Abstract:
BACKGROUND:Usefulness of thiopurine and scheduled infliximab combination therapy in non-immunomodulator (IM)-naïve Crohn's disease (CD) patients and the optimal length of dual therapy are still debated. AIMS:To determine proportion of patients developing disease flare requiring rescue therapy and risk factors associated with disease flare after de-escalation of IM from combination therapy. METHODS:Adult CD patients in clinical remission on combination therapy were identified from a large single-center database between 2002 and 2009. Patients who had their IM stopped in the absence of adverse events were included. Association between clinical and demographic variables and time until rescue therapy was analyzed using Cox-proportional hazard models. RESULTS:Forty-three CD patients on combination therapy in clinical remission at time of IM de-escalation were identified and followed up for a median duration of 61.6 months (range 5.4-129.5). Median duration of remission on combination therapy prior to IM de-escalation was 12.0 months (range 4-74). Thirty-one patients (72.1%) required rescue therapy during follow-up. On multivariable analysis, age at diagnosis < 16 years versus > 40 years (HR 4.55, 95% CI 1.18-17.62, p = 0.028), using methotrexate instead of azathioprine in combination with infliximab (HR 3.37, 95% CI 1.14, 9.96, p = 0.028), and duration of combination therapy < 6 months (HR 5.68, 95% CI 1.58, 20.36, p = 0.007) increased risk for rescue therapy. CONCLUSIONS:A large proportion of CD patients on combination therapy experienced a flare following IM withdrawal. Young age at diagnosis, short duration of combination therapy, and methotrexate use were independent predictors of the need for rescue therapy.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Fischer M,Campbell SC,Calley CSJ,Helper DJ,Chiorean MV,Fadda HMdoi
10.1007/s10620-017-4771-zsubject
Has Abstractpub_date
2017-11-01 00:00:00pages
3131-3137issue
11eissn
0163-2116issn
1573-2568pii
10.1007/s10620-017-4771-zjournal_volume
62pub_type
杂志文章abstract::Achalasia is the best described motor disorder of the esophagus. Associations with familial glucocorticoid deficiency and alacrima (triple A syndrome) have been described in the pediatric population, but no attention has been paid to the possibility of this association in adults. Tear production was assessed in 20 pat...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1026679723941
更新日期:1999-05-01 00:00:00
abstract::In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01299875
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Improved survival with chronic liver disease (CLD) and increased incidence in the older has led to a rapidly expanding population which faces similar "geriatric syndromes" as the general population. With risk factors such as autonomic dysfunction, cognitive impairment, and muscle abnormalities in CLD it is e...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-012-2193-5
更新日期:2012-10-01 00:00:00
abstract::If an effective hepatic assist system existed, it could serve as a bridge to transplantation. Most of the patients waiting for liver transplantation have chronic liver insufficiency but are not in hepatic coma. Various hepatic assist systems have been used to salvage patients with acute liver insufficiency. Most attem...
journal_title:Digestive diseases and sciences
pub_type: 历史文章,杂志文章,评审
doi:10.1007/BF01307531
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:The regulation of apoptosis of intestinal mucosal cells is important in maintenance of normal intestinal physiology. SUMMARY:Sphingosine-1-phosphate (S1P) has been shown to play a critical role in cellular protection to otherwise lethal stimuli in several nonintestinal tissues. METHODS:The current study det...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-008-0393-9
更新日期:2009-03-01 00:00:00
abstract::Basal gastric acid output was analyzed prospectively in 110 patients with endoscopically documented duodenal ulcer disease to determine the frequency of gastric acid hypersecretion in patients with bleeding versus nonbleeding ulcers. Thirty-eight patients with stigmata of an actively or recently bleeding duodenal ulce...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01307543
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:The role of 5-aminosalicylic acid (5-ASA or mesalamine) in the prevention of colorectal cancer in ulcerative colitis (UC) patients was reported, but the effect on molecular targets in UC colon mucosa is unknown. AIM:This observational study evaluates gene expression levels of 5-ASA targets using serial colo...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-018-5378-8
更新日期:2019-03-01 00:00:00
abstract::Hemorrhage into the biliary tract, known as hemobilia, is discussed almost exclusively in the surgical literature. Internists should also be aware of this entity. Two cases of hemobilia from hepatic artery aneurysm that ruptured into the biliary tract are presented. Both patients developed pancreatitis in addition to ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01308313
更新日期:1980-02-01 00:00:00
abstract::An association between hypothermia and gastric ulceration has been reported in rats in cervical cord section and in restraint models. The present study was designed to determine this relationship in cervical and in lumbar cord sectioned Sprague-Dawley rats. Ambient temperatures were varied by placing the sectioned ani...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01307976
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Eradication therapies for Helicobacter pylori infection are advancing as new acid inhibitory reagents approved. The aim of this study was to assess the efficacy and safety of vonoprazan-based triple treatment. MATERIALS AND METHODS:Triple therapy with vonoprazan and two antibiotics (amoxicillin and clarithr...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,多中心研究,评审
doi:10.1007/s10620-017-4664-1
更新日期:2017-11-01 00:00:00
abstract::Resistant starch is by definition that part of starch that escapes digestion in the small bowel. Cecal fermentation of resistant starch into short-chain fatty acids will result subsequently in a decrease in pH. Thus, resistant starch may have the same effect on colonic luminal contents and mucosa as some fiber compone...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF02087431
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:COVID-19 has caused a backlog of endoscopic procedures; colonoscopy must now be prioritized to those who would benefit most. We determined the proportion of screening and surveillance colonoscopies appropriate for rescheduling to a future year through strict adoption of US Multi-Society Task Force (USMSTF) g...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-020-06539-1
更新日期:2020-08-16 00:00:00
abstract:BACKGROUND:The outcomes of infliximab dose escalation in ulcerative colitis (UC) have not been well evaluated. AIMS:To assess the short- and long-term outcomes of infliximab dose escalation in a cohort of patients with UC. METHODS:This was a multicenter, retrospective, cohort study. All consecutive UC patients who ha...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,多中心研究
doi:10.1007/s10620-015-3735-4
更新日期:2015-10-01 00:00:00
abstract::The destruction of the integrity of the gastric epithelial barrier underlies the pathology of many gastric diseases, including gastric tumors. The Helicobacter pylori virulence factor CagA is one of the main destroyers of the gastric epithelial barrier. There are differences among CagA proteins that originate from dif...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,评审
doi:10.1007/s10620-013-2589-x
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:We hypothesized that the severity of dextran sodium sulfate (DSS)-induced colitis could differ between DSS preparations of the same molecular weight, and that this difference may be affected by the sulfur content. To test this, we used three DSS preparations of similar molecular weights but with different su...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-011-1881-x
更新日期:2012-02-01 00:00:00
abstract::Octreotide is an effective therapeutic option in controlling secretory diarrhea of varied etiology. However, marked patient-to-patient differences in the antidiarrheal effects necessitate titration of octreotide dose in individual patients to achieve optimal symptom control. A consensus development panel established g...
journal_title:Digestive diseases and sciences
pub_type: 共识发展会议,杂志文章,评审
doi:10.1007/BF02285194
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Current guidelines recommend starting colorectal cancer (CRC) surveillance 8-10 years after inflammatory bowel disease (IBD) onset. Recent studies report that the incidence of CRC within 8-10 years of IBD onset (i.e., early CRC) ranges from 12 to 42%. AIMS:To describe the current prevalence of early CRC in ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-019-05554-1
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Determining the risk stratification of nonvariceal upper gastrointestinal bleeding (NVUGIB) plays a vital role in treating upper gastrointestinal bleeding (UGIB). Traditional scores like Glasgow-Blatchford score (GBS), Rockall score (RS), and AIMS65 score have been widely utilized in UGIB practice, however e...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-020-06420-1
更新日期:2020-06-24 00:00:00
abstract::The purpose of this study was to determine the effects of altering gastric emptying on postprandial plasma glucose concentration after a physiologic meal in patients with type II diabetes mellitus (T II DM). Nine T II DM patients underwent a double-blind, randomized, three-way crossover study, receiving erythromycin 2...
journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1023/a:1022528414264
更新日期:2003-03-01 00:00:00
abstract::The effects of deoxycholic acid (DCA) on the intestinal microbiota, bile acid (BA) metabolism, and intestinal epithelium can be influenced by various factors. Depending on the specific conditions, DCA can be "bad" (proinflammatory) or "good" (anti-inflammatory). Mouse models of colitis show an increase in conjugated B...
journal_title:Digestive diseases and sciences
pub_type: 信件
doi:10.1007/s10620-020-06650-3
更新日期:2020-10-16 00:00:00
abstract::The effects of vasoactive intestinal polypeptide (VIP), glucagon, and secretin on lower esophageal sphincter pressure were investigated in awake baboons. The three hormones were compared with respect to effect on (1) resting lower esophageal sphincter pressure and (2) maximal stimulatory response to pentagastrin. VIP ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01297119
更新日期:1979-05-01 00:00:00
abstract::Alcoholic liver disease (ALD) is characterized by elevated serum IgA concentrations, the presence of circulating immune complexes containing IgA, and IgA deposits along sinusoids in the liver. When combined with the presupposed IgA-clearance function of the liver, a causal association between IgA abnormalities and the...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01540430
更新日期:1988-06-01 00:00:00
abstract::Many physiological factors can alter gastric emptying, and the role of gastric emptying in functional dyspepsia is controversial. The aim of this study was to assess the effects of different factors (age, sex, the degree of dyspeptic and irritable bowel symptoms, lactase deficiency, smoking habits, the use of antiinfl...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1018826917657
更新日期:1998-06-01 00:00:00
abstract::Effects of selective beta-adrenoceptor agonists on rectosigmoid motility during prolonged rectal distension were studied in 12 healthy volunteers in a double-blind, randomized fashion. Continuous distension was performed with a balloon in the proximal part of the rectum. Pressure was recorded by this balloon and by a ...
journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01320259
更新日期:1985-06-01 00:00:00
abstract::A 70-year-old woman with secretory diarrhea was studied with a novel technique of recording small intestinal myoelectrical activity which allowed us to obtain long, uninterrupted records of slow waves and spikes at eight or more different intestinal levels simultaneously. Typical migrating action potential complexes (...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01300207
更新日期:1987-10-01 00:00:00
abstract::Gastric stasis and duodenogastric reflux have each been implicated in the pathogenesis of various upper gastrointestinal disorders. However, the relationship between intragastric bile and gastric emptying has not been explored. In each of nine healthy volunteers (seven men and two women, ages 22-47 years), gastric emp...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01535751
更新日期:1988-03-01 00:00:00
abstract::The peroxisome proliferator-activated receptor gamma (PPARgamma) is a nuclear receptor highly expressed in the colon and playing an anti-inflammatory role through inhibition of the NF-kappaB pathway. Toll-like receptor 4 (TLR4) has been known to mediate LPS-induced cellular signaling through activation of NF-kappaB pa...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-006-3193-0
更新日期:2006-04-01 00:00:00
abstract::The distribution of tissue kallikrein (TK) and its plasma inhibitor, kallistatin in plasma and intestinal tissue, was studied in patients with active ulcerative colitis (UC) and Crohn's disease (CD). TK was localized to goblet cells and kallistatin to epithelial cells of normal human intestine. Both proteins are visua...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1022569623350
更新日期:2003-03-01 00:00:00
abstract::The original version of the article unfortunately contained an error in article title. The corrected title is 'Fecal Microbiota Transplantation Capsules with Targeted Colonic Versus Gastric Delivery in Recurrent Clostridium difficile Infection: A Comparative Cohort Analysis of High and Low Dose'. ...
journal_title:Digestive diseases and sciences
pub_type: 已发布勘误
doi:10.1007/s10620-019-05527-4
更新日期:2019-07-01 00:00:00
abstract::Cyclic GMP plays an important role in maintaining homeostasis in the gastric mucosa. NSAIDs damage the mucosa by mechanisms that may be mediated by alterations in the intragastric concentration of cyclic GMP. To test this hypothesis we studied the effects of the oral administration of acetylsalicylic acid (100, 300, a...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1023020201005
更新日期:2003-05-01 00:00:00