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Ingrasciotta Y, Grova M, Crispino F, Isgrò V, Calapai F, Macaluso FS, Mattace-Raso F, Trifirò G, Orlando A. Safety and potential interaction of immunosuppressive drugs for the treatment of inflammatory bowel disease in elderly patients. Minerva Gastroenterol (Torino) 2024; 70:98-108. [PMID: 34057333 DOI: 10.23736/s2724-5985.21.02919-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, are chronic diseases associated with increased morbidity and reduced quality of life. Age may represent a risk factor for adverse events, due to the multimorbidity and polypharmacy, common in elderly patients. Elderly are often not included in clinical trials evaluating efficacy and safety of study drugs for the treatment of inflammatory bowel diseases. Several drugs, such as aminosalicylates, systemic corticosteroids, immunosuppressant drugs, biological drugs and Janus Kinase inhibitors, are available for the management of inflammatory bowel diseases. Therefore, with the increasing spectrum of therapeutic options it is important to analyze the evidence regarding the safety of the use of these agents in elderly patients. Selection of immunosuppressive therapy is a challenge in the management of elderly patients with inflammatory bowel diseases, for whom biologics with a lower risk of infection or cancer, such as vedolizumab and ustekinumab, may be preferred in elderly patients. Concomitant therapies and comorbidities must be thoroughly investigated before initiating any immunosuppressive or biological therapy in order to minimize the risk of drug-drug interactions. This review aimed to provide an overview of the safety of thiopurines, methotrexate and target therapies as well as their drug-drug interactions in patients with inflammatory bowel diseases.
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Affiliation(s)
- Ylenia Ingrasciotta
- Department of Internal Medicine, Erasmus MC University-Medical Center, Rotterdam, the Netherlands -
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy -
| | - Mauro Grova
- Unit of Inflammatory Bowel Disease, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
- Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, Department of Health Promotion Sciences Maternal and Infant Care (PROMISE), University of Palermo, Palermo, Italy
| | - Federica Crispino
- Unit of Inflammatory Bowel Disease, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
- Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, Department of Health Promotion Sciences Maternal and Infant Care (PROMISE), University of Palermo, Palermo, Italy
| | - Valentina Isgrò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Fabrizio Calapai
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Fabio S Macaluso
- Unit of Inflammatory Bowel Disease, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Francesco Mattace-Raso
- Department of Internal Medicine, Erasmus MC University-Medical Center, Rotterdam, the Netherlands
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ambrogio Orlando
- Unit of Inflammatory Bowel Disease, A.O.O.R. Villa Sofia-Cervello, Palermo, Italy
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Sferrazza S, Crispino F, Vieceli F, Fiorentino A, Michielan A, de Pretis G. Circumferential endoscopic submucosal dissection for long-segment Barrett's adenocarcinoma: the double-tunnel and single clip-and-loop traction method. Endoscopy 2023; 55:E645-E646. [PMID: 37084786 PMCID: PMC10121328 DOI: 10.1055/a-2058-8202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- Sandro Sferrazza
- Gastroenterology and Digestive Endoscopy Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
| | - Federica Crispino
- Gastroenterology and Hepatology Section, PROMISE, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Filippo Vieceli
- Gastroenterology and Digestive Endoscopy Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
| | - Andrea Fiorentino
- Gastroenterology and Digestive Endoscopy Unit, Presidio Ospedaliero Sant'Ottone Frangipane, Ariano Irpino, Italy
| | - Andrea Michielan
- Gastroenterology and Digestive Endoscopy Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
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Michielan A, Crispino F, de Pretis N, Sartori C, Decarli NL, de Pretis G, Merola E. Cap-assisted endoscopic mucosal resection as a salvage technique for challenging colorectal laterally spreading tumors. Surg Endosc 2023; 37:7859-7866. [PMID: 37626237 DOI: 10.1007/s00464-023-10347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Cap-assisted endoscopic mucosal resection (EMR-c) has emerged as a potential alternative to standard piecemeal wide-field EMR (WF-EMR) for the resection of laterally spreading tumors (LSTs). However, clear indications for this technique are still lacking. Our objective was to investigate the performance of salvage EMR-c after WF-EMR failure in the resection of large colorectal LSTs. METHODS The data of consecutive patients undergoing WF-EMR for large colorectal LSTs (2015-2021) were analyzed in this single-center, retrospective, observational study. In the event of a WF-EMR failure, the procedure was switched to EMR-c in the same session. The efficacy of the two techniques was evaluated in terms of complete endoscopic resection, R0 resection, and recurrence rate. Safety was also assessed. RESULTS Overall, the data from 81 WF-EMRs were collected. Eighteen cases of WF-EMR failure were switched to EMR-c in the same session and complete endoscopic resection was achieved in 17/18 patients (94.4%). No statistically significant difference was observed between WF-EMR and salvage EMR-c in terms of macroscopic radicality (P = 0.40) and R0 resection (P = 0.12). However, recurrence was more common with EMR-c (44.4% vs. 23.5%; P = 0.05), as were adverse events, particularly intraprocedural bleeding (27.8% vs. 7.9%; P = 0.04). CONCLUSION EMR-c is an effective salvage technique for challenging colorectal LSTs following WF-EMR failure. Due to the elevated risk of adverse events associated with this procedure, careful patient selection, endoscopic expertise, and close follow-up are strongly recommended.
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Affiliation(s)
- Andrea Michielan
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Federica Crispino
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
- Gastroenterology and Hepatology Section, PROMISE, University of Palermo, Palermo, Italy
| | - Nicolò de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
- Gastroenterology B Unit, Department of Medicine, The Pancreas Institute, University and Hospital Trust of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Chiara Sartori
- Surgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Nicola Libertà Decarli
- Surgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
- Pathology Unit, San Giovanni di Dio Hospital, Via Torregalli, 3, 50143, Florence, Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Elettra Merola
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
- Gastroenterology Unit, G.B. Grassi Hospital (ASL Roma 3), Rome, Italy.
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Crispino F, Michielan A, Grova M, Tieppo C, Mazza M, Rogger TM, Armelao F. Exit strategies in inflammatory bowel disease: Looking beyond anti-tumor necrosis factors. World J Clin Cases 2023; 11:2657-2669. [PMID: 37214561 PMCID: PMC10198103 DOI: 10.12998/wjcc.v11.i12.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/10/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
The long-term management of patients with inflammatory bowel disease (IBD) is still a matter of debate, and no clear guidelines have been issued. In clinical practice, gastroenterologists often have to deal with patients in prolonged remission after immunomodulatory or immunosuppressive therapies. When planning an exit strategy for drug withdrawal, the risk of disease relapse must be balanced against the risk of drug-related adverse events and healthcare costs. Furthermore, there is still a dearth of data on the withdrawal of novel biologics, such as the anti-α4β7 integrin antibody (vedolizumab) and anti-IL12/23 antibody (ustekinumab), as well as the small molecule tofacitinib. Models for estimating the risk of disease relapse and the efficacy of retreatment should be evaluated according to the patient's age and IBD phenotype. These models should guide clinicians in programming a temporary drug withdrawal after discussing realistic outcomes with the patient. This would shift the paradigm from an exit strategy to a holiday strategy.
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Affiliation(s)
- Federica Crispino
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
| | - Andrea Michielan
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
| | - Mauro Grova
- Inflammatory Bowel Disease Unit, Department of Medicine, Azienda Ospedaliera Ospedali Riuniti, Villa Sofia-Cervello, Palermo 90146, Italy
| | - Chiara Tieppo
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
| | - Marta Mazza
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
| | - Teresa Marzia Rogger
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
| | - Franco Armelao
- Azienda Provinciale per i Servizi Sanitari, Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Trento 38122, Italy
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Crispino F, Merola E, Tasini E, Cammà C, di Marco V, de Pretis G, Michielan A. Adverse events in gastrointestinal endoscopy: Validation of the AGREE classification in a real-life 5-year setting. Dig Liver Dis 2023:S1590-8658(23)00566-2. [PMID: 37100710 DOI: 10.1016/j.dld.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/08/2023] [Accepted: 04/09/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND The novel AGREE classification for adverse events (AEs) in gastrointestinal (GI) endoscopy has not yet been validated in a real-world setting. AIMS Our study aims to evaluate the correlation between the grades of AEs in the ASGE and AGREE classifications and to assess the interobserver agreement of the two classification systems. METHODS The correlation and association between the AE grades of the ASGE and AGREE classifications were analyzed using the Spearman rank correlation test and the chi-squared analysis, respectively. A weighted Cohen's kappa coefficient analysis was performed to determine the interobserver agreement of both classification systems. RESULTS We prospectively collected the AEs that occurred in our endoscopy unit over the past five years. A total of 226 AEs (226/84,863, 0.3%) occurred. There was a correlation between the ASGE and AGREE classifications (ρ = 0.61) and a moderately significant association (p < 0.01, Cramer's V = 0.7). The interobserver agreement for the ASGE classification was fair (kappa 0.60, 95% confidence interval [CI]: 0.54, 0.67), whereas it was good for the AGREE classification (kappa 0.80, 95% CI: 0.62, 0.87). CONCLUSIONS The AGREE classification was validated for the first time in a real-world setting and showed a positive correlation and higher interobserver agreement than the ASGE classification.
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Affiliation(s)
- Federica Crispino
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (PROMISE), Gastroenterology and Hepatology Unit, Piazza delle Cliniche 2, Palermo 90127, Italy; Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy
| | - Elettra Merola
- Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy; Gastroenterology Unit, G.B. Grassi Hospital (ASL Roma 3), Via Gian Carlo Passeroni 28, 00122 Lido di Ostia, Roma, Italy
| | - Enrico Tasini
- Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy
| | - Calogero Cammà
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (PROMISE), Gastroenterology and Hepatology Unit, Piazza delle Cliniche 2, Palermo 90127, Italy
| | - Vito di Marco
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (PROMISE), Gastroenterology and Hepatology Unit, Piazza delle Cliniche 2, Palermo 90127, Italy
| | - Giovanni de Pretis
- Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy
| | - Andrea Michielan
- Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy.
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Grova M, Crispino F, Maida M, Vitello A, Renna S, Casà A, Tesè L, Macaluso FS, Orlando A. Sarcopenia is a negative predictive factor for endoscopic remission in patients with Crohn's disease treated with biologics. Dig Liver Dis 2023:S1590-8658(23)00482-6. [PMID: 36925319 DOI: 10.1016/j.dld.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Sarcopenia has been associated with poor prognosis in chronic diseases. AIMS To investigate the role of sarcopenia in predicting clinical and endoscopic outcomes in patients with Crohn's disease (CD). METHODS Consecutive CD patients who started biologics between 2014 and 2020 and underwent abdominal magnetic resonance or computed tomography within 6 months from the beginning of the biological therapy were enroled. Sarcopenia was defined as Psoas Muscle Index (PMI) lower than 5.4 cm²/m² (men) and 3.56 cm²/m² (women). Univariate and multivariate analyses were used to evaluate whether sarcopenia could predict steroid-free clinical remission (SFCR), endoscopic remission (ER), hospitalisation and surgery after 12 months of therapy. RESULTS 358 patients were included. Sarcopenia was found in 18.2% of patients, and it was associated with a lower rate of ER (14.8% vs 47.7%; p = 0.002) after 12 months of therapy, while it was not associated with SFCR (65.1% vs 70.1%; p = 0.435), hospitalisation (9.2% vs 7.8%; p = 0.801) and surgery (3.1% vs 6.1%; p = 0.549). Sarcopenia was identified as a predictor of lack of ER (odds ratio [OR]=5.2; p = 0.006), as well as smoking (OR=2.5; p = 0.028) and perianal disease (OR=2.6; p = 0.020). CONCLUSION Sarcopenia is a negative prognostic factor for ER in CD patients treated with biologics.
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Affiliation(s)
- Mauro Grova
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy; Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
| | - Federica Crispino
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy; Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Marcello Maida
- Section of Gastroenterology, "S. Elia-Raimondi" Hospital", Caltanissetta, Italy
| | - Alessandro Vitello
- Section of Gastroenterology, "S. Elia-Raimondi" Hospital", Caltanissetta, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Angelo Casà
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Lorenzo Tesè
- Radiology Unit, A.O.O.R. "Villa Sofia-Cervello Hospital", Palermo, Italy
| | - Fabio Salvatore Macaluso
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Michielan A, Merola E, Vieceli F, Rogger TM, Crispino F, Sartori C, Decarli NL, de Pretis G, de Pretis N. Recurrence rates after piecemeal endoscopic mucosal resection of large colorectal laterally spreading tumors. Ann Gastroenterol 2023; 36:195-202. [PMID: 36864943 PMCID: PMC9932858 DOI: 10.20524/aog.2023.0774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023] Open
Abstract
Background Piecemeal endoscopic mucosal resection (pEMR) is routinely employed for large laterally spreading tumors (LSTs). Recurrence rates following pEMR are still unclear, especially when cap-assisted EMR (EMR-c) is performed. We assessed the recurrence rates and recurrence risk factors post-pEMR for large colorectal LSTs, including both wide-field EMR (WF-EMR) and EMR-c. Methods This was a single-center, retrospective study of consecutive patients who underwent pEMR for colorectal LSTs ≥20 mm at our institution between 2012 and 2020. Patients had a post-resection follow-up period of at least 3 months. A risk factor analysis was carried out using the Cox regression model. Results The analysis included 155 pEMR: 51 WF-EMR and 104 EMR-c, with a median lesion size of 30 (range: 20-80) mm and a median endoscopic follow up of 15 (range: 3-76) months. Overall, disease recurrence occurred in 29.0% of cases; there was no significant difference in recurrence rates between WF-EMR and EMR-c. Recurrent lesions were safely managed by endoscopic removal, and at risk analysis lesion size was the only significant risk factor for recurrence (mm; hazard ratio 1.03, 95% confidence interval 1.00-1.06, P=0.02). Conclusions Recurrence of large colorectal LSTs after pEMR occurs in 29% of cases. This rate is mainly dependent on lesion size, and the use of a cap during pEMR has no effect on recurrence. Prospective controlled trials are needed to validate these results.
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Affiliation(s)
- Andrea Michielan
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
| | - Elettra Merola
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
| | - Filippo Vieceli
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
| | - Teresa Marzia Rogger
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
| | - Federica Crispino
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
- Section of Gastroenterology and Hepatology, PROMISE, University of Palermo (Federica Crispino)
| | - Chiara Sartori
- Surgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Trento (Chiara Sartori, Nicola Libertà Decarli)
| | - Nicola Libertà Decarli
- Surgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Trento (Chiara Sartori, Nicola Libertà Decarli)
- Pathology Unit, San Giovanni di Dio Hospital, Firenze (Nicola Libertà Decarli)
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
| | - Nicolò de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento (Andrea Michielan, Elettra Merola, Filippo Vieceli, Teresa Marzia Rogger, Federica Crispino, Giovanni de Pretis, Nicolò de Pretis)
- Gastroenterology B Unit, Department of Medicine, The Pancreas Institute, University and Hospital Trust of Verona (Nicolò de Pretis), Italy
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Michielan A, Crispino F, de Pretis G. Cannulation of an intradiverticular papilla using a novel slim colonoscope with a short-bending section. VideoGIE 2022; 7:427-431. [DOI: 10.1016/j.vgie.2022.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sinagra E, Shahini E, Crispino F, Macaione I, Guarnotta V, Marasà M, Testai S, Pallio S, Albano D, Facciorusso A, Maida M. COVID-19 and the Pancreas: A Narrative Review. Life (Basel) 2022; 12:life12091292. [PMID: 36143329 PMCID: PMC9504204 DOI: 10.3390/life12091292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
The outbreak of COVID-19, initially developed in China in early December 2019, has rapidly spread to other countries and represents a public health emergency of international concern. COVID-19 has caused great concern about respiratory symptoms, but it is worth noting that it can also affect the gastrointestinal tract. However, the data on pancreatic involvement during SARS-CoV-2 infection are limited. The prevalence and severity of pancreatic damage and acute pancreatitis, as well as its pathophysiology, are still under debate. Moreover, the possible implication of pancreatic damage as an apparent adverse effect of COVID-19 therapies or vaccines are issues that need to be addressed. Finally, the COVID-19 pandemic has generated delays and organizational consequences for pancreatic surgery, an element that represent indirect damage from COVID-19. This narrative review aims to summarize and analyze all the aspects of pancreatic involvement in COVID-19 patients, trying to establish the possible underlying mechanisms and scientific evidence supporting the association between COVID-19 and pancreatic disease.
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Affiliation(s)
- Emanuele Sinagra
- Gastroenterology and Endoscopy Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
- Correspondence: ; Tel.: +39-921920712; Fax: +39-921920406
| | - Endrit Shahini
- Division of Gastroenterology, National Institute of Research “Saverio De Bellis”, Via Turi, 27, Castellana Grotte, 70013 Bari, Italy
| | - Federica Crispino
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology & Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90133 Palermo, Italy
| | - Ina Macaione
- Surgery Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Valentina Guarnotta
- Section of Endocrinology, Department of Health Promotion Sciences, Maternal-Infant Care, Internal Medicine and Specialties of Excellence “G.D’Alessandro” (PROMISE), University Hospital P. Giaccone, University of Palermo, Piazza Delle Cliniche 2, 90133 Palermo, Italy
| | - Marta Marasà
- Radiology Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Sergio Testai
- Radiology Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Socrate Pallio
- Endoscopy Unit, Department of Clinical and Experimental Medicine, University of Messina, AOUP Policlinico G. Martino, 98122 Messina, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
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Grova M, Crispino F, Maida M, Macaluso FS, Orlando A. Authors' reply to 'Use of restrictive iron transfusion strategy in IBD: one size does not fit all'. Eur J Gastroenterol Hepatol 2022; 34:808. [PMID: 35352695 DOI: 10.1097/meg.0000000000002373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Mauro Grova
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., 'Villa Sofia-Cervello' Hospital
| | - Federica Crispino
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., 'Villa Sofia-Cervello' Hospital
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo
| | - Marcello Maida
- Department of Gastroenterology and Digestive Endoscopy, Section of Gastroenterology, 'S. Elia-Raimondi' Hospital, Caltanissetta, Italy
| | - Fabio Salvatore Macaluso
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., 'Villa Sofia-Cervello' Hospital
| | - Ambrogio Orlando
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., 'Villa Sofia-Cervello' Hospital
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Pugliese D, Privitera G, Crispino F, Mezzina N, Castiglione F, Fiorino G, Laterza L, Viola A, Bertani L, Caprioli F, Cappello M, Barberio B, Ricci C, Balestrieri P, Daperno M, Pluchino D, Rizzello F, Scribano ML, Sablich R, Pastorelli L, Manguso F, Variola A, Di Sario A, Grossi L, Armuzzi A, Biscaglia G, Buda A, Mocci G, Viscido A, Di Paolo MC, Onali S, Rodino S, Coletta M, Principi M, Miranda A, Amato A, Bezzio C, Petruzzellis C, Mazzuoli S, Festa S, Sartini A, Checchin D, Fanigliulo L, Gallina S, Cesarini M, Bodini G, Stradella D, Spagnuolo R, Guidi L, Savarino E, Scrivo B, Soru P, Costa F, Fries W, Scaldaferri F, Allocca M, Pellegrini L, Massari A, Orlando A. Effectiveness and safety of vedolizumab in a matched cohort of elderly and nonelderly patients with inflammatory bowel disease: the IG-IBD LIVE study. Aliment Pharmacol Ther 2022; 56:95-109. [PMID: 35876062 PMCID: PMC9324100 DOI: 10.1111/apt.16923] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/13/2022] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Vedolizumab registration trials were the first to include elderly patients with moderate-to-severe ulcerative colitis (UC) or Crohn's disease (CD), but few real-life data have been reported in this population. AIMS We investigated the effectiveness and safety of vedolizumab in matched cohorts of elderly and nonelderly UC and CD patients. METHODS The Long-term Italian Vedolizumab Effectiveness (LIVE) study is a retrospective-prospective study including UC and CD patients who started vedolizumab from April 2016 to June 2017. Elderly patients (≥65 years) were matched clinically 1:2 to nonelderly patients (18-64 years); the 2 groups were followed until drug discontinuation or June 2019. RESULTS The study included 198 elderly (108 UC, 90 CD) and 396 matched nonelderly patients (205 UC, 191 CD). Nonelderly UC patients had a significantly higher persistence on vedolizumab compared to elderly patients (67.6% vs. 51.4%, p = 0.02). No significant difference in effectiveness was observed between elderly and nonelderly CD patients (59.4% vs. 52.4%, p = 0.32). Age ≥65 years was associated with lower persistence in UC; for CD, previous exposure to anti-TNF-α agents, Charlson comorbidity index >2 and moderate-to-severe clinical activity at baseline were associated with lower persistence. There were recorded 130 adverse events, with comparable rates between the two groups. A Charlson comorbidity index >2 was associated with an increased risk of adverse events. CONCLUSION Vedolizumab can be considered a safe option in elderly IBD patients. Its effectiveness in elderly UC patients may be reduced, while no age-dependent effect on effectiveness was observed in CD.
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Affiliation(s)
- Daniela Pugliese
- CEMAD – IBD UNIT, Unità Operativa Complessa di Medicina Interna e GastroenterologiaDipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCSRomeItaly
| | - Giuseppe Privitera
- Dipartimento Universitario di Medicina e Chirurgia TraslazionaleUniversità Cattolica del Sacro CuoreRomeItaly
| | - Federica Crispino
- Riuniti Villa Sofia–Cervello Hospital, Internal Medicine e 2IBD Unit PalermoPalermoItaly
| | - Nicolò Mezzina
- Department of Biochemical and Clinical Science “L. Sacco” ASST Fatebenefratelli Sacco–University of MilanMilanItaly
| | | | - Gionata Fiorino
- IBD Center, Gastroenterology, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy¸ Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Lucrezia Laterza
- CEMAD – IBD UNIT, Unità Operativa Complessa di Medicina Interna e GastroenterologiaDipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCSRomeItaly
| | - Anna Viola
- UOSD Malattie Intestinali Croniche, Dip. di Medicina Clinica e SperimentalePoliclinico MessinaSicilyItaly
| | - Lorenzo Bertani
- Gastroenterology and Digestive Endoscopy Department of Medical Specialties Apuane HospitalTuscany North‐West ASLMassaItaly
| | - Flavio Caprioli
- Gastroenterology and Endoscopy Unit, La Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Policlinico, Department of Pathophysiology and TransplantationUniversity of MilanMilanLombardiaItaly
| | - Maria Cappello
- Head IBD Clinic, Gastroenterology Section, PromiseUniversity of PalermoSicilyItaly
| | - Brigida Barberio
- Gastroenterology Unit, Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
| | - Chiara Ricci
- Gastroenterology Unit, Spedali Civili Hospital, Department of Experimental and Clinical SciencesUniversity of BresciaBresciaItaly
| | - Paola Balestrieri
- Unit of Digestive Disease of Campus Bio Medico University of RomeItaly
| | - Marco Daperno
- Gastroenterology UnitAzienda Ospedaliera Ordine Mauriziano di TorinoTorinoPiemonteItaly
| | - Dario Pluchino
- Gastroenterology UnitA.O.U. Policlinico "Vittorio Emanuele"CataniaItaly
| | - Fernando Rizzello
- Department of Internal Medicine and GastroenterologyPoliclinico Sant’Orsola MalpighiBolognaItaly
| | | | - Renato Sablich
- Gastroenterology UnitSanta Maria degli Angeli HospitalPordenoneItaly
| | - Luca Pastorelli
- Gastroenterology UnitIRCCS Policlinico San Donato Research HospitalMilanItaly
| | - Francesco Manguso
- Gastoenterology UnitAO A. CardarelliVia A. Cardarelli, 5Naples80131Italy
| | - Angela Variola
- IBD Unit, IRCCS Sacro Cuore Don CalabriaNegrar di ValpolicellaVeronaItaly
| | - Antonio Di Sario
- Clinica di GastroenterologiaUniversità Politecnica delle MarcheAnconaItaly,IBD‐UNIT, and Dipartimento Gastroenterologico e dei TrapiantiPolo Ospedaliero‐Universitario "Umberto I‐G.M. Lancisi‐ G. Salesi"AnconaItaly
| | - Laurino Grossi
- G. D’Annunzio University‐Digestive Physiopathology Ospedale Spirito Santo PescaraPescaraItaly
| | - Alessandro Armuzzi
- IBD CenterIRCCS Humanitas Research HospitalMilanItaly,Department of Biomedical Sciences, Humanitas UniversityPieve EmanueleMilanItaly
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Grova M, Crispino F, Maida M, Renna S, Mannino M, Casà A, Rizzuto G, Macaluso FS, Orlando A. Effectiveness and safety of an on-demand ferric carboxymaltose infusion strategy in patients with inflammatory bowel disease: a real world experience. Eur J Gastroenterol Hepatol 2022; 34:607-612. [PMID: 35102111 DOI: 10.1097/meg.0000000000002348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND We evaluated an on-demand ferric carboxymaltose (FCM) infusion strategy in inflammatory bowel disease (IBD) patients with iron deficiency anemia (IDA). AIMS The primary outcome was the response rate to single or multiple FCM infusions after 12 months. Secondary outcomes were the response rate to a single FCM infusion after 3 months and the FCM safety profile. METHODS We retrospectively included 185 IBD patients who received at least one FCM infusion of 500 mg, between 2015 and 2018. FCM was administered to patients with Hb ≤10 g/dL and hypoferritinemia and repeated according to the physician's assessment. Complete response (CR) was defined as Hb ≥12 g/dL (≥13 g/dL for men) or Hb increase ≥2 g/dL. Partial response (PR) was defined as an Hb increase between 1 and 2 g/dL. A univariate analysis was performed at 3 and 12 months. RESULTS After 12 months, the response rate was 75.1% (CR, 48.6%; PR, 26.4%; mean number of FCM infusions, 1.7 ± 1.1). In total 169/185 patients received a single FCM infusion during the first 3 months and 79.2% achieved response (CR, 56.8%; PR, 22.4%). At univariate analysis, no variable was associated with response. No adverse events were reported. CONCLUSIONS An on-demand strategy was effective and well-tolerated in treating IDA in IBD patients.
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Affiliation(s)
- Mauro Grova
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Federica Crispino
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Marcello Maida
- Department of Gastroenterology and Digestive Endoscopy, Section of Gastroenterology, "S. Elia-Raimondi" Hospital, Caltanissetta, Italy
| | - Sara Renna
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Mariella Mannino
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Angelo Casà
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Giulia Rizzuto
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Fabio Salvatore Macaluso
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
| | - Ambrogio Orlando
- Department of Medicine, Inflammatory Bowel Disease Unit, A.O.O.R., "Villa Sofia-Cervello" Hospital, Palermo
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Macaluso FS, Cappello M, Crispino F, Grova M, Privitera AC, Piccillo G, Magnano A, Ferracane C, Belluardo N, Giangreco E, Fries W, Viola A, Di Mitri R, Mocciaro F, Camilleri S, Garufi S, Renna S, Casà A, Maida M, Orlando A. Vedolizumab may be an effective option for the treatment of postoperative recurrence of Crohn's disease. Dig Liver Dis 2022; 54:629-634. [PMID: 34924320 DOI: 10.1016/j.dld.2021.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/04/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The role of Vedolizumab (VDZ) as therapeutic option for the postoperative recurrence of Crohn's disease (CD) following ileocolonic resection is unknown. AIMS To assess the effectiveness of VDZ in this setting. METHODS All consecutive CD patients with a baseline colonoscopy at 6-12 months from the ileocolonic resection showing postoperative recurrence (Rutgeerts score ≥i2) and treated with VDZ after the baseline colonoscopy were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD). The primary outcome was endoscopic success, assessed at the first colonoscopy following initiation of VDZ and defined as reduction of at least one point of Rutgeerts score. The secondary outcome was clinical failure, assessed at one year and at the end of follow-up. RESULTS Fifty-eight patients were included (mean follow-up: 24.8 ± 13.1 months). Endoscopic success was reported in 47.6% of patients. Clinical failure was reported in 19.0% of patients at one year, and in 32.8% of patients at the end of follow-up. A new resection was required in 7 patients (12.1%). CONCLUSIONS VDZ may be an effective option for the treatment of postoperative recurrence of CD.
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Affiliation(s)
| | - Maria Cappello
- Gastroenterology & Hepatology Section, Promise, University of Palermo, Italy
| | - Federica Crispino
- Inflammatory bowel disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy; Gastroenterology & Hepatology Section, Promise, University of Palermo, Italy
| | - Mauro Grova
- Inflammatory bowel disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy; Gastroenterology & Hepatology Section, Promise, University of Palermo, Italy
| | | | - Giovita Piccillo
- Inflammatory Bowel Disease Unit, "Cannizzaro" Hospital, Catania, Italy
| | - Antonio Magnano
- Gastroenterology Unit, "Vittorio Emanuele" Hospital, Catania, Italy
| | | | | | | | - Walter Fries
- Inflammatory bowel disease Unit, "G. Martino" Hospital, Messina, Italy
| | - Anna Viola
- Inflammatory bowel disease Unit, "G. Martino" Hospital, Messina, Italy
| | - Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, "ARNAS Civico - Di Cristina - Benfratelli" Hospital, Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, "ARNAS Civico - Di Cristina - Benfratelli" Hospital, Palermo, Italy
| | - Salvatore Camilleri
- Gastroenterology and Endoscopy Unit, "S. Elia- Raimondi" Hospital, Caltanissetta, Italy
| | - Serena Garufi
- Gastroenterology and Endoscopy Unit, "S. Elia- Raimondi" Hospital, Caltanissetta, Italy
| | - Sara Renna
- Inflammatory bowel disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Angelo Casà
- Inflammatory bowel disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, "S. Elia- Raimondi" Hospital, Caltanissetta, Italy
| | - Ambrogio Orlando
- Inflammatory bowel disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Crispino F, Grova M, Maida M, Renna S, Mocciaro F, Casà A, Rizzuto G, Tesè L, Scimeca D, Di Mitri R, Macaluso FS, Orlando A. Blood-based prognostic biomarkers in Crohn's Disease patients on biologics: a promising tool to predict endoscopic outcomes. Expert Opin Biol Ther 2021; 21:1133-1141. [PMID: 34042009 DOI: 10.1080/14712598.2021.1935857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE There is a growing need for biomarkers to predict therapeutic outcome in Crohn's disease (CD). MAIN OUTCOME MEASURES The aim was to evaluate whether NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), ELR (eosinophil-to-lymphocyte ratio), and ENLR (eosinophil*neutrophil-to-lymphocyte ratio), could be prognostic biomarkers of endoscopic response (ER) when starting biologics. RESEARCH DESIGN AND METHODS Patients with CD who started biologics were enrolled. Multivariate analysis was used to evaluate whether NLR, PLR, ELR and ENLR at baseline and at w12 could predict ER (Simple Endoscopic Score for Crohn's disease [SES-CD] ≤2 or SES-CD≤2 and Rutgeerts i0-i1) after 52 weeks of treatment. Area under the curve (AUC) was calculated to find the cutoffs. RESULTS 107 patients were included. Patients who achieved ER had significantly lower baseline NLR (p = 0.025), ELR (p = 0.013), and ENLR (p = 0.020) compared with those without ER; results after 12 weeks of treatment for ELR (p = 0.006) and ENLR (p = 0.003). AUC was 0.64 (p = 0.003), 0.67 (p = 0.006) and 0.65 (p = 0.014) for NLR, ELR and ENLR. CONCLUSIONS Low NLR, ELR and ENLR can predict ER and could be used in clinical practice for a better management of CD patients.
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Affiliation(s)
- Federica Crispino
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology & Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Italy.,Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Mauro Grova
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology & Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Italy.,Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Marcello Maida
- Section of Gastroenterology, "S.Elia-Raimondi" Hospital, Caltanissetta, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, ARNAS Civico - Di Cristina - Benfratelli Hospital, Palermo,Italy
| | - Angelo Casà
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Lorenzo Tesè
- Radiology Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Daniela Scimeca
- Gastroenterology and Endoscopy Unit, ARNAS Civico - Di Cristina - Benfratelli Hospital, Palermo,Italy
| | - Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, ARNAS Civico - Di Cristina - Benfratelli Hospital, Palermo,Italy
| | | | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, A.O.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
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Crispino F, Brinch D, Carrozza L, Cappello M. Acceptance of SARS-CoV-2 Vaccination Among a Cohort of IBD Patients From Southern Italy: A Cross-Sectional Survey. Inflamm Bowel Dis 2021; 27:e134-e135. [PMID: 34089256 PMCID: PMC8195093 DOI: 10.1093/ibd/izab133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Federica Crispino
- Gastroenterology & Hepatology Section, PROMISE, University of Palermo, Palermo, Italy,Address correspondence to: Federica Crispino, Gastroenterology & Hepatology Section, PROMISE, University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy. E-mail:
| | - Daniele Brinch
- Gastroenterology & Hepatology Section, PROMISE, University of Palermo, Palermo, Italy
| | - Lucio Carrozza
- Gastroenterology & Hepatology Section, PROMISE, University of Palermo, Palermo, Italy
| | - Maria Cappello
- Gastroenterology & Hepatology Section, PROMISE, University of Palermo, Palermo, Italy
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Macaluso FS, Maida M, Grova M, Crispino F, Teresi G, Orlando A, Orlando A. Head-to-head comparison of biological drugs for inflammatory bowel disease: from randomized controlled trials to real-world experience. Therap Adv Gastroenterol 2021; 14:17562848211010668. [PMID: 33995582 PMCID: PMC8111554 DOI: 10.1177/17562848211010668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/29/2021] [Indexed: 02/04/2023] Open
Abstract
During past years, the increasing knowledge of molecular mechanisms of inflammatory bowel disease (IBD) have led to the development of several targeted biological therapies. This great expansion of available medical options has prompted the need for comparative data between drugs. For years, given that most randomized controlled trials (RCTs) were performed only versus placebo, this demand has clashed with the absence of head-to-head trials comparing two or more treatments. The quality of evidence coming from real-world experience was low overall, so it was extremely difficult to clarify the correct positioning of the biologicals inside the therapeutic algorithms for IBD. Fortunately, times are changing: head-to-head comparative RCTs have been conducted or are ongoing, and the methodological quality of real-world studies is gradually increasing, mainly thanks to a higher rate of application of statistical methods capable of reducing the selection bias, such as the propensity score. In this evolving scenario, the increasing number of comparative RCTs is providing high-quality data for a correct drug positioning in IBD. In parallel, real-world observational studies are supporting the data coming from RCTs, and covering those comparisons not performed in the RCT setting. We believe that there is moderate evidence already available to support clinicians in the correct choice between different biologicals, and data will certainly be more robust in the near future.
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Affiliation(s)
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, “S. Elia-M. Raimondi” Hospital, Caltanissetta, Italy
| | - Mauro Grova
- Department of Medicine, IBD Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy,Department of Health Promotion, Sciences, Maternal and Infant Care, Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Italy
| | - Federica Crispino
- Department of Medicine, IBD Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy,Department of Health Promotion, Sciences, Maternal and Infant Care, Section of Gastroenterology and Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Italy
| | - Giulia Teresi
- Department of Medicine, IBD Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Adele Orlando
- Department of Medicine, IBD Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
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Broséus J, Rhumorbarbe D, Mireault C, Ouellette V, Crispino F, Décary-Hétu D. Studying illicit drug trafficking on Darknet markets: Structure and organisation from a Canadian perspective. Forensic Sci Int 2016; 264:7-14. [DOI: 10.1016/j.forsciint.2016.02.045] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/18/2016] [Accepted: 02/23/2016] [Indexed: 11/24/2022]
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Milot E, Courteau J, Crispino F, Mailly F. Inclusion probability with dropout: an operational formula. Forensic Sci Int Genet 2015; 16:71-76. [PMID: 25559642 DOI: 10.1016/j.fsigen.2014.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 11/06/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
In forensic genetics, a mixture of two or more contributors to a DNA profile is often interpreted using the inclusion probabilities theory. In this paper, we present a general formula for estimating the probability of inclusion (PI, also known as the RMNE probability) from a subset of visible alleles when dropouts are possible. This one-locus formula can easily be extended to multiple loci using the cumulative probability of inclusion. We show that an exact formulation requires fixing the number of contributors, hence to slightly modify the classic interpretation of the PI. We discuss the implications of our results for the enduring debate over the use of PI vs likelihood ratio approaches within the context of low template amplifications.
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Affiliation(s)
- E Milot
- Département de chimie, biochimie et physique, Université du Québec à Trois-Rivières, 3351 boul. des Forges, CP 500, Trois-Rivières, QC, Canada G9A 5H7; Centre international de criminologie comparée, Université du Québec à Trois-Rivières, 3351 boul. des Forges, CP 500, Trois-Rivières, QC, Canada G9A 5H7.
| | - J Courteau
- Groupe de recherche PRIMUS, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e Avenue N., Sherbrooke, QC, Canada J1H 5N4.
| | - F Crispino
- Département de chimie, biochimie et physique, Université du Québec à Trois-Rivières, 3351 boul. des Forges, CP 500, Trois-Rivières, QC, Canada G9A 5H7; Centre international de criminologie comparée, Université du Québec à Trois-Rivières, 3351 boul. des Forges, CP 500, Trois-Rivières, QC, Canada G9A 5H7.
| | - F Mailly
- Laboratoire de sciences judiciaires et de médecine légale, Ministère de la sécurité publique du Québec, 1701, rue Parthenais, Montréal, QC, Canada H2K 3S7.
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Abstract
A portable case has been developed by which cyanoacrylate (super glue) fuming can be used inside a vehicle suspected of being involved in serious crime. The car itself serves as a fumigation chamber and the cyanoacrylate vapours are fed into the car via a hose. Connected to the hose and suspended inside the car is a vapour diffuser. The cyanoacrylate originates from a portable case where there is a sealed heater and also a command panel with hygrometer and thermometer for a technician to control the process. There is also space inside the case for other necessary equipment.
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Affiliation(s)
- P Tissier
- Institut de Recherche Criminelle de la Gendarmerie Nationale, Département EDG, Sous Bois, France
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