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Review
- IBD
- Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
- Filiz Akyüz, Yoon Kyo An, Jakob Begun, Satimai Aniwan, Huu Hoang Bui, Webber Chan, Chang Hwan Choi, Nazeer Chopdat, Susan J Connor, Devendra Desai, Emma Flanagan, Taku Kobayashi, Allen Yu-Hung Lai, Rupert W Leong, Alex Hwong-Ruey Leow, Wai Keung Leung, Julajak Limsrivilai, Virly Nanda Muzellina, Kiran Peddi, Zhihua Ran, Shu Chen Wei, Jose Sollano, Michelle Mui Hian Teo, Kaichun Wu, Byong Duk Ye, Choon Jin Ooi
- Intest Res 2025;23(1):37-55. Published online November 4, 2024
- DOI: https://doi.org/10.5217/ir.2024.00089
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Abstract
PDF
PubReader
ePub - The lack of clear definition and classification for “moderate ulcerative colitis (UC)” creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition comprised 24 experts who convened to share, discuss and vote electronically on management recommendations for moderate UC. Experts emphasized that the goal of treating UC is to attain clinical, biomarker, and endoscopic remission using cost-effective strategies such as 5-aminosalicylates (5-ASAs), well-tolerated therapy that can be optimized to improve outcomes. Experts agreed that 5-ASA therapy could be optimized by maximizing dosage (4 g/day for induction of remission), combining oral and topical administration, extending treatment duration beyond 8 weeks, and enhancing patient adherence through personalized counselling and reduced pill burden. Treatment escalation should ideally be reserved for patients with predictors of aggressive disease or those who do not respond to 5-ASA optimization. Premature treatment escalation to advanced therapies (including biologics and oral small molecules) may have long-term health and financial consequences. This paper provides consensus-based expert recommendations and a treatment algorithm, based on current evidence and practices, to assist decision-making in real-world settings.
- 3,773 View
- 222 Download
- 1 Web of Science
Original Articles
- IBD
- Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
- Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
- Intest Res 2023;21(3):353-362. Published online July 27, 2023
- DOI: https://doi.org/10.5217/ir.2023.00013
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Abstract
PDF
Supplementary MaterialPubReaderePub - Background/Aims
Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD.
Methods
A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn’s and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD.
Results
A total of 384 physicians responded to the questionnaire. The majority of Korean (n=70, 63.6%) and Chinese (n=51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n=62, 66.7%) preferred metronidazole. Physicians in Korea (n=88, 80.0%) and China (n=46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n=71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n=89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n=53, 57.0%) did not consider vaccination.
Conclusions
Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD. -
Citations
Citations to this article as recorded by
- Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
Ki Jin Kim, Su-Bin Song, Jung-Bin Park, June Hwa Bae, Ji Eun Baek, Ga Hee Kim, Min-Jun Kim, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Yong-Sik Yoon, Jong-Lyul Lee, Min Hy
The Korean Journal of Internal Medicine.2025; 40(2): 243. CrossRef - The Burden ofClostridioides difficileInfection in Korea
Seong Ran Jeon
Journal of Korean Medical Science.2024;[Epub] CrossRef - Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
The Korean Journal of Internal Medicine.2024; 39(5): 783. CrossRef - Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
Ping Han, Chaohui Wang, Yan Qiu
Critical Public Health.2024; 34(1): 1. CrossRef - Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
Ji Eun Baek, Sung Wook Hwang
Intestinal Research.2023; 21(3): 277. CrossRef
- Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
- 3,291 View
- 103 Download
- 5 Web of Science
- 5 Crossref
- Inflammatory Bowel Diseases
- Efficacy and safety of vedolizumab in ulcerative colitis in patients from Asian countries in the GEMINI 1 study
- Choon Jin Ooi, Ida Normiha Hilmi, Hyo-Jong Kim, Umesh Jalihal, Deng-Chyang Wu, Dirk Demuth, Dirk Lindner, Shashi Adsul
- Intest Res 2021;19(1):71-82. Published online September 4, 2020
- DOI: https://doi.org/10.5217/ir.2019.09159
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
The efficacy and safety of vedolizumab in moderate to severely active ulcerative colitis (UC) have been demonstrated in the GEMINI 1 study (NCT00783718). This post-hoc exploratory analysis sought to establish the efficacy and safety of vedolizumab in a subgroup of patients from Asian countries with UC from GEMINI 1.
Methods
Efficacy outcomes of interest were clinical response, clinical remission and mucosal healing at week 6 (induction phase); and clinical remission, durable clinical response, durable clinical remission, mucosal healing and glucocorticoid-free remission at week 52 (maintenance phase). Differences in outcome rates between vedolizumab and placebo in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) were assessed using descriptive analyses, and efficacy and safety compared between Asian and non-Asian countries.
Results
During induction, in Asian countries (n = 58), clinical response rates at week 6 with vedolizumab and placebo were 55.2% and 24.1%, respectively (difference 31.0%; 95% confidence interval: 7.2%–54.9%). In non-Asian countries (n = 316), response rates at week 6 with vedolizumab and placebo were 45.9% and 25.8%, respectively. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 8 weeks, vedolizumab administered every 4 weeks and placebo were 9.1%, 36.8%, and 31.6%, respectively; corresponding rates for mucosal healing were 45.5%, 47.4%, and 47.4%, respectively. Vedolizumab was well-tolerated; adverse event frequency was comparable in Asian and non-Asian countries.
Conclusions
In patients from Asian countries, the efficacy and safety of vedolizumab in treatment of UC were broadly consistent with that in the overall study population. -
Citations
Citations to this article as recorded by- Application of clinical decision support tools for predicting outcomes with vedolizumab therapy in patients with inflammatory bowel disease: A KASID multicentre study
Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun‐Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk‐Kyun Yang, Byong Duk Ye
Alimentary Pharmacology & Therapeutics.2024; 59(12): 1539. CrossRef - Clinical performance of fecal calprotectin, lactoferrin, and hemoglobin for evaluating the disease activity of IBD and detecting colorectal tumors
Tsukasa Yamakawa, Takakazu Miyake, Yoshihiro Yokoyama, Tomoe Kazama, Yuki Hayashi, Daisuke Hirayama, Shinji Yoshii, Hiro‐o Yamano, Satoshi Takahashi, Hiroshi Nakase
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Intestinal Research.2023; 21(1): 168. CrossRef - The treatment of inflammatory bowel disease with monoclonal antibodies in Asia
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Biomedicine & Pharmacotherapy.2023; 157: 114081. CrossRef - Effectiveness and safety of vedolizumab for ulcerative colitis: a single-center retrospective real-world study in China
Kaituo Huang, Jing Liu, Wenhao Xia, Chuwen Tian, Lingya Yao, Qian Cao, Haotian Chen
Frontiers in Pharmacology.2023;[Epub] CrossRef - The effectiveness and safety of vedolizumab induction for moderate to severe ulcerative colitis for Asia patient: A real practice observational study
Chia-Jung Kuo, Puo-Hsien Le, Wei-Chen Tai, Keng-Liang Wu, Hsu-Heng Yen, Chih-Wei Yen, Shui-Yi Tung, Chen-Shuan Chung, Ming-Yao Su, Cheng-Tang Chiu
Journal of the Formosan Medical Association.2022; 121(9): 1689. CrossRef - Vedolizumab does not increase perioperative surgical complications in patients with inflammatory bowel disease, cohort study
Vitaliy Y. Poylin, Jose Cataneo Serrato, Jonathan Pastrana Del Valle, Joseph D. Feuerstein
Intestinal Research.2022; 20(1): 72. CrossRef - Comparative effectiveness of second-line biological therapies for ulcerative colitis and Crohn’s disease in patients with prior failure of anti-tumour necrosis factor treatment
Hye Kyung Hyun, Hyun-Soo Zhang, Jongwook Yu, Eun Ae Kang, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
BMC Gastroenterology.2022;[Epub] CrossRef - The Risk of Tuberculosis in Patients With Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab in Korea
Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
Journal of Korean Medical Science.2022;[Epub] CrossRef - Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef - Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
The Korean Journal of Internal Medicine.2022; 37(6): 1140. CrossRef - Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef - Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef - Natural history of inflammatory bowel disease: a comparison between the East and the West
Eun Mi Song, Suk-Kyun Yang
Intestinal Research.2022; 20(4): 418. CrossRef - Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies
Hyo Yeop Song, Geom Seog Seo
Journal of the Korean Medical Association.2021; 64(9): 605. CrossRef - Combination of vedolizumab and immunomodulators in ulcerative colitis
P Pinton
Journal of Gastroenterology and Hepatology.2021; 36(12): 3556. CrossRef - Adalimumab, Infliximab, and Vedolizumab in Treatment of Ulcerative Colitis: A Long-Term Retrospective Study in a Tertiary Referral Center
Ann-Lorie Gagnon, William Beauchesne, Laurence Tessier, Charles David, Djamal Berbiche, Alexandre Lavoie, Alban Michaud-Herbst, Karine Tremblay
Crohn's & Colitis 360.2021;[Epub] CrossRef - Vedolizumab in Inflammatory Bowel Disease: West versus East
Prasanta Debnath, Pravin M. Rathi
Inflammatory Intestinal Diseases.2021; 6(1): 1. CrossRef
- Application of clinical decision support tools for predicting outcomes with vedolizumab therapy in patients with inflammatory bowel disease: A KASID multicentre study
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- 250 Download
- 17 Web of Science
- 18 Crossref
Review
- IBD
- Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn’s disease in Asia
- Choon Jin Ooi, Ida Hilmi, Rupa Banerjee, Sai Wei Chuah, Siew Chien Ng, Shu Chen Wei, Govind K Makharia, Pises Pisespongsa, Min Hu Chen, Zhi Hua Ran, Byong Duk Ye, Dong Il Park, Khoon Lin Ling, David Ong, Vineet Ahuja, Khean Lee Goh, Jose Sollano, Wee Chian Lim, Wai Keung Leung, Raja Affendi Raja Ali, Deng Chyang Wu, Evan Ong, Nazri Mustaffa, Julajak Limsrivilai, Tadakazu Hisamatsu, Suk Kyun Yang, Qin Ouyang, Richard Geary, Janaka H De Silva, Rungsun Rerknimitr, Marcellus Simadibrata, Murdani Abdullah, Rupert WL Leong, the Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn’s and Colitis
- Intest Res 2019;17(3):285-310. Published online May 31, 2019
- DOI: https://doi.org/10.5217/ir.2019.00026
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Abstract
PDFPubReaderePub
- The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn’s and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn’s disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
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Citations
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Phoebe Hodges, Oluwafunmilayo Adeniyi, Smita Devani, Chinenye Nwoko, Opeyemi Owoseni, Kwadwo Gyebi Agyenim Boateng, Anthony Ocanit, Abdallah Muhofa, Nasiru Altine Dankiri, Babatunde Duduyemi, Zenahebezu Abay Alemayehu, Yusuf Musa, Eileen Micah, Pissi Kaba
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World Journal of Clinical Pediatrics.2025;[Epub] CrossRef - Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
Filiz Akyüz, Yoon Kyo An, Jakob Begun, Satimai Aniwan, Huu Hoang Bui, Webber Chan, Chang Hwan Choi, Nazeer Chopdat, Susan J Connor, Devendra Desai, Emma Flanagan, Taku Kobayashi, Allen Yu-Hung Lai, Rupert W Leong, Alex Hwong-Ruey Leow, Wai Keung Leung, Ju
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Gastroenterología y Hepatología.2023; 46(10): 784. CrossRef - Study on the anti‐inflammatory effect of stachyose by inhibiting TLR4/NF‐κB signalling pathway in vitro and in vivo
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Clinical and Experimental Pharmacology and Physiology.2023; 50(7): 573. CrossRef - Physiologically‐Based Pharmacokinetic Modeling of Anti‐Tumor Necrosis Factor Agents for Inflammatory Bowel Disease Patients to Predict the Withdrawal Time in Pregnancy and Vaccine Time in Infants
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Inflammatory Bowel Diseases.2022; 28(Supplement): S16. CrossRef - Personalized medicine in inflammatory bowel disease: Perspectives on Asia
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Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef - Antiviral Prophylaxis Against Hepatitis B Virus in Patients Treated with Anti-Tumor Necrosis Factor α Agents for Inflammatory Bowel Disease
Eun Ae Kang, Jae Hee Cheon
Gut and Liver.2022; 16(4): 501. CrossRef - Therapeutic Drug Monitoring of Biologics for Patients with Inflammatory Bowel Diseases: How, When, and for Whom?
Jia-Feng Wu
Gut and Liver.2022; 16(4): 515. CrossRef - Risk of Hepatitis B Virus (HBV) Reactivation in Patients with Immune-Mediated Inflammatory Diseases Receiving Biologics: Focus on the Timing of Biologics after Anti-HBV Treatment
Soo Min Ahn, Jonggi Choi, Byong Duk Ye, Suk-Kyun Yang, Ji Seon Oh, Yong‑Gil Kim, Chang-Keun Lee, Bin Yoo, Sang Hyoung Park, Seokchan Hong
Gut and Liver.2022; 16(4): 567. CrossRef - Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
The Korean Journal of Internal Medicine.2022; 37(6): 1140. CrossRef - Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef - Current Status of Opportunistic Infection in Inflammatory Bowel Disease Patients in Asia: A Questionnaire-Based Multicenter Study
Hong Yang, Zhihua Ran, Meng Jin, Jia-Ming Qian
Gut and Liver.2022; 16(5): 726. CrossRef - Natural history of inflammatory bowel disease: a comparison between the East and the West
Eun Mi Song, Suk-Kyun Yang
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Special Review
- IBD
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- Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang
- Intest Res 2018;16(1):4-16. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.4
-
Abstract
PDFPubReaderePub
Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
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Citations
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Special Review: Consensus on TB in IBD
- IBD
- Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
- Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang
- Intest Res 2018;16(1):17-25. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.17
-
Abstract
PDFPubReaderePub
Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
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Citations
Citations to this article as recorded by- Risk of Tuberculosis and Hepatitis B Reactivation in Patients With Crohn’s Disease on Ustekinumab: A Nationwide Real-World Study
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