118 results on '"Federico, Argüelles-Arias"'
Search Results
2. Rapidity of clinical response to adalimumab and improvement of quality of life in luminal Crohn's disease: RAPIDA study
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Luisa Castro-Laria, Ana M. Sánchez-Migallón, David Busquets, Ana Echarri, Maria Esteve, Federico Argüelles-Arias, R. Vicente, José María Huguet, María Dolores Martín-Arranz, D Ceballos, Francesc Casellas, Jordina Llaó, for Rapida trial investigators, M Navarro-Llavat, Ignacio Marín-Jiménez, Manuel Barreiro-de Acosta, Santiago García-López, José Miguel Boudet, and Gema Díaz more...
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Population ,Disease ,Inflammatory bowel disease ,Severity of Illness Index ,Young Adult ,Quality of life ,Crohn Disease ,Internal medicine ,medicine ,Adalimumab ,Humans ,Prospective Studies ,education ,Fatigue ,Aged ,Crohn's disease ,education.field_of_study ,Hepatology ,business.industry ,Remission Induction ,Gastroenterology ,General Medicine ,Middle Aged ,medicine.disease ,Clinical disease ,Intention to Treat Analysis ,Clinical trial ,Treatment Outcome ,Spain ,Quality of Life ,Female ,Tumor Necrosis Factor Inhibitors ,business ,Biomarkers ,medicine.drug - Abstract
No studies evaluating the rapidity of response to biological therapies are available for Crohn's disease (CD). The aim of this study was to evaluate rapidity of onset of clinical response and impact on quality of life (QoL) of adalimumab therapy in adult anti-TNF-naïve patients with moderately-to-severely active CD.RAPIDA was an open-label, single-arm, prospective, multicenter clinical trial. Adult patients with moderately-to-severely active luminal CD, anti-TNF-naïve, and unresponsive to conventional therapy were treated with adalimumab. Clinical disease activity, QoL and inflammatory biomarkers were measured at day 4, and weeks 1, 2, 4, and 12 after treatment initiation.Eighty-six patients were included in the intention-to-treat (ITT) analyses. Clinical disease activity was reduced from a median of 9.0 points to 6.0 points at day 4. Clinical response (≥ 3-point reduction in the Harvey-Bradshaw Index, HBI) was achieved by 61.6% (d4) and 75.6% (w1) of patients in the ITT population (median 2.5 days) and with non-responder imputation (NRI), by 55.8% and 53.4%, respectively. The proportion of patients in clinical remission (HBI5) at weeks 2 and 4 in the ITT population was 54.7% and 62.8%, respectively (median 7.0 days), and 38.4% and 45.3% in the NRI population. All QoL scores significantly improved and inflammatory biomarkers significantly decreased from day 4 onwards (p0.0001).Rapid clinical response and remission, improvement in QoL and fatigue, and a reduction of inflammatory biomarkers were achieved with adalimumab as early as day 4 in adult anti-TNF-naïve patients with moderately-to-severely active CD. more...
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- 2022
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Catalog
3. Optimización del tratamiento de la colitis ulcerosa leve a moderada: Consenso Delphi CU-Forum
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Miquel Sans Cuffi, Federico Argüelles Arias, Ana Echarri Piudo, Daniel Ginard Vicens, Ana Gutiérrez Casbas, and Ignacio Marín-Jiménez
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Hepatology ,Gastroenterology - Published
- 2023
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4. sj-docx-2-tag-10.1177_17562848231153560 – Supplemental material for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study
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Teresa, Valdés Delgado, Rául, Olmedo Martín, Marisa, Iborra, Claudia, Herrera de Guisé, Esteban, Fuentes-Valenzuela, Luigi, Melcarne, Mª Mar, Martín-Rodríguez, Lilyan, Kolle Casso, Luisa, De Castro Parga, Ángel, Ponferrada Díaz, Raquel, Vicente Lidón, Noemí, Manceñido Marcos, Benito, Velayos Jiménez, Marta, Lázaro Sáez, Beatriz, López Cauce, Francisco, Mesonero Gismero, Pau, Gilabert Álvarez, and Federico, Argüelles-Arias more...
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FOS: Clinical medicine ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, sj-docx-2-tag-10.1177_17562848231153560 for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study by Valdés Delgado Teresa, Olmedo Martín Rául, Iborra Marisa, Herrera de Guisé Claudia, Fuentes-Valenzuela Esteban, Melcarne Luigi, Martín-Rodríguez Mª Mar, Kolle Casso Lilyan, De Castro Parga Luisa, Ponferrada Díaz Ángel, Vicente Lidón Raquel, Manceñido Marcos Noemí, Velayos Jiménez Benito, Lázaro Sáez Marta, López Cauce Beatriz, Mesonero Gismero Francisco, Gilabert Álvarez Pau and Argüelles-Arias Federico in Therapeutic Advances in Gastroenterology more...
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- 2023
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5. sj-docx-3-tag-10.1177_17562848231153560 – Supplemental material for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study
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Teresa, Valdés Delgado, Rául, Olmedo Martín, Marisa, Iborra, Claudia, Herrera de Guisé, Esteban, Fuentes-Valenzuela, Luigi, Melcarne, Mª Mar, Martín-Rodríguez, Lilyan, Kolle Casso, Luisa, De Castro Parga, Ángel, Ponferrada Díaz, Raquel, Vicente Lidón, Noemí, Manceñido Marcos, Benito, Velayos Jiménez, Marta, Lázaro Sáez, Beatriz, López Cauce, Francisco, Mesonero Gismero, Pau, Gilabert Álvarez, and Federico, Argüelles-Arias more...
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FOS: Clinical medicine ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, sj-docx-3-tag-10.1177_17562848231153560 for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study by Valdés Delgado Teresa, Olmedo Martín Rául, Iborra Marisa, Herrera de Guisé Claudia, Fuentes-Valenzuela Esteban, Melcarne Luigi, Martín-Rodríguez Mª Mar, Kolle Casso Lilyan, De Castro Parga Luisa, Ponferrada Díaz Ángel, Vicente Lidón Raquel, Manceñido Marcos Noemí, Velayos Jiménez Benito, Lázaro Sáez Marta, López Cauce Beatriz, Mesonero Gismero Francisco, Gilabert Álvarez Pau and Argüelles-Arias Federico in Therapeutic Advances in Gastroenterology more...
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- 2023
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6. sj-docx-3-tag-10.1177_17562848231153560 – Supplemental material for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study
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Teresa, Valdés Delgado, Rául, Olmedo Martín, Marisa, Iborra, Claudia, Herrera de Guisé, Esteban, Fuentes-Valenzuela, Luigi, Melcarne, Mª Mar, Martín-Rodríguez, Lilyan, Kolle Casso, Luisa, De Castro Parga, Ángel, Ponferrada Díaz, Raquel, Vicente Lidón, Noemí, Manceñido Marcos, Benito, Velayos Jiménez, Marta, Lázaro Sáez, Beatriz, López Cauce, Francisco, Mesonero Gismero, Pau, Gilabert Álvarez, and Federico, Argüelles-Arias more...
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FOS: Clinical medicine ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, sj-docx-3-tag-10.1177_17562848231153560 for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study by Valdés Delgado Teresa, Olmedo Martín Rául, Iborra Marisa, Herrera de Guisé Claudia, Fuentes-Valenzuela Esteban, Melcarne Luigi, Martín-Rodríguez Mª Mar, Kolle Casso Lilyan, De Castro Parga Luisa, Ponferrada Díaz Ángel, Vicente Lidón Raquel, Manceñido Marcos Noemí, Velayos Jiménez Benito, Lázaro Sáez Marta, López Cauce Beatriz, Mesonero Gismero Francisco, Gilabert Álvarez Pau and Argüelles-Arias Federico in Therapeutic Advances in Gastroenterology more...
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- 2023
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7. sj-docx-2-tag-10.1177_17562848231153560 – Supplemental material for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study
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Teresa, Valdés Delgado, Rául, Olmedo Martín, Marisa, Iborra, Claudia, Herrera de Guisé, Esteban, Fuentes-Valenzuela, Luigi, Melcarne, Mª Mar, Martín-Rodríguez, Lilyan, Kolle Casso, Luisa, De Castro Parga, Ángel, Ponferrada Díaz, Raquel, Vicente Lidón, Noemí, Manceñido Marcos, Benito, Velayos Jiménez, Marta, Lázaro Sáez, Beatriz, López Cauce, Francisco, Mesonero Gismero, Pau, Gilabert Álvarez, and Federico, Argüelles-Arias more...
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FOS: Clinical medicine ,111199 Nutrition and Dietetics not elsewhere classified ,FOS: Health sciences ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,111299 Oncology and Carcinogenesis not elsewhere classified - Abstract
Supplemental material, sj-docx-2-tag-10.1177_17562848231153560 for Effectiveness and safety of ustekinumab in bio-naïve Crohn’s disease patients: a multicentre observational retrospective study by Valdés Delgado Teresa, Olmedo Martín Rául, Iborra Marisa, Herrera de Guisé Claudia, Fuentes-Valenzuela Esteban, Melcarne Luigi, Martín-Rodríguez Mª Mar, Kolle Casso Lilyan, De Castro Parga Luisa, Ponferrada Díaz Ángel, Vicente Lidón Raquel, Manceñido Marcos Noemí, Velayos Jiménez Benito, Lázaro Sáez Marta, López Cauce Beatriz, Mesonero Gismero Francisco, Gilabert Álvarez Pau and Argüelles-Arias Federico in Therapeutic Advances in Gastroenterology more...
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- 2023
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8. Severe outbreak of ulcerative colitis and cerebral neoplasia. Difficult management in COVID times
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Samer Mouhtar El Hálabi, Teresa Valdés Delgado, Belén Maldonado Pérez, María Belvis Jiménez, and Federico Argüelles Arias
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Gastroenterology ,General Medicine - Published
- 2023
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9. Intraductal Papillary Mucinous Tumors Principal and Lateral Branch of IPMT: Preoperative Management, Surgical Indications, and Surgical Techniques
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Victoria Alejandra Jiménez-García, Ana Argüelles-Arias, Federico Argüelles-Arias, Rafael Romero-Castro, and Marc Giovannini
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- 2023
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10. Unusual presentation of jejunal adenocarcinoma and ovarian metastasis
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María Desirée García García, María Dolores Galván Fernández, Samer Alejandro Mouhtar El Halabi, Jesús Machuca Aguado, and Federico Argüelles-Arias
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Gastroenterology ,General Medicine - Published
- 2023
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11. Unusual presentation of biliopancreatic cancer as primary retroperitoneal tumor
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María Desirée García-García, Reyes Aparcero López, Juan Antonio Bellido Luque, Manuel Rodríguez-Téllez, Jesús Machuca Aguado, and Federico Argüelles Arias
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Gastroenterology ,General Medicine - Published
- 2023
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12. Perianal Paget's disease
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Pilar Navajas Hernández, Teresa Valdés Delgado, Jesús Machuca Aguado, Ricardo González-Cámpora, and Federico Argüelles Arias
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Gastroenterology ,General Medicine - Abstract
The incidence of extramammary Paget's disease (EMPD) is very low. It is very important to distinguish between primary Paget's disease and secondary to another process. An 85-year-old man consulted for the presence of an erythematous plaque located in the anal and gluteal area, confirming Paget cells in the biopsy. more...
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- 2022
13. Clinical outcome after anti‐tumour necrosis factor therapy discontinuation in 1000 patients with inflammatory bowel disease: the EVODIS long‐term study
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Luis Javier Lamuela‐Calvo, Marta Aicart‐Ramos, Joaquín Hinojosa, José Manuel Benítez, M Rojas-Feria, María del Mar Martín‐Rodríguez, Míriam Mañosa, Eduardo Leo-Carnerero, Óscar Nantes, José Lázaro Pérez-Calle, María José Casanova, Luis Bujanda, Joan Tosca, Manuel Barreiro-de Acosta, Jordi Guardiola, Gloria Esther Rodríguez‐González, Isabel Pérez-Martínez, Jesús Castro-Poceiro, A Martín-Cardona, José María Huguet, Javier P. Gisbert, María Chaparro, R. Pajares, Federico Argüelles-Arias, and C González-Muñoza more...
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Retrospective cohort study ,medicine.disease ,Ulcerative colitis ,Inflammatory bowel disease ,Confidence interval ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Cohort ,Medicine ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,Cumulative incidence ,030212 general & internal medicine ,Colitis ,business - Abstract
Background The long-term outcome of patients after antitumour necrosis factor alpha (anti-TNF) discontinuation is not well known. Aims To assess the risk of relapse in the long-term after anti-TNF discontinuation. Methods This was an extension of the evolution after anti-TNF discontinuation in patients with inflammatory bowel disease (EVODIS) study (Crohn's disease or ulcerative colitis patients treated with anti-TNFs in whom these drugs were withdrawn after achieving clinical remission) based in the same cohort of patients whose outcome was updated. Clinical remission was defined as a Harvey-Bradshaw index ≤4 points in Crohn's disease, a partial Mayo score ≤2 in ulcerative colitis and the absence of fistula drainage despite gentle finger compression in perianal disease. Results This was an observational, retrospective, multicenter study. A total of 1055 patients were included. The median follow-up time was 34 months. The incidence rate of relapse was 12% per patient-year (95% confidence interval [CI] = 11-14). The cumulative incidence of relapse was 50% (95% CI = 47-53): 19% at one year, 31% at 2 years, 38% at 3 years, 44% at 4 years and 48% at 5 years of follow-up. Of the 60% patients retreated with the same anti-TNF after relapse, 73% regained remission. Of the 75 patients who did not respond, 48% achieved remission with other therapies. Of the 190 patients who started other therapies after relapse, 62% achieved remission with the new treatment. Conclusions A significant proportion of patients who discontinued the anti-TNF remained in remission. In case of relapse, retreatment with the same anti-TNF was usually effective. Approximately half of the patients who did not respond after retreatment achieved remission with other therapies. more...
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- 2021
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14. 116 - VEDOLIZUMAB EN ENFERMEDAD INFLAMATORIA INTESTINAL: DOS AÑOS DE SEGUIMIENTO EN PRÁCTICA CLÍNICA
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Samer Mouhtar El Halabi, Pilar Del Pino Bellido, María Belvis Jiménez, Belén Maldonado Pérez, and Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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15. 101 - EVOLUCIÓN DEL ESTADO NUTRICIONAL DE UNA COHORTE DE PACIENTES CON ENFERMEDAD INFLAMATORIA INTESTINAL DERIVADOS A LA UNIDAD DE NUTRICIÓN CLÍNICA
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Samer Mouhtar El Halabi, Maria Lorena Cadena Herrera, Carmen Vías Parrado, Belén Maldonado Pérez, and Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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16. 84 - ¿INFLUYE EL GENOTIPO HLA-DQA1*05 EN LA RESPUESTA FRENTE A LOS FÁRMACOS BIOLÓGICOS ANTI-TNF?
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Pilar Navajas Hernández, Ana Caridad González Parra, Samer Alejandro Mouhtar El Halabi, Luisa Castro Laria, Belén Maldonado Pérez, and Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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17. 94 - LA PRESENCIA DEL GENOTIPO HLA-DQA1*05 NO PARECE PREDECIR PEOR RESPUESTA FRENTE A LOS FÁRMACOS BIOLÓGICOS USTEKINUMAB Y VEDOLIZUMAB
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Pilar Navajas Hernández, Pilar Pino Bellido, Laura Lorenzo González, Luisa Castro Laria, Belén Maldonado Pére, and Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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18. 110 - PARÁMETROS CLÍNICOS Y COMPLICACIONES ASOCIADAS CON MALNUTRICIÓN EN UNA COHORTE DE PACIENTES CON ENFERMEDAD INFLAMATORIA INTESTINAL
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Samer Mouhtar El Halabi, Maria Lorena Cadena Herrera, Carmen Vías Parrado, and Belén Maldonado Pérez y Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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19. 112 - IMPACTO DEL TRATAMIENTO CON NUTRICIÓN ENTERAL SOBRE LOS PARÁMETROS INFLAMATORIOS EN PACIENTES CON ENFERMEDAD INFLAMATORIA INTESTINAL
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Samer Mouhtar El Halabi, Maria Lorena Cadena Herrera, Carmen Vías Parrado, Belén Maldonado Pérez, and Federico Argüelles Arias
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Hepatology ,Gastroenterology - Published
- 2023
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20. Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn's Disease Patients on Ustekinumab
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María Chaparro, Iria Baston-Rey, Estela Fernández Salgado, Javier González García, Laura Ramos, María Teresa Diz-Lois Palomares, Federico Argüelles-Arias, Eva Iglesias Flores, Mercedes Cabello, Saioa Rubio Iturria, Andrea Núñez Ortiz, Mara Charro, Daniel Ginard, Carmen Dueñas Sadornil, Olga Merino Ochoa, David Busquets, Eduardo Iyo, Ana Gutiérrez Casbas, Patricia Ramírez de la Piscina, Marta Maia Boscá-Watts, Maite Arroyo, María José García, Esther Hinojosa, Jordi Gordillo, Pilar Martínez Montiel, Benito Velayos Jiménez, Cristina Quílez Ivorra, Juan María Vázquez Morón, José María Huguet, Yago González-Lama, Ana Isabel Muñagorri Santos, Víctor Manuel Amo, María Dolores Martín Arranz, Fernando Bermejo, Jesús Martínez Cadilla, Cristina Rubín de Célix, Paola Fradejas Salazar, Antonio López San Román, Nuria Jiménez, Santiago García-López, Anna Figuerola, Itxaso Jiménez, Francisco José Martínez Cerezo, Carlos Taxonera, Pilar Varela, Ruth de Francisco, David Monfort, Gema Molina Arriero, Alejandro Hernández-Camba, Francisco Javier García Alonso, Manuel Van Domselaar, Ramón Pajares-Villarroya, Alejandro Núñez, Francisco Rodríguez Moranta, Ignacio Marín-Jiménez, Virginia Robles Alonso, María del Mar Martín Rodríguez, Patricia Camo-Monterde, Iván García Tercero, Mercedes Navarro-Llavat, Lara Arias García, Daniel Hervías Cruz, Sebastian Kloss, Alun Passey, Cynthia Novella, Eugenia Vispo, Manuel Barreiro-de Acosta, Javier P. Gisbert, Institut Català de la Salut, [Chaparro M] Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain. [Baston-Rey I] Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. [Fernández Salgado E] Complejo Hospitalario de Pontevedra, Pontevedra, Spain. [González García J] Hospital Público Comarcal la Inmaculada, Almería, Spain. [Ramos L] Hospital Universitario de Canarias, Tenerife, Spain. [Diz-Lois Palomares MT] Hospital Universitario A Coruña, A Coruña, Spain. [Robles Alonso V] Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus more...
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acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinflamatorios [COMPUESTOS QUÍMICOS Y DROGAS] ,predictive factors ,Factors de risc en les malalties ,Risk factors in diseases ,Crohn’s Disease ,ustekinumab ,Antiinflamatoris - Ús terapèutic ,Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease [DISEASES] ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Crohn's Disease ,General Medicine ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn [ENFERMEDADES] ,Crohn, Malaltia de - Tractament ,Ciencias de la información::metodologías computacionales::algoritmos::inteligencia artificial::aprendizaje automático [CIENCIA DE LA INFORMACIÓN] ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Inflammatory Agents [CHEMICALS AND DRUGS] ,Malaltia de Crohn ,Aprenentatge automàtic ,Information Science::Computing Methodologies::Algorithms::Artificial Intelligence::Machine Learning [INFORMATION SCIENCE] - Abstract
Malaltia de Crohn; Factors predictius; Ustekinumab Enfermedad de Crohn; Factores predictivos; Ustekinumab Crohn’s disease; Predictive factors; Ustekinumab Ustekinumab has shown efficacy in Crohn’s Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients’ data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index ≤ 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission. This work was supported by Janssen-Cilag Spain. This sponsor had a partial role in study design, analysis, and interpretation of data. more...
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- 2022
21. COST-EFFECTIVENESS ANALYSIS OF FERRIC CARBOXYMALTOSE VERSUS IRON SUCROSE FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN SPAIN
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Federico Argüelles-Arias, Fernando Bermejo, Joaquín Borrás-Blasco, Eugeni Domènech, Beatriz Sicilia, José M. Huguet, Antonio Ramirez de Arellano, William J. Valentine, Barnaby Hunt, and Universidad de Sevilla. Departamento de Medicina more...
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Cost ,Iron deficiency anemia ,Gastroenterology ,Cost-effectiveness ,Inflammatory bowel disease - Abstract
Background: Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) and can result in reduced quality of life and increased healthcare costs. IDA is treated with iron supplementation, commonly with intravenous iron formulations, such as ferric carboxymaltose (FCM), and iron sucrose (IS). Methods: This study assessed the cost-effectiveness of FCM compared with IS, in terms of additional cost per additional responder in patients with IDA subsequent to IBD in the Spanish setting. An economic model was developed to assess the additional cost per additional responder, defined as normalization or an increase of ⩾2 g/dl in hemoglobin levels, for FCM versus IS from a Spanish healthcare payer perspective. Efficacy inputs were taken from a randomized controlled trial comparing the two interventions (FERGIcor). Costs of treatment were calculated in 2021 Euros (EUR) using a microcosting approach and included the costs of intravenous iron, healthcare professional time, and consumables. Cost-effectiveness was assessed over one cycle of treatment, with a series of sensitivity analyses performed to test the robustness of the results. Results: FCM was more effective than IS, with 84% of patients achieving a response compared with 76%. When expressed as number needed to treat, 13 patients would need to switch treatment from IS to FCM in order to achieve one additional responder. Costs of treatment were EUR 323 with FCM compared with EUR 470 with IS, a cost saving of EUR 147 with FCM. Cost savings with FCM were driven by the reduced number of infusions required, resulting in a reduced requirement for healthcare professional time and use of consumables compared with the IS arm. Conclusion: The present analysis suggests that FCM is less costly and more effective than IS for the treatment of IDA subsequent to IBD in Spain and therefore was considered dominant. more...
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- 2022
22. Switch to subcutaneous infliximab during the SARS-CoV-2 pandemic: preliminary results
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Federico, Argüelles-Arias, Paula, Fernández Álvarez, Luisa, Castro Laria, Belén, Maldonado Pérez, María, Belvis Jiménez, Vicente, Merino-Bohórquez, Ángel, Caunedo Álvarez, and Miguel Ángel, Calleja Hernández more...
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Treatment Outcome ,Gastrointestinal Agents ,Drug Substitution ,SARS-CoV-2 ,COVID-19 ,Humans ,Prospective Studies ,Inflammatory Bowel Diseases ,Biosimilar Pharmaceuticals ,Pandemics ,Infliximab ,Retrospective Studies - Abstract
A new subcutaneous formulation of the infliximab biosimilar CT-P13 has recently been developed for the treatment of inflammatory bowel disease (IBD), providing response rates similar to intravenous treatment. The use of this new formulation was requested, in an effort to limit patient attendance at intravenous infusion centers and to maintain biological treatment during the COVID-19 pandemic. The objective of this observational, retrospective and descriptive study was to assess CT-P13 efficacy and safety after switching from intravenous to a subcutaneous formulation in patients with IBD receiving maintenance therapy. This article shows preliminary results after six months of follow-up. more...
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- 2021
23. Cost-effectiveness analysis of ferric carboxymaltose
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Federico, Argüelles-Arias, Fernando, Bermejo, Joaquín, Borrás-Blasco, Eugeni, Domènech, Beatriz, Sicilia, José M, Huguet, Antonio Ramirez, de Arellano, William J, Valentine, and Barnaby, Hunt
- Abstract
Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) and can result in reduced quality of life and increased healthcare costs. IDA is treated with iron supplementation, commonly with intravenous iron formulations, such as ferric carboxymaltose (FCM), and iron sucrose (IS).This study assessed the cost-effectiveness of FCM compared with IS, in terms of additional cost per additional responder in patients with IDA subsequent to IBD in the Spanish setting. An economic model was developed to assess the additional cost per additional responder, defined as normalization or an increase of ⩾2 g/dl in hemoglobin levels, for FCMFCM was more effective than IS, with 84% of patients achieving a response compared with 76%. When expressed as number needed to treat, 13 patients would need to switch treatment from IS to FCM in order to achieve one additional responder. Costs of treatment were EUR 323 with FCM compared with EUR 470 with IS, a cost saving of EUR 147 with FCM. Cost savings with FCM were driven by the reduced number of infusions required, resulting in a reduced requirement for healthcare professional time and use of consumables compared with the IS arm.The present analysis suggests that FCM is less costly and more effective than IS for the treatment of IDA subsequent to IBD in Spain and therefore was considered dominant. more...
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- 2021
24. Cap-Polyposis: A Cause of Treatment Failure in Ulcerative Colitis
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Teresa Valdés Delgado, Daniel Barranco Castro, and Federico Argüelles Arias
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Adenomatous Polyposis Coli ,Gastroenterology ,Colonic Polyps ,Humans ,Immunology and Allergy ,Colitis, Ulcerative ,Treatment Failure - Published
- 2022
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25. Randomized, double-blind, placebo-controlled clinical trial on the usefulness of probiotic Lactobacillus reuteri in bismuth-containing quadruple eradication therapy for infection with Helicobacter pylori
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Paula Fernández Álvarez, Federico Argüelles Arias, Blas José Gómez Rodríguez, Luisa Castro Laria, Ángel Caunedo Álvarez, Carolina Moreno Márquez, and Teresa Valdés Delgado
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Limosilactobacillus reuteri ,medicine.medical_specialty ,Abdominal pain ,Placebo ,Gastroenterology ,Helicobacter Infections ,Internal medicine ,Metronidazole ,medicine ,Adjuvant therapy ,Humans ,Bismuth Subcitrate Potassium ,biology ,Helicobacter pylori ,business.industry ,Probiotics ,General Medicine ,Abdominal distension ,biology.organism_classification ,Lactobacillus reuteri ,Abdominal Pain ,Anti-Bacterial Agents ,Clinical trial ,Treatment Outcome ,Drug Therapy, Combination ,medicine.symptom ,business ,Bismuth - Abstract
INTRODUCTION The primary goal of this study was to compare gastrointestinal symptom reduction in patients on bismuth-containing quadruple eradication therapy supplemented with Lactobacillus reuteri strains (DSM 17938 and ATCC PTA 6475) or placebo. MATERIALS AND METHODS This was randomized, double-blind, parallel-arm, placebo-controlled clinical trial. Patients received first-line an eradication regimen based on bismuth subcitrate potassium, metronidazole, tetracycline hydrochloride (three-in-one capsules), and omeprazole 40 mg twice a day for ten days, plus a probiotic or placebo tablet for 30 days. During follow-up gastrointestinal symptoms were assessed using an evaluation scale (GSRS), and adverse events were collected at 0, 14, 28, and 56 days. RESULTS A total of 80 patients were included from February 2018 to May 2019 at a single site. Eradication therapy was effective for 85% of patients, with no differences between treatment arms. In the group receiving the probiotic, abdominal pain decreased in 42% of patients, compared with 19% in the control group (OR: 0.27; CI, 0.13-0.58; p < 0.001), and abdominal distension decreased in 25% versus 17% in the control group (OR: 0.24; IC, 0.19-0.84; p < 0.001); Conclusions: Treatment with L. reuteri only reduced abdominal pain and distension. Further studies are needed to establish the role of probiotics as adjuvant therapy in H. pylori eradication. more...
- Published
- 2021
26. Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study
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Xavier Cortés, Alonso Fernández-Nistal, Esther Garcia-Planella, J Santos-Fernández, M. Barreiro-de Acosta, Ignacio Marín-Jiménez, Beatriz Sicilia, Xavier Aldeguer, J. Aparicio, R Ferreiro-Iglesias, Olga Merino, A Forés, Ignacio Tagarro, Carmen Montoto, Federico Argüelles-Arias, Francisco Mesonero, Guillermo Bastida, M Boscá-Watts, and Mariam Aguas more...
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Adult ,Male ,medicine.medical_specialty ,Treatment discontinuation ,Disease ,Inflammatory bowel disease ,Anti-TNFα ,Crohn Disease ,Internal medicine ,medicine ,Adalimumab ,Humans ,Retrospective Studies ,Hepatology ,business.industry ,Treatment intensification ,Gastroenterology ,Induction Chemotherapy ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Infliximab ,Discontinuation ,Withholding Treatment ,Observational study ,Tumor necrosis factor alpha ,Colitis, Ulcerative ,Female ,Tumor Necrosis Factor Inhibitors ,business ,medicine.drug ,Follow-Up Studies - Abstract
Altres ajuts: Takeda Farmacéutica España S.A. Background: Anti-TNFα represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs. Aims: To assess the treatment patterns with the first anti-TNFα in IBD. Methods: Retrospective, observational study. Results: 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC. Conclusions: Around one-third of IBD biologic-naive patients treated with an anti-TNFα required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNFα due to inappropriate disease control. more...
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- 2021
27. New therapies for inflammatory bowel diseases
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Federico Argüelles Arias
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medicine.medical_specialty ,business.industry ,Internal medicine ,Medicine ,Inflammatory Bowel Diseases ,business ,Gastroenterology - Abstract
Currently, Inflammatory Bowel Disease (IBD) is considered an immune-mediated disease. The most widely accepted etiopathogenic hypothesis is that it is due to an inadequate interaction between the immune system and the microorganisms that form the normal intestinal flora. This abnormal interaction occurs in genetically predisposed subjects under the influence of various environmental factors (such as tobacco, diet, stress, or recurrent bacterial infections), which could act as triggers for alterations in the intestinal epithelial barrier. This would lead to an increase in the permeability of barrier, allowing the translocation of microbial products to the wall of the digestive tract, which would activate an acute cell-mediated immune response[1]. The failure of the anti-inflammatory regulatory mechanisms, together with an excess in the production of pro-inflammatory cytokines, would promote an aberrant immune response that would be self-perpetuating over time, thus giving rise to the chronic inflammation that characterizes IBD[2]. Since the first descriptions of Ulcerative Colitis (UC) and Crohn's Disease (CD), many treatments have been developed, with varying degrees of safety and efficacy. At the end of the 20th century, the first biological, called Infliximab, began to be used. A biological drug is one that has a biotechnological origin and arises from proteins derived from DNA and hybridization processes, which require living organisms as a fundamental part of the production process[3]. Undoubtedly, the appearance of biologics in the therapeutic arsenal of IBD was a very important advance in the treatment of these patients, a true revolution. Until that date, many of the patients who began to be treated with this biologic could only do with corticosteroids or by surgery. These drugs have been shown to be effective in reducing intestinal damage caused by chronic inflammation, the need for surgery and hospital admissions and, consequently, have improved the quality of life of many patients[4]. The demonstrated benefit of these drugs, especially when administered early, as well as their favorable safety profile, have led to their increasingly frequent use in the treatment of patients with IBD. They can be divided into - anti-TNF drugs (blocking the cytokine TNF-α), - Vedolizumab (blocking the integrin α4β7) and - Ustekinumab (blocking Interleukin 12 and 23). Recently, and only for use in UC, Tofacitinib (an inhibitor of the JAK-kinase pathway) has been approved and has demonstrated its efficacy in the treatment of moderate-severe active UC[5]. The management of all these drugs represents a challenge for the digestive specialist who must know their mechanisms of action and use them appropriately in patients with IBD. Anti-TNF drugs, being the oldest, are the ones with which we have the most experience and, therefore, they are usually used in the first line in those cases in which conventional drugs (corticosteroids and / or immunosuppressants) have failed. There are three currently marketed in Spain: Infliximab (for intravenous administration), Adalimumab (for subcutaneous administration) and Golimumab (for subcutaneous administration). Vedolizumab (administered intravenously), and Ustekinumab (administered subcutaneously, after a first intravenous administration) are characterized by having an excellent safety profile and a very low immunogenic potential compared to anti-TNF drugs. There are many lines of research currently underway to try to identify the clinical factors of the patient that would make one drug or another more useful in the first line. Other lines seek to identify genetic factors (it seems that mutations in the HLA DQA1 * 05 haplotype could increase immunogenicity to anti-TNF drugs[6]) and also molecular factors[7]. References: [1] Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014; 14(5): 329-342. [2] Zhang YZ, Li YY. Inflammatory bowel disease: Pathogenesis. World J Gastroenterol. 2014; 20(1): 91-99. [3] Pithadia AB, Jain S. Treatment of inflammatory bowel disease (IBD). Pharmacol Rep. 2011; 63(3): 629-42. [4] Weisshof R, El Jurdi K, Zmeter N, Rubin DT. Emerging Therapies for Inflammatory Bowel Disease. Adv Ther. 2018; 35(11): 1746-1762. [5] Boland BS, Vermeire S. Janus Kinase Antagonists and Other Novel Small Molecules for the Treatment of Crohn’s Disease. Gastroenterol Clin North Am. 2017; 46(3): 627-644. [6] Sazonovs A, Kennedy NA, Moutsianas L, et al. HLA-DQA1*05 Carriage Associated With Development of Anti-Drug Antibodies to Infliximab and Adalimumab in Patients With Crohn's Disease. Gastroenterology. 2020; 158(1): 189-199. [7] Atreya R, Neurath MF. Mechanisms of molecular resistance and predictors of response to biological therapy in inflammatory bowel disease. Lancet Gastroenterol Hepatol. 2018; 3(11): 790-802. more...
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- 2021
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28. Ustekinumab in Crohn's disease: real-world outcomes and predictors of response
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Héctor Pallarés Manrique, María Belén Maldonado Pérez, Teresa Valdés Delgado, Luisa Castro Laria, Juan María Vázquez Morón, Damián Sánchez Capilla, Federico Argüelles Arias, Laura Lorenzo González, Grupo de Enfermedad Inflamatoria de Andalucía, Eduardo Leo Carnerero, and Antonia Sáez Díaz more...
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Disease ,Crohn Disease ,Internal medicine ,Ustekinumab ,medicine ,Humans ,Retrospective Studies ,Crohn's disease ,Univariate analysis ,business.industry ,Remission Induction ,Gastroenterology ,Real world outcomes ,Antibodies, Monoclonal ,General Medicine ,Clinical disease ,medicine.disease ,Ulcerative colitis ,Treatment Outcome ,Female ,business ,medicine.drug - Abstract
Background Ustekinumab is a monoclonal antibody that inhibits interleukins (IL)- 12 and -23 and it is approved for the treatment of Crohn's disease (CD) and more recently also ulcerative colitis (UC). Our aim was to evaluate the effectiveness and safety of Ustekinumab, as well as to identify possible predictive factors of response in a real-life setting. Methods Observational, retrospective, and multicenter study carried out in 4 hospitals in Andalusia. Adult patients with a confirmed diagnosis of CD treated with Ustekinumab from 2017 to 2019 were included. Clinical response was analyzed at 3, 6, and 12 months of treatment. Clinical disease activity was assessed with the Harvey Bradshaw index (HBI) and the Crohn's Disease Activity Index (CDAI), and the biochemical response was assessed with analytical parameters such as CRP and ESR. One-year ustekinumab drug-survival was analyzed. Results 98 patients were analyzed (mean age 43 and 52% men). 56% had failed to ≥2 previous biologicals therapies. At 3 months, 69% of the patients were in response and 40.8% in remission. At 6 months, 56% were in clinical remission. At 12 months, 73.7% in clinical response and 60.5% in remission. Corticosteroid-free remission was 32.4%, 44%, 47.4% at 3, 6, and 12 months, respectively. The cumulative survival at one year of treatment with ustekinumab was 85.3%. Biochemical parameters, such as CRP and ESR showed a statistically significant decrease between baseline and control levels at 3, 6, and 12 months. A lower HBI at baseline and female sex were predictors of corticosteroid-free clinical remission in a univariate analysis. In the multivariate analysis, no variables were found as predictors of corticosteroid-free clinical remission Conclusion: Ustekinumab therapy is safe and useful inducing a clinical response in more than 50% of patients including patients who have failed other biological therapies. more...
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- 2021
29. Switch to infliximab subcutaneous during SARS-CoV-2 pandemic: preliminary results
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Paula Fernández Álvarez, Federico Argüelles-Arias, Ángel Caunedo Álvarez, María Belén Maldonado Pérez, Luisa Castro Laria, Vicente Merino-Bohórquez, María Belvis Jiménez, and Miguel Ángel Calleja Hernández more...
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Gastroenterology ,Biosimilar ,General Medicine ,medicine.disease ,Inflammatory bowel disease ,Infliximab ,Maintenance therapy ,Internal medicine ,Pandemic ,Medicine ,Observational study ,business ,medicine.drug - Abstract
A new subcutaneous formulation of the infliximab biosimilar CT-P13 has recently been developed for the treatment of inflammatory bowel disease (IBD), providing response rates similar to intravenous treatment. In an effort to limit patient attendance at intravenous infusion centers and to maintain biological treatment during the COVID-19 pandemic, the use of this new formulation was requested. The objective of this observational, retrospective, and descriptive study was to assess CT-P13 efficacy and safety after switching from intravenous to subcutaneous formulation in patients with IBD receiving maintenance therapy. This article shows preliminary results after six months of follow-up. more...
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- 2021
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30. Polyphenolic Maqui Extract as a Potential Nutraceutical to Treat TNBS-Induced Crohn's Disease by the Regulation of Antioxidant and Anti-Inflammatory Pathways
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Laura Macías-García, Federico Argüelles-Arias, Elena Talero, Tamara Ortiz, Ana Alcudia, Manuel De-Miguel, Victoria Vázquez-Román, Matilde Illanes, Josefa María García-Montes, Virginia Motilva, Universidad de Sevilla. Departamento de Farmacología, Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. Departamento de Química Orgánica y Farmacéutica, Ministerio de Educación y Ciencia (MEC). España, and Junta de Andalucía more...
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0301 basic medicine ,Male ,Crohn’s disease ,Antioxidant ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Administration, Oral ,Nitric Oxide Synthase Type II ,Pharmacology ,Inflammatory bowel disease ,Antioxidants ,0302 clinical medicine ,Crohn Disease ,maqui ,Nutritional Physiological Phenomena ,Crohn's disease ,Mice, Inbred BALB C ,Nutrition and Dietetics ,macrophages ,antioxidants ,030220 oncology & carcinogenesis ,medicine.symptom ,Inflammation Mediators ,lcsh:Nutrition. Foods and food supply ,Signal Transduction ,medicine.drug_class ,NF-E2-Related Factor 2 ,Macrophage polarization ,lcsh:TX341-641 ,Inflammation ,Anti-inflammatory ,Article ,03 medical and health sciences ,Nutraceutical ,inflammatory bowel disease ,medicine ,Animals ,Acute-Phase Reaction ,polyphenols ,business.industry ,Membrane Proteins ,inflammatory proteins ,medicine.disease ,acute inflammation ,Disease Models, Animal ,030104 developmental biology ,Trinitrobenzenesulfonic Acid ,Polyphenol ,Cyclooxygenase 2 ,Fruit ,Dietary Supplements ,business ,Heme Oxygenase-1 ,Food Science ,Phytotherapy - Abstract
Nutraceuticals include a wide variety of bioactive compounds, such as polyphenols, which have been highlighted for their remarkable health benefits. Specially, maqui berries have shown great antioxidant activity and anti-inflammatory effects on some inflammatory diseases. The objectives of the present study were to explore the therapeutic effects of maqui berries on acute-phase inflammation in Crohn&rsquo, s disease. Balb/c mice were exposed to 2,4,6-trinitrobenzene sulfonic acid (TNBS) via intracolonic administration. Polyphenolic maqui extract (Ach) was administered orally daily for 4 days after TNBS induction (Curative Group), and for 7 days prior to the TNBS induction until sacrifice (Preventive Group). Our results showed that both preventive and curative Ach administration inhibited body weight loss and colon shortening, and attenuated the macroscopic and microscopic damage signs, as well as significantly reducing transmural inflammation and boosting the recovery of the mucosal architecture and its muco-secretory function. Additionally, Ach promotes macrophage polarization to the M2 phenotype and was capable of down-regulating significantly the expression of inflammatory proteins COX-2 and iNOS, and at the same time it regulates the antioxidant Nrf-2/HO-1 pathway. In conclusion, this is the first study in which it is demonstrated that the properties of Ach as could be used as a preventive and curative treatment in Crohn&rsquo, s disease. more...
- Published
- 2020
31. Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU
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Jordi Guardiola, ANTONIO GARCIA HEROLA, Manuel Barreiro de Acosta, JESÚS BARRIO, Víctor Jair Morales Alvarado, Luis Bujanda, Javier Pérez Gisbert, Luis Fernández-Salazar, Federico Argüelles-Arias, MARIA DOLORES MARTIN ARRANZ, Carlos Taxonera, María Teresa Arroyo Villarino, Montserrat Rivero, David Bernardo, Alfonso Muriel, Beatriz Sicilia, Yolanda Ber Nieto, Luis Hernández, and MARIA ESTEVE more...
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Inflammatory bowel disease ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Internal medicine ,Humans ,Immunologic Factors ,Medicine ,Pharmacology (medical) ,Registries ,030212 general & internal medicine ,Family history ,Young adult ,Biological Products ,Hepatology ,business.industry ,Proportional hazards model ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Age Factors ,Gastroenterology ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,Cohort ,Female ,030211 gastroenterology & hepatology ,business ,Immunosuppressive Agents ,Cohort study - Abstract
BACKGROUND Cohort studies comparing the characteristics of childhood-onset and adulthood-onset inflammatory bowel disease (IBD) in the biologics era are scarce. AIM To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood- and adulthood-onset IBD. METHODS Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood-onset cohort comprised patients diagnosed at ≤16 years of age and the adulthood-onset cohort those diagnosed at >16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan-Meier curves, compared by the log-rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. RESULTS The adulthood-onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood-onset cohort 846 (4%). Median follow-up was 54 months in the childhood-onset cohort and 38 months in the adulthood-onset cohort (P more...
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- 2019
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32. Serial Tuberculin Skin Tests Improve the Detection of Latent Tuberculosis Infection in Patients With Inflammatory Bowel Disease
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Carlos, Taxonera, Ángel, Ponferrada, Sabino, Riestra, Fernando, Bermejo, Cristina, Saro, María Dolores, Martín-Arranz, José Luis, Cabriada, Manuel, Barreiro-de Acosta, María Luisa, de Castro, Pilar, López-Serrano, Jesús, Barrio, Cristina, Suarez, Eva, Iglesias, Federico, Argüelles-Arias, Isabel, Ferrer, Ignacio, Marín-Jiménez, Alejandro, Hernández-Camba, Guillermo, Bastida, Manuel, Van Domselaar, Pilar, Martínez-Montiel, David, Olivares, Montserrat, Rivero, Luis, Fernandez-Salazar, Óscar, Nantes, Olga, Merino, Cristina, Alba, Javier P, Gisbert, and Ruth, de Francisco more...
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Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Antitubercular Agents ,Tuberculin ,03 medical and health sciences ,0302 clinical medicine ,Gastrointestinal Agents ,Adrenal Cortex Hormones ,Latent Tuberculosis ,Interquartile range ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Skin Tests ,030203 arthritis & rheumatology ,Gastrointestinal agent ,Latent tuberculosis ,Tumor Necrosis Factor-alpha ,business.industry ,Smoking ,Adalimumab ,Gastroenterology ,Antibodies, Monoclonal ,General Medicine ,Odds ratio ,Middle Aged ,Inflammatory Bowel Diseases ,bacterial infections and mycoses ,medicine.disease ,Infliximab ,Seroconversion ,Cohort ,Female ,030211 gastroenterology & hepatology ,business ,Immunosuppressive Agents - Abstract
Aim To assess the likelihood of detecting latent tuberculosis infection [LTBI] by the positive conversion of a serial tuberculin skin test [TST] at 1 year in inflammatory bowel disease [IBD] patients with negative baseline two-step TST. Methods In this multicentre prospective cohort study, we evaluated rate and predictors of conversion of TST at 1 year in patients with negative baseline TST. We also evaluated management of patients who had a positive TST at baseline or a conversion at 1 year. In all patients we assessed TB cases occurring during follow-up. Results Of the 192 IBD patients receiving anti-tumour necrosis factor [TNF] and 220 IBD controls not receiving anti-TNF, 35 [8.5%, 95% CI 5.7-11.3] had positive conversion (median TST induration 13 mm, interquartile range [IQR] 9-16). Ten anti-TNF cohort patients [5.2%, 95% CI 2.5-9.5] versus 25 controls [11.4%, 95% CI 7.5-16.3] had TST conversion [p = 0.029]. In multivariate analysis, conversion was associated with smoking habit (odds ratio [OR] 2.19, 95% CI 1.08-3.97; p = 0.028). Anti-TNF-treated patients had a lower conversion rate [OR 0.41, 95% CI 0.20-0.83; p = 0.013]. The likelihood of conversion correlates with fewer immunosuppressive therapies between baseline TST and TST at 1 year [p = 0.042]. One case of active TB [isoniazid-resistant strain] occurred in a patient with positive baseline TST receiving anti-TNF [0.05 events/100 patient-years]. Conclusions Serial TST at 1 year can detect LTBI in IBD patients receiving anti-TNF therapy with negative baseline TST. Serial TST seems to be advisable to reduce the risk of TB cases associated with inability to detect LTBI in pre-treatment screening. more...
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- 2018
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33. DOP40 Comorbidities and epidemiological risk factor but not immunosuppressive therapies increase the risk of COVID-19 in Inflammatory Bowel Disease (IBD): An ENEIDA-based, case-control study
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Alfredo J. Lucendo, M. Barreiro-de Acosta, M.D. Martín, Iván Guerra, M Piqueras, Santiago García-López, Pilar Martínez-Montiel, Marisa Iborra, Carlos Taxonera, Noemí Manceñido, David Busquets, M. Rivero, Patricia Vega, Anyeli de la C. López, C Rodríguez, M Esteve, José Luis Monereo Pérez, Jesus Barrio, Isabel Vera, Míriam Mañosa, L Melcarne, Isabel Pérez-Martínez, A. Ponferrada-Diaz, O. Benítez, B Caballol, Francisco Mesonero, E. Domènech, Ignacio Marín-Jiménez, M Navarro-Llavat, V. Hernández, Y. Z. Abdo, Jordi Gordillo, Javier P. Gisbert, Luis Bujanda, Federico Argüelles-Arias, I Rodríguez-Lago, T. Martinez-Perez, Lara Arias, M Boscá-Watts, and Mario Calvo more...
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Gastroenterology ,Case-control study ,General Medicine ,medicine.disease ,DOP Session 5 - Recent advances in epidemiology ,Comorbidity ,Inflammatory bowel disease ,Aminosalicylate ,Internal medicine ,Epidemiology ,Digital oral presentations ,medicine ,Risk factor ,business ,AcademicSubjects/MED00260 - Abstract
Background The information regarding IBD patients with COVID-19 suggests that the factors related to bad outcome are older age and comorbidity whereas immunosuppressants do not have a significant impact worsening the disease evolution. To date, there is no information to assess if there are differences in epidemiological, demographical, and clinical characteristics between infected and non-infected IBD patients. Methods Case-control study in IBD patients with COVID-19 (cases) compared to IBD without COVID-19 (controls) in the period March-July/2020 within the ENEIDA registry (promoted by GETECCU and with more than 60.000 IBD patients included). Cases were matched 1:2 by age (±5y), type of disease (CD/UC), gender, and centre. All controls were selected from only one investigator blind to other clinical characteristics of the patients to avoid selection bias. Results 496 cases and 964 controls from 63 Spanish centres were included. No differences were found within the basal characteristics including CD location, CD behaviour, extraintestinal manifestations, family history of IBD or smoking habits. Cases had ≥ 1 comorbidities (cases:43%vs. controls:36%, p=0.01) and occupational risk (cases:27% vs. controls:10.6%, p Conclusion Comorbidities and epidemiological risk factors are the most relevant aspects for the risk of COVID-19 in IBD patients. This risk of COVID-19 seems to be increased by aminosalicylates but not by immunosuppressants or biologics. The attitude regarding treating IBD patients with aminosalicylates during the COVID-19 pandemic deserves a deeper analysis. Funded by the Carlos III Health Institute COV20/00227. more...
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- 2021
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34. P478 Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard-dose subcutaneous maintenance therapy: an observational multicentre study
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R Olmedo-Martín, L Lorenzo-González, Gateii, M D M Martín-Rodríguez, M Lopez-Vico, Á Hernández-Martínez, M Lázaro-Sáez, Federico Argüelles-Arias, and J M Vázquez-Morón
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Oncology ,medicine.medical_specialty ,Crohn's disease ,business.industry ,Gastroenterology ,Interleukin ,General Medicine ,medicine.disease ,Maintenance therapy ,Internal medicine ,Ustekinumab ,medicine ,Observational study ,Biological response modifiers ,Adverse effect ,business ,Abdominal surgery ,medicine.drug - Abstract
Background Ustekinumab is a human monoclonal antibody that targets interleukin (IL)-12 and IL-23 and it is effective for the treatment of Crohn’s disease (CD). However, a group of patients will not respond or over time will experience loss of response (LOR) to ustekinumab. Evidence supporting the effectiveness of ustekinumab dose escalation for LOR is scarce. The aim of this study was to assess the effectiveness of ustekinumab dose escalation in a cohort of patients with active CD Methods Multicentric retrospective cohort study conducted in 5 tertiary Andalusian centers. Patients with active CD who received a standard-dose intravenous (IV) induction and at least one subcutaneous (SC) ustekinumab dose were included. All enrolled patients received dose escalation by either shortening the interval between the maintenance doses to every 4 or 6 weeks, IV reinduction or a combination of strategies. The primary outcome of the study was to assess corticosteroid (CS)-free clinical remission (HBI ≤4) at week 16. Secondary outcomes were CS-free clinical response (decrease of HBI ≥ 3 points from baseline) at week 16 and on the last follow-up, CS-free clinical remission on the last follow-up and ustekinumab persistence after dose escalation Results A total of 84 patients were included (54,8% female, median duration of CD 13,5 years). A 47,5% of the patients had history of previous abdominal surgery and 55% had been treated with 2 or more biologics. Patients were dose-escalated after a median treatment duration of 37 weeks (IQR 23–54). The most frequent type of dose escalation was the 90 mg every 4 weeks regimen (58%). A 25% of the patients were on concomitant immunomodulators at escalation. At week 16 from dose escalation the proportion of patients in CS-free response was 50/84 (59%) including 18/84 (21,4%) in CS-free remission. Follow-up data beyond week 20 were available for 61/84 patients (72.6%). On the last follow-up visit, 29/61 (47,5%) patients responded to treatment without concomitant CS of which 19/61 (31%) were in CS-free clinical remission. Systemic CS were discontinued in 21/44 (47.7%) patients who were on CS at the time of dose escalation. Ustekinumab was discontinued in 14/84 (17%) of the patients due to clinical non-response (ustekinumab persistence was 81% at 14 months of follow-up). Adverse events following dose escalation were reported in 4 of the 84 patients (7.7%), none of them were serious. Conclusion Dose escalation of ustekinumab maintenance was effective in over 50% of the patients and the treatment persistence was high. This strategy should be considered in patients who are not responsive or have LOR to ustekinumab on an 8-week dose maintenance interval more...
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- 2021
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35. Autoimmune Encephalitis During Treatment With Adalimumab: A Case Report in Crohn’s Disease
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Luisa Castro Laria, Belén Maldonado Pérez, Federico Argüelles-Arias, and Paula Fernández Álvarez
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Autoimmune encephalitis ,Crohn's disease ,business.industry ,Immunology ,Gastroenterology ,medicine ,Adalimumab ,Immunology and Allergy ,medicine.disease ,business ,Anti tnf α therapy ,medicine.drug - Published
- 2020
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36. Index of the Mayo Endoscopy and Ulcerative Colitis Endoscopy Index of Severity: are they equally valid?
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Victoria Alejandra Jiménez García, Ángel Caunedo Álvarez, Pedro Hergueta-Delgado, Luisa Castro Laria, María Dolores Galván Fernández, Blas José Gómez Rodríguez, María Belvis Jiménez, Antonio Benítez Roldán, Belén Maldonado Pérez, María Fernanda Guerra Veloz, Manuel Rodríguez-Téllez, Cristina Castro Márquez, Federico Argüelles Arias, Reyes Aparcero López, Antonio Garrido Serrano, María Luisa Morales Barroso, and Rafael Romero Castro more...
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Cohort Studies ,Observer Variation ,business.industry ,Gastroenterology ,Humans ,Medicine ,Colitis, Ulcerative ,Colonoscopy ,General Medicine ,Middle Aged ,business ,Severity of Illness Index ,Humanities - Abstract
Introduccion: la endoscopia tiene un papel fundamental en el manejo de los pacientes con colitis ulcerosa (CU), ya que permite la visualizacion y evaluacion de la gravedad de la enfermedad. No obstante, dicha evaluacion no es siempre algo objetivo, por lo que se han desarrollado diferentes escalas que pretenden homogeneizar los hallazgos. Objetico: el objetivo del estudio fue evaluar la variabilidad interobservador entre el Indice de Mayo Endoscopico (IME) y el Indice de Severidad Endoscopica de la Colitis Ulcerosa (UCEIS), al analizar la gravedad de las lesiones endoscopicas en pacientes con CU. El objetivo secundario fue analizar si la preparacion catartica afectaba al grado de concordancia entre los endoscopistas. Material y metodos: se trata de un estudio observacional comparativo de una unica cohorte a la cual se realiza una colonoscopia bajo guia de practica clinica habitual a pacientes con CU y se estadifica segun el IME y el UCEIS por tres endoscopistas expertos. Para valorar el grado de correlacion interobservador se utilizaron el indice de Kappa para el IME y el coeficiente de correlacion intraclase para el UCEIS. Se incluyeron 67 pacientes, con edad media de 51 anos (DE ± 16,7) e indice de Mayo clinico medio de 3,07 (DE ± 2,54). Resultados: el indice de Kappa ponderado entre los endoscopistas A y B para el IME fue de 0,8; entre el A y el C, de 0,52; y entre el B y el C, de 0,49. Para el UCEIS, el coeficiente de correlacion intraclase fue del 0,922 entre los tres endoscopistas (IC 95 %: 0,832-0,959). Se encontro una mejor correlacion interobservador cuando la preparacion catartica era ≥ 8 segun la escala de Boston. Conclusion: existe, por tanto, una superior correlacion entre los diferentes endoscopistas para el UCEIS que para el IME, por lo que deberia ser considerado como el mejor indice a utilizar en la practica clinica. Una buena preparacion catartica es importante para mejorar la correlacion interobservador. more...
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- 2020
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37. Cut-off ranges of infliximab serum levels in Crohn�s disease in the clinical practice
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María Fernanda Guerra Veloz, Vicente Merino Bohórquez, Antonia Sáez, Belén Maldonado Pérez, Raúl Perea Amarillo, Federico Argüelles Arias, Ángel Caunedo Álvarez, Luisa Castro Laria, and Teresa Valdés Delgado more...
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Adult ,Male ,medicine.medical_specialty ,Gastroenterology ,Antibodies to infliximab ,Crohn Disease ,Gastrointestinal Agents ,Internal medicine ,medicine ,Humans ,In patient ,Retrospective Studies ,Crohn's disease ,medicine.diagnostic_test ,Maintenance dose ,business.industry ,Remission Induction ,Antibodies, Monoclonal ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Infliximab ,Clinical Practice ,Treatment Outcome ,Therapeutic drug monitoring ,Female ,business ,medicine.drug - Abstract
Introduction between 30 % and 40 % of patients treated with infliximab lose response during maintenance. Therapeutic drug monitoring could be used to optimize management in these situations. However, infliximab serum levels are not well defined. The aim of this study was to determine the cut-off range of infliximab serum levels in Crohn's disease patients in remission in the clinical practice. Methods an observational retrospective study was performed from 2016 to 2017. Patients were included with established Crohn's disease, who had been on a maintenance dose schedule of infliximab. Infliximab levels and antibodies to infliximab were measured at least twice in all patients, after induction and after six months of treatment. Clinical remission was defined as ≤ 4 using the Harvey-Bradshaw index. Cluster analysis was used to analyze the results. Results one hundred and five Crohn's disease patients were included in the study; 57.1 % were male with a mean age of 39 years (SD ± 12.9). The median (range) time of the disease was eleven years (7-15) and the median (range) time of follow-up was 32 months (22-38). Patients who achieved remission had infliximab serum levels between 4.26-8.26 ug/ml versus 0.06-1.43 ug/ml in patients who did not achieve remission after induction. Infliximab serum levels were 2.84-7.75 ug/ml and 0.05-2.69 ug/ml in patients who achieved remission versus those who did not achieve remission after six months of treatment. Overall, 4.26-8.26 ug/ml was found to be the best cut-off range for remission. Conclusions in our clinical practice, serum levels of infliximab in Crohn's disease patients should be higher than 4 ug/ml to achieve clinical remission. more...
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- 2020
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38. National survey on the experiences of people with celiac disease in Spain. The CELIAC-SPAIN project
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María van der Hofstadt Rovira, Rosa Burgos, Federico Argüelles Arias, and Francesc Casellas Jordá
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Adult ,Delayed Diagnosis ,business.industry ,Gastroenterology ,General Medicine ,Celiac Disease ,Diet, Gluten-Free ,Spain ,Quality of Life ,Humans ,Patient Compliance ,Medicine ,Child ,business ,Humanities - Abstract
Introduccion: la enfermedad celiaca (EC) es muy bien conocida, pero no asi las percepciones y necesidades de los pacientes. Objetivo: determinar en nuestro entorno la repercusion de la EC en la vida del paciente celiaco tanto en las vertientes del diagnostico, seguimiento y tratamiento de la EC. Material y metodos: encuesta telematica autoadministrada, realizada entre mayo y julio del 2019, y dirigida a socios de FACE. Se han definido tres perfiles de participantes: adultos diagnosticados en la edad adulta, adultos diagnosticados en la infancia y padres/tutores de ninos celiacos. Resultados: se han incluido 540 encuestas (343 celiacos adultos, 58 celiacos desde ninos y 139 padres/tutores) procedentes de todas las comunidades autonomas. En el proceso diagnostico destaca la demora diagnostica (de hasta 2 anos) y las limitaciones para hacer el cribado de los familiares. Tras el diagnostico cerca del 20 % de adultos no refieren seguir ningun control. Padecer una EC genera distintas reacciones, pero es muy comun la preocupacion y la limitacion de la calidad de vida. En cuanto a la dieta sin gluten, el 90 % de pacientes se consideran buenos cumplidores, que se acompana de una mejora de los sintomas y ganancia ponderal. El seguimiento de la dieta limita la vida diaria de los pacientes. Los productos manufacturados sin gluten se consideran caros, con etiquetado poco claro y poco apetecibles. Conclusiones: los resultados del proyecto “CELIAC-SPAIN” demuestran que aun quedan muchos aspectos por mejorar en la EC, tanto el diagnostico como en el seguimiento y en facilitar el acceso a los productos sin gluten. more...
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- 2020
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39. Views of patients with inflammatory bowel disease during the COVID-19 pandemic: ACCU survey results
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Luisa Castro Laria, Paula Fernández Álvarez, María Belvis Jiménez, José Luis Rodríguez de Los Ríos, Belén Maldonado Pérez, Federico Argüelles-Arias, and Ángel Caunedo Álvarez
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Adult ,Male ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Gastroenterology ,COVID-19 ,Survey result ,General Medicine ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,Inflammatory bowel disease ,Self-Help Groups ,Young Adult ,medicine ,Humans ,Female ,Self Report ,business ,Humanities - Abstract
Introduccion y objetivos: la pandemia por el SARS-COV2 ha obligado a un cambio sustancial en la atencion a los pacientes con patologias digestivas, en especial a los pacientes con enfermedad inflamatoria intestinal (EII), por estar tratados con farmacos inmunomoduladores. En este sentido, algunas guias nacionales e internacionales han indicado las normas a tener en cuenta. No obstante, pocos trabajos han evaluado como han afrontado los pacientes esta infeccion. Por ello, hemos realizado este estudio con el objetivo de conocer como ha afectado la pandemia por SARS-COV2 a nuestros pacientes con EII. Material y metodos: se realizo una encuesta on-line entre los 295 miembros de la Asociacion de Enfermos de Crohn y Colitis Ulcerosa (ACCU) que constaba de 19 preguntas. Resultados: participaron 168 pacientes de la ACCU, de los cuales un 58 % eran mujeres, el 63,7 % tenia una EC y el 53 % recibia tratamiento biologico. Un 5 % fueron infectados por el SARS-CoV2, todos ellos varones. La principal preocupacion de los pacientes era el miedo a adquirir la infeccion (80,9 %). Mas del 90 % continuo con su tratamiento inmunosupresor y biologico. La mitad de los pacientes teletrabajaron durante el periodo de pandemia. Conclusiones: la perspectiva de los pacientes es fundamental para conseguir un adecuado manejo y evolucion de la enfermedad. Son necesarios mas trabajos que evaluen el impacto que situaciones excepcionales como la pandemia COVID-19 puede ocasionar sobre los pacientes con EII para mejorar la adherencia y el control de la enfermedad. more...
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- 2020
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40. Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry
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Laura Ramos, Patricia Ramirez de la Piscina, Carlos Taxonera, Luisa de Castro, Belén Beltrán, Fernando Bermejo, Rosa Eva Madrigal, E Sesé, Fernando Gomollón, Alfredo J. Lucendo, Jesús Barrio, Xavier Calvet, Joaquín Hinojosa, Cristina Rodríguez, Gloria Esther Rodriguez, Carmen Muñoz, Ana Gutiérrez, Mara Charro, Eugeni Domènech, David Monfort, Esther Garcia-Planella, M F García-Sepulcre, José María Huguet, María Chaparro, Javier P. Gisbert, R. Pajares, José Lázaro Pérez-Calle, Montserrat Rivero, Jordi Guardiola, Luis Fernández-Salazar, Federico Argüelles-Arias, Xavier Aldeguer, Agueda Abad, Jordina Llaó, Guillermo Alcain, Pedro Almela, Sabino Riestra, Olga Merino, M Navarro-Llavat, Luis Bujanda, Manuel Domínguez-Cajal, Maria Esteve, Sam Khorrami, María Dolores Martín-Arranz, Lucía Márquez, Antonio Roman, María Isabel Vera, Rufo Lorente, Antonio García-Herola, Beatriz Sicilia, A Rodríguez-Pérez, Pilar Varela, Santiago García-López, Pilar Martínez-Montiel, Miguel Minguez, Manuel Van Domselaar, María José Casanova, Patricia Romero, Iago Rodríguez-Lago, Elena Ricart, and Eva Iglesias more...
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Crohn’s disease ,Male ,Kaplan-Meier Estimate ,Inflammatory bowel disease ,Crohn Disease ,Immunology and Allergy ,Prospective Studies ,Registries ,Child ,anti-TNF ,Crohn's disease ,Incidence (epidemiology) ,Remission Induction ,Hazard ratio ,Gastroenterology ,Middle Aged ,Necrosi ,ulcerative colitis ,Ulcerative colitis ,switch ,Malalties inflamatòries intestinals ,Child, Preschool ,Female ,inflammatory bowel disease ,Adult ,medicine.medical_specialty ,Adolescent ,Combination therapy ,Inflammatory bowel diseases ,Crohn’s disease, anti-TNF, inflammatory bowel disease, switch, ulcerative colitis ,Young Adult ,Necrosis ,Internal medicine ,medicine ,Humans ,Adverse effect ,Aged ,business.industry ,Adalimumab ,medicine.disease ,Infliximab ,Confidence interval ,Logistic Models ,Spain ,Multivariate Analysis ,Colitis, Ulcerative ,Tumor Necrosis Factor Inhibitors ,business - Abstract
Background The effectiveness of the switch to another anti–tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8–3; P < 0.0001) and ulcerative colitis vs Crohn’s disease (HR, 1.6; 95% CI, 1.1–2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response. more...
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- 2020
41. Consensus document on the management preferences of patients with ulcerative colitis: points to consider and recommendations
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Manuel Barreiro-de Acosta, Yago González-Lama, Santiago García-López, Francesc Casellas, Daniel Guinard Vicens, Estíbaliz Loza, Ana Cabez, R Saldaña, Federico Argüelles-Arias, Susana Gómez, Juan Manuel Mendive, and Laura Marín Sánchez more...
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medicine.medical_specialty ,Consensus ,Adolescent ,media_common.quotation_subject ,Delphi method ,MEDLINE ,03 medical and health sciences ,0302 clinical medicine ,Multidisciplinary approach ,quality of care ,Health care ,Medicine ,Humans ,Quality (business) ,clinical excellence ,adherence ,preferences ,media_common ,ulcerative colitis ,Hepatology ,business.industry ,Gastroenterology ,Primary care physician ,Nominal group ,quality of life ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Family medicine ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,Female ,business ,Qualitative research - Abstract
Background and aims Our objective was to define, describe and organize (on the basis of consensus) the patient's preferences in the management of ulcerative colitis (UC), in order to further incorporate them in daily practice and improve patients satisfaction, adherence to the treatment and quality of care. Methods Qualitative study. A narrative literature review in Medline using Mesh and free-text terms was conducted to identify articles on UC patient preferences as well as clinical scenarios that may influence the preferences. The results were presented and discussed in a multidisciplinary nominal group meeting composed of six gastroenterologists, one primary care physician, one nurse practitioner and one expert patient. Key clinical scenarios and patient preferences were then defined, generating a series of points to consider and recommendations. The level of agreement with the final selection of preferences was established following a Delphi process. Results The narrative review retrieved 69 articles of qualitative design and moderate quality. The following key clinical scenarios were identified: diagnosis, follow-up, surgery, and special situations/patients profiles such as adolescents or women. Patient preferences were classified into information, treatment (pharmacological and non-pharmacological), follow-up, relations with health professionals, relations with the health system and administration. Finally, 11 recommendations on patient preferences for UC in relation to its management reached the level of agreement established. Conclusion The consensual description of patient's preferences contribute to identify different areas for improvement in healthcare practice. more...
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- 2020
42. BEWARE OF THE GLUE
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F Pellicer-Bautista, R Romero-Castro, P Hergueta-Delgado, VA Jimenez-Garcia, ML Morales-Barroso, A Caunedo-Alvarez, B. Maldonado-Pérez, JL Caceres-Galan, Federico Argüelles-Arias, and P Cordero-Ruiz
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Polymer science ,media_common.quotation_subject ,Art ,GLUE ,media_common - Published
- 2019
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43. Long-term safety and efficacy study of a medical device containing xyloglucan, pea protein reticulated with tannins and xylo-oligosaccharides, in patients with diarrhoea-predominant irritable bowel syndrome
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Carlos Teruel, Blanca Serrano Falcón, Esperanza Pérez, Enrique Rey, Constanza Ciriza de los Ríos, Fernando Geijo, Federico Argüelles-Arias, and Universidad de Sevilla. Departamento de Medicina
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medicine.medical_specialty ,mucoprotectants ,RC799-869 ,Gastroenterology ,chemistry.chemical_compound ,xyloglucan ,Internal medicine ,medicine ,Gut permeability ,In patient ,xylo-oligosaccharides ,Irritable bowel syndrome ,Original Research ,irritable bowel syndrome ,business.industry ,Pea protein ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Pathophysiology ,diarrhoea ,Xyloglucan ,chemistry ,gut permeability ,Long term safety ,business ,Efficacy Study - Abstract
Background: Irritable bowel syndrome with diarrhoea (IBS-D) is a frequent problem associated with a significant socioeconomic implication. Increased gut permeability is an important pathophysiological mechanism. A medical device containing xyloglucan (XG), pea protein and tannins (PPT) from grape-seed extract, and xylo-oligosaccharides (XOS) has proven restoration of intestinal barrier function. Our objective was to evaluate the efficacy and safety of treatment with the medical device XG + PPT + XOS (XG-PPT-XOS) in adult patients with IBS-D in a clinical setting for 6 months. Material and methods: This was a multicentre, open-label, prospective, observational study conducted to evaluate long-term safety and efficacy of XG-PPT-XOS. IBS-D adult patients (Rome IV criteria) were included and received two tablets twice daily for 6 months. IBS Symptom Severity Score (IBS-SSS) and bowel habit were registered at baseline and monthly, until the end of follow up. Efficacy was evaluated by comparison of mean scores at each time point. Results: 50 patients were included, of which 19 completed the 6 months. IBS-SSS score decreased from 312.2 ± 82.2 to 213.6 ± 109.9 ( p Conclusion: Treating IBS-D patients with XG-PPT-XOS is effective and safe in the long term within a clinical setting, improving all IBS-D symptoms from the first month of treatment and showing a sustained response over the term of therapy. more...
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- 2021
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44. SEGURIDAD Y EFICACIA DE LA CÁPSULA ENDOSCÓPICA EN PACIENTES CON MARCAPASOS Y DESFIBRILADORES AUTOMÁTICOS IMPLANTABLES
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Laura Lorenzo González, Victoria Alejandra Jiménez García, Daniel Barranco Castro, Ángel Caunedo Álvarez, Pilar Del Pino Bellido, Blas José Gómez Rodríguez, Pedro Hergueta Delgado, Federico Argüelles Arias, Teresa Valdés Delgado, and Lorena Cadena Herrera more...
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- 2019
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45. Long-term follow up after switching from original infliximab to an infliximab biosimilar: real-world data
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Vicente Merino Bohórquez, Belén Maldonado Pérez, Teresa Valdés Delgado, Luisa Castro Laria, Ángel Vilches Arenas, Ángel Caunedo Álvarez, Federico Argüelles-Arias, Raúl Perea Amarillo, María Fernanda Guerra Veloz, María Belvis Jiménez, Universidad de Sevilla. Departamento de Medicina, and Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública more...
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Crohn’s disease ,medicine.medical_specialty ,Crohn's disease ,business.industry ,Long term follow up ,Gastroenterology ,Biosimilar ,medicine.disease ,Inflammatory bowel disease ,Ulcerative colitis ,Infliximab ,Internal medicine ,medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,lcsh:RC799-869 ,business ,Real world data ,CT-P13 ,medicine.drug ,Original Research ,ulcerative colitis - Abstract
Background: Several studies have reported positive efficacy outcomes for patients with inflammatory bowel disease treated with CT-P13, an infliximab biosimilar. Data from follow-up periods longer than 1 year are still scarce. Here, we assessed the long-term efficacy data, loss of response and safety after switching from infliximab to CT-P13 in patients with inflammatory bowel disease. Methods: This was a prospective single-center observational study involving patients with moderate-to-severe Crohn’s disease and ulcerative colitis switched from infliximab to CT-P13 treatment and reviewed up to 24 months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. C-reactive protein, infliximab drug levels, adverse events and antidrug antibodies were also monitored throughout the study. Results: A total of 64 patients with Crohn’s disease and 36 patients with ulcerative colitis were included. Most of them (72%) remained on CT-P13. Overall, 28% of patients discontinued the therapy due to loss of response, adverse events or long-lasting clinical remission. Remission at 18 and 24 months occurred in 69.9% and 68.5% of patients, respectively. Dose increase was performed in 22% of patients, with remission being reached in 60% of them. HB index, partial Mayo score, C-reactive protein and infliximab drug levels did not show significant changes. Serious adverse events were reported in 14% of patients. Overall, two patients developed low levels of antidrug antibodies. Conclusions: Most of the patients switching from original infliximab were maintained on CT-P13 at 2 years of follow up with a good profile of efficacy and safety. more...
- Published
- 2019
46. Patients' perceptions of the impact of ulcerative colitis on social and professional life: results from the UC-LIFE survey of outpatient clinics in Spain
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Xavier, Calvet, Federico, Argüelles-Arias, Antonio, López-Sanromán, Luis, Cea-Calvo, Berta, Juliá, Cristina Romero, de Santos, and Daniel, Carpio
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Ulcerative colitis (UC) may cause many patients to miss out on important personal and professional opportunities. We therefore conducted a survey (UC-LIFE) to assess patients' perceptions of the impact of UC on social and professional lives.Consecutive unselected UC patients aged ≥18 years were recruited from 38 outpatient clinics in Spain. Patients completed the survey at home, returning it by post. The survey comprised 44 multiple-choice questions, including questions about the impact of UC on social, personal, professional, and academic activities.Of 585 patients invited, 436 (75%) returned the survey (mean age 46 years; 47% women). High proportions of patients considered their disease "sometimes", "frequently" or "mostly/always" influenced leisure activities (65.1%), recreational or professional activities (57.6%), or relationships with relatives or friends (9.9%). Patients also reported that UC influenced their decision to have children (17.2%), or their ability to take care of children (40.7%); these percentages were higher in women and in younger patients. Overall, 47.0% of patients declared that UC influenced the kind of job they performed, 20.3% had rejected a job due to UC, 14.7% had lost a job due to UC, and 19.4% had had academic problems due to UC.Beyond symptoms alone, UC imposes an enormous additional burden on patients' social, professional, and family lives. This extra burden clearly needs to be addressed so that the ultimate goal of IBD treatment - normalization of patient quality of life - can be attained by as many patients as possible. more...
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- 2018
47. Does the Antitumor Necrosis Factor-α Therapy Decrease the Vertebral Fractures Occurrence in Inflammatory Bowel Disease?
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M. Giner-García, L. Castro-Laria, A. Caunedo-Álvarez, Federico Argüelles-Arias, María-José Montoya-García, M.B. Maldonado-Pérez, M. Romero-Gómez, and M.A. Vázquez-Gámez
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Bone density ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,030209 endocrinology & metabolism ,Inflammatory bowel disease ,Bone remodeling ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Bone Density ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Orthopedics and Sports Medicine ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,Child ,Femoral neck ,Aged ,Bone mineral ,Lumbar Vertebrae ,business.industry ,Femur Neck ,Incidence ,Odds ratio ,Middle Aged ,medicine.disease ,Inflammatory Bowel Diseases ,medicine.anatomical_structure ,Treatment Outcome ,Spinal Fractures ,Female ,Tumor Necrosis Factor Inhibitors ,030101 anatomy & morphology ,Bone Remodeling ,business ,Osteoporotic Fractures - Abstract
Background/Objective: Osteoporosis and osteoporotic fracture risk are extraintestinal manifestations of the inflammatory bowel disease, whose etiopathogenic mechanisms have not been determined yet. Anti-tumor necrosis factor (TNF)-α are used in treatment of inflammatory bowel disease (IBD), but it is unknown if they play a role in osteoporotic fracture prevention. The objective of this study was to know if anti-TNF decreases fracture risk or modifies bone mineral density. To determine the possible risk factors associated with fractures, and assess the incidence of vertebral fractures in IBD patients. Methods: Longitudinal prospective cohort study (7 yr of follow-up); which included 71 IBD patients, 23 received anti-TNF-α; the remaining 48 received conventional treatment, constituted the control group. Patients participated in a questionnaire which gathered risk factors associated with the development of osteoporosis and fractures. Radiographs of the dorsolumbar-spine were performed and also a bone density measurement. Their biochemical and bone remodeling parameters were determined. Results: Although patients who did not receive anti-TNF-α, suffered more fractures but biologic therapy did not reduce the risk of new vertebral fractures. The increase of bone mass was significantly higher the group treated with anti-TNF-α. The increase in the lumbar spine was of 8% and in the femoral neck was of 6.7%. The only determinant factor for the incidence of vertebral fractures was a history of previous fractures (odds ratio of 12.8; confidence interval 95% 2.37–69.9; p = 0.003). The incidence of vertebral fractures in IBD patients was considerably high: 26.7/700 patient-yr. Conclusions: Anti-TNF-α, although increased bone mass in these patients, did not reduce the risk of new vertebral fractures. In this study, patients with IBD have a considerably high incidence of fractures. Only the existence of previous vertebral fractures was a predictive factor for consistent fractures. more...
- Published
- 2018
48. Prognosis of Patients with Ulcerative Colitis in Sustained Remission After Thiopurines Withdrawal
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María Gómez-García, Eduardo Leo-Carnerero, M Rojas-Feria, José Manuel Benítez, Juan María Vázquez-Morón, Manuel Castro-Fernandez, María José Cabello-Tapia, Federico Argüelles-Arias, Luisa Castro-Laria, José Manuel Herrera-Justiniano, Valle García-Sánchez, Raquel Camargo-Camero, Francisco Javier Serrano-Ruiz, Estefanía Moreno-Rincón, Héctor Pallarés-Manrique, Eva Iglesias-Flores, and Guillermo Alcaín-Martínez more...
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Adult ,Male ,medicine.medical_specialty ,Pancolitis ,Colonoscopy ,Drug withdrawal ,Pharmacotherapy ,Internal medicine ,Azathioprine ,medicine ,Humans ,Immunology and Allergy ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,Mercaptopurine ,business.industry ,Remission Induction ,Hazard ratio ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Ulcerative colitis ,Confidence interval ,Treatment Outcome ,Withholding Treatment ,Colitis, Ulcerative ,Drug Therapy, Combination ,Female ,medicine.symptom ,business ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
Background The ideal length of treatment with thiopurines in patients with ulcerative colitis (UC) in sustained remission remains unknown. It is widely accepted that the drug withdrawal is associated with a worse outcome. The aim of this study was to analyze the outcome after this withdrawal and to identify predictors of relapse. Methods A multicenter and retrospective study was designed. A total of 102 patients with UC who discontinued thiopurines in a situation of sustained remission were included. All the patients were followed up until last revision or until relapse (understood as the occurrence of signs and symptoms of UC that required a rescue treatment). Results After thiopurines withdrawal, overall relapse was recorded in 32.35% of the patients: 18.88% in the first year, 36.48% in the third, and 43.04% in the fifth year after withdrawal. On multivariate analysis, predictors of relapse were the time from diagnosis of UC until the starting of thiopurines (hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.01-1.02; P = 0.039), the number of relapses before the withdrawal (HR, 1.3; 95% CI, 1.01-1.66; P = 0.029), pancolitis (HR, 5.01; 95% CI, 1.95-26.43; P = 0.028), the duration of treatment with thiopurines (HR, 0.15; 95% CI, 0.03-0.66; P = 0.013) and the situation of biological remission at withdrawal (HR, 0.004; 95% CI, 0.0001-0.14; P = 0.002). Conclusions The withdrawal of thiopurines in patients with UC, although in sustained remission, is related to a high relapse rate. Clinical variables such as the extent of the disease, the duration of treatment or time from diagnosis to the start of thiopurines should be considered before stopping these drugs. more...
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- 2015
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49. ÍNDICE DE MAYO ENDOSCÓPICO Y GRAVEDAD DE LA COLITIS ULCEROSA: ¿SABEMOS REALIZARLO O ES NECESARIO OTRO ÍNDICE?
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Belén Maldonado Pérez, Luisa Castro Laria, Blas José Gómez Rodríguez, Antonio Benítez Roldán, Federico Argüelles Arias, Antonio Torrico Laguna, Pedro Hergueta Delgado, Ángel Vilches Arenas, Ángel Caunedo Álvarez, and María Belvis Jiménez more...
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- 2018
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50. Influence of age, body mass index and comorbidity on major outcomes in acute pancreatitis, a prospective nation-wide multicentre study
- Author
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Gregorio Martín-Benítez, Vikesh K. Singh, Federico Argüelles-Arias, Beatriz Romero-Mosquera, Eugenia Lauret-Braña, Ruben Hernaez, Esther Fort-Martorell, M Asunción Marcaide-Ruiz-de-Apodaca, Emma Martínez-Moneo, Guillermo García-Rayado, José L de-Benito, Jennifer Hinojosa-Guadix, Eduardo Bajador-Andreu, Francia C. Díaz, José Antonio Pajares-Díaz, Carlos Prieto-Martínez, Enrique de-Madaria, Georgios I. Papachristou, Jesús Leal-Téllez, Daniel De la Iglesia-García, Carla Tafur-Sánchez, Robert A. Moran, Noé Quesada-Vázquez, Pilar Marqués-García, Fabio Ausania, Jaume Boadas, Oswaldo Moreno, Miguel González-de-Cabo, and Mar Concepción-Martín more...
- Subjects
medicine.medical_specialty ,business.industry ,Gastroenterology ,morbidity ,Original Articles ,medicine.disease ,comorbidities ,Comorbidity ,mortality ,Acute pancreatitis ,03 medical and health sciences ,comorbidity ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,organ failure ,Acute pancreatitis, comorbidities, comorbidity, morbidity, mortality, organ failure ,Prospective cohort study ,business ,Body mass index - Abstract
Background There are few large prospective cohort studies evaluating predictors of outcomes in acute pancreatitis. Objectives The purpose of this study was to determine the role of age and co-morbid disease in predicting major outcomes in acute pancreatitis. Methods Data points were collected according to a predefined electronic data collection form. Acute pancreatitis and its complications were defined according to the revised Atlanta classification. Univariable and multivariable analyses were conducted using Cox proportional hazard regression and multiple logistic regression. Results From June 2013-February 2015, 1655 adult patients were recruited from 23 centres across Spain. Co-morbid disease, obesity, open surgical necrosectomy within 30 days, and pancreatic necrosis were independently associated with both 30-day mortality and persistent organ failure (p < 0.05 for all). Age was not associated with persistent organ failure, however the extreme of age (>85 years) was associated with mortality (p < 0.05). Co-morbid disease and obesity were not independently associated with a prolonged length of stay or other markers of morbidity on adjusted analysis (p > 0.05). Conclusion Comorbidity and obesity are important determinates of mortality and persistent organ failure in acute pancreatitis, but in the absence of organ failure they do not appear to independently contribute to morbidity. This has important implications for severity classification and predictive models of severity in acute pancreatitis. more...
- Published
- 2018
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