Intestinal Research

Original Articles

Incidence and treatment-based risk stratification of opportunistic infections in patients with inflammatory bowel disease: an ambispective cohort study in Brazil: Rios Ricci José Eugenio, Tarsila Campanha da Rocha Ribeiro, Fernando Antonio Basile Colugnati, Lívia de Almeida Costa, Pedro de Morais, Jordana AS Lopes, Hugo B Araújo, Matheus A Pacheco, Mariana V de S Paulo, João Baptista de Paula Fraga, Lucélia Paula Cabral Schmidt, Thais de Andrade Almeida, Roberta Oliveira Raimundo Borsato, Liliana Andrade Chebli, Júlio Maria Fonseca Chebli; Received September 4, 2025 Accepted February 11, 2026 Published online May 21, 2026; DOI: https://doi.org/10.5217/ir.2025.00208 [Epub ahead of print]

Abstract PDF: Background/Aims
The risk of opportunistic infections (OIs) in inflammatory bowel disease (IBD) patients in Latin America is poorly known. We assessed the incidence and stratified the risk of OIs in IBD patients on immunosuppressive therapies.
Methods
In this ambispective cohort study, we retrospectively analyzed the medical charts of IBD patients between March 2014 and March 2021 and prospectively analyzed those from April 2021 to April 2024. The incidence rate of OIs was expressed as the number per 1,000 patient-years (PY) and calculated for each treatment category. The risks of OIs associated with immunosuppressants were compared with exposure to aminosalicylates or no treatment using the Cox proportional hazards model.
Results
In a total of 3,279.6 PY of follow-up, OIs occurred in 60 of 498 patients (12.0%) with an incidence rate of 18.3 per 1,000 PY. The most common OIs were herpes zoster (HZ; n = 28, 5.6%) and tuberculosis (n = 17, 3.4%). The incidence rates of HZ and tuberculosis were 8.5 and 5.18 per 1,000 PY, respectively. Compared with patients on aminosalicylates or no treatment, the risk of OIs was higher in those on combination therapies with anti-tumor necrosis factor (TNF) and thiopurines (hazard ratio [HR], 7.67; 95% confidence interval [CI], 2.26–26.06), followed by thiopurine monotherapy (HR, 5.35; 95% CI, 1.56–18.3), and anti-TNF monotherapy (HR, 5.04; 95% CI, 1.50–16.97).
Conclusions
IBD patients on long-term anti-TNF and/or thiopurine therapy had a higher risk of OIs, especially HZ and tuberculosis, compared with non-immunosuppressed patients. In the choice of therapies for IBD, the balance of individual drug effectiveness and safety is crucial.

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Latent tuberculosis infection screening in patients with inflammatory bowel disease: a nationwide retrospective cohort study in South Korea comparing IGRA alone versus a combination of TST and IGRA: Ye-Jee Kim, Jiyeon Kim, Jiwon Lee, Tae Sun Shim, Sang Hyoung Park, Kyung-Wook Jo; Intest Res 2025;23(4):541-550. Published online October 14, 2025; DOI: https://doi.org/10.5217/ir.2025.00136

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We aimed to evaluate if using the interferon-gamma release assay (IGRA) alone is effective for latent tuberculosis infection (LTBI) screening in preventing active tuberculosis in patients with inflammatory bowel disease (IBD) before initiating anti-tumor necrosis factor alpha (anti-TNF-α) therapy, compared to using both the tuberculin skin test and IGRA.
Methods
Using South Korea’s Health Insurance Review and Assessment Service, we selected IBD patients treated with anti-TNF-α agents for ≥ 1 year who underwent LTBI screening between 2018 and 2021. We compared the 1-year incidence rate and standardized incidence ratio of active tuberculosis incidence after starting anti-TNF-α treatment to the general population based on the LTBI screening strategy.
Results
Of the 4,215 enrolled patients, 3,505 underwent IGRA alone for LTBI screening, while 710 received both tuberculin skin test and IGRA. Within 1 year of starting anti-TNF-α treatment, 15 patients (0.36%) developed active tuberculosis, with a mean follow-up period of 4,200.6 person-years. The 1-year tuberculosis incidence rates were 372.3 (95% confidence interval [CI], 198.2–636.6) per 100,000 person-years for the IGRA alone group and 282.3 (95% CI, 34.2–1,019.9) per 100,000 person-years for the combination group. The standardized incidence ratios were similar: 14.34 (95% CI, 7.63–24.52) for the IGRA alone group and 11.25 (95% CI, 1.26–40.61) for the combination group.
Conclusions
Using IGRA alone may be an effective strategy for LTBI screening in IBD patients before starting anti-TNF-α therapy. (Intest Res, Published online)

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Risk Factors of Latent Tuberculosis Infection among Incarcerated Populations: A Case–Control Study in Shenzhen, China
Zhenyang Liu, Yawei Cui, Jiarong Xu, Zhikai Ding, Ao Huang
Journal of Epidemiology and Global Health.2026;[Epub] CrossRef

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IBD

The duration of prior anti-tumor necrosis factor agents is associated with the effectiveness of vedolizumab in patients with ulcerative colitis: a real-world multicenter retrospective study: Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Minoru Matsuura, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Mary Cavaliere, Kaori Ishiguro, Jovelle L Fernandez, Toshifumi Hibi; Intest Res 2026;24(2):281-292. Published online June 4, 2025; DOI: https://doi.org/10.5217/ir.2024.00126

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Background/Aims
Previous literature suggests that the response of patients with ulcerative colitis to vedolizumab may be affected by previous biologic therapy exposure. This real-world study evaluated vedolizumab treatment effectiveness in biologicnon-naïve patients.
Methods
This was a multicenter, retrospective, observational chart review of records from 16 hospitals in Japan (December 1, 2018, to February 29, 2020). Included patients who had ulcerative colitis, were aged ≥ 20 years, and received at least 1 dose of vedolizumab. Outcomes included clinical remission rates from weeks 2 to 54 according to prior biologic exposure status and factors associated with clinical remission up to week 54.
Results
A total of 370 eligible patients were included. Clinical remission rates were significantly higher in biologic-naïve (n=197) than in biologic-non-naïve (n=173) patients for weeks 2 to 54 of vedolizumab treatment. Higher clinical remission rates up to week 54 were significantly associated with lower disease severity (partial Mayo score ≤ 4, P= 0.001; albumin ≥ 3.0, P= 0.019) and the duration of prior anti-tumor necrosis factor α (anti-TNFα) therapy (P= 0.026). Patients with anti-TNFα therapy durations of < 3 months, 3 to < 12 months, and ≥ 12 months had clinical remission rates of 28.1%, 32.7%, and 60.0%, respectively (P= 0.001 across groups).
Conclusions
The effectiveness of vedolizumab in biologic-non-naïve patients was significantly influenced by duration of prior anti-TNFα therapy. (Japanese Registry of Clinical Trials: jRCT-1080225363)

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Interpreting vedolizumab persistence: lessons from real-world trajectories in ulcerative colitis
Jung Min Moon
Intestinal Research.2026; 24(1): 3. CrossRef
Long-Term Outcomes and Prognostic Factors for Vedolizumab-Treated Japanese Patients with Ulcerative Colitis
Shinya Fukushima, Takehiko Katsurada, Takahiro Ito, Atsuo Maemoto, Fumika Orii, Toshifumi Ashida, Masanao Nasuno, Hiroki Tanaka, Katsuyoshi Ando, Mikihiro Fujiya, Yoshihiro Yokoyama, Satoshi Motoya, Hiroshi Nakase
Inflammatory Intestinal Diseases.2025; 11(1): 1. CrossRef

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IBD

Tuberculosis risk in patients with Crohn’s disease on biologics: a retrospective analysis of the Japanese Medical Claims Database: Koji Fujimoto, Shuhei Hosomi, Yumie Kobayashi, Rieko Nakata, Yu Nishida, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Satoko Ohfuji, Yasuhiro Fujiwara; Intest Res 2025;23(3):309-317. Published online August 19, 2024; DOI: https://doi.org/10.5217/ir.2024.00076

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Background/Aims
Treatment using tumor necrosis factor-α (TNF-α) inhibitors is one of the risk factors for active tuberculosis (TB) in patients with Crohn’s disease (CD). Biologics, such as ustekinumab (UST) and vedolizumab (VDZ), are less likely to cause opportunistic infections. However, large-scale studies for active TB and biologics other than TNF-α inhibitors are limited. We aimed to investigate the association between biologics and active TB utilizing a Japanese medical claims database.
Methods
We analyzed retrospectively the association of the risk of active TB development with treatment using TNF-α inhibitors and other biologics (UST and VDZ) in patients with CD using the Japanese Medical Data Vision (MDV) database between April 2008 and June 2022. The durations of each biologic and biologic-free treatment were calculated for each patient. Univariate and multivariate analyses were performed using the Cox proportional hazards model, with the utilization of biologics considered as time-dependent covariates.
Results
We included 28,811 patients with CD in MDV database. Finally, 17,169 patients were analyzed. In total, 7,064 patients were categorized as biologic-naïve, while 10,105 were classified as biologic-experienced. Seventeen patients developed active TB, including 7 on infliximab, 5 on adalimumab, and 5 on no biologics. None of the patients treated with UST and VDZ developed active TB. Multivariate analysis suggested that TNF-α inhibitors were the risk factors for active TB (hazard ratio, 3.66; P= 0.020).
Conclusions
TNF-α inhibitors, but not UST or VDZ, are risk factors for active TB in Japanese patients with CD.

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Research Communication: Risk of Tuberculosis With Advanced Therapies in 20,705 Patients With Inflammatory Bowel Diseases in Low Incidence Regions—A U.S. Claims‐Based Study
Dhruv Ahuja, Kuan‐Hung Yeh, Sagar B. Patel, Soo‐kyung Park, Ronghui Xu, Siddharth Singh
Alimentary Pharmacology & Therapeutics.2026; 63(6): 885. CrossRef
Prevalence and clinical impact of latent tuberculosis infection in patients with inflammatory bowel disease in Japan: a retrospective multicenter study by the IBD-Quality team
Nanae Tsuruoka, Hironobu Takedomi, Yasuhisa Sakata, Shin Fujioka, Ryosuke Sakemi, Shinya Ashizuka, Nobuaki Nishimata, Kazumi Inaba, Shuji Kanmura, Tetsu Kinjo, Yoki Furuta, Shinichiro Yoshioka, Shojiro Yamamoto, Ayako Takamori, Fumihito Hirai, Motohiro Es
Journal of Gastroenterology.2026;[Epub] CrossRef
Subacute respiratory symptoms in a patient with Crohn’s disease and ankylosing spondylitis
Doohyuck Lee, Kwangwoo Nam, Ho Jin Yong, Juntae Kim, Miil Kang
The Korean Journal of Internal Medicine.2026; 41(3): 557. CrossRef
Miliartuberkulose nach Adalimumabtherapie eines M. Crohn
Wolfgang Schima, Maximilian Emich, Helmut Kopf
Journal für Gastroenterologische und Hepatologische Erkrankungen.2026;[Epub] CrossRef
Risk of tuberculosis disease among patients with inflammatory bowel disease and inflammatory rheumatic disease treated with biologics in Denmark: a nationwide cohort study
Christian Kraef, Anne Ahrens Østergaard, Troels Lillebaek, Pernille Ravn, Andreas Fløe, Lone Larsen, Ada Colic, Inge Petersen, Isik Somuncu Johansen
Clinical Microbiology and Infection.2025;[Epub] CrossRef
Assessing tuberculosis risk in Crohn’s disease patients receiving biologic therapies: real-world insights from Japan
Jung Won Lee, Yoo Min Han
Intestinal Research.2025; 23(3): 231. CrossRef
Practices and perceptions of 5-aminosalicylic acid use in Crohn’s disease: a nationwide survey of physicians in Korea by KASID Guidelines Taskforce Team
June Hwa Bae, Seung Yong Shin, Dong Hyun Kim, Seung Min Hong, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Sung Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Won Moon, Sung-Ae Jung
Intestinal Research.2025; 23(4): 491. CrossRef
Safety assessment of ustekinumab in inflammatory bowel disease: a real-world analysis based on the FDA adverse event reporting system (FAERS)
Likang Xu, Zhenkai Huang, Gong Chen, Chao Sun, Yang Yu, Sujun Gao
European Journal of Medical Research.2025;[Epub] CrossRef

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IBD

Defining management strategies for acute severe ulcerative colitis using predictive models: a simulation-modeling study: Danny Con, Peter De Cruz; Intest Res 2024;22(4):439-452. Published online May 7, 2024; DOI: https://doi.org/10.5217/ir.2023.00175

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Background/Aims
Robust management algorithms are required to reduce the residual risk of colectomy in acute severe ulcerative colitis (ASUC) refractory to standard infliximab salvage therapy. The aim of this study was to evaluate the performance and benefits of alternative ASUC management strategies using simulated prediction models of varying accuracy.
Methods
This was a simulation-based modeling study using a hypothetical cohort of 5,000 steroid-refractory ASUC patients receiving standard infliximab induction. Simulated predictive models were used to risk-stratify patients and escalate treatment in patients at high risk of failing standard infliximab induction. The main outcome of interest was colectomy by 3 months.
Results
The 3-month colectomy rate in the base scenario where all 5,000 patients received standard infliximab induction was 23%. The best-performing management strategy assigned high-risk patients to sequential Janus kinase inhibitor inhibition and mediumrisk patients to accelerated infliximab induction. Using a 90% area under the curve (AUC) prediction model and optimistic treatment efficacy assumptions, this strategy reduced the 3-month colectomy rate to 8% (65% residual risk reduction). Using an 80% AUC prediction model with only modest treatment efficacy assumptions, the 3-month colectomy rate was reduced to 15% (35% residual risk reduction). Overall management strategy efficacy was highly dependent on predictive model accuracy and underlying treatment efficacy assumptions.
Conclusions
This is the first study to simulate predictive model-based management strategies in steroid-refractory ASUC and evaluate their effect on short-term colectomy rates. Future studies on predictive model development should incorporate simulation studies to better understand their expected benefit.

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Medical management of acute severe ulcerative colitis in the hospitalized patient
Loren G Rabinowitz, Ajay Gade, Joseph D. Feuerstein
Expert Review of Gastroenterology & Hepatology.2025; 19(5): 467. CrossRef
Three Janus kinase inhibitors in ulcerative colitis: is upadacitinib taking the lead?
Yoon Suk Jung
Intestinal Research.2025; 23(4): 394. CrossRef

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IBD

Serum albumin is the strongest predictor of anti-tumor necrosis factor nonresponse in inflammatory bowel disease in resource-constrained regions lacking therapeutic drug monitoring: Peeyush Kumar, Sudheer K. Vuyyuru, Prasenjit Das, Bhaskar Kante, Mukesh Kumar Ranjan, David Mathew Thomas, Sandeep Mundhra, Pabitra Sahu, Pratap Mouli Venigalla, Saransh Jain, Sandeep Goyal, Rithvik Golla, Shubi Virmani, Mukesh K. Singh, Karan Sachdeva, Raju Sharma, Nihar Ranjan Dash, Govind Makharia, Saurabh Kedia, Vineet Ahuja; Intest Res 2023;21(4):460-470. Published online March 17, 2023; DOI: https://doi.org/10.5217/ir.2022.00128

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Background/Aims
Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn’s disease (CD).
Methods
Inflammatory bowel disease patients treated with anti-TNF agents (January 2005–October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies.
Results
One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1±13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28–100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P<0.001), postoperative recurrence (P=0.001) and high IL-7R expression (P<0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03–0.28; P<0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15–0.62; P=0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P<0.001), and high C-reactive protein (P<0.001), OSM (P<0.04) and OSM-R (P=0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03–0.39; P=0.001) on multivariate analysis respectively.
Conclusions
Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients.

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Does surgical approach affect Hirschsprung-associated enterocolitis risk? A comparison between transanal Swenson-like and endorectal pull-throughs
Azzahra Fatinnuha Azmi Prayogi Putri, Dwiki Afandy, Ahmad Zakiy Habibiy, Setiani Silvy Nurhidayah, Khanza Adzkia Vujira, Pramana Adhityo, Gilang Vigorous Akbar Eka Candy, Kristy Iskandar, Eko Purnomo, Gunadi, Kota V. Ramana
PLOS One.2026; 21(1): e0340813. CrossRef
HLA-DQB1*03:01 and HLA-DQA1*05:05 as key genetic determinants of infliximab response and immunogenicity in Japanese patients with inflammatory bowel disease
Ryuya Osaka, Takeo Naito, Seik-Soon Khor, Yoichi Kakuta, Yosuke Kawai, Masao Nagasaki, Hiroshi Meguro, Hideya Iwaki, Daisuke Okamoto, Hiroshi Nagai, Yusuke Shimoyama, Rintaro Moroi, Hisashi Shiga, Yoshitaka Kinouchi, Atsushi Masamune
Journal of Gastroenterology.2026; 61(5): 547. CrossRef
Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study
Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim
Gut and Liver.2025; 19(3): 376. CrossRef
The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn’s disease: a cohort study
Chen Huang, Chao Chen, Hao Wu, Hanyu Yin, Weixiang Yao, Susu Bai, Baixue Zhuo, Xiaoli Wu
Frontiers in Nutrition.2025;[Epub] CrossRef
Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef
Progress in the Study of Inflammatory Bowel Disease Patients with Primary Non-Responsiveness
Yixue Liu, Xiaoping Tan
Journal of Biosciences and Medicines.2024; 12(01): 72. CrossRef
Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
Sayan Malakar, Srikanth Kothalkar, Umair Shamsul Hoda, Uday C Ghoshal
Cureus.2023;[Epub] CrossRef

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IBD

Abdominal aortic calcification in patients with inflammatory bowel disease: does anti-tumor necrosis factor α use protect from chronic inflammation-induced atherosclerosis?: Aikaterini Mantaka, Nikolaos Galanakis, Dimitrios Tsetis, Ioannis E. Koutroubakis; Intest Res 2022;20(4):495-505. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2022.00017

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Background/Aims
Abdominal aortic calcium (AAC) deposition has been suggested as a marker of early atherosclerosis. There is no published data on the evaluation of AAC in inflammatory bowel disease (IBD).
Methods
AAC was quantified by computed tomography or enterography scans performed in 98 IBD patients and 1:1 age and sex matched controls. AAC deposition was correlated with IBD characteristics, disease activity or severity parameters, laboratory tests and cardiovascular disease (CVD) risk factors.
Results
Moderate-severe grade of AAC was found in 35.7% of IBD patients compared to 30.6% of controls (P= 0.544). IBD with CVD and ulcerative colitis patients had significantly higher rates of more severe atherosclerotic lesions (P= 0.001 and P= 0.01, respectively). AAC deposition was similarly distributed in age groups ( < 45, 45–64, and ≥ 65 years) among patients and controls. Multivariate analysis after excluding CVD risk confounders for non-CVD patients found extensive disease (P= 0.019) and lifetime steroids (P= 0.04) as independent risk factors for AAC. Anti-tumor necrosis factor α (TNF-α) use was negatively associated with AAC deposition in non-CVD IBD patients (odds ratio, 0.023; 95% confidence interval, 0.001–0.594; P= 0.023).
Conclusions
More than one-third of IBD patients have moderate to severe AAC. Better control of inflammation with anti-TNF-α agents seems to protect IBD patients from ACC deposition and subsequent atherosclerosis.

Citations

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Neutrophils at the Crossroads of Inflammatory Bowel Disease and Atherosclerosis: A State-of-the-Art Review
Vadim Genkel, Yana Zaripova, Alla Kuznetsova, Alena Sluchanko, Anna Minasova, Maria Zotova, Anna Saenko, Albina Savochkina, Anastasiya Dolgushina
Cells.2025; 14(10): 738. CrossRef
Bridging the gut and the heart-Exploring pathophysiology, risk factors, and therapeutic implications of cardiovascular disease in inflammatory bowel disease
Diana Othon-Martínez, Sylvia Valeria Peña-Muñoz, Margarita Riojas-Barrett, Genesis Vidales-López, Josué Moisés Sánchez Guzmán, Lukasz Kwapisz
Journal of Investigative Medicine.2025; 73(8): 593. CrossRef
Inhibition of long interspersed nuclear element-1 by nucleoside reverse transcriptase inhibitors attenuates vascular calcification
Jianshuai Ma, Dayu He, Mingxuan Zhang, Ziting Zhou, Jinkun Cheng, Aoran Huang, Yaxin Lian, Yuncong Shi, Changming Xie, Zhengyan Guan, Zhengzhipeng Zhang, Chen Xie, Tingting Zhang, Hui Huang
Signal Transduction and Targeted Therapy.2025;[Epub] CrossRef
Abdominal aortic calcification among gastroenterological and transplant surgery
Yuki Imaoka, Masahiro Ohira, Miho Akabane, Kazunari Sasaki, Hideki Ohdan
Annals of Gastroenterological Surgery.2024; 8(6): 987. CrossRef
A Potential New Link Between Inflammation and Vascular Calcification
Xinjiang Cai, Yin Tintut, Linda L. Demer
Journal of the American Heart Association.2023;[Epub] CrossRef
Associations between systemic immune-inflammation index and abdominal aortic calcification: Results of a nationwide survey
Ruijie Xie, Xiaozhu Liu, Haiyang Wu, Mingjiang Liu, Ya Zhang
Nutrition, Metabolism and Cardiovascular Diseases.2023; 33(7): 1437. CrossRef
Cardiovascular manifestations of inflammatory bowel diseases and the underlying pathogenic mechanisms
Ying Xiao, Don W. Powell, Xiaowei Liu, Qingjie Li
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.2023; 325(2): R193. 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

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Impact of 5‐ASA discontinuation in children with ulcerative colitis on biologic therapy: A propensity score‐matched study
Giulia D'Arcangelo, Luca Scarallo, Giulia Mancuso, Mara Corpino, Claudio Romano, Lorenzo Norsa, Serena Arrigo, Matteo Bramuzzo, Maria Teresa Fioretti, Giovanna Zuin, Maria Teresa Illiceto, Paolo Lionetti, Marina Aloi
Journal of Pediatric Gastroenterology and Nutrition.2026;[Epub] CrossRef
Development and Validation of a Clinical Decision Support Tool to Predict Disease Progression in Crohn’s Disease Treated with Ustekinumab
Lingya Yao, Yushu Cao, Chenhao Bai, Rongbei Liu, Wenjing Yang, Kang Chao, Zhaopeng Huang, Yun Qiu, Xiang Gao, Minhu Chen, Qian Cao
Journal of Clinical Medicine.2025; 14(22): 7919. CrossRef
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-
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Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
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Sophie Vieujean, Edouard Louis
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Soo-Young Na
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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
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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
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IBD

Correlation of serum levels of anti-tumor necrosis factor agents with perianal fistula healing in Crohn’s disease: a narrative review: Eron Fabio Miranda, Rodrigo Bremer Nones, Paulo Gustavo Kotze; Intest Res 2021;19(3):255-264. Published online November 6, 2020; DOI: https://doi.org/10.5217/ir.2020.00029

Abstract PDF PubReader ePub

With the overspread use of measurement of serum levels of anti-tumor necrosis factor (TNF) agents (therapeutic drug monitoring, TDM), new therapeutic strategies have been used in the management of Crohn’s disease (CD). Different targets are correlated with increased levels of circulating drugs. Recent evidence demonstrated that higher serum levels of anti-TNF agents may be associated to better outcomes in perianal fistulizing CD (PFCD). Overall, patients with healed fistulas had higher serum levels of infliximab and adalimumab as compared to those with active drainage. This was demonstrated in some cohort studies, in induction and maintenance, in adults and children with PFCD. In this narrative review, authors summarize current evidence on the use of serum level measurement of anti-TNF agents and its correlation with perianal fistula healing in CD patients. Data on the use of TDM in PFCD is discussed in detail. The retrospective design of the studies and the lack of objective parameters to measure fistula healing are the main limitations of published data. Prospective studies, with central reading of objective radiological parameters, such as pelvic magnetic resonance imaging scores, can improve the level of evidence on the possible advantages of TDM in perianal fistula in CD and are warranted.

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Kwang Woo Kim, Hyoun Woo Kang, Seong-Joon Koh, Hyuk Yoon, Sihyun Kim, Yukyung Jun, Hyun Jung Lee, Jong Pil Im, Young Soo Park, Ji Won Kim, Joo Sung Kim
Intestinal Research.2025; 23(4): 483. CrossRef
Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
Inflammatory Bowel Diseases.2024; 30(9): 1579. CrossRef
Evaluating the Efficacy of Infliximab in Inflammatory Bowel Disease: A Systematic Review of the Literature
Maria P Vallejo, Arturo P Jaramillo, Carlos Luis Guanín Cabrera, Maria G Cueva, Mario Navarro Grijalva, Xavier Grandes
Cureus.2024;[Epub] CrossRef
Comparison of the Pharmacokinetics of CT-P13 Between Crohn’s Disease and Ulcerative Colitis
Eun Soo Kim, Sung Kook Kim, Dong Il Park, Hyo Jong Kim, Yoo Jin Lee, Ja Seol Koo, Eun Sun Kim, Hyuk Yoon, Ji Hyun Lee, Ji Won Kim, Sung Jae Shin, Hyung Wook Kim, Hyun-Soo Kim, Young Sook Park, You Sun Kim, Tae Oh Kim, Jun Lee, Chang Hwan Choi, Dong Soo Ha
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Early Infliximab Trough Levels Predict the Long-term Efficacy of Infliximab in a Randomized Controlled Trial in Patients with Active Crohn’s Disease Comparing, between CT-P13 and Originator Infliximab
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Gut and Liver.2023; 17(3): 430. CrossRef
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Mir Zulqarnain, Parakkal Deepak, Andres J. Yarur
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Management of Non-response and Loss of Response to Anti-tumor Necrosis Factor Therapy in Inflammatory Bowel Disease
Jan Marsal, Manuel Barreiro-de Acosta, Irina Blumenstein, Maria Cappello, Thomas Bazin, Shaji Sebastian
Frontiers in Medicine.2022;[Epub] CrossRef
Editorial: higher concentrations of cytokine blockers are needed to obtain small bowel mucosal healing during maintenance therapy in Crohn's disease
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Alimentary Pharmacology & Therapeutics.2021; 54(8): 1085. CrossRef

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Original Articles

Inflammatory Bowel Diseases

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study: Yasuo Suzuki, Takashi Hagiwara, Mariko Kobayashi, Kazuo Morita, Tomoyo Shimamoto, Toshifumi Hibi; Intest Res 2021;19(3):301-312. Published online August 20, 2020; DOI: https://doi.org/10.5217/ir.2020.00013

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The safety and effectiveness of adalimumab was demonstrated in a phase 3 trial in Japanese patients with intestinal Behçet’s disease. The aim of this study was to evaluate the long-term safety and effectiveness of adalimumab in Japanese patients with intestinal Behçet’s disease.
Methods
This prospective, all-case, post-marketing study was conducted at 254 centers in Japanese patients with intestinal Behçet’s disease receiving adalimumab. The primary endpoint was incidence of adverse drug reactions. Effectiveness endpoints included global improvement rating and change in C-reactive protein levels.
Results
Of the 473 registered patients, 462 and 383 included in the safety and effectiveness populations were administered adalimumab for a mean of 515.3 and 579.5 days, respectively. Overall, 395 patients (85.5%) received adalimumab at the recommended dose. Adverse drug reactions and serious adverse drug reactions were reported in 120 (25.97%) and 51 (11.04%) patients, respectively. The incidence of adverse drug reactions was significantly higher in patients with comorbidities (P< 0.0001), patients taking concomitant oral corticosteroids (P< 0.0001), and those not self-administering adalimumab (P= 0.0257). At study end, global improvement rating was “effective” (n = 156, 40.7%) or “markedly effective” (n = 168, 43.9%) in 324 patients (overall effective, 84.6%). Mean C-reactive protein levels (mg/dL) decreased from 1.96 at baseline (n = 324) to 0.58 at week 24 (n = 208) and 0.25 at week 156 (n = 37).
Conclusions
This large real-world study confirmed the long-term safety and effectiveness of adalimumab in patients with intestinal Behçet’s disease. No new safety concerns were identified. (Clinical trial registration number: NCT01960790)

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Yesim Ozguler, Sinem Nihal Esatoglu, Gunnar Tomasson, Louise Falzon, Stephane Barete, Alessandra Bettiol, Bahram Bodaghi, Vladimira Boyadzhieva, Luca Cantarini, Aykut Ferhat Celik, Omar Dhrif, Georgina Ducker, Giacomo Emmi, Ahmet Gül, Jörg Henes, Ina Koet
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Makoto Naganuma, Mitsuhiro Takeno, Aykut Ferhat Çelik, Robert Moots, Philippe Pinton, Tadakazu Hisamatsu
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Long-Term Outcomes and Clinical Factors Associated with Conventional Therapy Failure in Intestinal Behçet’s Disease: A Retrospective Cohort Study in Japan
Keita Murakami, Junya Arai, Sozaburo Ihara, Yumi Tsuchida, Haruka Tsuchiya, Mayo Tsuboi, Ken Kurokawa, Nobumi Suzuki, Hiroto Kinoshita, Yoku Hayakawa, Keishi Fujio, Mitsuhiro Fujishiro
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Jung-Bin Park, So Jung Han, Seung Bum Lee, Dong Hyun Kim, Jae Hee Cheon, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Soo Jung Park, Sang Hyoung Park
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Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
European Journal of Gastroenterology & Hepatology.2024; 36(4): 445. CrossRef
Prevalence and risk factors for gallstone and renal stone formation in patients with intestinal Behçet’s disease
Jaewon Song, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2024; 39(5): 770. CrossRef
Long‐term clinical outcomes of intestinal Behçet's disease: A 30‐year cohort study at a tertiary hospital in South Korea
Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon
Journal of Gastroenterology and Hepatology.2023; 38(3): 386. CrossRef
Risk Factors for Surgery in Patients with Intestinal Behçet’s Disease During Anti-Tumor Necrosis Factor-Alpha Therapy
So Jung Han, Eun Ae Kang, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Yonsei Medical Journal.2023; 64(2): 111. CrossRef
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Jihye Park, Hongyul An, Jiwoo Lim, I Seul Park, Mi Hyun Kim, Ji Hyung Kim, Seung Won Kim, Young Il Koh, Eun Young Lee, Jae Hee Cheon
Arthritis Research & Therapy.2023;[Epub] CrossRef
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Inflammatory bowel diseases

Safety of tumor necrosis factor inhibitor use in patients with concomitant malignancy: Hiep Phan, Rick A. Weideman, Daisha J. Cipher, Linda A. Feagins; Intest Res 2020;18(3):282-288. Published online April 7, 2020; DOI: https://doi.org/10.5217/ir.2019.09140

Abstract PDF PubReader ePub

Background/Aims
Safety for tumor necrosis factor inhibitors (TNFi) in cancer has been focused on risk of incident malignancies, but studies on prognostic effects have been scarce. We determined survival and recurrence rates at 1, 2, and 5 years after cancer diagnosis in patients with and without concurrent TNFi use.
Methods
Chart reviews were performed between 1996 and 2015 at the VA North Texas Healthcare System. Cases were patients with inflammatory disease, concomitant malignancy, and TNFi use while controls were patients with inflammatory disease, concomitant malignancy but no TNFi use. Cases and controls were matched for type of malignancy. Analysis was performed with log-rank tests on Kaplan-Meier curves.
Results
Thirty-six cases and 72 controls were identified. For cases, survival at 1, 2, and 5 years were 32 (89%), 31 (86%), and 29 (81%) compared to 63 (90%), 61 (87%), and 51 (73%) for the control group (P=0.985). For cases, recurrence rates at 1, 2, and 5 years were 3 (8%), 5 (14%), and 6 (17%) compared to 2 (3%), 5 (7%), and 7 (10%) for the control group (P=0.158).
Conclusions
Our findings suggest TNFi may be safely used in select inflammatory disease patients with concurrent cancer if therapy is needed for proper disease control. However, case-by-case consideration in conjunction with an oncologist is recommended while considering the apparent safety of TNFi for patients suffering from active inflammatory diseases despite having a concomitant malignancy.

Citations

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Oh Chan Kwon, Hye Sun Lee, So Young Jeon, Min-Chan Park
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Risk of Cancer Recurrence in Patients With Immune-Mediated Diseases With Use of Immunosuppressive Therapies: An Updated Systematic Review and Meta-Analysis
Akshita Gupta, Laurent Peyrin-Biroulet, Ashwin N. Ananthakrishnan
Clinical Gastroenterology and Hepatology.2024; 22(3): 499. CrossRef
Survival in patients with rheumatoid arthritis and early breast cancer treated with tumor necrosis factor inhibitors
Juan I. Ruiz, Xiudong Lei, Wu Chi-Fang, Sharon H. Giordano, Hui Zhao, Suja S. Rajan, Heather Lin, Maria E. Suarez-Almazor
Breast Cancer.2024; 31(6): 1059. CrossRef
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Takeshi Takasago, Ryohei Hayashi, Yoshitaka Ueno, Misa Ariyoshi, Kana Onishi, Ken Yamashita, Yuichi Hiyama, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka, Yasuhiko Kitadai, Shinji Tanaka, Kenji Fujiwara
PLOS ONE.2023; 18(3): e0283822. CrossRef
Dermatofibrosarcoma Protuberans (DFSP) with Fibrosarcomatous Changes in a Patient with Crohn’s Disease Treated with Anti-TNF (Adalimumab)
Ivo Klarin, Yoshihiro Moriwaki
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Young Bin Joo, Seung Min Jung, Yune-Jung Park, Ki-Jo Kim, Kyung-Su Park
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Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
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Julia Berman, Yarden Yavne, Yonatan Edel, Ori Elkayam, Victoria Furer, Daniel Shepshelovich
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IBD

Influence of anti-tumor necrosis factor-alpha therapy to pregnant inflammatory bowel disease women and their children’s immunity: Ko Eun Lee, Sung-Ae Jung, Sang Hyoung Park, Chang Mo Moon, So Yeon Shim, Eun Soo Kim, Su Jin Cho, Seong-Eun Kim, Kwang Bum Cho, Suk-Kyun Yang; Intest Res 2019;17(2):237-243. Published online February 8, 2019; DOI: https://doi.org/10.5217/ir.2018.00071

Abstract PDF PubReader ePub

Background/Aims
The onset of inflammatory bowel disease (IBD) usually occurs at young age, and therefore, women IBD patients experience pregnancy during their disease progression. Recently, the use of anti-tumor necrosis factor-α (anti-TNF-α) has been rapidly increasing. The aim of this study was to evaluate pregnancy related outcomes in women with IBD who were treated with anti-TNF-α during pregnancy and immunity of their children.
Methods
Korean women with IBD who had been treated with anti-TNF-α during pregnancy had been enrolled. Medical records were reviewed and a survey was performed for each patient. For the patients who agreed on additional examination for their children, children’s growth, medical history and antibody to hepatitis B surface antigen (anti-HBs) titer were checked.
Results
All 18 patients had been diagnosed with Crohn’s disease. There was not any case of preterm delivery, low birth-weight infant, congenital anomaly, nor stillbirth. All 12 children had followed the regular vaccination schedule for hepatitis B and 4 of them showed negative results for anti-HBs. After the 1 booster vaccination, all children demonstrated seroconversion. Regarding live vaccines, 4 children had bacillus Calmette-Guerin and 4 had rotavirus vaccine before 6 months, without any specific side effects.
Conclusions
This was the first study of immunity of the children born from IBD women who had been treated with anti-TNF-α medication during their pregnancy. IBD women had comparable pregnancy outcomes with the general women population, suggesting that the disease activity rather than the administered medication would be more important in healthy pregnancy. Considering the history of vaccination and anti-HBs titers, immunity seems to be intact in the children.

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Global consensus statement on the management of pregnancy in inflammatory bowel disease
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Gut.2026; 75(2): 1. CrossRef
Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease
Uma Mahadevan, Cynthia H. Seow, Edward L. Barnes, María Chaparro, Emma Flanagan, Sonia Friedman, Mette Julsgaard, Sunanda Kane, Siew Ng, Joana Torres, Gillian Watermeyer, Jesus Yamamoto-Furusho, Christopher Robinson, Susan Fisher, Phil Anderson, Richard G
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Murali Krishna Moka, Deepalaxmi Rathakrishnan, Sriram. D.K, Melvin George
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Trevor L Schell, Lucas Fass, Mary E Hitchcock, Francis A Farraye, Mary S Hayney, Sumona Saha, Freddy Caldera
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Society for Maternal-Fetal Medicine Consult Series #64: Systemic lupus erythematosus in pregnancy
Robert Silver, Sabrina Craigo, Flint Porter, Sarah S. Osmundson, Jeffrey A. Kuller, Mary E. Norton
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Vaccines in Children Exposed to Biological AgentsIn Uteroand/or During Breastfeeding: Are They Effective and Safe?
Javier P Gisbert, María Chaparro
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Vaccination for rheumatic diseases: Current issues (based on ACR guidelines)
B. S. Belov, N. V. Muravyeva, E. L. Nasonov
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Pregnancy Outcomes Associated With Biologic Agent Exposure in Patients With Several Rheumatic Diseases and Inflammatory Bowel Diseases
Soo Min Ahn, Young Bin Joo, Yun Jin Kim, So-Young Bang, Hye-Soon Lee
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B. S. Belov, N. V. Muravyeva
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Suboptimal Vaccination Administration in Mothers With Inflammatory Bowel Disease and Their Biologic-Exposed Infants
Helene Chiarella-Redfern, Sangmin Lee, Bellal Jubran, Nastaran Sharifi, Remo Panaccione, Cora Constantinescu, Eric I Benchimol, Cynthia H Seow
Inflammatory Bowel Diseases.2022; 28(1): 79. CrossRef
A systematic review of live vaccine outcomes in infants exposed to biologic disease modifying anti-rheumatic drugs in utero
Bethan Goulden, Nicole Chua, Elaine Parker, Ian Giles
Rheumatology.2022; 61(10): 3902. CrossRef
The Risk of Adverse Neonatal Outcomes With Maternal Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Kristel K Leung, Parul Tandon, Vivek Govardhanam, Cynthia Maxwell, Vivian Huang
Inflammatory Bowel Diseases.2021; 27(4): 550. CrossRef
The Influence of Disease Activity on Pregnancy Outcomes in Women With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Min-A Kim, Young-Han Kim, Jaeyoung Chun, Hye Sun Lee, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Jae Jun Park
Journal of Crohn's and Colitis.2021; 15(5): 719. CrossRef
Biologics During Pregnancy and Breastfeeding Among Women With Rheumatic Diseases: Safety Clinical Evidence on the Road
Asmaa Beltagy, Azin Aghamajidi, Laura Trespidi, Wally Ossola, Pier Luigi Meroni
Frontiers in Pharmacology.2021;[Epub] CrossRef
ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease
T Kucharzik, P Ellul, T Greuter, J F Rahier, B Verstockt, C Abreu, A Albuquerque, M Allocca, M Esteve, F A Farraye, H Gordon, K Karmiris, U Kopylov, J Kirchgesner, E MacMahon, F Magro, C Maaser, L de Ridder, C Taxonera, M Toruner, L Tremblay, M Scharl, N
Journal of Crohn's and Colitis.2021; 15(6): 879. CrossRef
Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD)—Part 1: Live Vaccines
Eric I. Benchimol, Frances Tse, Matthew W. Carroll, Jennifer C. deBruyn, Shelly A. McNeil, Anne Pham-Huy, Cynthia H. Seow, Lisa L. Barrett, Talat Bessissow, Nicholas Carman, Gil Y. Melmed, Otto G. Vanderkooi, John K. Marshall, Jennifer L. Jones
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Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD)—Part 1: Live Vaccines
Eric I Benchimol, Frances Tse, Matthew W Carroll, Jennifer C deBruyn, Shelly A McNeil, Anne Pham-Huy, Cynthia H Seow, Lisa L Barrett, Talat Bessissow, Nicholas Carman, Gil Y Melmed, Otto G Vanderkooi, John K Marshall, Jennifer L Jones
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Safety and Optimal Timing of BCG Vaccination in Infants Born to Mothers Receiving Anti-TNF Therapy for Inflammatory Bowel Disease
Sang Hyoung Park, Hyo Jong Kim, Chang Kyun Lee, Eun Mi Song, Sang-Bum Kang, Byung Ik Jang, Eun Soo Kim, Kyeong Ok Kim, Yoo Jin Lee, Eun Young Kim, Yun Jin Jung, Soo-Kyung Park, Dong Il Park, Byong Duk Ye, Sung-Ae Jung, Suk-Kyun Yang
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Intrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic Review
N. Ghalandari, R. J. E. M. Dolhain, J. M. W. Hazes, E. P. van Puijenbroek, M. Kapur, H. J. M. J. Crijns
Drugs.2020; 80(16): 1699. CrossRef

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IBD

β-(1,3)-Glucan derived from Candida albicans induces inflammatory cytokines from macrophages and lamina propria mononuclear cells derived from patients with Crohn's disease: Kiyoto Mori, Makoto Naganuma, Shinta Mizuno, Hiroaki Suzuki, Mina T. Kitazume, Katsuyoshi Shimamura, Sayako Chiba, Akira Sugita, Katsuyoshi Matsuoka, Tadakazu Hisamatsu, Takanori Kanai; Intest Res 2018;16(3):384-392. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.384

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

Recent research has highlighted the importance of interactions between commensal fungi and intestinal inflammation. However, there are few studies investigating whether commensal fungi contribute to inflammation in patients with Crohn's disease (CD). The aim of this study is to investigate reveal interactions between commensal fungi and host immune cells in CD.

Methods

CD14-positive monocytes were isolated from peripheral blood mononuclear cells from healthy human volunteers and then differentiated in the presence of macrophage colony-stimulating factor (M-CSF) (referred to as M-macrophages, M-Mϕs) or M-CSF and interferon-γ (IFN-γ) (referred to as M-gamma macrophages, Mγ-Mϕs). Cytokine production by these in vitro differentiated macrophages in response to β-(1,3)-glucan was analyzed by flow cytometry. Expression of Dectin-1 was examined using flow cytometry, western blotting, and quantitative reverse transcription-polymerase chain reaction. Cytokine production by in vitro differentiated macrophages in response to β-(1,3)-glucan was measured in the presence of an anti-Dectin-1 receptor antagonist, anti-Syr, or an anti-Fas-1 antibody. Cytokine production by lamina propria mononuclear cells (LPMCs) derived from CD patients in response to β-(1,3)-glucan was also analyzed.

Results

Mγ-Mϕs produced a large amount of tumor necrosis factor-α (TNF-α) and interleukin-6 in response to β-(1,3)-glucan. Dectin-1 expression was significantly higher in Mγ-Mϕs than in M-Mϕs. The increase in TNF-α production by Mγ-Mϕs stimulated with glucan was reversed by blocking Dectin-1, Syr or Fas-1. LPMCs derived from CD patients stimulated with β-(1,3)-glucan produced significantly higher amount of TNF-α than LPMCs derived from UC patients.

Conclusions

These results suggest that commensal fungal microbiota may contribute to the pathogenesis of CD by inducing macrophages-derived pro-inflammatory cytokines.

Citations

Citations to this article as recorded by

Heat Shock Protein SSA1 Enriched in Hypoxic Secretome of Candida albicans Exerts an Immunomodulatory Effect via Regulating Macrophage Function
Wei Teng, Phawinee Subsomwong, Kouji Narita, Akio Nakane, Krisana Asano
Cells.2024; 13(2): 127. CrossRef
Antifungal immunity mediated by C-type lectin receptors may be a novel target in immunotherapy for urothelial bladder cancer
Tianhang Li, Tianyao Liu, Zihan Zhao, Yuchen Pan, Xinyan Xu, Yulin Zhang, Shoubin Zhan, Shengkai Zhou, Wenjie Zhu, Hongqian Guo, Rong Yang
Frontiers in Immunology.2022;[Epub] CrossRef
Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease
Katia Farias e Silva, Hayandra F Nanini, Cynthia Machado Cascabulho, Siane L B Rosas, Patricia T Santana, Antonio José de V Carneiro, Elias Anaissie, Marcio Nucci, Heitor Siffert Pereira de Souza
World Journal of Gastroenterology.2021; 27(9): 866. CrossRef
Effects of Medicinal Fungi-Derived β-Glucan on Tumor Progression
Vaclav Vetvicka, Tamara V. Teplyakova, Alexandra B. Shintyapina, Tatiana A. Korolenko
Journal of Fungi.2021; 7(4): 250. CrossRef
The Role of IL-17-Producing Cells in Cutaneous Fungal Infections
Yu Sawada, Ayako Setoyama, Yumiko Sakuragi, Natsuko Saito-Sasaki, Haruna Yoshioka, Motonobu Nakamura
International Journal of Molecular Sciences.2021; 22(11): 5794. CrossRef

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IBD

Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease: Sakiko Hiraoka, Shiho Takashima, Yoshitaka Kondo, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Jun Kato, Hiroyuki Okada; Intest Res 2018;16(1):75-82. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.75

Abstract PDF PubReader ePub

Background/Aims

The efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn's disease (CD) in patients who were treated with these agents prior to surgery is largely unknown.

Methods

CD patients who underwent intestinal resection and received anti-TNFα agents after surgery were divided into 2 groups according to the presence or absence of preoperative anti-TNFα treatment: anti-TNFα restart group or anti-TNFα naïve group. Endoscopic recurrence after surgery was examined according to the preoperative conditions, including administration of anti-TNFα agents before surgery.

Results

Thirty-six patients received anti-TNFα antibody after surgery: 22 in the anti-TNFα restart group and 14 in the anti-TNFα naïve group. Endoscopic recurrence after surgery was more frequently observed in the anti-TNFα restart group than in the anti-TNFα naïve group (68% vs. 14%, P<0.001). Multivariate analysis revealed the following significant risk factors of endoscopic recurrence after surgery: anti-TNF restart group (odds ratio [OR], 28.10; 95% CI, 3.08–722.00), age at diagnosis <23 years (OR, 24.30; 95% CI, 1.67–1,312.00), serum albumin concentration at surgery <3.3 g/dL (OR, 34.10; 95% CI, 1.72–2,804.00), and presence of inflammation outside of the surgical site (OR, 21.40; 95% CI, 1.02–2,150.00). Treatment intensification for patients with endoscopic recurrence in the anti-TNFα restart group showed limited responses, with only 1 of 12 patients achieving endoscopic remission.

Conclusions

The efficacy of restarting anti-TNFα antibody treatment after surgery was limited, and treatment intensification or a change to different classes of biologics should be considered for those patients.

Citations

Citations to this article as recorded by

Efficacy of Consistency Versus Switching of Biologics for Prevention of Postoperative Recurrence in Crohn’s Disease: A Multicenter Real-World Retrospective Study
Chunjie Zhang, Juan Wu, Zhaoxiu Liu, Leilei Luo, Wen Tang, Jing Sun, Fenfen Wang, Yan Chen, Yanjun Chen, Wei Han, Meijiao Lu, Zhaolian Bian, Cuihua Lu, Naizhong Hu, Lanxiang Zhu, Xiujun Liao, Yi Li
Inflammatory Bowel Diseases.2026; 32(5): 841. CrossRef
Influence of preoperative anti TNF alpha antibody therapy on postoperative recurrence of Crohn’s disease
Yuki Sekido, Takayuki Ogino, Takashi Takeda, Mitsunobu Takeda, Tsuyoshi Hata, Atsushi Hamabe, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Yuichiro Doki, Hidetoshi Eguchi, Tsunekazu Mizushima
Scientific Reports.2025;[Epub] CrossRef
Common Mistakes in Managing Patients with Inflammatory Bowel Disease
Javier P. Gisbert, María Chaparro
Journal of Clinical Medicine.2024; 13(16): 4795. CrossRef
Anti-TNF Agents and New Biological Agents (Vedolizumab and Ustekinumab) in the Prevention and Treatment of Postoperative Recurrence After Surgery in Crohn’s Disease
Javier P. Gisbert, María Chaparro
Drugs.2023; 83(13): 1179. CrossRef
Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease
Marco Valvano, Annalisa Capannolo, Nicola Cesaro, Gianpiero Stefanelli, Stefano Fabiani, Sara Frassino, Sabrina Monaco, Marco Magistroni, Angelo Viscido, Giovanni Latella
Nutrients.2023; 15(17): 3824. CrossRef
Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events
Mitchell R. K. L. Lie, Emma Paulides, C. Janneke van der Woude
International Journal of Colorectal Disease.2020; 35(8): 1489. CrossRef
Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results From the ENEIDA Registry
Fiorella Cañete, Míriam Mañosa, María José Casanova, Ramiro C González-Sueyro, Jesús Barrio, Fernando Bermejo, Pilar Nos, Eva Iglesias-Flores, Esther García-Planella, José Lázaro Pérez-Calle, Raquel Vicente, Maribel Vera, Laura Ramos, Montserrat Rivero, R
Inflammatory Bowel Diseases.2019; 25(11): 1862. CrossRef
Maneuvering Clinical Pathways for Crohn’s Disease
Thomas X. Lu, Russell D. Cohen
Current Gastroenterology Reports.2019;[Epub] CrossRef
Author's Reply
Sakiko Hiraoka, Jun Kato, Hiroyuki Okada
Intestinal Research.2018; 16(2): 321. CrossRef
The old versus the new: which do you keep in postoperative Crohn's disease?
Paulo Gustavo Kotze, Christopher Ma, Miguel Regueiro, Remo Panaccione
Intestinal Research.2018; 16(2): 319. CrossRef

7,393 View
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IBD

Comparison of time until elective intestinal resection regarding previous anti-tumor necrosis factor exposure: a Brazilian study on patients with Crohn's disease: Paulo Gustavo Kotze, Daniela Oliveira Magro, Barbara Saab, Mansur Paulo Saab, Lilian Vital Pinheiro, Marcia Olandoski, Maria de Lourdes Setsuko Ayrizono, Carlos Augusto Real Martinez, Claudio Saddy Rodrigues Coy; Intest Res 2018;16(1):62-68. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.62

Abstract PDF PubReader ePub

Background/Aims

The use of anti-tumor necrosis factor (anti-TNF) agents seems to reduce surgical rates and delay surgical procedures in prospective trials and population-based studies in the management of Crohn's disease (CD). This study aimed to identify whether preoperative anti-TNF agents influence the time from diagnosis to surgery.

Methods

An observational retrospective cohort study was conducted on patients with CD submitted to intestinal resections due to complications or medical therapy failure in a period of 7 years. The patients were allocated into 2 groups according to their previous exposure to anti-TNF agents in the preoperative period. Epidemiological aspects regarding age at diagnosis, smoking, perianal disease, and preoperative conventional therapy were considered. A Kaplan-Meier survival analysis was used to outline possible differences between the groups regarding the time to surgery.

Results

A total of 123 patients were included (71 and 52 with and without previous exposure to biologics, respectively). The overall time to surgery was 108±6.9 months (maximum, 276 months). The survival estimation revealed no difference in the mean time to intestinal resection between the groups (99.78±10.62 months in the patients without and 114.01±9.07 months in those with previous anti-TNF use) (log-rank P=0.35). There was no significant difference in the time to surgery regarding perianal CD (P=0.49), smoking (P=0.63), preoperative azathioprine (P=0.073) and steroid use (P=0.58).

Conclusions

The time from diagnosis to surgery was not influenced by the preoperative use of anti-TNF therapy in this cohort of patients.

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Challenges in the diagnosis and treatment of inflammatory bowel disease in Latin America
Domingo Balderramo, Abel Botelho Quaresma, Pablo A Olivera, Mariane Christina Savio, Maria Paz Gimenez Villamil, Remo Panaccione, Siew C Ng, Gilaad G Kaplan, Paulo Gustavo Kotze
The Lancet Gastroenterology & Hepatology.2024; 9(3): 263. 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
Establishing a rabbit model of perianal fistulizing Crohn’s disease
Shuang-Shuang Lu, Wen-Jia Liu, Qiu-Ya Niu, Chun-Yan Huo, Yu-Qing Cheng, En-Jing Wang, Rong-Nan Li, Fang-Fang Feng, Yi-Ming Cheng, Rong Liu, Jin Huang
World Journal of Gastroenterology.2022; 28(15): 1536. CrossRef
Modern surgical strategies for perianal Crohn's disease
Gilmara Pandolfo Zabot, Ornella Cassol, Rogerio Saad-Hossne, Willem Bemelman
World Journal of Gastroenterology.2020; 26(42): 6572. CrossRef
Increased prevalence of anti‐TNF therapy in paediatric inflammatory bowel disease is associated with a decline in surgical resections during childhood
James J. Ashton, Florina Borca, Enrico Mossotto, Tracy Coelho, Akshay Batra, Nadeem A. Afzal, Hang T. T. Phan, Michael Stanton, Sarah Ennis, Robert Mark Beattie
Alimentary Pharmacology & Therapeutics.2019; 49(4): 398. CrossRef
Early Initiation of Anti-TNF is Associated with Favourable Long-term Outcome in Crohn’s Disease: 10-Year-Follow-up Data from the Swiss IBD Cohort Study
Roy Frei, Nicolas Fournier, Jonas Zeitz, Michael Scharl, Bernhard Morell, Thomas Greuter, Philipp Schreiner, Benjamin Misselwitz, Ekaterina Safroneeva, Alain M Schoepfer, Stephan R Vavricka, Gerhard Rogler, Luc Biedermann
Journal of Crohn's and Colitis.2019; 13(10): 1292. CrossRef
Are Surgical Rates Decreasing in the Biological Era In IBD?
Francesca Di Candido, Gionata Fiorino, Marco Spadaccini, Silvio Danese, Antonino Spinelli
Current Drug Targets.2019; 20(13): 1356. CrossRef

7,361 View
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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 1: risk assessment: 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 PDF PubReader ePub

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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Kyuwon Kim, Kyung-Wook Jo, Tae Sun Shim, Jin Hwa Park, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Frontiers in Medicine.2021;[Epub] CrossRef
Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab
Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang
Yeungnam University Journal of Medicine.2021; 38(3): 251. CrossRef
Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study
Haruhiko Ogata, Takashi Hagiwara, Takeshi Kawaberi, Mariko Kobayashi, Toshifumi Hibi
Intestinal Research.2021; 19(4): 419. CrossRef
Targeted versus universal tuberculosis chemoprophylaxis in 1968 patients with inflammatory bowel disease receiving anti‐TNF therapy in a tuberculosis endemic region
Lingna Ye, Thomas P. Chapman, Zhenzhen Wen, Lang Lin, Yun Qiu, Zhanju Liu, Zhihua Ran, Jiaming Qian, Kaichun Wu, Xiang Gao, Pinjin Hu, Minhu Chen, Simon P. L. Travis, Qian Cao
Alimentary Pharmacology & Therapeutics.2021; 53(3): 390. CrossRef
Biologics for the Management of Inflammatory Bowel Disease: A Review in Tuberculosis-Endemic Countries
Rupa Banerjee, Raja Affendi Raja Ali, Shu Chen Wei, Shashi Adsul
Gut and Liver.2020; 14(6): 685. CrossRef
Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
Hosim Soh, Jaeyoung Chun, Kyungdo Han, Seona Park, Gukhwan Choi, Jihye Kim, Jooyoung Lee, Jong Pil Im, Joo Sung Kim
Gut and Liver.2019; 13(3): 333. CrossRef
Screening for latent tuberculosis in patients with inflammatory bowel disease under antitumor necrosis factor: data from a Portuguese center
Mafalda Sousa, Inês Ladeira, Ana Ponte, Carlos Fernandes, Adélia Rodrigues, Ana P. Silva, João Silva, Catarina Gomes, Edgar Afeto, João Carvalho
European Journal of Gastroenterology & Hepatology.2019; 31(9): 1099. CrossRef
The Use of Biologics and Biosimilar in Asian patients with IBD: Are we ready?
Joyce WY Mak, Joseph JY Sung
Journal of Gastroenterology and Hepatology.2019; 34(8): 1269. CrossRef
Comparison of outcomes of continuation/discontinuation of 5-aminosalicylic acid after initiation of anti-tumor necrosis factor-alpha therapy in patients with inflammatory bowel disease
Youn I Choi, Tae Jun Kim, Dong Kyun Park, Jun-won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim
International Journal of Colorectal Disease.2019; 34(10): 1713. CrossRef
Multidrug-resistant Disseminated Tuberculosis Related to Infliximab in a Patient with Ulcerative Colitis and Negative Evaluation for Latent Tuberculosis
Yu Kyung Jun, Jaeyoung Chun, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
The Korean Journal of Gastroenterology.2019; 74(3): 168. CrossRef
Evidence-based consensus on opportunistic infections in inflammatory bowel disease (republication)

Intestinal Research.2018; 16(2): 178. CrossRef
High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India
Ashish Agarwal, Saurabh Kedia, Saransh Jain, Vipin Gupta, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Venigalla Pratap Mouli, Rajan Dhingra, Govind Makharia, Vineet Ahuja
Intestinal Research.2018; 16(4): 588. CrossRef
Risk of infection associated with anti-TNF-α therapy
Mario Fernández-Ruiz, José María Aguado
Expert Review of Anti-infective Therapy.2018; 16(12): 939. CrossRef

14,668 View
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34 Crossref

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 PDF PubReader ePub

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.

Citations

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Beyond the Flare: A Case of Disseminated Tuberculosis and Thrombosis Masquerading as IBD Exacerbation
Germán Ramírez-Olivencia, Celia Caravaca, Marta Sanz Alba, Álvaro de la Serna Gamboa, Ignacio Díaz Villalonga
Clinical Journal of Gastroenterology.2026;[Epub] CrossRef
Adverse Events in Patients with Inflammatory Bowel Disease Treated with Advanced Therapies: A Nationwide, Population-Based, Propensity-Matched Cohort Study
Hyoung Il Choi, Jung Rock Moon, Seon Hwa Lee, Jae Myung Cha
Journal of Clinical Medicine.2026; 15(7): 2562. CrossRef
Risk of Tuberculosis and Hepatitis B Reactivation in Patients With Crohn’s Disease on Ustekinumab: A Nationwide Real-World Study
Rongbei Liu, Zhilun Li, Lingna Ye, Jing Hu, Jian Tang, Baili Chen, Xiuli Chen, Bei Tan, Yubei Gu, Chen Xie, Chunhui Ouyang, Xiaomei Song, Fan Li, Yanyun Fan, Haixia Ren, Liangru Zhu, Min Chen, Wenyu Jiang, Qian Cao
Inflammatory Bowel Diseases.2024; 30(1): 45. CrossRef
Reduced gut microbiota diversity in ulcerative colitis patients with latent tuberculosis infection during vedolizumab therapy: insights on prophylactic anti-tuberculosis effects
Yibing Hu, Zhenping Wu, Xiaoyun Yang, Jin Ding, Qunying Wang, Hao Fang, Lujian Zhu, Minli Hu
BMC Microbiology.2024;[Epub] 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
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
Miliary Tuberculosis in a Patient With Ulcerative Colitis Treated With Tofacitinib
Shruti Verma, Arshdeep Singh, Chandan Kakkar, Ashish Tripathi, Vandana Midha, Ajit Sood
ACG Case Reports Journal.2023; 10(6): e01066. CrossRef
IBD barriers across the continents – East Asia
Joyce Wing Yan Mak, Agnes Hiu Yan Ho, Siew Chien Ng
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Development of Spinal Tuberculosis in an Adolescent With Crohn's Disease After Infliximab Therapy: A Case Report With Literature Review
Jae Hoon Jung, Sujin Choi, Youra Kang, Dae-Chul Cho, So Mi Lee, Tae In Park, Byung-Ho Choe, Dongsub Kim, Ben Kang
Frontiers in Pediatrics.2022;[Epub] CrossRef
A case of paradoxical response during anti-tuberculosis treatment in a patient with ulcerative colitis
Shuhei Hosomi, Naoko Sugita, Atsushi Kanamori, Masaki Ominami, Koji Otani, Noriko Kamata, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Yasuhiro Fujiwara
Clinical Journal of Gastroenterology.2022; 15(3): 592. CrossRef
Prophylactic Antitubercular Therapy Is Associated With Accelerated Disease Progression in Patients With Crohn's Disease Receiving Anti-TNF Therapy: A Retrospective Multicenter Study
Fen Liu, Jian Tang, Lingna Ye, Jinyu Tan, Yun Qiu, Fan Hu, Jinshen He, Baili Chen, Yao He, Zhirong Zeng, Ren Mao, Qian Cao, Xiang Gao, Minhu Chen
Clinical and Translational Gastroenterology.2022; 13(6): e00493. CrossRef
Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab
Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang
Yeungnam University Journal of Medicine.2021; 38(3): 251. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef
Anti-tumor Necrosis Factor Agents and Tuberculosis in Inflammatory Bowel Disease
Yunho Jung
The Korean Journal of Gastroenterology.2020; 75(1): 1. CrossRef
Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy
Jihye Kim, Jong Pil Im, Jae-Joon Yim, Chang Kyun Lee, Dong Il Park, Chang Soo Eun, Sung-Ae Jung, Jeong Eun Shin, Kang-Moon Lee, Jae Hee Cheon
The Korean Journal of Gastroenterology.2020; 75(1): 29. CrossRef
Preoperative hypoalbuminemia is an independent risk factor for postoperative complications in Crohn's disease patients with normal BMI: A cohort study
Xiaolong Ge, Huaying Liu, Shasha Tang, Yan Wu, Yipeng Pan, Wei Liu, Weilin Qi, Lingna Ye, Qian Cao, Wei Zhou
International Journal of Surgery.2020; 79: 294. CrossRef
Biologics for the Management of Inflammatory Bowel Disease: A Review in Tuberculosis-Endemic Countries
Rupa Banerjee, Raja Affendi Raja Ali, Shu Chen Wei, Shashi Adsul
Gut and Liver.2020; 14(6): 685. CrossRef
Comparison of outcomes of continuation/discontinuation of 5-aminosalicylic acid after initiation of anti-tumor necrosis factor-alpha therapy in patients with inflammatory bowel disease
Youn I Choi, Tae Jun Kim, Dong Kyun Park, Jun-won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim
International Journal of Colorectal Disease.2019; 34(10): 1713. CrossRef
Translating the gut microbiome: ready for the clinic?
Susan V. Lynch, Siew C. Ng, Fergus Shanahan, Herbert Tilg
Nature Reviews Gastroenterology & Hepatology.2019; 16(11): 656. CrossRef
Multidrug-resistant Disseminated Tuberculosis Related to Infliximab in a Patient with Ulcerative Colitis and Negative Evaluation for Latent Tuberculosis
Yu Kyung Jun, Jaeyoung Chun, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
The Korean Journal of Gastroenterology.2019; 74(3): 168. CrossRef
Evidence-based consensus on opportunistic infections in inflammatory bowel disease (republication)

Intestinal Research.2018; 16(2): 178. CrossRef
A rare case of disseminated histoplasmosis in a patient with Crohn’s disease on immunosuppressive treatment
Bhavesh Bhut, Akshay Kulkarni, Varnika Rai, Vinita Agrawal, Abhai Verma, Manoj Jain, Rungmei S K Marak, Ajai Kumar Dixit, Uday C Ghoshal
Indian Journal of Gastroenterology.2018; 37(5): 472. CrossRef
High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India
Ashish Agarwal, Saurabh Kedia, Saransh Jain, Vipin Gupta, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Venigalla Pratap Mouli, Rajan Dhingra, Govind Makharia, Vineet Ahuja
Intestinal Research.2018; 16(4): 588. CrossRef

11,155 View
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Case Reports

Fatal infections in older patients with inflammatory bowel disease on anti-tumor necrosis factor therapy: Way-Seah Lee, Najib Azmi, Ruey-Terng Ng, Sik-Yong Ong, Sasheela Sri La Ponnampalavanar, Sanjiv Mahadeva, Ida Hilmi; Intest Res 2017;15(4):524-528. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.524

Abstract PDF PubReader ePub

Anti-tumor necrosis factor (anti-TNF) is highly effective in inflammatory bowel disease (IBD); however, it is associated with an increased risk of infections, particularly in older adults. We reviewed 349 patients with IBD, who were observed over a 12-month period, 74 of whom had received anti-TNF therapy (71 patients were aged <60 years and 3 were aged ≥60 years). All the 3 older patients developed serious infectious complications after receiving anti-TNFs, although all of them were also on concomitant immunosuppressive therapy. One patient developed disseminated tuberculosis, another patient developed cholera diarrhea followed by nosocomial pneumonia, while the third patient developed multiple opportunistic infections (Pneumocystis pneumonia, cryptococcal septicemia and meningitis, Klebsiella septicemia). All 3 patients died within 1 year from the onset of the infection(s). We recommend that anti-TNF, especially when combined with other immunosuppressive therapy, should be used with extreme caution in older adult patients with IBD.

Citations

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Infection toxicity assessment of tumor necrosis factor α inhibitors in the treatment of IBD: a real-world study based on the US food and drug administration adverse events reporting system (FAERS)
Qian Cheng, Zeyu Yao, Xuan Shi, Shupeng Zou, Yazheng Zhao, Mengling Ouyang, Minghui Sun
Expert Opinion on Drug Safety.2025; : 1. CrossRef
Elderly-onset inflammatory bowel disease in Asia: clinical characteristics and therapeutic strategies
Jiyoung Yoon, Daein Kim, You Sun Kim
Intestinal Research.2025; 23(4): 430. CrossRef
RATE OF INFECTION (TUBERCULOSIS) IN BRAZILIANS IBD PRIVATE PATIENTS: FOLLOW-UP 15 YEARS
Didia B CURY, Liana C B CURY, Ana C MICHELETTI, Rogério A OLIVEIRA, José J S GONÇALVES
Arquivos de Gastroenterologia.2024;[Epub] CrossRef
Cryptococcosis Associated With Biologic Therapy: A Narrative Review
Xin Li, Olivier Paccoud, Koon-Ho Chan, Kwok-Yung Yuen, Romain Manchon, Fanny Lanternier, Monica A Slavin, Frank L van de Veerdonk, Tihana Bicanic, Olivier Lortholary
Open Forum Infectious Diseases.2024;[Epub] CrossRef
Inflammatory bowel disease complicated with rare pathogen infection
Jia-Heng Fang, Guo-Xiong Li
World Chinese Journal of Digestology.2023; 31(1): 8. CrossRef
Pulmonary cryptococcosis after immunomodulator treatment in patients with Crohn’s disease: Three case reports
Yan-Fei Fang, Xiang-Han Cao, Ling-Ya Yao, Qian Cao
World Journal of Gastroenterology.2023; 29(4): 758. CrossRef
Systemic lupus erythematosus complicated by Crohn’s disease with rectovaginal fistula
Heng Yeh, Ren-Chin Wu, Wen-Sy Tsai, Chia-Jung Kuo, Ming-Yao Su, Cheng-Tang Chiu, Puo-Hsien Le
BMC Gastroenterology.2021;[Epub] CrossRef
Systematic review with meta‐analysis: biologics and risk of infection or cancer in elderly patients with inflammatory bowel disease
Daniele Piovani, Silvio Danese, Laurent Peyrin‐Biroulet, Georgios K. Nikolopoulos, Stefanos Bonovas
Alimentary Pharmacology & Therapeutics.2020; 51(9): 820. CrossRef
Safety of Biologic Therapy in Older Patients With Immune-Mediated Diseases: A Systematic Review and Meta-analysis
Nienke Z. Borren, Ashwin N. Ananthakrishnan
Clinical Gastroenterology and Hepatology.2019; 17(9): 1736. CrossRef
Improving Quality in the Care of Patients with Inflammatory Bowel Diseases
Matthew D Egberg, Ajay S Gulati, Ziad F Gellad, Gil Y Melmed, Michael D Kappelman
Inflammatory Bowel Diseases.2018; 24(8): 1660. CrossRef

8,281 View
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8 Web of Science
10 Crossref

Crohn's disease and smoldering multiple myeloma: a case report and literature review: So Young Park, Jae Min Kim, Hyun Joon Kang, Minje Kim, Jae Joon Han, Chi Hoon Maeng, Sun Kyung Baek, Hwi-Joong Yoon, Si-Young Kim, Hyo Jong Kim; Intest Res 2017;15(2):249-254. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.249

Abstract PDF PubReader ePub

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that presents with abdominal pain, weight loss, and diarrhea. Although the etiology has not been fully elucidated, both environmental and genetic causes are known to be involved. In chronic inflammatory conditions such as IBD, B lymphocytes are chronically stimulated, and they induce monoclonal expansion of plasma cells, sometimes resulting in monoclonal gammopathy of undetermined significance. Immunomodulators that are commonly used to control inflammation, such as tumor necrosis factor-α (TNF-α) blockers could increase the possibility of hematologic malignancy. The pathogenesis of multiple myeloma in association with TNF-α inhibitor therapy is attributed to decreased apoptosis of plasma cell populations. Here, we describe a case of a 36-year-old male patient who was diagnosed with immunoglobulin A subtype smoldering multiple myeloma during the treatment for CD with infliximab and adalimumab. We report this case along with a review of the literature on cases of multiple myeloma that occurred in conjunction with CD.

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Associations Between Immune-Related Conditions and Lymphoid Disorders: An Analysis of the Diverse All of Us Research Program
Hanna Terhaar, Mohammad Saleem, Evan Liu, Nabiha Yusuf
Lymphatics.2025; 3(1): 3. CrossRef
Tissue-resident macrophages promote early dissemination of multiple myeloma via IL-6 and TNFα
Ilseyar Akhmetzyanova, Tonya Aaron, Phillip Galbo, Anastasia Tikhonova, Igor Dolgalev, Masato Tanaka, Iannis Aifantis, Deyou Zheng, Xingxing Zang, David Fooksman
Blood Advances.2021; 5(18): 3592. CrossRef
Clinical Characteristics of 18 Patients with Psoriasis and Multiple Myeloma Identified Through Digital Health Crowdsourcing
Joy Q. Jin, Jenny M. Ahlstrom, Nathan W. Sweeney, Wilson Liao
Dermatology and Therapy.2020; 10(4): 815. CrossRef
CROHN'S DISEASE AND MULTIPLE MYELOMA: A CLINICAL CASE AND LITERATURE REVIEW
O. V. Taratina, P. A. Makarchuk, L. L. Vysotskaya
Koloproktologia.2019; 18(3(69)): 84. CrossRef

10,085 View
69 Download
2 Web of Science
4 Crossref

Review

Preoperative use of anti-tumor necrosis factor therapy in Crohn's disease: promises and pitfalls: Paulo Gustavo Kotze, Subrata Ghosh, Willem A. Bemelman, Remo Panaccione; Intest Res 2017;15(2):160-165. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.160

Abstract PDF PubReader ePub

Recent advances in medical and surgical therapy were achieved during the last two decades in the management of Crohn's disease (CD). Anti-tumor necrosis factor (anti-TNF) agents are widely used worldwide. However, a significant proportion of patients still need surgical resections. The impact of previous exposure to these agents on the perioperative and postoperative outcomes is still controversial. In this critical review, we aimed to position the strategy of intentional preoperative use of anti-TNF agents in the management of CD. The indications and contraindications for this strategy are detailed, and despite scarce evidence, the possible advantages and disadvantages of the intentional use of anti-TNF agents before abdominal surgery in CD are discussed.

Citations

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From resection to preservation: redefining the surgical paradigm in Crohn’s disease
Giulia Migliorisi, Raphaëlle Delaplace, Sailish Honap, Adeline Germain, Thomas Mouillot, Laurent Peyrin-Biroulet, Paulo G Kotze
Journal of Crohn’s and Colitis.2026;[Epub] CrossRef
Clinical guidelines. Crohn’s disease (К50), adults
Yury A. Shelygin, Vladimir T. Ivashkin, Sergey I. Achkasov, Igor V. Reshetov, Igor V. Maev, Elena A. Belousova, Armen V. Vardanyan, Bella A. Nanaeva, Leila V. Adamyan, Oksana M. Drapkina, Leila S. Namazova-Baranova, Aleksandr Yu. Razumovsky, Amiran Sh. Re
Koloproktologia.2023; 22(3): 10. CrossRef
Surgical Management of Small Bowel Crohn's Disease
Pramodh Chandrasinghe
Frontiers in Surgery.2022;[Epub] CrossRef
Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
Abel Botelho Quaresma, Fernanda da Silva Barbosa Baraúna, Fábio Vieira Teixeira, Rogério Saad-Hossne, Paulo Gustavo Kotze
Journal of Clinical Medicine.2021; 10(4): 710. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Crohn’s Disease
Amy L. Lightner, Jon D. Vogel, Joseph C. Carmichael, Deborah S. Keller, Samir A. Shah, Uma Mahadevan, Sunanda V. Kane, Ian M. Paquette, Scott R. Steele, • Daniel L. Feingold
Diseases of the Colon & Rectum.2020; 63(8): 1028. CrossRef
Enterocutaneous fistula in severely active Crohn’s disease: preoperative anti-TNF alpha treatment to limit bowel resection—report of a case
Peter Wilhelm, Andreas Kirschniak, Jonas Johannink, Sascha Kaufmann, Thomas Klag, Jan Wehkamp, Claudius Falch
International Journal of Colorectal Disease.2019; 34(2): 369. CrossRef
Management of Biological Therapy Before Elective Inflammatory Bowel Disease Surgeries
Tawnya M Hansen, Laura E Targownik, Ahmer Karimuddin, Yvette Leung
Inflammatory Bowel Diseases.2019; 25(10): 1613. CrossRef
Gestion périopératoire des biothérapies en 2019
Thibault Martinez, Jean Derely, Astrée Swiech, Gaël de Roquigny, Charlotte Delattre, Frederic Banal, Mehdi Ould-Ahmed, Diane Commandeur
Anesthésie & Réanimation.2019; 5(4): 274. CrossRef
Biological Treatment and the Potential Risk of Adverse Postoperative Outcome in Patients With Inflammatory Bowel Disease: An Open-Source Expert Panel Review of the Current Literature and Future Perspectives
Alaa El-Hussuna, Pär Myrelid, Stefan D Holubar, Paulo G Kotze, Graham Mackenzie, Gianluca Pellino, Des Winter, Justin Davies, Ionut Negoi, Perbinder Grewal, Gaetano Gallo, Kapil Sahnan, Ines Rubio-Perez, Daniel Clerc, Nicolas Demartines, James Glasbey, Mi
Crohn's & Colitis 360.2019;[Epub] CrossRef
Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
Paulo Gustavo Kotze, Christopher Ma, Nicholas Mckenna, Abdulelah Almutairdi, Gilaad G. Kaplan, Laura E. Raffals, Edward V. Loftus, Remo Panaccione, Amy L. Lightner
Therapeutic Advances in Gastroenterology.2018;[Epub] CrossRef
Emerging Therapies: What Are Promising in the Near Future?
Geom Seog Seo, Sung Hee Lee
The Korean Journal of Gastroenterology.2018; 71(2): 81. CrossRef
Perioperative Care of Patients with Inflammatory Bowel Disease: Focus on Nutritional Support
Patrick L. Stoner, Amir Kamel, Fares Ayoub, Sanda Tan, Atif Iqbal, Sarah C. Glover, Ellen M. Zimmermann
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef

7,778 View
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12 Crossref

Case Report

Rectal tuberculosis after infliximab therapy despite negative screening for latent tuberculosis in a patient with ulcerative colitis: Jatinderpal Singh, Amarender S Puri, Sanjeev Sachdeva, Puja Sakhuja, Kulandaivelu Arivarasan; Intest Res 2016;14(2):183-186. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.183

Abstract PDF PubReader ePub

Tumor necrosis factor-α inhibitors are now considered as standard therapy for patients with severe inflammatory bowel disease who do not respond to corticosteroids, but they carry a definite risk of reactivation of tuberculosis. We present a case in which a patient with inflammatory bowel disease developed a de novo tuberculosis infection after the start of anti-tumor necrosis factor-α treatment despite showing negative results in tuberculosis screening. Although there are many case reports of pleural, lymph nodal and disseminated tuberculosis following infliximab therapy, we present the first case report of rectal tuberculosis following infliximab therapy.

Citations

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Rectal tuberculosis: A systematic review
Poras Chaudhary, Ashutosh Nagpal, Sam B. Padala, Mangarai Mukund, Lalit K. Bansal, Romesh Lal
Indian Journal of Tuberculosis.2022; 69(3): 268. CrossRef
A case of paradoxical response during anti-tuberculosis treatment in a patient with ulcerative colitis
Shuhei Hosomi, Naoko Sugita, Atsushi Kanamori, Masaki Ominami, Koji Otani, Noriko Kamata, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Yasuhiro Fujiwara
Clinical Journal of Gastroenterology.2022; 15(3): 592. CrossRef
Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study
Haruhiko Ogata, Takashi Hagiwara, Takeshi Kawaberi, Mariko Kobayashi, Toshifumi Hibi
Intestinal Research.2021; 19(4): 419. CrossRef
Risk of tuberculosis with anti-tumor necrosis factor-alpha therapy in patients with psoriasis and psoriatic arthritis in Indian population
Soumajyoti Sarkar, Saumya Panda, Byungsoo Kim, SmritiK Raychaudhuri, Asutosh Ghosh, SibaP Raychaudhuri
Indian Journal of Dermatology, Venereology and Leprology.2020; 86(1): 1. CrossRef
Tuberculosis rectal: presentación clínica infrecuente y diagnóstico diferencial con enfermedad de Crohn
M. Gompertz, L. Carreño, L.C. Gil La Rotta
Revista de Gastroenterología de México.2019; 84(4): 524. CrossRef
Bacteriologically Determined De Novo Tuberculosis during Tumor Necrosis Factor-α Inhibitor Therapy
Gen Takahashi, Hiroyuki Kobayashi, Yasuyuki Saito, Sho Ohsawa, Kuniaki Suzuki, Shinichi Ishihara, Takeshi Hisada
Internal Medicine.2019; 58(24): 3593. CrossRef
Rectal tuberculosis: An uncommon clinical presentation and differential diagnosis with Crohn's disease
M. Gompertz, L. Carreño, L.C. Gil La Rotta
Revista de Gastroenterología de México (English Edition).2019; 84(4): 524. CrossRef
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 1: risk assessment
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, Yasu
Intestinal Research.2018; 16(1): 4. CrossRef
Asian Organization for Crohn's and Colitis and Asian Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti‐tumor necrosis factor treatment. Part 1: Risk assessment
Dong II 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, Yasu
Journal of Gastroenterology and Hepatology.2018; 33(1): 20. CrossRef

7,016 View
42 Download
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9 Crossref

Original Articles

Adalimumab induction and maintenance therapy achieve clinical remission and response in Chinese patients with Crohn's disease: Kai-Chun Wu, Zhi Hua Ran, Xiang Gao, Minhu Chen, Jie Zhong, Jian-Qiu Sheng, Michael A Kamm, Simon Travis, Kori Wallace, Nael M Mostafa, Marisa Shapiro, Yao Li, Roopal B Thakkar, Anne M Robinson; Intest Res 2016;14(2):152-163. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.152

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

This was a Phase 2 study (NCT02015793) to evaluate the pharmacokinetics, safety, and efficacy of adalimumab in Chinese patients with Crohn's disease (CD).

Methods

Thirty, adult Chinese patients with CD (CD Activity Index [CDAI] 220–450; high-sensitivity [hs]-C-reactive protein [CRP] ≥3 mg/L) received double-blind adalimumab 160/80 mg or 80/40 mg at weeks 0/2, followed by 40 mg at weeks 4 and 6. An open-label extension period occurred from weeks 8–26; patients received 40 mg adalimumab every other week. Serum adalimumab concentration and change from baseline in fecal calprotectin (FC) were measured during the double-blind period. Clinical remission (CDAI <150), response (decrease in CDAI ≥70 points from baseline), and change from baseline in hs-CRP were assessed through week 26. Nonresponder imputation was used for missing categorical data and last observation carried forward for missing hs-CRP/FC values. No formal hypothesis was tested. Adverse events were monitored.

Results

Mean adalimumab serum concentrations during the induction phase were 13.9–18.1 µg/mL (160/80 mg group) and 7.5−9.5 µg/mL (80/40 mg group). During the double-blind period, higher remission/response rates and greater reductions from baseline in hs-CRP and FC were observed with adalimumab 160/80 mg compared to that with 80/40 mg. Adverse event rates were similar among all treatment groups.

Conclusions

Adalimumab serum concentrations in Chinese patients with CD were comparable to those observed previously in Western and Japanese patients. Clinically meaningful remission rates and improvement in inflammatory markers were achieved with both dosing regimens; changes occurred rapidly with adalimumab 160/80 mg induction therapy. No new safety signals were reported.

Citations

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Prospective study of an adalimumab combined with partial enteral nutrition in the induction period of Crohn’s disease
Sisi Zhou, Zeyu Huang, Wenjing Hou, Yiting Lin, Jing Yu
Inflammation Research.2024; 73(2): 199. CrossRef
Efficacy of biological therapies and small molecules in induction and maintenance of remission in luminal Crohn’s disease: systematic review and network meta-analysis
Brigida Barberio, David J Gracie, Christopher J Black, Alexander C Ford
Gut.2023; 72(2): 264. CrossRef
Seronegative spondyloarthropathy-associated inflammatory bowel disease
Chrong-Reen Wang, Hung-Wen Tsai
World Journal of Gastroenterology.2023; 29(3): 450. CrossRef
Early Change in Fecal Calprotectin Predicts One‐Year Outcome in Children Newly Diagnosed With Ulcerative Colitis
Chenthan Krishnakumar, Ashwin N. Ananthakrishnan, Brendan M. Boyle, Anne M. Griffiths, Neal S. LeLeiko, David R. Mack, James F. Markowitz, Joel R. Rosh, Cary G. Sauer, Thomas D. Walters, Erin Bonkowski, Lee A. Denson, Jeffrey S. Hyams, Subra Kugathasan
Journal of Pediatric Gastroenterology and Nutrition.2022; 74(1): 72. CrossRef
Long-Term Safety of Adalimumab in 29,967 Adult Patients From Global Clinical Trials Across Multiple Indications: An Updated Analysis
Gerd R. Burmester, Kenneth B. Gordon, James T. Rosenbaum, Dilek Arikan, Winnie L. Lau, Peigang Li, Freddy Faccin, Remo Panaccione
Advances in Therapy.2020; 37(1): 364. CrossRef
Comparative Evaluation of 4 Commercially Available ELISA Kits for Measuring Adalimumab and Anti-adalimumab Antibodies
Melissa Joyce Sam, Susan Jane Connor, Watson Wa-Sang Ng, Catherine Mei-Ling Toong
Therapeutic Drug Monitoring.2020; 42(6): 821. CrossRef
Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang
Intestinal Research.2018; 16(3): 400. CrossRef
Updated treatment strategies for intestinal Behçet’s disease
Yong Eun Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2018; 33(1): 1. CrossRef
Changing treatment paradigms for the management of inflammatory bowel disease
Jong Pil Im, Byong Duk Ye, You Sun Kim, Joo Sung Kim
The Korean Journal of Internal Medicine.2018; 33(1): 28. CrossRef
Long-Term Outcomes of Adalimumab Treatment in 254 Patients with Crohn’s Disease: A Hospital-Based Cohort Study from Korea
Hyungil Seo, Byong Duk Ye, Eun Mi Song, Sun-Ho Lee, Kiju Chang, Ho-Su Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Digestive Diseases and Sciences.2017; 62(10): 2882. CrossRef
Rare occurrence of inflammatory bowel disease in a cohort of Han Chinese ankylosing spondylitis patients- a single institute study
Chrong-Reen Wang, Chia-Tse Weng, Chung-Ta Lee, Kuo-Yuan Huang, Sheng-Min Hsu, Ming-Fei Liu
Scientific Reports.2017;[Epub] CrossRef

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Pregnancy outcome in women with inflammatory bowel disease treated with anti-tumor necrosis factor and/or thiopurine therapy: a multicenter study from Japan: Shunsuke Komoto, Satoshi Motoya, Yuji Nishiwaki, Toshiyuki Matsui, Reiko Kunisaki, Katsuyoshi Matsuoka, Naoki Yoshimura, Takashi Kagaya, Makoto Naganuma, Nobuyuki Hida, Mamoru Watanabe, Toshifumi Hibi, Yasuo Suzuki, Soichiro Miura, Ryota Hokari; Intest Res 2016;14(2):139-145. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.139

Abstract PDF PubReader ePub

Background/Aims

Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines.

Methods

This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines.

Results

Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037).

Conclusions

Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.

Citations

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Safety of advanced therapies in pregnant women with inflammatory bowel disease: a systematic review and Meta-Analysis
Bernardo de Faria Moraes, Gustavo André Pedral Diniz Leite, Luisa Medeiros Visentini, Gabriel André Pedral Diniz Leite, Igor Boechat Silveira, Valbert Oliveira Costa Filho, Luis Pedro Possapp Beis, Leonardo Corrêa Süffert, Pedro Robson Costa Passos, Guilh
Journal of Crohn's and Colitis.2026;[Epub] CrossRef
Ulcerative Colitis in Pregnancy: A Japanese Multicenter Cohort Study Focusing on Their Mutual Influence
Yuichi Shimodate, Akiko Shiotani, Ken-ichi Tarumi, Hiroshi Matsumoto, Osamu Handa, Noriaki Tomioka, Naoyuki Nishimura, Kazuhiro Matsueda, Hirokazu Mouri, Motowo Mizuno
Internal Medicine.2025; 64(11): 1633. CrossRef
North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations
Raed Alhusayen, Serena Dienes, Megan Lam, Afsaneh Alavi, Ali Alikhan, Maria Aleshin, Emad Bahashwan, Steve Daveluy, Noah Goldfarb, Amit Garg, Wayne Gulliver, Tarannum Jaleel, Alexa B. Kimball, Mark G. Kirchhof, Joslyn Kirby, Joi Lenczowski, Hadar Lev-Tov,
Journal of the American Academy of Dermatology.2025; 92(4): 825. CrossRef
A retrospective study of neonatal and pregnancy outcomes in pregnant women suffering from inflammatory arthropathy treated with adalimumab
Navid Najarpour, Elham Rajaei, Karim Mowla, Alireza Ghanbaran
Revista Colombiana de Reumatología.2024; 31(3): 290. CrossRef
Anti-tumor necrosis factor-α therapy may not be safe during pregnancy in women with inflammatory bowel disease: an updated meta-analysis and systematic review
Wei Huang, Xinxing Zhang, Li Zhang, Xiaosong Dai, Heping Chen, Qin Xie
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
A retrospective study of neonatal and pregnancy outcomes in pregnant women suffering from inflammatory arthropathy treated with adalimumab
Navid Najarpour, Elham Rajaei, Karim Mowla, Alireza Ghanbaran
Revista Colombiana de Reumatología (English Edition).2024; 31(3): 290. CrossRef
The treatment of inflammatory bowel disease with monoclonal antibodies in Asia
Yu Chen, Guolin Zhang, Yuewen Yang, Shuangshuang Zhang, Haozheng Jiang, Kang Tian, Arenbaoligao, Dapeng Chen
Biomedicine & Pharmacotherapy.2023; 157: 114081. CrossRef
Saudi consensus guidance for the management of inflammatory bowel disease during pregnancy
Nahla A. Azzam, Abdulelah Almutairdi, Hajer Y. Almudaiheem, Turki AlAmeel, Shakir A. Bakkari, Othman R. Alharbi, Khalidah A. Alenzi, Maha A. AlMolaiki, Bedor A. Al-Omari, Rayan G. Albarakati, Ahmed H. Al-Jedai, Omar I. Saadah, Majid A. Almadi, Badr Al-Baw
Saudi Journal of Gastroenterology.2023;[Epub] CrossRef
Biologics for Inflammatory Bowel Disease and Their Safety in Pregnancy: A Systematic Review and Meta-analysis
Ole Haagen Nielsen, John Mark Gubatan, Carsten Bogh Juhl, Sarah Elizabeth Streett, Cynthia Maxwell
Clinical Gastroenterology and Hepatology.2022; 20(1): 74. CrossRef
British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids
Mark D Russell, Mrinalini Dey, Julia Flint, Philippa Davie, Alexander Allen, Amy Crossley, Margreta Frishman, Mary Gayed, Kenneth Hodson, Munther Khamashta, Louise Moore, Sonia Panchal, Madeleine Piper, Clare Reid, Katherine Saxby, Karen Schreiber, Naz Se
Rheumatology.2022;[Epub] CrossRef
Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-Analysis
Yang Zhang, Dandan Li, Heng Guo, Weina Wang, Xingang Li, Su Shen
Current Pharmaceutical Design.2021; 27(19): 2317. CrossRef
Exposure to Infliximab During Pregnancy: Post-Marketing Experience
Anja Geldhof, Jennifer Slater, Michael Clark, Urmila Chandran, Danielle Coppola
Drug Safety.2020; 43(2): 147. CrossRef
The use of biological disease-modifying antirheumatic drugs for inflammatory arthritis in Korea: results of a Korean Expert Consensus
Eun-Jung Park, Hyungjin Kim, Seung Min Jung, Yoon-Kyoung Sung, Han Joo Baek, Jisoo Lee
The Korean Journal of Internal Medicine.2020; 35(1): 41. CrossRef
The Use of Biological Disease-modifying Antirheumatic Drugs for Inflammatory Arthritis in Korea: Results of a Korean Expert Consensus
Eun-Jung Park, Hyungjin Kim, Seung Min Jung, Yoon-Kyoung Sung, Han Joo Baek, Jisoo Lee
Journal of Rheumatic Diseases.2020; 27(1): 4. CrossRef
Maternal and neonatal outcomes associated with biologic exposure before and during pregnancy in women with inflammatory systemic diseases: a systematic review and meta-analysis of observational studies
Nicole W Tsao, Nevena Rebic, Larry D Lynd, Mary A De Vera
Rheumatology.2020; 59(8): 1808. CrossRef
Intrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic Review
N. Ghalandari, R. J. E. M. Dolhain, J. M. W. Hazes, E. P. van Puijenbroek, M. Kapur, H. J. M. J. Crijns
Drugs.2020; 80(16): 1699. CrossRef
Pregnancy and Neuromyelitis Optica Spectrum Disorder – Reciprocal Effects and Practical Recommendations: A Systematic Review
Rohan D'Souza, Danielle Wuebbolt, Katarina Andrejevic, Rizwana Ashraf, Vanessa Nguyen, Nusrat Zaffar, Dalia Rotstein, Ahraaz Wyne
Frontiers in Neurology.2020;[Epub] CrossRef
Relationship between the Clinical Course of Ulcerative Colitis during Pregnancy and the Outcomes of Pregnancy: A Retrospective Evaluation
Ayumi Ito, Bunei Iizuka, Teppei Omori, Shinichi Nakamura, Katsutoshi Tokushige
Internal Medicine.2018; 57(2): 159. CrossRef
The use of biologics and small molecules in pregnant patients with rheumatic diseases
Maria Gerosa, Lorenza Maria Argolini, Carolina Artusi, Cecilia Beatrice Chighizola
Expert Review of Clinical Pharmacology.2018; 11(10): 987. CrossRef
Long-term clinical outcome after infliximab discontinuation in patients with inflammatory bowel disease
Ji Min Lee, Yoon Jae Kim, Kang-Moon Lee, Hyuk Yoon, Bo-In Lee, Dae Bum Kim, Donghoon Kang
Scandinavian Journal of Gastroenterology.2018; 53(10-11): 1280. CrossRef
Impact of inflammatory bowel disease activity and thiopurine therapy on birth weight: A meta-analysis
Begoña Gonzalez-Suarez, Shreyashee Sengupta, Alan C Moss
World Journal of Gastroenterology.2017; 23(45): 8082. CrossRef
Maternal and fetal outcomes in pregnant Japanese women with inflammatory bowel disease: our experience with a series of 23 cases
Naoki Minami, Minoru Matsuura, Yorimitsu Koshikawa, Satoshi Yamada, Yusuke Honzawa, Shuji Yamamoto, Hiroshi Nakase
Intestinal Research.2017; 15(1): 90. CrossRef
Concerns in pregnancy and childbirth of women with inflammatory bowel disease
Sung-Ae Jung
Intestinal Research.2016; 14(2): 107. CrossRef
Common Adverse Effects of Anti-TNF Agents on Gestation
Zacharias Fasoulakis, Panagiotis Antsaklis, Nikolaos Galanopoulos, Emmanuel Kontomanolis
Obstetrics and Gynecology International.2016; 2016: 1. CrossRef

9,059 View
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24 Crossref

Conventional Versus Biological Therapy for Prevention of Postoperative Endoscopic Recurrence in Patients With Crohn's Disease: an International, Multicenter, and Observational Study: Paulo Gustavo Kotze, Antonino Spinelli, Rodolff Nunes da Silva, Ivan Folchini de Barcelos, Fábio Vieira Teixeira, Rogério Saad-Hossne, Idblan Carvalho de Albuquerque, Marcia Olandoski, Lorete Maria da Silva Kotze, Yasuo Suzuki, Akihiro Yamada, Ken Takeuchi, Matteo Sacchi, Takayuki Yamamoto; Intest Res 2015;13(3):259-265. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.259

Abstract PDF PubReader

Background/Aims

Postoperative endoscopic recurrence (PER) occurs in nearly 80% of patients 1 year after ileocecal resection in patients with Crohn's disease (CD). Biological agents were more effective in reducing the rates of PER in comparison with conventional therapy, in prospective trials. The aim of this study was to compare the PER rates of biological versus conventional therapy after ileocecal resections in patients with CD in real-world practice.

Methods

The MULTIPER (Multicenter International Postoperative Endoscopic Recurrence) database is a retrospective analysis of PER rates in CD patients after ileocecal resection, from 7 referral centers in 3 different countries. All consecutive patients who underwent ileocecal resections between 2008 and 2012 and in whom colonoscopies had been performed up to 12 months after surgery, were included. Recurrence was defined as Rutgeerts' score ≥i2. The patients were allocated to either biological or conventional therapy after surgery, and PER rates were compared between the groups.

Results

Initially, 231 patients were evaluated, and 63 were excluded. Of the 168 patients in the database, 96 received anti-tumor necrosis factor agents and 72 were treated with conventional therapy after resection. The groups were comparable regarding age, gender, and perianal disease. There was longer disease duration, more previous resections, and more open surgical procedures in patients on biologicals postoperatively. PER was identified in 25/96 (26%) patients on biological therapy and in 24/72 (33.3%) patients on conventional therapy (P=0.310).

Conclusions

In this retrospective observational analysis from an international database, no difference was observed between biological and conventional therapy in preventing PER after ileocecal resections in CD patients.

Citations

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Are the New Biologics Effective in the Management of Postoperative Crohn’s Disease?
Fadi H Mourad, Rami G Maalouf, Roni Aoun, Paulo Gustavo Kotze, Jana G Hashash
Inflammatory Bowel Diseases.2024; 30(3): 459. CrossRef
How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis
Eline M. L. van der Does de Willebois, Vittoria Bellato, Marjolijn Duijvestein, Susan van Dieren, Silvio Danese, Pierpaolo Sileri, Christianne J. Buskens, Andrea Vignali, Willem A. Bemelman
Annals of Surgery Open.2024; 5(1): e397. CrossRef
Trends in Surgical Recurrence Among Pediatric Crohn’s Disease Patients Using Administrative Claims Data
Matthew D Egberg, Xian Zhang, Michael Phillips, Michael D Kappelman
Crohn's & Colitis 360.2023;[Epub] CrossRef
Optimal strategies to prevent recrudescent Crohn's disease after resection
Natália Sousa Freitas Queiroz, Takayuki Yamamoto, Paulo Gustavo Kotze
Seminars in Colon and Rectal Surgery.2020; 31(2): 100746. CrossRef
Profile of Consecutive Fecal Calprotectin Levels in the Perioperative Period and Its Predictive Capacity for Early Endoscopic Recurrence in Crohn’s Disease
Ruiqing Liu, Zhen Guo, Lei Cao, Zhiming Wang, Jianfeng Gong, Yi Li, Weiming Zhu
Diseases of the Colon & Rectum.2019; 62(3): 318. CrossRef
Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease
Sakiko Hiraoka, Shiho Takashima, Yoshitaka Kondo, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Jun Kato, Hiroyuki Okada
Intestinal Research.2018; 16(1): 75. CrossRef
Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study
I. F. de Barcelos, P. G. Kotze, A. Spinelli, Y. Suzuki, F. V. Teixeira, I. C. de Albuquerque, R. Saad‐Hossne, L. M. da Silva Kotze, T. Yamamoto
Colorectal Disease.2017;[Epub] CrossRef
Disease Phenotype, Activity and Clinical Course Prediction Based on C-Reactive Protein Levels at Diagnosis in Patients with Crohn’s Disease: Results from the CONNECT Study
Jee Hye Kwon, Jong Pil Im, Byong Duk Ye, Jae Hee Cheon, Hyun Joo Jang, Kang Moon Lee, You Sun Kim, Sang Wook Kim, Young Ho Kim, Geun Am Song, Dong Soo Han, Won Ho Kim, Joo Sung Kim
Gut and Liver.2016; 10(4): 595. CrossRef

7,897 View
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8 Crossref

Reviews

Diagnosis and Treatment of Ulcerative Colitis with Cytomegalovirus Infection: Importance of Controlling Mucosal Inflammation to Prevent Cytomegalovirus Reactivation: Hiroshi Nakase, Yusuke Honzawa, Takahiko Toyonaga, Satoshi Yamada, Naoki Minami, Takuya Yoshino, Minoru Matsuura; Intest Res 2014;12(1):5-11. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.5

Abstract PDF PubReader

Human cytomegalovirus (HCMV) is a member of the herpesvirus family. HCMV infection persists throughout the host lifespan in a latent state following primary infection. The ability of HCMV to escape control by the host immune system and its resulting reactivation suggests the importance of ongoing immune surveillance in the prevention of HCMV reactivation. HCMV is a common cause of opportunistic infection that causes severe and fatal disease in immune-compromised individuals. In inflammatory bowel disease patients, particularly those with ulcerative colitis (UC), HCMV is often reactivated because these patients are frequently treated with immunosuppressive agents. This reactivation exacerbates colitis. Additionally, HCMV infection can induce severe colitis, even in patients with UC who have never been treated with immunosuppressive agents. However, the role of HCMV in colonic inflammation in patients with UC remains unclear. Here, we present previous and current clinical data on the diagnosis and treatment of HCMV infection in UC. Additionally, our experimental data from a newly established mouse model mimicking UC with concomitant CMV infection clearly demonstrate that inflammation could result in the exacerbation of UC disease activity with induction of HCMV reactivation. In summary, optimal control of colonic inflammation should be achieved in UC patients who are refractory to conventional immunosuppressive therapies and are positive for HCMV.

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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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