Abstract:
BACKGROUND:The impact of thiopurine (TP) use on perianal surgery is uncertain. Our aim was to determine trends in perianal surgery and the impact of timing and duration of TPs on the risk of first perianal surgery. METHODS:We identified a population-based cohort of incident cases of Crohn's disease between 1995 and 2009. We used Kaplan-Meier analysis to determine trends in TP usage and first perianal surgery by era of diagnosis: era 1 (1995-2002) and era 2 (2003-2009). We quantified the impact of duration and timing of TPs on the risk of perianal surgery using a Cox regression model. RESULTS:We identified a cohort of 5235 incident cases of Crohn's disease. The 5-year cumulative probability of first perianal surgery decreased from 2.7% to 1.7% between era 1 and era 2, respectively (P = 0.03). TP use for greater than 18 months was associated with a 40% risk reduction for first perianal surgery (hazard ratio: 0.60, 95% confidence interval: 0.39-0.95) and 49% if TPs were used for 2 years or more (hazard ratio: 0.51, 95% confidence interval: 0.32-0.99). There was no demonstrable additional benefit from early TP use within the first year after diagnosis (hazard ratio: 0.85, 95% confidence interval: 0.52-1.40, P = 0.53). CONCLUSIONS:Over the past 15 years, TP use has increased by 50%, whereas perianal surgery rates have decreased by 37% among UK population with Crohn's disease. Sustained use for 18 months was associated with a reduced risk of perianal surgery by almost a half in the first 5 years after diagnosis.
journal_name
Inflamm Bowel Disjournal_title
Inflammatory bowel diseasesauthors
Chhaya V,Saxena S,Cecil E,Subramanian V,Curcin V,Majeed A,Pollok RCdoi
10.1097/MIB.0000000000000290subject
Has Abstractpub_date
2015-02-01 00:00:00pages
385-91issue
2eissn
1078-0998issn
1536-4844journal_volume
21pub_type
杂志文章abstract:Background:Clinical trials investigating the use of cannabinoid drugs for the treatment of intestinal inflammation are anticipated secondary to preclinical literature demonstrating efficacy in reducing inflammation. Methods:We systematically reviewed publications on the benefit of drugs targeting the endo-cannabinoid ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,meta分析
doi:10.1093/ibd/izy014
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abstract:BACKGROUND:The accuracy and utility of electronic health record (EHR)-derived phenotypes in replicating genotype-phenotype relationships have been infrequently examined. Low circulating vitamin D levels are associated with severe outcomes in inflammatory bowel disease (IBD); however, the genetic basis for vitamin D ins...
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abstract::Induction and maintenance of remission, mucosal healing, the avoidance of surgical intervention, and decreasing the likelihood of cancer developing are the primary therapeutic goals in ulcerative colitis (UC). For the traditional therapies, 5-aminosalicylic acid (including mesalamine), corticosteroids, and thiopurines...
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journal_title:Inflammatory bowel diseases
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doi:10.1097/01.mib.0000165115.18310.e7
更新日期:2005-07-01 00:00:00
abstract:Background:Social media is commonly used among the adolescent and young adult population, including those with chronic diseases. For adults, these platforms have been shown to be a major source of health information. Our aims were to explore how youth with inflammatory bowel disease (IBD) use social media for (1) disea...
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abstract:BACKGROUND:Unlike other anti-tumor necrosis factor alpha antibodies, golimumab does not deliver on its promise of effectiveness for treating patients with ulcerative colitis. We investigated the value of therapeutic drug monitoring for optimizing golimumab therapy. METHODS:We analyzed the golimumab pharmacokinetics da...
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abstract:BACKGROUND:Cytomegalovirus (CMV) colitis can contribute to an unfavorable outcome of acute severe ulcerative colitis (ASUC). The purpose of this study was to evaluate the clinical outcomes of ASUC according to the CMV status and identify risk factors for CMV colitis in patients with ASUC. METHODS:We retrospectively an...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
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abstract:BACKGROUND:Immunosuppressive therapy with anti-TNF-alpha antibodies is effective in patients with inflammatory bowel disease (IBD). However, there is an increased risk for infections associated with this therapy. METHODS:Here, we report the case of a 58-year-old patient with Crohn's disease (CD) treated with steroids ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20866
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abstract:INTRODUCTION:Antitumor necrosis factor (anti-TNF) medications are known to be highly efficacious in persons with moderate-to-severe inflammatory bowel disease (IBD). There is a paucity of data from population-based sources to elucidate persistence with these medications in the general population of IBD. Discontinuation...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000001025
更新日期:2017-03-01 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1002/ibd.20267
更新日期:2008-02-01 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000000736
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,随机对照试验
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更新日期:2008-10-01 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.21287
更新日期:2010-10-01 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,meta分析,评审
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更新日期:2017-02-01 00:00:00
abstract::A prospective study was conducted to determine the implications of acute pouchitis on the long-term functional results of restorative proctocolectomy with J-pouch ileoanal anastomosis (IPAA). Between July 1988 and June 1996, 137 consecutive patients underwent IPAA for treatment of ulcerative colitis. 127 patients (93%...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.3780040405
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Easily accessible predictors of disease course in inflammatory bowel disease (IBD) are scarce, and it remains largely unknown whether a family history of IBD predicts the course of Crohn's disease (CD) and ulcerative colitis (UC). We aimed to compare the course of disease in familial and sporadic cases of IB...
journal_title:Inflammatory bowel diseases
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更新日期:2015-12-01 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000000872
更新日期:2016-09-01 00:00:00
abstract:SUMMARY:: In recent years, heparin has emerged as a possible therapy for inflammatory bowel disease (IBD). Several recent, strongly positive, open-labeled series of heparin in both ulcerative colitis (UC) and Crohn's disease (CD) reinforce the work of Gaffney and co-workers that suggested a benefit of heparin in UC. Al...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::The complex and yet unknown etiology of Crohn's disease (CD) might consist of various disease endophenotypes, each of which represent their own pathogenesis. This review focuses on the disease endophenotype linked to polymorphisms in the nucleotide-binding oligomerization domain containing 2 (NOD2) protein and on the ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,meta分析
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abstract:Background:Discontinuation of antitumour necrosis factor (TNF)α therapy with perianal fistulising Crohn's disease remains controversial due to the risk of severe relapse without any clear evidence. Aim:The aim of this study was to assess the rate and type of perianal and luminal relapses following anti-TNFα discontinu...
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pub_type: 杂志文章,多中心研究
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更新日期:2018-01-18 00:00:00
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/01.mib.0000183419.17563.17
更新日期:2005-10-01 00:00:00
abstract::The limited efficacy of standard medical therapies for inflammatory bowel diseases has resulted in a continuing search for alternative treatments. Growth hormone (GH) has shown to have mutagenic and proliferative effects on intestinal cells. This study was designed to identify the effect of growth hormone on trinitrob...
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pub_type: 杂志文章
doi:10.1097/00054725-200403000-00008
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20238
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Vitamin D (25(OH)D) deficiency occurs in active Crohn's disease (CD) and may be secondary to reduced sunlight exposure and oral intake. Vitamin D-binding protein (VDBP) levels, however, fluctuate less with season and sunlight. The aim, therefore, was to examine patients with CD in remission and determine any...
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pub_type: 杂志文章
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更新日期:2016-10-01 00:00:00
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doi:10.1002/ibd.21562
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journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
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