements, intestinal microbial flora, as well as innate and adaptive immune system are implicated in the pathogenesis and development of IBD. Despite remarkable progression of IBD therapy has been achieved by chemical drugs and biological therapies such as aminosalicylates,...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Crohn’s disease is an inflammatory condition that can affect any part of the gastrointestinal tract. Together with ulcerative colitis, Crohn’s is one of the two main types of inflammatory bowel disease (IBD). Crohn’s affects approximately 500,000 Americans and is a chronic, lifelong condition that typically alternates between periods of relatively stable or absent symptoms (remission) and periods of symptom flare-ups that can last for days, weeks, or even months. The goal of treatment is to induce remission and then to maximize the chance that patients stay in remission. However, almost everyone with Croh...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Digestive Disorders Health Source Type: blogs
CONCLUSIONS: the prevalence of CeD in our patients with IBD was higher than that reported in the literature for other series of patients with IBD. A combination of anti-tTG testing and CeD genetics may screen patients for CeD in this population of patients with IBD. PMID: 31718200 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Abstract Patients with ulcerative colitis and Crohn's disease often present to surgery malnourished and on combination immunosuppression. These factors affect operation selection and postoperative outcomes. Corticosteroids have a well-established detrimental effect on postoperative outcomes, whereas the impact of biologic agents is more controversial. In a patient exposed to these medications, and in the presence of other risk factors, temporary intestinal diversion is likely the best choice. Enteral nutrition may help optimize malnourished patients at high risk of adverse postoperative outcomes. PMID: 316760...
Source: The Surgical Clinics of North America - Category: Surgery Authors: Tags: Surg Clin North Am Source Type: research
CC) Abstract Prospective data of vedolizumab treatment for inflammatory bowel disease (IBD) patients beyond one year of treatment is scarce but needed for clinical decision making. We prospectively enrolled 310 IBD (191 Crohn's disease CD, 119 ulcerative colitis, UC) patients with a follow-up period of 104 weeks (IQR: 103-104) in a nationwide registry. The corticosteroid-free clinical remission rate (Harvey Bradshaw Index ≤4, short clinical colitis activity index ≤2) at week 52 and 104 was 28% and 19% for CD and 27% and 28% for UC, respectively. 59% maintained corticosteroid-free clinical remission between w...
Source: Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Pharmacol Ther Source Type: research
ConclusionAlthough biologic therapies have higher pharmacy costs, treatment decisions should consider the increased AE risks and long-term MRU costs associated with chronic use of OCS-containing therapies.FundingThis study was funded by F. Hoffmann-La Roche Ltd. The journal ’s Rapid Service Fee and Open Access publication were paid for by ApotheCom on behalf of Genentech, a member of the Roche group who funded the study.
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Patients with ulcerative colitis and Crohn's disease often present to surgery malnourished and on combination immunosuppression. These factors affect operation selection and postoperative outcomes. Corticosteroids have a well-established detrimental effect on postoperative outcomes, whereas the impact of biologic agents is more controversial. In a patient exposed to these medications, and in the presence of other risk factors, temporary intestinal diversion is likely the best choice. Enteral nutrition may help optimize malnourished patients at high risk of adverse postoperative outcomes.
Source: Surgical Clinics of North America - Category: Surgery Authors: Source Type: research
Authors: Chou JW, Lai HC, Chang CH, Cheng KS, Feng CL, Chen TW Abstract The incidence and prevalence of inflammatory bowel disease (IBD) are low but increasing in Taiwan. We aimed to investigate the epidemiology and clinical outcomes of IBD in central Taiwan. We retrospectively analyzed patients with IBD diagnosed at our hospital between January 2000 and September 2018. The diagnostic criteria were based on endoscopic and pathologic findings. Clinical characteristics, treatment regimens, and treatment outcomes were analyzed. A total of 190 patients with IBD were enrolled (80 with Crohn's disease (CD) and 110 with u...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
AbstractPrior to the biologic era, the medical management of patients with inflammatory bowel disease (IBD) was dominated by the use of aminosalicylates, corticosteroids, and immunosuppressants. In the past two decades, the advent of biologic agents that target specific components of the immune response has greatly improved the care of patients with Crohn ’s disease and ulcerative colitis (UC). However, not all patients respond or maintain response to biologic therapy and some patients develop adverse events that necessitate treatment discontinuation. Furthermore, sensitization with formation of anti-drug antibodies ...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
More News: Corticosteroid Therapy | Crohn's Disease | Inflammatory Bowel Disease | Methotrexate | Ulcerative Colitis