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2. Management and Long-term Outcomes of Crohn's Disease Complicated with Enterocutaneous Fistula: ECUFIT Study from GETECCU

Author

Barreiro-de Acosta, M, Riestra, S, Calafat, M, Soto, MP, Calvo, M, Rodriguez, ES, Caballol, B, Vela, M, Rivero, M, Munoz, F, de Castro, L, Calvet, X, Garcia-Alonso, FJ, Fornals, AU, Ferreiro-Iglesias, R, Gonzalez-Munoza, C, Chaparro, M, Bujanda, L, Sicilia, B, Alfambra, E, Rodriguez, A, Fernandez, RP, Rodriguez, C, Almela, P, Arguelles, F, Busquets, D, Tamarit-Sebastian, S, Castro, CR, Jimenez, L, Marin-Jimenez, I, Alcaide, N, Fernandez-Salgado, E, Iglesias, A, Ponferrada, A, Pajares, R, Roncero, O, Morales-Alvarado, VJ, Ispizua-Madariaga, N, Sainz, E, Merino, O, Marquez-Mosquera, L, Garcia-Sepulcre, M, Elorza, A, Estrecha, S, Suris, G, Van Domselaar, M, Brotons, A, de Francisco, R, Canete, F, Iglesias, E, Vera, MI, Mesonero, F, Lorente, R, Zabana, Y, Cabriada, JL, Domenech, E, Rodriguez-Lago, I, and Registry, ESGFTE

Subjects
surgery, Crohn's disease, enterocutaneous fistula, fistula
Abstract

Background and aims Crohn's disease [CD] can develop penetrating complications at any time during the disease course. Enterocutaneous fistulae [ECF] are disease-related complications with an important impact on quality of life. Our aim was to describe the outcomes of this complication, including its medical and/or surgical management and their temporal trends. The primary endpoint was fistula closure, defined as the absence of drainage, with no new abscess or surgery, over the preceding 6 months. Methods Clinical information from all adult patients with CD and at least one ECF-excluding perianal fistulae-were identified from the prospectively-maintained ENEIDA registry. All additional information regarding treatment for this complication was retrospectively reviewed. Results A total of 301 ECF in 286 patients [January 1970-September 2020] were analysed out of 30 088 records. These lesions were mostly located in the ileum [67%] and they had a median of one external opening [range 1-10]. After a median follow-up of 146 months (interquartile range [IQR], 69-233), 69% of patients underwent surgery. Fistula closure was achieved in 84%, mostly after surgery, and fistula recurrence was uncommon [13%]. Spontaneous and low-output fistulae were associated with higher closure rates (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.17-1.93, p = 0.001, and HR 1.49, 95% CI 1.07-2.06, p = 0.03, respectively); this was obtained more frequently with medical therapy since biologics have been available. Conclusions ECF complicating CD are rare but entail a high burden of medical and surgical resources. Closure rates are high, usually after surgery, and fistula recurrence is uncommon. A significant proportion of patients receiving medical therapy can achieve fistula closure.

Published
2022

3. Long-term outcomes of enterocutaneous fistula complicating Crohn's Disease: The ECUFIT study from GETECCU

Author

Rodriguez-Lago, I, Perez, CG, Calafat, M, Soto, MP, Calvo, M, Rodriguez, ES, Caballol, B, Vela, M, Rivero, M, Munnoz, F, De Castro, L, Calvet, X, Garcia-Alonso, FJ, Fornals, AU, Ferreiro-Iglesias, R, Gonzalez-Munoza, C, Chaparro, M, Luis, B, Sicilia, B, Alfambra, E, Rodriguez, A, Fernandez, RP, Rodriguez, C, Almela, P, Arguelles, F, Busquets, D, Tamarit-Sebastian, S, Castro, CR, Jimenez, L, Marin-Jimenez, I, Alcaide, N, Fernandez-Salgado, E, Gomez, AI, Ponferrada, A, Pajares, R, Roncero, O, Morales-Alvarado, VJ, Cabriada, JL, Domenech, E, and Barreiro-de Acosta, M

Published
2021

4. Long-term effectiveness and safety of ustekinumab (UST) in patients with active Crohn's disease (CD) in real life: Interim analysis of the SUSTAIN study

Author

Chaparro, M, Sulleiro, S, Baston-Rey, I, Rodriguez, C, Garcia-Tercero, I, Ramirez, P, Garcia-Lopez, S, Rojas-Feria, M, Gutierrez, A, Malaves, J, Garcia-Sepulcre, M, Sicilia, B, Bermejo, F, Rodriguez-Moranta, F, Arguelles, F, Marin, I, Leo, E, Arroyo, M, Garcia, M, Vazquez, J, Ginard, D, Cadilla, J, de Celix, C, Garcia-Herola, A, Hernandez-Camba, A, Martin-Arranz, M, Riestra, S, Varela, P, Velayos, B, Busquets, D, Duenas, C, Fernandez-Salgado, E, Martinez-Montiel, P, Diz-Lois, M, Gonzalez-Lama, Y, Munagorri, A, Navarro-Llavat, M, Guisado, C, Barreiro-de Acosta, M, Gisbert, J, and SUSTAIN Study Grp

Published
2020

5. Physiological variations in the pigmentation of newborn infants

Author

Grande, R., Gutierrez, E., Latorre, E., and Arguelles, F.

Subjects
Melanin -- Research -- Physiological aspects, Skin color -- Physiological aspects -- Research, Gestational age -- Research -- Physiological aspects, Infants (Newborn) -- Physiological aspects -- Research, Biological sciences, Physiological aspects, Research
Abstract

Skin pigmentation is a physiological feature of great value and usefulness from both an anthropological point of view and a clinical point of view. This article is a first approach to the study of the skin pigmentation of 126 full-term newborn infants (37-42 weeks gestational age) at the Maternity Hospital 'La Paz' (Madrid, Spain) using the reflectance method. We provide the normal patterns, which have to be taken into account when applying this method to detect transcutaneous bilirubin and some physiopathological conditions, such as hyperbilirubinemia, anemia, plethora, and hormonal disturbances. Measurements of the reflectance were taken at the forehead, the internal and external aspects of the arm, the thorax, and the gluteus with blue, green, and amber tristimulus filters. With all filters the least pigmented zone was the thorax, and the most pigmented zone was the forehead; the internal aspect of the arm, the gluteus, and the external aspect of the arm were intermediate in increasing order. Our data confirm a higher pigmentation at birth than during the first year. We think that the idea of cephalocaudal progression of hyperbilirubinemia must be rejected. Our results also indicate that the thickening of the skin with gestational age is one of the most important factors in the skin color changes of newborn infants with an apparently different rhythm in males than in females., Studies of pigmentation are abundant for specific populations and for later growth periods, but they are scarce for the immediate neonatal period--the first three days of life. The studies on [...]

Published
1994

6. Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Author

Chaparro, M, Garre, A, Ricart, E, Iglesias-Flores, E, Taxonera, C, Manosa, M, Mendoza, IV, Minguez, M, Arguelles, F, Parga, LD, Arroyo, M, Lopez-Sanroman, A, Tirado, MR, Guardiola, J, Arranz, MDM, Beltran, B, Barrio, J, Riestra, S, Garcia-Planella, E, Calvet, X, Alcain, G, Sicilia, B, Garcia, S, Esteve, M, Marquez, L, Salazar, LIF, Casbas, AG, Piqueras, M, Bermejo, F, Calle, JLP, Hinojosa, J, Perez, AR, Aldeguer, X, Sepulcre, MFG, Bujanda, L, Montiel, PM, Poyatos, RL, Gutierrez, CR, Merino, O, Cabriada, JL, Roncero, O, Cara, PR, Navarro-Llavat, M, Ber, Y, Madrigal, RE, Van Domselaar, M, Barreiro-de Acosta, M, Llao, J, Ramos, L, Riera, J, Villarin, AJL, Gonzalez, ER, Malaves, JMH, Villafranca, CM, Almela, P, Charro, M, de la Piscina, PR, Sese, E, Lacruz, AA, Khorrami, S, Alvarado, VJM, Gil, JL, Martinez, AMT, Villaroya, RP, Acevedo, J, Herola, AG, Villalba, LH, Munoz, E, Duran, MTN, Menacho, M, Lopez, VMN, Retamero, MD, Bernardo, D, Muriel, A, Domenech, E, Gisbert, JP, and ENEIDA Study Grp

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. 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 < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood-onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood-onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1-1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1-1.3). However, childhood-onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8-1.2). Conclusions Childhood-onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood-onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery.

Published
2019

7. Effectiveness and Safety of the Switch from Remicade (R) to CT-P13 in Patients with Inflammatory Bowel Disease

Author

Chaparro, M, Garre, A, Veloz, MFG, Moron, JMV, De Castro, ML, Leo, E, Rodriguez, E, Carbajo, AY, Riestra, S, Jimenez, I, Calvet, X, Bujanda, L, Rivero, M, Gomollon, F, Benitez, JM, Bermejo, F, Alcaide, N, Gutierrez, A, Manosa, M, Iborra, M, Lorente, R, Rojas-Feria, M, Barreiro-de Acosta, M, Kolle, L, Van Domselaar, M, Amo, V, Arguelles, F, Ramirez, E, Morell, A, Bernardo, D, and Gisbert, JP

Subjects
Crohn's disease, Remicade (R), +CT-P13%22">sup > CT-P13, Inflammatory bowel disease, switch, ulcerative colitis
Abstract

Background and Aims: To evaluate the clinical outcomes in patients with IBD after switching from Remicade (R) to CT-P13 in comparison with patients who maintain Remicade (R). Methods: Patients under Remicade (R) who were in clinical remission with standard dosage at study entry were included. The 'switch cohort' [SC] comprised patients who made the switch from Remicade (R) to CT-P13, and the 'non-switch' cohort [NC] patients remained under Remicade (R). Results: A total of 476 patients were included: 199 [42%] in the SC and 277 [58%] in the NC. The median follow-up was 18 months in the SC and 23 months in the NC [p < 0.01]. Twenty-four out of 277 patients relapsed in the NC; the incidence of relapse was 5% per patient-year. The cumulative incidence of relapse was 2% at 6 months and 10% at 24 months in this group. Thirty-eight out of 199 patients relapsed in the SC; the incidence rate of relapse was 14% per patient-year. The cumulative incidence of relapse was 5% at 6 months and 28% at 24 months. In the multivariate analysis, the switch to CT-P13 was associated with a higher risk of relapse (HR = 3.5, 95% confidence interval [CI] = 2-6). Thirteen percent of patients had adverse events in the NC, compared with 6% in the SC [p < 0.05]. Conclusions: Switching from Remicade (R) to CT-P13 might be associated with a higher risk of clinical relapse, although this fact was not supported in our study by an increase in objective markers of inflammation. The nocebo effect might have influenced this result. Switching from Remicade (R) to CT-P13 was safe.

Published
2019

8. Is the switch to a second thiopurine a safe strategy in elderly patients with inflammatory bowel disease? A multi-centre cohort study of the ENEIDA registry

Author

Calafat, M, Manosa, M, Ricart, E, Iglesias, E, Calvo, M, Rodriguez-Moranta, F, Taxonera, C, Nos, P, Mesonero, F, Martin-Arranz, M, Minguez, M, Gisbert, JP, Garcia-Lopez, S, de Francisco, R, Gomollon, F, Calvet, X, Garcia-Planella, E, Rivero, M, Martinez-Cadila, J, Arguelles, F, Arias, L, Cimavilla, M, Zabana, Y, Canete, F, Cabre, E, and Domenech, E

Published
2019

9. Increased risk of thiopurine-related adverse events in elderly patients with IBD

Author

Calafat M, Manosa M, Canete F, Ricart E, Iglesias E, Calvo M, Rodriguez-Moranta F, Taxonera C, Nos P, Mesonero F, Martin-Arranz M, Minguez M, Gisbert J, Garcia-Lopez S, de Francisco R, Gomollon F, Calvet X, Garcia-Planella E, Rivero M, Martinez-Cadilla J, Arguelles F, Arias L, Cimavilla M, Zabana Y, Domenech E, Abad A, Alcain G, Almela P, Barreiro-de-Acosta M, Ber Y, Bermejo F, Bujanda L, Busquets D, Charro M, Garcia-Bosch O, Garcia-Sepulcre M, Gutierrez A, Khorrami S, Lazaro J, Legido J, Liao J, Lucendo A, Madrigal R, Marquez L, Martinez-Montiel P, Merino O, Monfort D, Mora M, Munoz-Villafranca C, Ramos L, Riera J, Perez A, Gutierrez C, Rodriguez-Pescador A, Romero P, Roncero O, Sese E, Trapero A, Van Domselaar M, Vela M, Velayos B, Verdejo C, Huguet J, and ENEIDA Registry GETECCU

Abstract

Background Thiopurines are the most widely used immunosuppressants in IBD although drug-related adverse events (AE) occur in 20%-30% of cases. Aim To evaluate the safety of thiopurines in elderly IBD patients Methods Cohort study including all adult patients in the ENEIDA registry who received thiopurines. Patients were grouped in terms of age at the beginning of thiopurine treatment, specifically in those who started thiopurines over 60 years or between 18 and 50 years of age. Thiopurine-related AEs registered in the ENEIDA database were compared. Results Out of 48 752 patients, 1888 thiopurines when over 60 years of age and 15 477 under 50 years of age. Median treatment duration was significantly shorter for those who started thiopurines >60 years (13 [IQR 2-55] vs 32 [IQR 5-82] months; P < .001). Patients starting >60 years had higher rates of all types of myelotoxicity, digestive intolerance and hepatotoxicity. Thiopurines were discontinued due to AEs (excluding malignancies and infections) in more patients starting >60 years (67.2% vs 63.1%; P < .001). Elderly age and female sex were independent risk factors for most AEs. Conclusion In elderly IBD patients, thiopurines are associated with an increased risk of non-infectious, non-neoplastic, AEs.

Published
2019

10. Risk of immunomediated adverse events or secondary loss of response to infliximab in elderly patients with inflammatory bowel disease: a cohort study of the ENEIDA registry

Author

Calafat, M, Manosa, M, Panes, J, Nos, P, Iglesias, E, Vera, I, Lopez-Sanroman, A, Guardiola, J, Taxonera, C, Minguez, M, Martin, MD, de Castro, L, Riestra, S, Rivero, M, Garcia-Planella, E, Calvet, X, Garcia-Lopez, S, Andreu, M, Gomollon, F, Barrio, J, Esteve, M, Rodriguez, A, Gisbert, JP, Gutierrez, A, Hinojosa, J, Arguelles, F, Busquets, D, Bujanda, L, Lazaro, J, Sicilia, B, Merino, O, Martinez, P, Bermejo, F, Lorente, R, Barreiro-de-Acosta, M, Rodriguez, C, Fe, M, Piqueras, M, Romero, P, Rodriguez, E, Roncero, O, Llao, J, Alcain, G, Riera, J, Sierra, M, Salazar, LIF, Jair, V, Navarro, M, Montoro, MA, Munoz, C, Lucendo, AJ, Van Domselaar, M, Moraleja, I, Huguet, M, Ramos, L, Ramirez, P, Almeda, P, Pajares, R, Khorrami, S, Madrigal, RE, Sese, E, Trapero, AM, Legido, J, Abad, A, Canete, F, Cabre, E, and Domenech, E

Published
2019

12. Ponderal indices at birth

Author

Grande, R., Guttierez, E., Arguelles, F., Susanne, Charles, Grande, R., Guttierez, E., Arguelles, F., and Susanne, Charles

Abstract

info:eu-repo/semantics/published

Published
1999

13. Cranial capacity of newborn infants

Author

Grande, R., Gutierrez, E., Arguelles, F., Latorre, E., Susanne, Charles, Grande, R., Gutierrez, E., Arguelles, F., Latorre, E., and Susanne, Charles

Abstract

info:eu-repo/semantics/published

Published
1996

16. Irradiation lesions of the growth plate in rabbits

Author

Arguelles, F, Gomar, F, Garcia, A, and Esquerdo, J

Abstract

The effects of gamma irradiation on the growth plate have been studied in nineteen rabbits with a 1,000 rads/skin dose. The rabbits were killed after one to ninety days. The growth plates were studied by microscopic examination, thymidine-H3 autoradiography, and fluorescence with radiographic measurement. Changes were already detected after twenty-four hours at the cell mitosis level, which showed the sensitiveness of the chondrocyte itself. The lesions were clearly seen with the optical microscope after seven days, and they were most advanced between the fourteenth and twenty-first day after irradiation. Regeneration of the cartilage began in the fourth week and the histological appearance became normal after seventy days. Fluorescence with tetracycline showed a temporary retardation of growth, with consequent shortening of the affected limb.

Published
1977
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17. The availability of anti-TNF agents is associated with reduced early surgical requirements in Crohn's disease but not in ulcerative colitis. A nationwide study from the Eneida registry

Author

Guasch, M., Clos, A., Ordas, I., Garcia-Sanchez, V., Gisbert, J. P., Taxonera, C., Vera, I., Minguez, M., Guardiola, J., Lopez-Sanroman, A., Rivero-Tirado, M., Nos, P., Gomollon, F., Carbajo, A. Y., Francisco, R., Martin-Arranz, M. D., Garcia-Planella, E., Garcia-Lopez, S., Castro, L., Calvet, X., Camargo, R., Esteve, M., Sicilia, B., Andreu, M., Macho, A., Piqueras, M., Bermejo, F., Gutierrez, A., Busquets, D., Martinez-Montiel, P., Hinojosa, J., Perez-Calle, J. L., Luis Bujanda, Rodriguez-Perez, A., Lorente, R., Jimenez, N., Navarro-Llavat, M., Cabriada, J. L., Camo, P., Domselaar, M., Rodriguez-Gonzalez, E., Rodriguez-Gutierrez, C., Huguet, J. M., Lucendo, A. J., Arguelles, F., Almela, P., Merino, O., Calafat, M., Ogueta, M., Charro, M., Llao, J., Munoz, C., Ramos, L., Abad, A., Roncero, O., Barreiro-De-Acosta, M., Sese, E., Manosa, M., and Domenech, E.

18. The initiation of thiopurines in elderly patients with inflammatory bowel disease is associated with an increased risk of adverse effects: a case-control study of the ENEIDA registry

Author

Calafat, M., Manosa, M., Canete, F., Panes, J., Garcia Sanchez, V., Calvo, M., Rodriguez-Moranta, F., Taxonera, C., Nos, P., Lopez Sanroman, A., Martin Arranz, M. D., Minguez, M., Gisbert, J. P., Garcia-Lopez, S., Francisco, R., Gomollon, F., Calvet, X., Garcia-Planella, E., Rivero, M., Martinez-Cadilla, J., Arguelles, F., Arias Garcia, L., Cimavilla, M., Zabana, Y., Marquez, L., Gutierrez, A., Alcain, G., Martinez Montiel, P., Lazaro, J., Busquets, D., Garcia Sepulcre, M. F., Verdejo, C., Bermejo, F., Mora, M., Monfort, D., Romero, P., Velayos, B., Rodriguez, C., Rodriguez, A., Merino, O., Rodriguez-Pescador, A., Luis Bujanda, Ber, Y., Vela, M., Roncero, O., Huguet, J. M., Garcia-Bosch, O., Barreiro-De-Acosta, M., Madrigal, R. E., Ramos, L., Domselaar, M., Almela, P., Llao, J., Lucendo, A. J., Munoz Vilafranca, C., Abad, A., Charro, M., Legido, J., Riera, J., Khorrami, S., Sese, E., Trapero, A. M., and Domenech, E.

19. Differential characteristics of patients with inflammatory bowel disease onset in paediatric age compared with patients diagnosed in adulthood: Results from the CAROUSEL study of GETECCU

Author

Chaparro, M., Garre, A., Ricart, E., Garcia-Sanchez, V., Taxonera, C., Manosa, M., Vera Mendoza, I., Minguez, M., Arguelles, F., Castro Parga, L., Arroyo, M., Lopez-San Roman, A., Rivero Tirado, M., Guardiola, J., Martin Arranz, M. D., Beltran, B., Barrio, J., Riestra, S., Garcia-Planella, E., Calvet, X., Alcain, G., Sicilia, B., Garcia, S., Esteve, M., Marquez, L., Fernandez Salazar, L., Gutierrez Casbas, A., Piqueras, M., Guerra, I., Perez Calle, J. L., Hinojosa, J., Rodriguez, A., Aldeguer, X., Garcia-Sepulcre, M., Bujanda, L., Martinez Montiel, P., Llorente Poyatos, R., Rodriguez Gutierrez, C., Merino, O., Cabriada, J. L., Octavio Roncero, Romero Cara, P., Navarro-Llavat, M., Ber, Y., Madrigal, R., Domselaar, M., Barreiro-De Acosta, M., Llao, J., Ramos, L., Riera, J., Lucendo Villarin, A. J., Rodriguez Gonzalez, E., Huguet Malaves, J. M., Munoz Villafranca, C., Almela, P., Charro, M., Ramirez La Piscina, P., Sese, E., Abad Lacruz, A., Khorrami, S., Morales Alvarado, V. J., Legido Gil, J., Trapero Martinez, A. M., Pajares, R., Acevedo, J., Garcia Herola, A., Hernandez Villalba, L., Munoz, E., Novella Duran, M. T., Menacho, M., Navas Lopez, V. M., Retamero, M. D., Domenech, E., and Gisbert, J. P.

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