Abstract:
PURPOSE OF REVIEW:This article describes the evolution of combination therapy in inflammatory bowel disease and how to determine when combination may not be necessary. RECENT FINDINGS:The combination of an immunosuppressive agent with an antibody to tumor necrosis factor has proven to be more effective than monotherapy with either an immunosuppressive agent or an antibody to tumor necrosis factor alone. The emergence of therapeutic drug monitoring has identified the importance of maintaining adequate circulating drug levels and suppressing antibody formation to the biological agent. The concomitant use of an immunosuppressive agent can help effect this. Although this may be optimal therapy in moderately ill patients. I review why there still remains a role for using monotherapy with immunosuppressive agents, as well as consideration of therapy withdrawal. SUMMARY:Although combination therapy is the treatment of choice in persons with moderate to severe disease or who have lost response to biological monotherapy, there remains a role for monotherapy with immunosuppressive agents. Though the newer biological therapies are mostly not used in combination, this may be a future approach considering their response rates are also correlated with higher drug levels. Many persons with inflammatory bowel disease can remain well on an immunosuppressive agent alone and some can even maintain a longstanding remission off all therapy.
journal_name
Curr Opin Gastroenteroljournal_title
Current opinion in gastroenterologyauthors
Bernstein CNdoi
10.1097/MOG.0000000000000281subject
Has Abstractpub_date
2016-07-01 00:00:00pages
287-93issue
4eissn
0267-1379issn
1531-7056journal_volume
32pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The prevalence of allergic diseases continues to rise globally in developed countries. Since the initial proposal of the hygiene hypothesis, there has been increasing evidence to suggest that the intestinal microbiota, particularly during early infancy, plays a critical role in regulating immune respo...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3283573017
更新日期:2012-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Research in celiac disease is unraveling new findings at a high rate, and major advances seem to occur in all areas such as genetics, environmental factor, pathophysiology, and even prospective therapeutic implications. RECENT FINDINGS:New insight is being gained into the interplay between genetic an...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e32830f4527
更新日期:2008-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Endoscopic ampullectomy has proven its safety and efficacy in multiple studies, making it the favorable option for the management of endoscopic ampullectomy. In this review, we plan to review the basic steps every endoscopist should be familiar with before undertaking endoscopic ampullectomy. RECENT ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/MOG.0000000000000657
更新日期:2020-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Therapy for inflammatory bowel diseases (IBD) has changed dramatically in recent years with a wider use of immunomodulators and the introduction of antitumor necrosis factor (anti-TNF) agents. This article reviews the existing data on the long-term efficacy of biologics, that is, anti-TNF agents, for ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000078
更新日期:2014-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to summarize recent advances in defining the clinical features, pathophysiology, natural history, and treatment of nonalcoholic fatty liver disease. RECENT FINDINGS:Nonalcoholic fatty liver disease is present in approximately 30% of the US population. A histologic gradin...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3282fbccf2
更新日期:2008-05-01 00:00:00
abstract:PURPOSE OF REVIEW:With recent advances in radiographic testing, there have been increases in the incidental identification of pancreatic cysts. Determining management, specifically, which cysts can be watched versus intervened upon has significant impact on at the patient-physician level as well as globally on resource...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000463
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Immunoglobulin G4-associated cholangitis is a recently identified clinical entity characterized by infiltration of immunoglobulin G4 -bearing plasma cells in bile ducts and other affected tissues. This review is focused mainly on the most recent studies published during the last 2 years that have incr...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3282f6a7c5
更新日期:2008-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on recent advances and novel insights into the mechanistic events that may link commensal microbiota and host innate immunity in the pathophysiology of intestinal inflammation and neoplasia. Unanswered questions are discussed and future perspectives in the field are highlighted. R...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e32835a670e
更新日期:2013-01-01 00:00:00
abstract::In the past year, numerous important papers were published on chronic pancreatitis, its causes, and its diagnosis; the cause of fibrosis; and pain in pancreatic cancer. More than 750 mutations have been described in the cystic fibrosis transmembrane regulator (CFTR) gene. Some mutations cause relatively mild reduction...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-199909000-00005
更新日期:1999-09-01 00:00:00
abstract:PURPOSE OF REVIEW:According to the current paradigm, ulcerative colitis and Crohn's disease occur in genetically predisposed individuals because of dysregulated immune responses against intraluminal bacterial antigens. Data have recently accumulated supporting alternative hypotheses for the pathogenesis of inflammatory...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3281c55eb2
更新日期:2007-07-01 00:00:00
abstract:PURPOSE OF REVIEW:There has been significant interest in gluten over the last decade, with an increase in interest of gluten-related disorders outside coeliac disease. Particularly, there has been a focus on the role of gluten in noncoeliac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS). There is signific...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000517
更新日期:2019-05-01 00:00:00
abstract::Diarrhea is a common sequela of deregulated immune pathways underlying the wide range of intestinal acute and chronic diseases. The ongoing investigation of novel immune components and susceptibility factors allows better understanding of these pathologic mechanisms and continues to advance therapeutic options. ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-200211000-00010
更新日期:2002-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer-related deaths worldwide. Diet has a significant impact on the risk of developing CRC, but though processed meat is a known positive contributor, the effects of other dietary components are largely mixed. ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000501
更新日期:2019-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The intestinal microbiota plays a central role in inflammatory diseases of the gut. Although most investigations regarding how the mucosal immune system interacts with the microbiota have focused on bacteria, recent studies are elucidating the additional role of commensal fungi in health and disease i...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000483
更新日期:2018-11-01 00:00:00
abstract:PURPOSE OF REVIEW:In both Crohn's disease and ulcerative colitis, the tissue damage results from an inappropriate or exaggerated immune response to antigens of the gut microflora. This review summarizes current knowledge regarding the role of immune-inflammatory mediators in the pathogenesis of inflammatory bowel disea...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mog.0000231808.10773.8e
更新日期:2006-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The 'Final Rule,' issued by the Health Resources and Service Administration in 2000, mandated that liver allocation policy should be based on disease severity and probability of death, and - among other factors - should be independent of a candidate's residence or listing. As a result, the Organ Procu...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000434
更新日期:2018-05-01 00:00:00
abstract::Colon carcinogenesis is a multistep process that involves deletions, mutations, and changes in expression of genes that regulate growth, differentiation, and apoptosis. Hyperproliferation can initiate dysplastic growth, resulting in accumulation of genetic defects and progression of colon cancer. Although genetic inst...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-200001000-00013
更新日期:2000-01-01 00:00:00
abstract:PURPOSE OF REVIEW:We critically analyze existing endoscopy-based interventions for gastroesophageal reflux disease (GERD). The focus is on the effectiveness of available procedures and to delineate goals for future research. RECENT FINDINGS:Recent evaluations of the EndoCinch system reveal poor long-term results and n...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e32832ad8b4
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Autoimmune hepatitis (AIH) is a chronic disease characterized by a lymphocyte infiltrate in the liver. For decades, nonspecific immunosuppression has been used to limit chronic liver inflammation. The high risk of relapse, the treatments side effects, and the significant number of refractory patients ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/MOG.0000000000000704
更新日期:2021-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Complicated intra-abdominal infections (cIAIs) are associated with significant morbidity and mortality. Clinical trials should help guide and improve the management of cIAIs. However, inappropriate selection or measurement of outcomes in cIAIs clinical trials can lead to misleading results on the effe...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/MOG.0000000000000591
更新日期:2020-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The past few years have seen an increase in the number of research and clinical groups around the world using high-resolution manometry (HRM) to record contractile activity in the anorectum and colon. Yet despite the uptake and growing number of publications, the clinical utility and potential advanta...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000229
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Increasing use of small bowel endoscopy unravels ulcers in a relevant number of patients. Although often attributed to inflammatory bowel disease (IBD), these ulcers may be unspecific or caused by a variety of other diseases. This review summarizes the recent literature related to differential diagnos...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000522
更新日期:2019-05-01 00:00:00
abstract::Gastric adenocarcinoma is the most common malignancy of the upper gastrointestinal tract. During the past two decades it has migrated toward the gastroesophageal junction. Gastroesophageal reflux and obesity may play a role. Recent research suggests that a number of biologic and molecular differences exist in patients...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-200011000-00009
更新日期:2000-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The composition of activated adipose tissue with adipocytes secreting a broad spectrum of immune-modulatory adipokines next to adipose tissue-derived stromal cells and professional immune effector cells in the visceral fat creates a complex network of inflammatory processes shaping local immune respon...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000324
更新日期:2017-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Noroviruses (NoVs) are the most common cause of epidemic and sporadic cases of acute gastroenteritis worldwide. This review summarizes recent NoV disease burden estimates, epidemiology findings and provides an update on virus-like particle (VLP) vaccine studies. RECENT FINDINGS:NoVs are the leading c...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000022
更新日期:2014-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Advances in our understanding of lymphoid tissue development has led to an appreciation of the variety of these structures in the intestinal mucosa. This knowledge has translated into more critical analysis of the function of mucosal lymphoid tissues and may lead to manipulation of development of thes...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3282f4906d
更新日期:2008-03-01 00:00:00
abstract:PURPOSE OF REVIEW:It is now over 8 years since small bowel capsule endoscopy (SBCE) was first introduced to the gastrointestinal community. The original capsule (Given Imaging, YoKneam, Israel) - a disposable 26 x 11 mm video capsule containing its own optical dome, light source, batteries, transmitter and antenna - is...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e328334df17
更新日期:2010-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Intestinal fibrosis is a potentially serious complication of inflammatory bowel disease and its pathophysiology is still unclear. This review will discuss recent developments relating to sources of fibroblasts in intestinal inflammation, mediators that modulate fibroblast activation and function, as w...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e3282ff8b36
更新日期:2008-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Cholangiocarcinoma (CCA) are heterogeneous tumors that arise from the malignant transformation of cholangiocytes along the biliary tree. CCA heterogeneity occurs at multiple levels and results in resistance to therapy and poor prognosis. Here, we review the molecular classification of CCA by focusing ...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0000000000000611
更新日期:2020-03-01 00:00:00
abstract::Over the past several years, the pharmacologic treatment of obesity has undergone changes in safety, efficacy, and therapeutic targeting. The prevalence of cardiac valvulopathy associated with treatment with phentermine, fenfluramine, and dexfenfluramine is now becoming clarified with the publication of longer-term st...
journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-200203000-00011
更新日期:2002-03-01 00:00:00