Search

Clinical trials have demonstrated efficacy of vedolizumab in ulcerative colitis (UC) and Crohn's disease (CD). Further real-world data is needed to inform clinical practice. The primary outcome was to assess corticosteroid-free and clinical remission after vedolizumab initiation. Secondary outcomes included effect on disease activity scores, biochemical markers, concomitant drug use, endoscopic remission, surgical intervention, hospital admissions and adverse events. A multi-centre retrospective observational study was conducted with patients initiated on vedolizumab across seven UK hospitals 1/11/14-30/11/16. Clinical disease activity was assessed using the partial Mayo Scores (pMS) and Harvey Bradshaw Index (HBI). Clinical remission was defined as HBI ≤4 or pMS <2 with a combined stool frequency and rectal bleeding sub score of ≤1. Clinical response was defined as ≥2-point decrease from baseline in pMS and ≥3-point decrease from baseline in HBI. One hundred ninety-two patients were included in the final analysis. 45% of UC and 10% of CD patients were anti-TNF naive. Over the observation period corticosteroid-free remission rates for UC and CD were 46% and 45%, while clinical remission rates were 52% and 44%, respectively. Time to corticosteroid free remission for UC and CD was 17.6 [IQR: 8.7–29.6] and 14.1 [QR: 6.0–21.7] weeks, respectively. Time to clinical response for UC was 9.4 [IQR: 5.7–15.4] and CD was 9.5 [IQR: 6.1–18.2] weeks. There was a substantial decrease in the concomitant use of immunomodulators and a similar decrease in concomitant corticosteroid use over the study period. Results in this predominately anti-TNF experienced population mirror other published real-world data, demonstrating good clinical effectiveness and a comparable safety profile. [ABSTRACT FROM AUTHOR]

In all kinds of political action, citizens are confronted with the performances of other citizens. An important guide to political behaviour is therefore likely to be the assumptions people make concerning how others can be expected to behave. This article explores common sense ideas about other citizens as potential political participants, drawing on a series of group interviews conducted with taxi-drivers in Britain, Germany and the Czech Republic. I argue the expectations voiced of other citizens tend to be pessimistic in nature, casting them as ill-informed, apathetic, passive and unduly self-interested, notwithstanding the appearance of a more optimistic view which holds they can be expected to follow the lead of those who 'take a stand'. These empirical observations lead to a discussion of the theoretical issues they raise, notably where to locate the origins of such views, and how to appraise their implications for democracy. [ABSTRACT FROM AUTHOR]

The article focuses on the revolutionary transformation of 18th-century Great Britain, particularly England, which saw the creation of a mass market in consumer goods and the emergence of modern spending patterns based on consumption for pleasure rather than need. Rising population and incomes unleashed the drive to emulate which permeated down through the social order, creating markets which could then be further developed by innovations in marketing techniques. These conditions created a modern commercial infrastructure, helping to generate the necessary convulsion on the demand side to fuel industrialization and the development of mass production.