Abstract:
GOALS:Our primary goal was to evaluate whether anti-tumor necrosis factor (TNF)-α trough levels above author-determined thresholds are associated with increased rates of mucosal healing among patients with Crohn's disease and ulcerative colitis. BACKGROUND:The introduction of anti-TNF agents has considerably advanced the approach to the management of patients with inflammatory bowel disease (IBD). As use of anti-TNF therapy has increased, there has been new interest in algorithms focused on the monitoring of pharmacodynamics and pharmacokinetics to improve outcomes. In addition, there has been an increased focus on mucosal healing as marker of treatment success. STUDY:We performed a systematic review and meta-analysis. The studies examined were restricted to randomized controlled trials and cohort studies with a high Jadad or Newcastle-Ottawa score. RESULTS:All pooled analyses were based on a random-effects model. Data from 2 randomized controlled trials and 5 observational studies (n=652) were included in the meta-analysis. Among patients with IBD, anti-TNF trough levels above prespecified values were associated with increased rates of mucosal healing (OR=5.57; 95% CI, 3.80-8.15). There was no heterogeneity detected (I=0, Q=5.88, df=6; P=0.436) and there was minimal evidence of publication bias present. CONCLUSIONS:There is a strong relationship between anti-TNF trough levels and increased rates of mucosal healing among patients with IBD. Given the increased emphasis on mucosal healing as an outcome in practice and clinical trials, continued focus on the proactive use of pharmacokinetic testing appears warranted.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Barnes EL,Allegretti JRdoi
10.1097/MCG.0000000000000441subject
Has Abstractpub_date
2016-10-01 00:00:00pages
733-41issue
9eissn
0192-0790issn
1539-2031journal_volume
50pub_type
杂志文章,meta分析,评审abstract::Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms comprising only 1% to 2% of all pancreatic tumors. In recent years, the number of incidentally discovered PNETs has greatly increased given the widespread use of axial imaging. However, a significant proportion of PNETs may not be visualized on con...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000152
更新日期:2014-11-01 00:00:00
abstract::We investigated whether autoimmune cholangitis (AC) has specific features that constitute an entity other than primary biliary cirrhosis (PBC). We compared clinical, laboratory, and liver biopsy features; response to treatment; and the follow-up of two groups of patients. The first group comprised seven patients with ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199610000-00007
更新日期:1996-10-01 00:00:00
abstract::Silybum marianum (milk thistle) and its derivatives have been used for centuries for the treatment of liver disease. This review focuses exclusively on published literature pertaining to the potential use of Silybum marianum or its derivatives for the treatment of alcoholic liver disease. Clinical studies have varied ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000165668.79530.a0
更新日期:2005-07-01 00:00:00
abstract::Idiopathic pylephlebitis and primary sclerosing peritonitis are two highly unusual entities. To our knowledge, the association of the two diseases has not been described previously. We report a 42-year-old patient with a protein S deficiency who presented with fever and chills, in whom idiopathic pylephlebitis was dia...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200103000-00020
更新日期:2001-03-01 00:00:00
abstract::In this manuscript, a short review is provided of the basic principles of screening, emphasizing some of the methodologic problems attendant on any screening test, in short, a "screening primer." My analysis of the "core" data supporting efforts to screen for colorectal cancer leads to the conclusion that the utility ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::We looked for factors predicting the therapeutic outcome in 66 patients with severe ulcerative colitis treated with intravenous hydrocortisone or corticotropin (ACTH) for 10 days. Patients were randomized before therapy within strata defined by whether they had received oral corticosteroids continuously before the stu...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-198702000-00013
更新日期:1987-02-01 00:00:00
abstract::Helicobacter pylori infection has proven to be extraordinarily difficult to eradicate. Antimicrobial monotherapies have been particularly disappointing, with most eradication rates in the range of 0-15%. Clarithromycin has potential advantages over other macrolides to which H. pylori is susceptible because of its acid...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199306000-00004
更新日期:1993-06-01 00:00:00
abstract::Aminosalicylates are of proven benefit in maintaining medically induced remissions of both ulcerative colitis and Crohn's disease. Even rectal 5-aminosalicylic acid has been found to be useful in maintaining long-term remissions of distal ulcerative colitis. Particularly noteworthy is the demonstrated efficacy of oral...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199503000-00009
更新日期:1995-03-01 00:00:00
abstract:AIM:To investigate the effects of prolonged tricyclic antidepressants (TCAs) therapy on the frequency and duration of episodes of cyclic vomiting syndrome (CVS) in adults, and the global assessment of clinical improvement and the number of emergency department (ED) visits and/or hospitalizations. METHOD:An open labele...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/MCG.0b013e3181ac6489
更新日期:2010-01-01 00:00:00
abstract::Gastrointestinal leaks and fistulae are common postoperative complications, whereas intestinal perforation more commonly complicates advanced endoscopic procedures. Although these complications have classically been managed surgically, there exists an ever-expanding role for endoscopic therapy and the involvement of a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000409
更新日期:2015-11-01 00:00:00
abstract:GOALS:To evaluate the impact of age on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing percutaneous radiofrequency ablation (RFA). BACKGROUND:Whether age plays an important role in the outcomes of HCC after RFA remains controversial. STUDY:Two hundred fifty-eight consecutive treatment naive H...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31822b36cc
更新日期:2012-01-01 00:00:00
abstract::Identical twins presented as sexagenarians with heartburn, regurgitation, and dysphagia; each had a Barrett esophagus remarkably similar to the other. This instance suggests a hereditary influence upon the development of mucosal dysplasia in some patients with this condition. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198306000-00011
更新日期:1983-06-01 00:00:00
abstract::Zoonotic visceral leishmaniasis is common in western Mediterranean countries. A strong link between visceral leishmaniasis and human immunodeficiency virus (coinfection) has been proved, especially in Spain, which is an endemic area. This suggests that Leishmania may behave opportunistically. We report a case of colon...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199712000-00029
更新日期:1997-12-01 00:00:00
abstract::Insulin resistance is an integral part of the underlying pathophysiology in most patients with nonalcoholic fatty liver disease (NAFLD). Insulin-sensitizing agents are therefore likely to be of key importance in the treatment of this disorder, especially in the histologically more severe form known as nonalcoholic ste...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000168647.71411.48
更新日期:2006-03-01 00:00:00
abstract::We describe a patient with primary biliary cirrhosis associated with Graves' disease and discuss the possible autoimmune connections between the two disorders. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198510000-00014
更新日期:1985-10-01 00:00:00
abstract::Peutz-Jeghers syndrome is a malignancy-associated polyposis syndrome. We describe a histopathologic phenomenon easily encountered when examining the nature of Peutz-Jeghers polyps but that is underreported in the literature. This phenomenon of "pseudo-invasion" may mimic invasive carcinoma due to epithelial displaceme...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199707000-00023
更新日期:1997-07-01 00:00:00
abstract::Hepatic cavernous hemangioma is the most common benign tumor of the liver. Appropriate management of this tumor remains a controversial topic. We have accumulated a number of cases with successful management of local hepatic tumors. Here we report a case where we performed an ultrasound-guided percutaneous radiofreque...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000196404.07487.1d
更新日期:2006-02-01 00:00:00
abstract:GOALS:To describe the epidemiology and microbiologic characteristics of bloodstream infections (BSIs) in patients receiving long-term total parenteral nutrition (TPN). BACKGROUND:Home TPN therapy has been reported as a risk factor for BSI. However, little knowledge exists regarding the epidemiology of BSIs in this pat...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000212606.13348.f7
更新日期:2007-01-01 00:00:00
abstract::We describe the clinical course and outcome of Rwandan refugees with cholera-like illness (n = 567) and clinical dysentery (n = 1,062) treated at the Israeli Army field hospital in the disaster region of Goma, Zaire, during the summer of 1994. Vigorous fluid administration was the primary therapy, complemented with an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199712000-00009
更新日期:1997-12-01 00:00:00
abstract::In a double-blind trial 60% of acute variceal bleeding episodes were controlled with terlipressin (glypressin) compared with 37% in patients given placebo (NS). Rebleeding was more common in the placebo group so that at 5 days bleeding remained under control in 54% of patients treated with terlipressin compared with o...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-198902000-00014
更新日期:1989-02-01 00:00:00
abstract::We report a patient with long-standing ulcerative colitis who developed carcinoma of the colon, sclerosing cholangitis, pericholangitis, and bronchiectasis over the course of 10-15 years. Occurrence of these rare conditions in the same patient supports their reported association and reemphasizes that there may be mult...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::A bronchobiliary fistula is a rare entity that manifests as bilioptysis. We report a 73-year-old woman with a hepato-cellular carcinoma who developed a bronchobiliary fistula. Endoscopic biliary sphincterotomy and insertion of a prosthesis led to successful resolution of symptoms and restoration of normal bile flow. W...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199609000-00012
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND/GOALS:Many patients with a history of injection drug use (IDU) are excluded from hepatitis C virus (HCV) treatment. This prospective multicenter study aimed to determine the impact of IDU history on HCV treatment candidacy and outcomes. STUDY:Between 1999 and 2001, 4318 HCV-infected patients seen at 24 VA M...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.mcg.0000212644.82853.51
更新日期:2007-02-01 00:00:00
abstract::We have found 20 cases of ectopic gastric mucosa in the proximal esophagus. Five patients had symptoms, usually a burning sensation in the neck and/or dysphagia. We report the results of immunoperoxidase staining of this tissue for gastrin, somatostatin, vasoactive intestinal peptide, and bombesin. In 85% of biopsy sp...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00003
更新日期:1986-10-01 00:00:00
abstract::A patient with long-standing Waldenström's disease and cryoglobulinemia, treated with chlorambucil, developed hepatocellular carcinoma. Although HBs antigen, anti-HBs, and anti-HBc antibodies were not detected in his serum by conventional polyclonal radioimmunoassays, immunofluorescence techniques showed HBs antigen t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198510000-00015
更新日期:1985-10-01 00:00:00
abstract::A prospective clinical, endoscopic, and histopathologic study of the esophagus was carried out in 24 patients with advanced liver disease who underwent esophageal variceal sclerotherapy (EVS) and who eventually came to autopsy. Patients were arbitrarily divided into three groups: acute (group I), intermediate (group I...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198712000-00006
更新日期:1987-12-01 00:00:00
abstract::Sixty-four black patients with inflammatory bowel disease (IBD) were seen from 1960 to 1987 at the Medical College of Georgia, representing 22% of all patients with IBD: 38 of them had Crohn's disease (CD) and 26 had ulcerative colitis (UC). In those with CD, the small intestine alone was involved in 16% and ileocolit...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198906000-00010
更新日期:1989-06-01 00:00:00
abstract::A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197909000-00005
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:The impact of methicillin-resistant Staphylococcus aureus (MRSA) colonization of percutaneous endoscopic gastrostomy (PEG) sites on morbidity and mortality is uncertain. AIM:We investigated the impact of known prior MRSA colonization on the incidence of symptomatic PEG site wound infection and mortality. M...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000210096.44123.b6
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Current methods to diagnose malignant biliary strictures are of low sensitivity. Confocal endomicroscopy is a new approach that may improve the diagnosis of indeterminate biliary strictures. The purpose of this study was to evaluate indeterminate biliary strictures using probe-based confocal laser e...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181fbdc38
更新日期:2011-03-01 00:00:00