Intestinal Research

Original Articles

IBD

Treatment of inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting: Eun Mi Song, Soo-Young Na, Sung Noh Hong, Siew Chien Ng, Tadakazu Hisamatsu, Byong Duk Ye; Intest Res 2023;21(3):339-352. Published online July 27, 2023; DOI: https://doi.org/10.5217/ir.2022.00135

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Background/Aims
As the characteristics of inflammatory bowel disease (IBD) differ between Asians and Westerners, it is necessary to determine adequate therapeutic strategy for Asian IBD patients. We evaluated the current treatment of IBD in Asian countries/regions using a web-based survey.
Methods
The Korean Association for the Study of Intestinal Diseases conducted a multinational web-based survey for current IBD care in Asia between September 16, 2020, and November 13, 2020.
Results
A total of 384 doctors treating IBD patients from 24 Asian countries/regions responded to the survey. Anti-tumor necrosis factor (TNF) agents, anti-integrins, and anti-interleukin-12/23 agents were available for use by 93.8%, 72.1%, and 70.1% of respondents in Asian countries/regions. Compared with a previous survey performed in 2014, an increased tendency for treatment with biologics, including anti-TNF agents, was observed. In the treatment of corticosteroid-refractory acute severe ulcerative colitis, 72.1% of respondents chose anti-TNF agents, followed by tacrolimus (11.7%). In the treatment of corticosteroid-refractory Crohn’s disease, 90.4% chose anti-TNF agents, followed by thiopurines (53.1%), anti-interleukin-12/23 agents (39.3%), and anti-integrin agents (35.7%). In the treatment of Crohn’s disease patients refractory to anti-TNF agents, the most preferred strategy was to measure serum levels of anti-TNF and anti-drug antibodies (40.9%), followed by empiric dose escalation or shortening of dosing intervals (25.3%).
Conclusions
Although there were some differences, treatment strategies for patients with IBD were mostly similar among Asian doctors. Based on the therapeutic outcomes, it is necessary to identify the most appropriate therapeutic strategy for Asian IBD patients.

Citations

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Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Continuing or stopping 5‐aminosalicylates in patients with inflammatory bowel disease on anti‐TNF therapy: A nationwide population‐based study
Jeongkuk Seo, Seonok Kim, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Ye‐Jee Kim, Byong Duk Ye
Alimentary Pharmacology & Therapeutics.2024; 60(3): 389. CrossRef
The Potential of Molecular Remission: Tissue Neutrophil Elastase Is Better Than Histological Activity for Predicting Long-Term Relapse in Patients With Ulcerative Colitis in Endoscopic Remission
Yu Kyung Jun, Hyeon Jeong Oh, Ji Ae Lee, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
How have treatment patterns for patients with inflammatory bowel disease changed in Asian countries?
Jihye Park
Intestinal Research.2023; 21(3): 275. CrossRef
Enrichment of Activated Fibroblasts as a Potential Biomarker for a Non-Durable Response to Anti-Tumor Necrosis Factor Therapy in Patients with Crohn’s Disease
Soo-Kyung Park, Gi-Young Lee, Sangsoo Kim, Chil-Woo Lee, Chang-Hwan Choi, Sang-Bum Kang, Tae-Oh Kim, Jaeyoung Chun, Jae-Myung Cha, Jong-Pil Im, Kwang-Sung Ahn, Seon-Young Kim, Min-Suk Kim, Chang-Kyun Lee, Dong-Il Park
International Journal of Molecular Sciences.2023; 24(19): 14799. CrossRef

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Infection

Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis: Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim; Intest Res 2023;21(4):481-492. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2023.00005

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Background/Aims
Immunocompromised patients with acute colonic diverticulitis are at high risk for complications and failure of non-surgical treatment. However, evidence on the comparative outcomes of immunocompromised and immunocompetent patients with diverticulitis is lacking. This systematic review and meta-analysis investigated the outcomes of medical treatment in immunocompromised and immunocompetent patients with diverticulitis.
Methods
A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library. Studies comparing the clinical outcomes of immunocompromised and immunocompetent patients with diverticulitis were included.
Results
A total of 10 studies with 1,946,461 subjects were included in the quantitative synthesis. The risk of emergency surgery and postoperative mortality after emergency surgery was significantly higher in immunocompromised patients than in immunocompetent patients with diverticulitis (risk ratio [RR], 1.76; 95% confidence interval [CI], 1.31–2.38 and RR, 3.05; 95% CI, 1.70–5.45, respectively). Overall risk of complications associated with diverticulitis was non-significantly higher in immunocompromised than in immunocompetent patients (RR, 1.24; 95% CI, 0.95–1.63). Overall mortality irrespective of surgery was significantly higher in immunocompromised than in immunocompetent patients with diverticulitis (RR, 3.65; 95% CI, 1.73–7.69). By contrast, postoperative mortality after elective surgery was not significantly different between immunocompromised and immunocompetent patients with diverticulitis. In subgroup analysis, the risk of emergency surgery and recurrence was significantly higher in immunocompromised patients with complicated diverticulitis, whereas no significant difference was shown in mild disease.
Conclusions
Immunocompromised patients with diverticulitis should be given the best medical treatment with multidisciplinary approach because they had increased risks of surgery, postoperative morbidity, and mortality than immunocompetent patients.

Citations

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Not all acute colonic diverticulitis follows the same course: a potential risk for immunocompromised individuals
Yehyun Park
Intestinal Research.2023; 21(4): 415. CrossRef

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IBD

Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study: Seung Yong Shin, Soo Jung Park, Young Kim, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-Ho Kim, Do Hyun Kim, Dennis Teng, Jong-Hwa Kim, Wonyong Kim, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):350-360. Published online July 23, 2021; DOI: https://doi.org/10.5217/ir.2021.00049

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Background/Aims
This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC).
Methods
A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score.
Results
A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients.
Conclusions
ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

Citations

Citations to this article as recorded by

Prospective Observational Evaluation of the Time-Dependency of Adalimumab Immunogenicity and Drug Concentration in Ulcerative Colitis Patients: the POETIC II Study
Sivan Harnik, Chaya M Abitbol, Ola Haj Natour, Miri Yavzori, Ella Fudim, Orit Picard, Timna Naftali, Efrat Broide, Ayal Hirsch, Limor Selinger, Eyal Shachar, Doron Yablecovitch, Ahmad Albshesh, Daniel Coscas, Uri Kopylov, Rami Eliakim, Shomron Ben-Horin,
Journal of Crohn's and Colitis.2024; 18(3): 341. CrossRef
Rapidly achieving clinical remission in ulcerative colitis indicates better endoscopic and histological outcomes
Rirong Chen, Yizhe Tie, Yongle Huang, Xi Zhang, Zhirong Zeng, Minhu Chen, Li Li, Shenghong Zhang
United European Gastroenterology Journal.2024; 12(4): 459. CrossRef
Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
Health Science Reports.2024;[Epub] CrossRef
Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
Gut Pathogens.2024;[Epub] CrossRef
Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis: Evidence from a systematic literature review
Peter M. Irving, Peter Hur, Raju Gautam, Xiang Guo, Severine Vermeire
Journal of Managed Care & Specialty Pharmacy.2024; 30(9): 1026. CrossRef
Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
Intestinal Research.2023; 21(1): 61. CrossRef
Changes in fecal metabolic and lipidomic features by anti-TNF treatment and prediction of clinical remission in patients with ulcerative colitis
Seok-Young Kim, Seung Yong Shin, Soo Jung Park, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-
Therapeutic Advances in Gastroenterology.2023; 16: 175628482311681. CrossRef
Reviewing not Homer’s Iliad, but “Kai Bao Ben Cao”: indigo dye—the past, present, and future
Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
Intestinal Research.2023; 21(2): 174. CrossRef
Precision medicine and drug optimization in adult inflammatory bowel disease patients
Sophie Vieujean, Edouard Louis
Therapeutic Advances in Gastroenterology.2023; 16: 175628482311733. CrossRef
Real-world effectiveness and safety of adalimumab in Korean patients with intestinal Behcet’s disease: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter study
Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
The Korean Journal of Internal Medicine.2023; 38(5): 661. CrossRef
Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
Soo-Young Na
The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
Prediction of Clinical Remission with Adalimumab Therapy in Patients with Ulcerative Colitis by Fourier Transform–Infrared Spectroscopy Coupled with Machine Learning Algorithms
Seok-Young Kim, Seung Yong Shin, Maham Saeed, Ji Eun Ryu, Jung-Seop Kim, Junyoung Ahn, Youngmi Jung, Jung Min Moon, Chang Hwan Choi, Hyung-Kyoon Choi
Metabolites.2023; 14(1): 2. CrossRef
Association of C-reactive Protein and Partial Mayo Score With Response to Tofacitinib Induction Therapy: Results From the Ulcerative Colitis Clinical Program
Marla C Dubinsky, Fernando Magro, Flavio Steinwurz, David P Hudesman, Jami A Kinnucan, Ryan C Ungaro, Markus F Neurath, Nicole Kulisek, Jerome Paulissen, Chinyu Su, Dario Ponce de Leon, Miguel Regueiro
Inflammatory Bowel Diseases.2022;[Epub] 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
Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef

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IBD

Individualized treatment based on CYP3A5 single-nucleotide polymorphisms with tacrolimus in ulcerative colitis: Shinji Okabayashi, Taku Kobayashi, Eiko Saito, Takahiko Toyonaga, Ryo Ozaki, Shintaro Sagami, Masaru Nakano, Junichi Tanaka, Keiji Yagisawa, Satoshi Kuronuma, Osamu Takeuchi, Toshifumi Hibi; Intest Res 2019;17(2):218-226. Published online February 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00117

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Background/Aims
The pharmacokinetics of tacrolimus (TAC) is known to be largely influenced by single-nucleotide polymorphisms (SNPs) in CYP3A5. Patients starting TAC require careful dose adjustment, owing to the wide range of optimal dosages, depending on their CYP3A5 expression status. Here, we evaluated whether individualization of TAC dosages based on CYP3A5 SNPs would improve its therapeutic efficacy in ulcerative colitis.
Methods
Twenty-one patients were prospectively treated, with their initial dosage adjusted according to their CYP3A5 status (0.1, 0.15, and 0.2 mg/kg/day for CYP3A5*3/*3, CYP3A5*1/*3, and CYP3A5*1/*1, respectively). Their clinical outcomes were compared with those of patients treated with a fixed dose (0.1 mg/kg/day).
Results
The first blood trough level of CYP3A5 expressors, CYP3A5*1/*3 or CYP3A5*1/*1, and the overall rate in achieving the target blood trough level within a week in the individualized-dose group were significantly higher than those in the fixed-dose group (5.15±2.33 ng/mL vs. 9.63±0.79 ng/mL, P=0.035 and 12.5% vs. 66.7%, P=0.01). The remission rate at 2 weeks in the expressors was as high as that in the nonexpressors, CYP3A5*3/*3, in the individualized-dose group.
Conclusions
Individualized TAC treatment is effective against ulcerative colitis regardless of the CYP3A5 genotype.

Citations

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The impact of cytochrome P450 3A genetic polymorphisms on tacrolimus pharmacokinetics in ulcerative colitis patients
Maizumi Furuse, Shuhei Hosomi, Yu Nishida, Shigehiro Itani, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Noriko Kamata, Toshio Watanabe, Kenji Watanabe, Yasuhiro Fujiwara, Erika Cecchin
PLOS ONE.2021; 16(4): e0250597. CrossRef
Advances in research of tacrolimus for treatment of inflammatory bowel disease
Jing-Jing Wang, Yi-Hong Fan
World Chinese Journal of Digestology.2019; 27(13): 842. CrossRef

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Colorectal neoplasia

Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review: Eun Ae Kang, Seung Jun Han, Jaeyoung Chun, Hyun Jung Lee, Hyunsoo Chung, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyun Chae Jung; Intest Res 2019;17(1):135-143. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00085

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Background/Aims
Spontaneous intramural small bowel hematoma (SISBH) is an extremely rare complication of anticoagulant or antiplatelet therapy. We assessed the clinical characteristics and outcomes of patients with SISBH according to the anatomical location of the hematoma.
Methods
From January 2003 to February 2016, medical records for all patients hospitalized for SISBH at 2 tertiary referral hospitals were retrospectively reviewed. The primary outcome was requirement for surgery.
Results
A total of 37 patients were enrolled. The mean age was 74.1 years. Among them, 33 patients (89.2%) were taking anticoagulant and/or antiplatelet agents. Duodenal intramural hematoma was detected in 4 patients (10.8%), jejunal in 16 (43.2%), and ileal in 17 (45.9%). Compared to jejunal and ileal involvement, duodenal intramural hematoma was significantly associated with high Charlson comorbidity index and low levels of white blood cells, hemoglobin, and platelets in the blood. SISBH in the duodenum was related to thrombocytopenia in 3 patients following systemic chemotherapy for malignancy. All patients with SISBH showed clinical improvement with conservative therapy. Mean length of hospital stay was 9.35 days. Independent predictors of a hospital stay of more than 7 days were body weight less than 60 kg (odds ratio [OR], 12.213; 95% confidence interval [CI], 1.755–84.998; P=0.011) and a history of cerebrovascular accidents (OR, 6.667; 95% CI, 1.121–39.650; P=0.037).
Conclusions
Compared to jejunal and ileal involvement, thrombocytopenia may result in spontaneous duodenal intramural hematoma among patients who are treated with systemic chemotherapy for malignancies. Patients with SISBH have excellent clinical outcomes with conservative therapy regardless of the anatomical location of the hematoma.

Citations

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A Case of Direct-Acting Oral Anticoagulant-Induced Intramural Colon Hematoma Successfully Treated by Laparoscopic Surgery
Daisuke Tomita, Shigeo Toda, Ryo Miyazaki, Shuichiro Matoba, Hiroya Kuroyanagi
Cureus.2024;[Epub] CrossRef
Spontaneous Intramural Small Bowel Hematoma in an Elderly Man with Multiple Myeloma
Sigrid L. Williamson, Aishwarya Suresh, Adrian Ong
The American Surgeon™.2023; 89(6): 2816. CrossRef
Intramural duodenal hematoma: diagnosis and management of a rare entity
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española (English Edition).2023; 101(7): 515. CrossRef
Hematoma intramural duodenal: diagnóstico y manejo de una entidad infrecuente
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española.2023; 101(7): 515. CrossRef
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Richelle G. Butcher, Baukje Lenting, Alison S. Clarke, Kelly Buckle, Cristina Gans
Veterinary Record Case Reports.2023;[Epub] CrossRef
Spontaneous Duodenal Hematoma: A Rare Complication of Triple Antithrombotic Therapy Case Report
Mazin N Habhab, Asad J Torabi, Julie M Clary, George E Revtyak
Future Cardiology.2023; 19(2): 71. CrossRef
Intestinal Spontaneous Intramural Hematoma Secondary to Anticoagulation Therapy: A Case Report
Karim El Aidaoui, Wahib Lahlou, Abderrahim Bourial, Nawal Bouknani, Chafik El Kettani
Cureus.2023;[Epub] CrossRef
Intramural Hematoma of Gastrointestinal Tract in People with Hemophilia A and B
Wei-Jung Teng, Ching-Huei Kung, Mei-Mei Cheng, Jia-Ruey Tsai, Chia-Yau Chang
Journal of Clinical Medicine.2023; 12(9): 3093. CrossRef
Endoscopic management of intramural spontaneous duodenal hematoma: A case report
Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
World Journal of Gastroenterology.2022; 28(20): 2243. CrossRef
Warfarin-induced spontaneous intramural small bowel hematoma presenting as an acute abdomen: A case report
Ding-Han Chen, Khay-Seng Soh, Ying-Tso Wang, Te-Chun Shen
Medicine.2022; 101(35): e30335. CrossRef
Spontaneous duodenal haematoma in a patient taking rivaroxaban
Rebeca de Barros Lopes, Finn McLennan Battleday, Toby Calvert, Rob Gwynne‐Jones, Rebecca Thomas
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SPONTANEOUS INTRAMURAL SMALL-BOWEL HEMATOMA: A CAUSE OF ACUTE ABDOMEN IN ANTICOAGULATED PATIENTS
Sergio Gil Rojas, Luis Miguel Estela Villa, Elsa María Jiménez Vicente
Revista Española de Enfermedades Digestivas.2021;[Epub] CrossRef
Small Bowel Obstruction
Allison A. Aka, Jesse P. Wright, Teresa DeBeche-Adams
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Double Trouble: Spontaneous Duodenal Hematoma of Pancreatic Origin
Luísa Martins Figueiredo, David Valadas Horta, Jorge A. Reis
GE - Portuguese Journal of Gastroenterology.2019; 26(6): 458. CrossRef

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Treatment of inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2^nd Asian Organization of Crohn's and Colitis (AOCC) meeting in Seoul: Hiroshi Nakase, Bora Keum, Byoung Duk Ye, Soo Jung Park, Hoon Sup Koo, Chang Soo Eun; Intest Res 2016;14(3):231-239. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.231

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Background/Aims

Inflammatory bowel disease (IBD) management guidelines have been released from Western countries, but no adequate data on the application of these guidelines in Asian countries and no surveys on the treatment of IBD in real practice exist. Since there is a growing need for a customized consensus for IBD treatment in Asian countries, Asian Organization of Crohn's and Colitis performed a multinational survey of medical doctors who treat IBD patients in Asian countries.

Methods

A questionnaire was developed between August 2013 and November 2013. It was composed of 4 domains: personal information, IBD diagnosis, IBD treatment, and quality of IBD care. Upon completion of the questionnaire, a web-based survey was conducted between 17 March 2014 and 12 May 2014.

Results

In total, 353 medical doctors treating IBD from ten Asian countries responded to the survey. This survey data suggested a difference in available medical treatments (budesonide, tacrolimus) among Asian countries. Therapeutic strategies regarding refractory IBD (acute severe ulcerative colitis [UC] refractory to intravenous steroids and refractory Crohn's disease [CD]) and active UC were coincident, however, induction therapies for mild to moderate inflammatory small bowel CD are different among Asian countries.

Conclusions

This survey demonstrated that current therapeutic approaches and clinical management of IBD vary among Asian countries. Based on these results and discussions, we hope that optimal management guidelines for Asian IBD patients will be developed.

Citations

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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
Intestinal Research.2023; 21(3): 353. CrossRef
Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef
Management and monitoring of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group: Surgical management,
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen Calixto Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 510. CrossRef
Treatment of inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Eun Mi Song, Soo-Young Na, Sung Noh Hong, Siew Chien Ng, Tadakazu Hisamatsu, Byong Duk Ye
Intestinal Research.2023; 21(3): 339. CrossRef
How have treatment patterns for patients with inflammatory bowel disease changed in Asian countries?
Jihye Park
Intestinal Research.2023; 21(3): 275. CrossRef
Drug therapy and monitoring for inflammatory bowel disease: a multinational questionnaire investigation in Asia
Chenwen Cai, Juntao Lu, Lijie Lai, Dongjuan Song, Jun Shen, Jinlu Tong, Qing Zheng, Kaichun Wu, Jiaming Qian, Zhihua Ran
Intestinal Research.2022; 20(2): 213. CrossRef
Indications, Postoperative Management, and Long-term Prognosis of Crohn’s Disease After Ileocecal Resection: A Multicenter Study Comparing the East and West
Jeanine H C Arkenbosch, Joyce W Y Mak, Jacky C L Ho, Evelien M J Beelen, Nicole S Erler, Frank Hoentjen, Alexander G L Bodelier, Gerard Dijkstra, Mariëlle Romberg-Camps, Nanne K H de Boer, Laurents P S Stassen, Andrea E van der Meulen, Rachel West, Oddeke
Inflammatory Bowel Diseases.2022; 28(Supplement): S16. CrossRef
UK Patients of Bangladeshi Descent with Crohn’s Disease Respond Less Well to TNF Antagonists Than Caucasian Patients
Radha Gadhok, Hannah Gordon, Gregory Sebepos-Rogers, Samantha Baillie, Saniath Akbar, Jane E. Abbott, Emma Michael, Omer F. Ahmad, Ben Cooper, James O. Lindsay
Digestive Diseases and Sciences.2020; 65(6): 1790. CrossRef
Optimizing the Use of Current Treatments and Emerging Therapeutic Approaches to Achieve Therapeutic Success in Patients with Inflammatory Bowel Disease
Hiroshi Nakase
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Incidence of suboptimal response to tumor necrosis factor antagonist therapy in inflammatory bowel disease in newly industrialised countries: The EXPLORE study
Jesus K. Yamamoto-Furusho, Othman Al Harbi, Alessandro Armuzzi, Webber Chan, Enrique Ponce de Leon, Jiaming Qian, Marina Shapina, Murat Toruner, Chia-Hung Tu, Byong Duk Ye, Morgane Guennec, Cecilia Sison, Dirk Demuth, Olga Fadeeva, Qasim M. Rana Khan
Digestive and Liver Disease.2020; 52(8): 869. CrossRef
CYP3A5 Genotype as a Potential Pharmacodynamic Biomarker for Tacrolimus Therapy in Ulcerative Colitis in Japanese Patients
Yuki Yamamoto, Hiroshi Nakase, Minoru Matsuura, Shihoko Maruyama, Satohiro Masuda
International Journal of Molecular Sciences.2020; 21(12): 4347. CrossRef
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Siew C Ng, Joyce Wing Yan Mak, Partha Pal, Rupa Banerjee
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Byong Duk Ye, Simon Travis
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Increased risk of atrial fibrillation in patients with inflammatory bowel disease: A nationwide population-based study
You-Jung Choi, Eue-Keun Choi, Kyung-Do Han, Jiesuck Park, Inki Moon, Euijae Lee, Won-Seok Choe, So-Ryoung Lee, Myung-Jin Cha, Woo-Hyun Lim, Seil Oh
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Ji Won Kim
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100 Download
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Differences in the public medical insurance systems for inflammatory bowel disease treatment in Asian countries: Shu Chen Wei; Intest Res 2016;14(3):218-223. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.218

Abstract PDF PubReader ePub

Background/Aims

The cost of caring for patients with inflammatory bowel disease (IBD) is high. Without government support, the cost burden will unavoidably rest on the patients and their family. However, the government providing full support will place a large financial burden on the health-care systems of a country. The aim of this study is to understand the current status of public medical insurance systems in caring for IBD patients among Asian countries.

Methods

Questionnaires inquiring about the availability of public health systems; medical, diagnostic, and endoscopy costs; and coverage rate of biologics use were designed and sent to IBD experts in each of the Asian countries studied. The results were summarized according to the feedback from the responders.

Results

The public health insurance coverage rate is high in Taiwan, Japan, South Korea, China, Hong Kong, and Singapore; but low in Malaysia and India. This probably affected the use of expensive medications mostly, such as biologics, as we found that the percentage of Crohn's disease (CD) treated with biologics were as high as 30%–40% in Japan, where the government covers all expenses for IBD patients. In India, the percentage maybe as low as 1% for CD patients, most of whom need to pay for the biologics themselves.

Conclusions

There were differences in the public health insurance systems among the Asian countries studied. This reportprovidesthe background information to understand the differences in the treatment of IBD patients among Asian countries.

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Efficacy and Safety of Long-Term Thiopurine Maintenance Treatment in Japanese Patients With Ulcerative Colitis: Satoshi Yamada, Takuya Yoshino, Minoru Matsuura, Masamichi Kimura, Yorimitsu Koshikawa, Naoki Minami, Takahiko Toyonaga, Yusuke Honzawa, Hiroshi Nakase; Intest Res 2015;13(3):250-258. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.250

Abstract PDF Supplementary Material PubReader

Background/Aims

The long-term clinical outcomes of patients with bio-naive ulcerative colitis (UC) who maintain remission with thiopurine are unclear. The aim of this study was to assess the long-term efficacy and safety of maintenance treatment with thiopurine in UC patients.

Methods

This was a retrospective observational cohort analysis conducted at a single center. Between December 1998 and August 2013, 59 of 87 patients with bio-naive UC who achieved remission after induction with treatments other than biologics were enrolled. Remission maintenance with thiopurine was defined as no concomitant treatment needed other than 5-aminosalicylate without relapse. We assessed the remission-maintenance rate, mucosal healing rate, colectomy-free rate, and treatment safety in UC patients who received thiopurine as maintenance treatment.

Results

The 84-month cumulative remission-maintenance and colectomy-free survival rates in the UC patients who were receiving maintenance treatment with thiopurine and 5-aminosalicylate were 43.9% and 88.0%, respectively. Of the 38 patients who underwent colonoscopy during thiopurine maintenance treatment, 23 (60.5%) achieved mucosal healing. Of the 59 patients who achieved clinical remission with thiopurine, 6 patients (10.2%) discontinued the thiopurine therapy because of adverse events.

Conclusions

Our study demonstrates the long-term efficacy and safety of thiopurine treatment in patients with bio-naive UC.

Citations

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Thiopurines Have Sustained Long-term Effectiveness in Patients with Inflammatory Bowel Disease, Which is Independent of Disease Duration at Initiation: A Propensity Score Matched Analysis
Mukesh Kumar Ranjan, Peeyush Kumar, Sudheer Kumar Vuyyuru, Bhaskar Kante, Sandeep K Mundhra, Rithvik Golla, Shubi Virmani, Raju Sharma, Peush Sahni, Prasenjit Das, Mani Kalaivani, Ashish Datt Upadhyay, Govind Makharia, Saurabh Kedia, Vineet Ahuja
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Potential benefits of immunomodulator use with vedolizumab for maintenance of remission in ulcerative colitis
Makoto Naganuma, Kenji Watanabe, Satoshi Motoya, Haruhiko Ogata, Toshiyuki Matsui, Yasuo Suzuki, Lyann Ursos, Shigeru Sakamoto, Mitsuhiro Shikamura, Tetsuharu Hori, Jovelle Fernandez, Mamoru Watanabe, Toshifumi Hibi, Takanori Kanai
Journal of Gastroenterology and Hepatology.2022; 37(1): 81. CrossRef
Real-World Long-Term Remission Maintenance for 10 Years With Thiopurines in Ulcerative Colitis
Satohiro Matsumoto, Hirosato Mashima
Crohn's & Colitis 360.2021;[Epub] CrossRef
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Zhaobei Cai, Shu Wang, Jiannan Li
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Predictive Role of NUDT15 Variants on Thiopurine-Induced Myelotoxicity in Asian Inflammatory Bowel Disease Patients
Natalia Sutiman, Sylvia Chen, Khoon Lin Ling, Sai Wei Chuah, Wai Fook Leong, Vinayak Nadiger, Madeline Tjai, Chris San Choon Kong, Brian John Schwender, Webber Chan, Hang Hock Shim, Wee Chian Lim, Chiea Chuen Khor, Yin Bun Cheung, Balram Chowbay
Pharmacogenomics.2018; 19(1): 31. CrossRef
NUDT15,FTO, andRUNX1genetic variants and thiopurine intolerance among Japanese patients with inflammatory bowel diseases
Toshiyuki Sato, Tetsuya Takagawa, Yoichi Kakuta, Akihiro Nishio, Mikio Kawai, Koji Kamikozuru, Yoko Yokoyama, Yuko Kita, Takako Miyazaki, Masaki Iimuro, Nobuyuki Hida, Kazutoshi Hori, Hiroki Ikeuchi, Shiro Nakamura
Intestinal Research.2017; 15(3): 328. CrossRef
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Yoon Jee Lee, Jae Hee Cheon, Jae Hyun Kim, SunHo Yoo, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim
Yonsei Medical Journal.2017; 58(1): 144. CrossRef
Rate and Predictors of Mucosal Healing in Ulcerative Colitis Treated with Thiopurines: Results of a Multicentric Cohort Study
Caroline Prieux-Klotz, Stéphane Nahon, Aurelien Amiot, Leila Sinayoko, Carole Galéano-Cassaz, Stanislas Chaussade, Romain Coriat, Pierre Lahmek, Vered Abitbol
Digestive Diseases and Sciences.2017; 62(2): 473. CrossRef
Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission
Jae Hyun Kim, Jae Hee Cheon, Yehyun Park, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim
Scandinavian Journal of Gastroenterology.2016; 51(9): 1069. CrossRef
Is Long-Term Therapy With Thiopurines Effective for Maintaining Remission in Patients With Moderate-To-Severe Ulcerative Colitis?
Seong Ran Jeon, Won Ho Kim
Intestinal Research.2015; 13(3): 191. CrossRef

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59 Download
12 Web of Science
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Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis: Jaeyoung Chun, Changhyun Lee, Ji-eun Kwon, Sung Wook Hwang, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2015;13(1):50-59. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.50

Abstract PDF PubReader

Background/Aims

Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.

Methods

We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×10⁵ polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.

Results

A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).

Conclusions

The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.

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Review

Diagnosis and Treatment of Latent Tuberculosis Infection in Patients with Inflammatory Bowel Diseases due to Initiation of Anti-Tumor Necrosis Factor Therapy: Tae Sun Shim; Intest Res 2014;12(1):12-19. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.12

Abstract PDF PubReader

Patients with intractable inflammatory bowel diseases (IBD) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in patients due to the initiation of anti-TNF therapy. Traditionally, LTBI has been diagnosed on the basis of clinical factors and a tuberculin skin test. Recently, interferon-gamma releasing assays (IGRAs) that can detect TB infection have become available. Considering the high-risk of developing TB in patients on anti-TNF therapy, the use of both a tuberculin skin test and an IGRA should be considered to detect and treat LTBI in patients with IBD due to the initiation of anti-TNF therapy. The traditional LTBI treatment regimen has consisted of isoniazid monotherapy for 9 months. However, shorter regimens such as 4 months of rifampicin or 3 months of isoniazid/rifampicin have been used increasingly to improve treatment completion rates. In this review, the incidence of TB and the prevalence of LTBI in patients with IBD will be briefly described, as well as methods for diagnosing latent and active TB before anti-TNF therapy, current LTBI treatment regimens, recommendations for managing TB that develops during anti-TNF therapy, the necessity of regular monitoring to detect new TB infection, and the re-initiation of anti-TNF therapy in patients who develop TB.

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