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Tursi A, Mocci G, Scaldaferri F, Napolitano D, Maresca R, Pugliese D, Semprucci G, Savarino E, Cuomo A, Donnarumma L, Bodini G, Pasta A, Maconi G, Cataletti G, Pranzo G, Rodinò S, Sebkova L, Costa F, Ferronato A, Gaiani F, Marzo M, Luppino I, Fabiano G, Paese P, Elisei W, Monterubbianesi R, Faggiani R, Grossi L, Serio M, Scarcelli A, Lorenzetti R, Allegretta L, Chiri S, Grasso G, Antonelli E, Bassotti G, Spagnuolo R, Luzza F, Fanigliulo L, Rocco G, Sacchi C, Zampaletta C, Rocchi C, Bolognini L, Bendia E, Bianco MA, Capone P, Meucci C, Colucci R, Tonti P, Neve V, Della Valle N, Felice C, Pica R, Cocco A, Forti G, Onidi FM, Usai Satta P, Checchin D, Gravina AG, Pellegrino R, Picchio M, Papa A. Ustekinumab safety and effectiveness in patients with ulcerative colitis: results from a large real-life study. Expert Opin Biol Ther 2024; 24:101-109. [PMID: 38250818 DOI: 10.1080/14712598.2024.2309300] [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: 09/13/2023] [Accepted: 01/19/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Ustekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist recently approved for treating ulcerative colitis (UC) but with limited real-world data. Therefore, we evaluated the effectiveness and safety of UST in patients with UC in a real-world setting. RESEARCH DESIGN AND METHODS This is a multicenter, retrospective, observational cohort study. The primary endpoints were the clinical remission rate (partial Mayo score, PMS, ≤1) and the safety of UST. Other endpoints were corticosteroid-free remission (CSFR) rate, clinical response rate (PMS reduction of at least 2 points), and fecal calprotectin (FC) reduction at week 24. RESULTS We included 256 consecutive patients with UC (M/F 139/117, median age 52). The clinical remission and clinical response rates at eight weeks were 18.7% (44/235) and 53.2% (125/235), respectively, and 27.6% (42/152) and 61.8% (94/152) at 24 weeks, respectively. At 24 weeks, CSFR was 20.3% (31/152), and FC significantly dropped at week 12 (p = 0.0004) and 24 (p = 0.038). At eight weeks, patients naïve or with one previous biologic treatment showed higher remission (p = 0.002) and clinical >response rates (p = 0.018) than patients previously treated with ≥ 2. Adverse events occurred in six patients (2.3%), whereas four patients (1.6%) underwent colectomy. CONCLUSION This real-world study shows that UST effectively and safely treats patients with UC.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Franco Scaldaferri
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Daniele Napolitano
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
| | - Rossella Maresca
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
| | - Daniela Pugliese
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Gianluca Semprucci
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Giorgia Bodini
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Andrea Pasta
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Giovanni Maconi
- Gastroenterology Unit, Department Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Milan, Italy
| | - Giovanni Cataletti
- Gastroenterology Unit, Department Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Milan, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Rodinò
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Francesco Costa
- IBD Unit, Department of General Surgery and Gastroenterology, Pisa University Hospital, Pisa, Italy
| | - Antonio Ferronato
- Digestive Endoscopy Unit, Hospital of Santorso, ULSS7, Santorso (VI), Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Manuela Marzo
- Division of Gastroenterology, "Veris-Delli Ponti" Hospital, Scorrano (LE), Italy
| | - Ileana Luppino
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Giulia Fabiano
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Pietro Paese
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Walter Elisei
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | - Laurino Grossi
- Gastroenterology Unit, "Spirito Santo" Hospital, "G d'Annunzio" University, Pescara, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Giuseppina Grasso
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Elisabetta Antonelli
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Rocco Spagnuolo
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Libera Fanigliulo
- Division of Gastroenterology, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Chiara Rocchi
- Division of Gastroenterology and Digestive Endoscopy, "Mater Olbia" Hospital, Olbia (SS), Italy
| | - Laura Bolognini
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, A.O. "Ospedali Riuniti", Ancona, Italy
| | - Emanuele Bendia
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, A.O. "Ospedali Riuniti", Ancona, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Pietro Capone
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Paolo Tonti
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Viviana Neve
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | | | - Carla Felice
- Division of Internal Medicine, "Ca' Foncello" University Hospital, Treviso, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | | | | | - Davide Checchin
- Division of Gastroenterology, " S Giovanni e Paolo" Hospital, Mestre - Venezia, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine, Hepatogastroenterology and Digestive Endoscopy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaele Pellegrino
- Department of Precision Medicine, Hepatogastroenterology and Digestive Endoscopy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Alfredo Papa
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
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Cantoro L, Monterubbianesi R, Falasco G, Camastra C, Pantanella P, Allocca M, Cosintino R, Faggiani R, Danese S, Fiorino G. The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease. Diagnostics (Basel) 2023; 13:3183. [PMID: 37892004 PMCID: PMC10605540 DOI: 10.3390/diagnostics13203183] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Delayed diagnosis is a challenge in the management of inflammatory bowel disease (IBD). Several studies show a significant association between diagnostic delay and disease progression to complications and surgery, especially in Crohn's disease (CD). What risk factors are associated with diagnostic delay in IBD remains unclear. In order to reduce diagnostic delay, the Red Flags Index has been developed and validated. The combination of the Red Flags Index score and non-invasive biomarkers such as fecal calprotectin seems to be highly accurate in screening patients with underlying IBD to be referred for further diagnostic workup and eventual early effective treatment strategies. Our literature review aims to obtain a comprehensive overview of the impacts of diagnostic delay in IBD on the potential risk factors associated with IBD, how diagnostic tools may be effective in reducing diagnostic delay, and future perspectives in this field.
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Affiliation(s)
- Laura Cantoro
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Rita Monterubbianesi
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Giuliano Falasco
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Caterina Camastra
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Paolo Pantanella
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Mariangela Allocca
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
| | - Rocco Cosintino
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Roberto Faggiani
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Silvio Danese
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
| | - Gionata Fiorino
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
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Tursi A, Mocci G, Cingolani L, Savarino E, Pica R, Cocco A, Zippi M, Napolitano D, Schiavoni E, Pugliese D, Scaldaferri F, Costa F, Marzo M, Serio M, Scarcelli A, Bolognini L, Bendia E, Maconi G, Cannatelli R, Piergallini S, Bodini G, Calabrese F, Ferronato A, Pranzo G, Elisei W, Monterubbianesi R, Faggiani R, Rodinò S, Sebkova L, Grossi L, Gaiani F, Dè Angelis G, Lorenzetti R, Allegretta L, Cazzato AI, Scorza S, Della Valle N, Sacco R, Forti G, Colucci R, Tonti P, Neve V, Rocco G, Sacchi C, Zampaletta C, Pagnini C, Graziani MG, Di Paolo MC, Onidi FM, Usai Satta P, Picchio M, Papa A. Use of tofacitinib as first or second-line therapy is associated with better outcomes in patients with ulcerative colitis: data from a real-world study. Expert Opin Pharmacother 2023; 24:1649-1656. [PMID: 37358928 DOI: 10.1080/14656566.2023.2230126] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Data regarding the real-world (RW) use of tofacitinib (TOF) in patients with ulcerative colitis (UC) are limited. We aimed to investigate TOF's RW efficacy and safety in Italian UC patients. RESEARCH DESIGN AND METHODS A retrospective assessment of clinical and endoscopic activity was performed according to the Mayo score. The primary endpoints were to evaluate the effectiveness and safety of TOF. RESULTS We enrolled 166 patients with a median follow-up of 24 (IQR 8-36) weeks. Clinical remission was achieved in 61/166 (36.7%) and 75/166 (45.2%) patients at 8-week and 24-week follow-ups, respectively. The optimization was requested in 27 (16.3%) patients. Clinical remission was achieved more frequently when TOF was used as a first/second line rather than a third/fourth line treatment (p = 0.007). Mucosal healing was reported in 46% of patients at the median follow-up time. Colectomy occurred in 8 (4.8%) patients. Adverse events occurred in 12 (5.4%) patients and severe in 3 (1.8%). One case of simple Herpes Zoster and one of renal vein thrombosis were recorded. CONCLUSIONS Our RW data confirm that TOF is effective and safe in UC patients. It performs remarkably better when used as the first/second line of treatment.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, Asl Bat, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Linda Cingolani
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Maddalena Zippi
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Daniele Napolitano
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Elisa Schiavoni
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniela Pugliese
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Franco Scaldaferri
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Francesco Costa
- IBD Unit, Department of General Surgery and Gastroenterology, Pisa University Hospital, Pisa, Italy
| | - Manuela Marzo
- Division of Gastroenterology, "Veris-Delli Ponti" Hospital, Scorrano (LE), Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Laura Bolognini
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, Ancona, Italy
| | - Emanuele Bendia
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, Ancona, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Rosanna Cannatelli
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy
| | - Giorgia Bodini
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Francesco Calabrese
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | | | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Walter Elisei
- Division of Gastroenterology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Stefano Rodinò
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Laurino Grossi
- Gastroenterology Unit, "Spirito Santo" Hospital, "G d'Annunzio" University, Pescara, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gianluigi Dè Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Stefano Scorza
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Rodolfo Sacco
- Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo Degli Infermi" Hospital, Spoleto (PG), Italy
| | - Paolo Tonti
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Viviana Neve
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | | | | | | | - Paolo Usai Satta
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Alfredo Papa
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
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Tursi A, Mocci G, Allegretta L, Aragona G, Bianco MA, Colucci R, Cuomo A, Della Valle N, Ferronato A, Forti G, Gaiani F, Giorgetti G, Graziani MG, Lofano K, Lorenzetti R, Larussa T, Penna A, Pica R, Pranzo G, Rodino' S, Scarcelli A, Zampaletta C, Bassotti G, Cazzato AI, Chiri S, Clemente V, Cocco A, De' Angelis G, Donnarumma L, Faggiani R, Graziosi C, Le Grazie M, Luzza F, Meucci C, Monterubbianesi R, Pagnini C, Perazzo P, Picchio M, Sacco R, Sebkova L, Serio M, Napolitano D, Pugliese D, Scaldaferri F, Schiavoni E, Turchini L, Armuzzi A, Elisei W, Maconi G, Papa A. Comparison of Performances of Adalimumab Biosimilars SB5, ABP501, GP2017, and MSB11022 in Treating Patients with Inflammatory Bowel Diseases: A Real-Life, Multicenter, Observational Study. Inflamm Bowel Dis 2023; 29:376-383. [PMID: 35579320 DOI: 10.1093/ibd/izac092] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Adalimumab (ADA) biosimilars have entered the therapeutic armamentarium of inflammatory bowel disease (IBD), allowing for the treatment of a greater number of patients for their reduced cost than the originator. However, comparative data on the efficacy and safety of the various ADA biosimilars remains scarce.We compare the efficacy and safety of ADA biosimilars SB5, ABP501, GP2017, and MSB11022 in treating IBD outpatients in a real-life Italian setting. METHODS A retrospective analysis was performed on consecutive IBD outpatients with complete clinical, laboratory, and endoscopic data. Clinical activity was measured using the Mayo score in ulcerative colitis (UC) and the Harvey-Bradshaw Index in Crohn's disease (CD). The primary endpoints were the following: (1) induction of remission in patients new to biologics and patients new to ADA but previously exposed to other anti-tumor necrosis factor agents or other biologics; (2) maintenance of remission in patients switched from the ADA originator to an ADA biosimilar; and (3) safety of various biosimilars. RESULTS A total of 533 patients were enrolled according to the inclusion criteria: 162 patients with UC and 371 patients with CD. Clinical remission was obtained in 79.6% of patients new to biologics and 59.2% of patients new to ADA but not to other biologics; clinical remission was maintained in 81.0% of patients switched from the originator, and adverse events were recorded in 6.7% of patients. There was no significant difference between the 4 ADA biosimilars for each predetermined endpoint. CONCLUSIONS Adalimumab biosimilars are effective and safe in IBD treatment, both in new patients and in patients switched from the ADA originator. No difference in efficacy and safety was found between ADA biosimilars.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Post-graduate School of Digestive Diseases, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Nicola Della Valle
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - GianMarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | | | - Katia Lofano
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | | | | | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | | | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Camilla Graziosi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Laura Turchini
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | | | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
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5
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Mocci G, Tursi A, Maconi G, Cataletti G, Mantia B, Serio M, Scarcelli A, Pagnini C, Graziani MG, Di Paolo MC, Pranzo G, Luppino I, Paese P, Elisei W, Monterubbianesi R, Faggiani R, Ferronato A, Perini B, Savarino E, Onidi FM, Binaghi L, Usai Satta P, Schiavoni E, Napolitano D, Scaldaferri F, Pugliese D, Pica R, Cocco A, Zippi M, Rodino S, Sebkova L, Rocco G, Sacchi C, Zampaletta C, Gaiani F, De Angelis G, Kayali S, Fanigliulo L, Lorenzetti R, Allegretta L, Scorza S, Cuomo A, Donnarumma L, Della Valle N, Sacco R, Forti G, Antonelli E, Bassotti G, Iannelli C, Luzza F, Aragona G, Perazzo P, Lauria A, Piergallini S, Colucci R, Bianco MA, Meucci C, Giorgetti G, Clemente V, Fiorella S, Penna A, De Medici A, Picchio M, Papa A. Real-world efficacy and safety of vedolizumab in managing ulcerative colitis versus Crohn's disease: results from an Italian multicenter study. Expert Opin Biol Ther 2023; 23:293-304. [PMID: 36843568 DOI: 10.1080/14712598.2023.2185510] [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] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Vedolizumab (VDZ) can be used to treat refractory ulcerative colitis (UC) and Crohn's disease (CD). We assessed whether there are differences in treating UC vs CD with VDZ. RESEARCH DESIGN AND METHODS Mayo score in UC and the Harvey-Bradshaw Index (HBI) in CD scored the clinical activity. Achievement and maintenance of clinical remission during the follow-up, and safety were the primary endpoints. RESULTS 729 patients (475 with UC and 254 with CD), median follow-up of 18 (IQR 6-36) months, were enrolled. Clinical remission at the 6th month of treatment was achieved in 488 (66.9%) patients (74.4% in CD vs 62.9% in UC, p<0.002) while, during the follow-up, no difference was found (81.5% in the UC group and 81.5% pts in the CD group; p=0.537). The clinical remission at the 6th month of treatment (p=0.001) and being naïve to biologics (p<0.0001) were significantly associated with prolonged clinical remission. The clinical response was significantly higher in UC (90.1%) vs CD (84.3%) (p=0.023), and surgery occurred more frequently in CD (1.9% in UC vs 5.1% in CD, p=0.016). CONCLUSION We found differences when using VDZ in UC vs CD in real life. These parameters can help the physician predict this drug's longterm efficacy.
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Affiliation(s)
- Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy.,Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Giovanni Cataletti
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Beatrice Mantia
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | | | | | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Ileana Luppino
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Pietro Paese
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Walter Elisei
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Barbara Perini
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | | | - Laura Binaghi
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Paolo Usai Satta
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Maddalena Zippi
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Stefano Rodino
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gianluigi De Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Stefano Kayali
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Libera Fanigliulo
- Division of Gastroenterology, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Stefano Scorza
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | | | - Rodolfo Sacco
- Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | - Elisabetta Antonelli
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | - Chiara Iannelli
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Angelo Lauria
- Division of Gastroenterology, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Gianmarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Serafina Fiorella
- Division of Gastroenterology, "Padre Pio" Hospital, Vasto (CH), Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy
| | - Antonio De Medici
- Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, Velletri (Roma), Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
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6
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Tursi A, Mocci G, Cuomo A, Ferronato A, Elisei W, Picchio M, Maconi G, Scaldaferri F, Papa A, Allegretta L, Aragona G, Bianco MA, Colucci R, Della Valle N, Faggiani R, Forti G, Gaiani F, Giorgetti G, Graziani MG, Lofano K, Lorenzetti R, Larussa T, Penna A, Bassotti G, Cazzato AI, Chiri S, Clemente V, Cocco A, De' Angelis G, Donnarumma L, Graziosi C, Le Grazie M, Luzza F, Meucci C, Monterubbianesi R, Pagnini C, Perazzo P, Pica R, Pranzo G, Rodino' S, Sacco R, Sebkova L, Scarcelli A, Serio M, Napolitano D, Pugliese D, Schiavoni E, Turchini L, Armuzzi A, Zampaletta C. Replacement of Adalimumab Originator to Adalimumab Biosimilar for a Non-Medical Reason in Patients with Inflammatory Bowel Disease: A Real-life Comparison of Adalimumab Biosimilars Currently Available in Italy. J Gastrointestin Liver Dis 2022; 31:411-416. [PMID: 36535057 DOI: 10.15403/jgld-4608] [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] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Adalimumab (ADA) biosimilars have been included into the therapeutic armamentarium of inflammatory bowel disease (IBD); however, comparative data on the efficacy and safety of the different ADA biosimilars after replacing the ADA originator for a non-medical reason remains scarce. We aimed to compare in a real-life setting the efficacy and safety of four ADA biosimilars SB5, APB501, GP2017, and MSB11022 in IBD patients after replacing the originator for a non-medical reason. METHODS A multicenter retrospective study was performed on consecutive IBD patients, analyzing clinical, laboratory, and endoscopic data. The primary endpoints of the study were maintenance of clinical remission and safety of the different biosimilars. RESULTS 153 patients were enrolled, 26 with UC and 127 with CD. Clinical remission was maintained in 124 out of 153 (81%) patients after a median (IQR) follow-up of 12 (6-24) months, without any significant difference between the four ADA biosimilars. ADA biosimilars dosage was optimized in five patients (3.3%). Loss of remission was significantly higher in UC patients (10/26 patients, 38.5%) than in CD patients (19/127 patients, 14.9%, p<0.025). Adverse events occurred in 12 (7.9%) patients; the large majority were mild. CONCLUSIONS No difference in efficacy and safety was found between ADA biosimilars when used to replace the ADA originator for a non-medical reason. However, in UC patients the replacement of ADA originator for this reason should be carefully assessed.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria; Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome, Italy.
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy.
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy.
| | | | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy.
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy.
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy.
| | - Franco Scaldaferri
- Gastroenterology Department, CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Gemelli, IRCCS, Rome; Catholic University, School of Medicine, Rome, Italy.
| | - Alfredo Papa
- Gastroenterology Department, CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Gemelli, IRCCS, Rome; Catholic University, School of Medicine, Rome, Italy.
| | | | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy.
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy.
| | | | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy.
| | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy.
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - GianMarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy.
| | | | - Katia Lofano
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy.
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy.
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy.
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | | | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy.
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy.
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy.
| | - Camilla Graziosi
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy.
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome.
| | - Patrizia Perazzo
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy.
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy.
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy.
| | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy.
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy.
| | | | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy.
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Laura Turchini
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
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7
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Scribano ML, Aratari A, Neri B, Bezzio C, Balestrieri P, Baccolini V, Falasco G, Camastra C, Pantanella P, Monterubbianesi R, Tullio A, Saibeni S, Papi C, Biancone L, Cosintino R, Faggiani R. Effectiveness of ustekinumab in patients with refractory Crohn's disease: a multicentre real-life study in Italy. Therap Adv Gastroenterol 2022; 15:17562848211072412. [PMID: 35186121 PMCID: PMC8848093 DOI: 10.1177/17562848211072412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/13/2021] [Accepted: 12/20/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The effectiveness of ustekinumab in patients with refractory Crohn's disease (CD) has been investigated in several real-world studies. However, very few data concerning the real-life experience in Italy have been reported. Therefore, this study assessed the effectiveness of ustekinumab in a large cohort of Italian patients with refractory CD. METHODS All patients who had started on ustekinumab after failure of or intolerance to antitumour necrosis factor-α (TNF-α) treatment at five tertiary centres between November 2018 and February 2020 were retrospectively enrolled. The coprimary outcome was corticosteroid-free clinical remission, defined as a Harvey-Bradshaw Index (HBI) score of ⩽4, at weeks 26 and 52. The secondary outcomes were changes in the HBI and C-reactive protein (CRP) values at weeks 8, 26, and 52 from baseline and the normalization of CRP in patients with initially abnormal values. RESULTS Totally, 140 patients who had previously received at least one anti-TNF-α agent were enrolled; 40.0% received two anti-TNF-α agents and 20.0% received vedolizumab. At baseline, 108 patients (77.1%) had HBI scores of >4; of these, 56.5% and 58.3% achieved corticosteroid-free clinical remission at weeks 26 and 52, respectively. Significant decreases in HBI and CRP values were observed at weeks 8, 26, and 52 in the entire study cohort (all p < 0.0001). The CRP values were normalized in 34.9%, 37.8%, and 49.3% of the patients by weeks 8, 26, and 52, respectively. The baseline HBI score of ⩾8 was a negative predictor of corticosteroid-free clinical remission at week 52 (odds ratio: 0.21, 95% confidence interval: 0.08-0.56, p = 0.002). The probability of remaining on ustekinumab after 52 weeks was 92.1%. Eleven (7.9%) patients discontinued ustekinumab (three for adverse events). CONCLUSION Our study findings confirm the effectiveness and safety of ustekinumab in patients with CD after failure of or intolerance to anti-TNF-α therapy.
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Affiliation(s)
| | | | - Benedetto Neri
- Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Bezzio
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Rho, Italy
| | | | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giuliano Falasco
- Gastroenterology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Caterina Camastra
- Gastroenterology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Paolo Pantanella
- Gastroenterology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | | | | | - Simone Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Rho, Italy
| | - Claudio Papi
- IBD Unit, San Filippo Neri Hospital, Rome, Italy
| | - Livia Biancone
- Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Rocco Cosintino
- Gastroenterology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Roberto Faggiani
- Gastroenterology Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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8
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Tursi A, Mocci G, Elisei W, Allegretta L, Colucci R, Della Valle N, De Medici A, Faggiani R, Ferronato A, Forti G, Larussa T, Lorenzetti R, Luzza F, Penna A, Pranzo G, Rodinò S, Sacco R, Sebkova L, Zampaletta C, Graziosi C, Picchio M, Bergna IMB, Maconi G. Long-term, Real-life, Observational Study in Treating Outpatient Ulcerative Colitis with Golimumab. J Gastrointestin Liver Dis 2021; 30:456-461. [PMID: 34812437 DOI: 10.15403/jgld-3992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Several studies have found Golimumab (GOL) effective and safe in the short-term treatment of ulcerative colitis (UC), but few long-term data are currently available from real world. Our aim was to assess the long-term real-life efficacy and safety of GOL in managing UC outpatients in Italy. METHODS A retrospective multicenter study assessing consecutive UC outpatients treated with GOL for at least 3-month of follow-up was made. Primary endpoints were the induction and maintenance of remission in UC, defined as Mayo score ≤2. Several secondary endpoints, including clinical response, colectomy rate, steroid free remission and mucosal healing, were also assessed during the follow-up. RESULTS One hundred and seventy-eight patients were enrolled and followed up for a median (IQR) time of 9 (3-18) months (mean time follow-up: 33.1±13 months). Clinical remission was achieved in 57 (32.1%) patients: these patients continued with GOL, but only 6 patients (3.4%) were still under clinical remission with GOL at the 42nd month of follow-up. Clinical response occurred in 64 (36.4%) patients; colectomy was performed in 8 (7.8%) patients, all of them having primary failure. Steroid-free remission occurred in 23 (12.9%) patients, and mucosal healing was achieved in 29/89 (32.6%) patients. Adverse events occurred in 14 (7.9%) patients. CONCLUSIONS Golimumab does not seem able to maintain long-term remission in UC in real life. The safety profile was good.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria; Department of Medical and Surgical Sciences, Post- graduate School of Digestive Diseases, Catholic University, Rome, Italy.
| | - Giammarco Mocci
- Division of Gastroenterology, Brotzu Hospital, Cagliari, Italy.
| | - Walter Elisei
- Division of Gastroenterology, S. Camillo Hospital, Rome, Italy.
| | - Leonardo Allegretta
- Division of Gastroenterology, Santa Caterina Novella Hospital, Galatina (LE), Italy.
| | - Raffaele Colucci
- Digestive Endoscopy Unit, San Matteo degli Infermi Hospital, Spoleto (PG), Italy.
| | | | - Antonio De Medici
- Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy.
| | | | | | - Giacomo Forti
- Division of Digestive Endoscopy, S. Maria Goretti Hospital, Latina, Italy.
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | | | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy.
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, Valle D'Itria Hospital, Martina Franca (TA), Italy.
| | - Stefano Rodinò
- Division of Gastroenterology, Ciaccio-Pugliese Hospital, Catanzaro, Italy.
| | - Rodolfo Sacco
- Division of Gastroenterology, A.O. Ospedali Riuniti, Foggia, Italy.
| | - Ladislava Sebkova
- Division of Gastroenterology, Ciaccio-Pugliese Hospital, Catanzaro, Italy.
| | | | - Camilla Graziosi
- Division of Gastroenterology, Belcolle Hospital, Viterbo, Italy.
| | - Marcello Picchio
- Division of General Surgery, P. Colombo Hospital, ASL Roma 6, Velletri (Roma), Italy.
| | - Irene Maria Bambina Bergna
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy.
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy.
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9
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Donato G, Occhipinti P, Correale L, Spadaccini M, Repici A, Anderloni A, Fugazza A, Mosca P, Tringali A, Costamagna G, Bulajic M, de Pretis G, Gabbrielli A, Di Matteo FM, Faggiani R, Ayoubi M, De Luca L, Cantù P, Blois M, Dell’Amico I, Maurano A, Savarese MF, Manes G, Ferraro R, Barberis M, Hassan C. A prospective study on quality in endoscopic retrograde cholangiopancreatography (ERCP): trend in Italy from the REQUEST study. Endosc Int Open 2021; 9:E1563-E1571. [PMID: 34540552 PMCID: PMC8445684 DOI: 10.1055/a-1531-4691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/07/2021] [Indexed: 12/28/2022] Open
Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure with a relatively high rate of adverse events. Data on training of operators and fulfillment of quality indicators in Italy are scarce. The goal of this study was to assess the overall quality of ERCP in Italy compared to international standards. Patients and methods This was a prospective, observational study from different Italian centers performing ERCP. Operators answered a questionnaire, then recorded data on ERCPs over a 1-to 3-month period. Results Nineteen Italian centers participated in the study. The most common concern of operators about training was the lack of structured programs. Seven/19 centers routinely used conscious sedation for ERCP. Forty-one experienced operators and 21 trainees performed 766 ERCPs: a successful deep biliary cannulation in native-papilla patients was achieved in 95.1 % of cases; the post-ERCP pancreatitis (PEP) rate was 5.4 % in native-papilla patients; cholangitis rate was 1.0 %; bleeding and perforation occurred in 2.7 % and 0.4 % of the patients, respectively. Conclusions This study revealed that, overall, ERCP is performed in the participating Italian centers meeting good quality standards, but structured training and sedation practice are still subpar. The bleeding and perforation rate slightly exceeded the American Society of Gastrointestinal Endoscopy indicator targets but they are comparable to the reported rates from other international surveys.
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Affiliation(s)
- Giulio Donato
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
| | - Pietro Occhipinti
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
| | - Loredana Correale
- Gastroenterology Unit, Department of Oncological and Specialty Medicine, Ospedale “Maggiore della Carità”, Novara, Italy
| | - Marco Spadaccini
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy,Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Pieve Emanuele, Milano, Italy
| | - Alessandro Repici
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy,Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Pieve Emanuele, Milano, Italy
| | - Andrea Anderloni
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | - Alessandro Fugazza
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | - Piergiorgio Mosca
- Division of Gastroenterology, Department of Gastroenterology & Transplantation, AOU Ospedali Riuniti, Ancona, Italy
| | - Andrea Tringali
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy,Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy,Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Milutin Bulajic
- Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy,Mater Olbia Hospital-Qatar Foundation Endowment & Gemelli Foundation, Gastroenterology and GI Endoscopy Unit, Olbia (OT), Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Ospedale S. Chiara, Trento, Italy
| | | | | | - Roberto Faggiani
- Gastroenterology and Endoscopy Unit, Department of Oncological and Specialty Medicine, S. Camillo Forlanini Hospital, Rome, Italy
| | - Mohammad Ayoubi
- Gastroenterology and Endoscopy Unit, Gradenigo-Humanitas, Torino, Italy
| | - Luca De Luca
- Gastroenterology and Digestive Endoscopy Unit, A.O. Ospedale Riuniti Marche Nord, Pesaro, Italy
| | - Paolo Cantù
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Matteo Blois
- Interventional Endoscopy Unit, Azienda USL Toscana Nord-Ovest, Livorno, Italy
| | | | - Attilio Maurano
- Operative Endoscopy Unit, Azienda Ospedaliera Universitaria di Salerno, Italy
| | - Maria Flavia Savarese
- Gastroenterology and Gastrointestinal Endoscopy, General Hospital, Sanremo (IM), Italy
| | - Giampiero Manes
- Department of Gastroenterology and Digestive Endoscopy, ASST Rhodense Garbagnate Milanese, Milano, Italy
| | - Raffaella Ferraro
- Gastroenterology and Digestive Endoscopy Unit, Ospedale S. Andrea, ASL VC, Vercelli, Italy
| | - Mauro Barberis
- Gastroenterology Unit, Policlinico di Monza, Monza (MB), Italy
| | - Cesare Hassan
- Department of Gastroenterology, Nuovo Regina Margherita Hospital, Roma, Italy
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Briganti V, Tursini S, Ianniello S, Cortese A, Faggiani R. Double isolated asynchronous duodenal perforation due to abdominal blunt trauma in a child: A case report. Int J Surg Case Rep 2020; 77:67-70. [PMID: 33157336 PMCID: PMC7644788 DOI: 10.1016/j.ijscr.2020.09.183] [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] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/03/2020] [Accepted: 09/26/2020] [Indexed: 11/26/2022] Open
Abstract
This is the first case described in literature of a double asynchronous isolated perforation of the duodenum. Timing of diagnosis and treatment are described. Radiologic findings are provided.
Background Isolated duodenal perforation following blunt abdominal trauma is a rare injury in children. Bicycle accidents (falling on to the handlebar) are a frequent cause of blunt abdominal trauma in children and may occasionally be associated with isolated duodenal perforation (IDP). Prompt diagnosis and surgical treatment are vital to prevent increased morbidity and mortality. Case presentation We report the rare case of an 11-year-old boy admitted for blunt abdominal trauma and treated for an asynchronous double IDP. The first perforation, located on the 2nd/3rd portion of the duodenum, was promptly diagnosed by contrast-enhanced abdominal CT scan after a negative US scan, five hours after injury, and the lesion repaired with a single stitch suture. The second duodenal perforation appeared in the duodenal bulb as a worsening biliary leakage, 48 h after the primary suture of the initial lesion. The perforation was initially seen by digestive endoscopy and sutured in the same way as the first lesion. A third laparotomy was needed 4 days later due to an intestinal obstruction, after which the patient was recovered completely and was discharged home. Discussion and conclusion IDP is a rare consequence of blunt abdominal trauma, and is normally associated with a lesion of other organs, such as the pancreas or bile duct. A delayed diagnosis strongly increases the incidence of morbidity and mortality, and different kinds of surgical management have been proposed, depending on the type of lesion. To our knowledge, this is the first case described in literature of a double isolated asynchronous duodenal perforation following blunt abdominal trauma in children.
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Affiliation(s)
- V Briganti
- Pediatric Surgery Operative Unit, San Camillo, Forlanini Hospital, Rome, Italy
| | - S Tursini
- Pediatric Surgery Operative Unit, San Camillo, Forlanini Hospital, Rome, Italy.
| | - S Ianniello
- Emergency Radiology Operative Unit, San Camillo, Forlanini Hospital, Rome, Italy
| | - A Cortese
- Radiology Operative Unit Operative Unit, San Camillo, Forlanini Hospital, Rome, Italy
| | - R Faggiani
- Gastroenterology and Diagnostic and Operative Digestive Endoscopy Operative Unit, San Camillo, Forlanini Hospital, Rome, Italy
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11
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Tursi A, Mocci G, Faggiani R, Allegretta L, Valle ND, Medici AD, Forti G, Franceschi M, Ferronato A, Gallina S, Grasso G, Larussa T, Luzza F, Lorenzetti R, Penna A, Rodino' S, Sebkova L, Lauria A, Piergallini S, Pranzo G, Scorza S, Zampaletta C, Picchio M, Elisei W. Vedolizumab is effective and safe in real-life treatment of inflammatory bowel diseases outpatients: A multicenter, observational study in primary inflammatory bowel disease centers. Eur J Intern Med 2019; 66:85-91. [PMID: 31208827 DOI: 10.1016/j.ejim.2019.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Italian data currently available in managing ulcerative colitis (UC) and Crohn's disease (CD) patients with vedolizumab (VDZ) are coming just from secondary and tertiary centers. The present study aimed to assess the real-life efficacy and safety of VDZ to achieve remission in inflammatory bowel diseases (IBD) outpatients in primary gastroenterology centers. METHODS Clinical activity was scored according to the Mayo score in UC and to the Harvey-Bradshaw Index (HBI) in CD. The primary endpoints were the achievement of clinical remission and safety. Secondary endpoints were clinical response to treatment, achievement of mucosal healing (MH), and steroid discontinuation. RESULTS One hundred and thirty-six pts. were enrolled (91 UC and 45 CD pts). During an 18-month median follow-up, clinical remission was present in 63 (46.3%) pts.: in particular, it occurred in 48 (52.7%) patients in UC group and in 15 (33.3%) patients in CD group (p = 0.003). more in UC group. Fecal calprotectin ≥400 μg/g and presence of comorbidities were factors significantly related to the failure of remission in UC and CD, respectively. Ten (7.3%) cases of adverse events were recorded (2 required suspension of treatment). Clinical response was present in 105 (72.2%) pts.: 71 (78.0%) in UC and 34 (75.5%) in CD group. MH occurred in 47 (62.7%) UC and in 9 (50.0%) CD patients. Steroids discontinuation occurred in 92 (67.6%) pts.; 61 (67.0%) UC and 31 (68.9%) CD pts. CONCLUSION VDZ is effective and safe in IBD outpatients, especially in UC patients.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy.
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Roberto Faggiani
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Antonio de Medici
- Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | | | | | - Sara Gallina
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Giuseppina Grasso
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy
| | - Antonio Penna
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, - Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, - Italy
| | - Angelo Lauria
- Division of Gastroenterology, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Scorza
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri, Roma, Italy
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma 6, Albano Laziale, Roma, Italy
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12
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Tursi A, Mocci G, Faggiani R, Allegretta L, Valle ND, Forti G, Franceschi M, Ferronato A, Gallina S, Larussa T, Luzza F, Lorenzetti R, Penna A, Rodino S, Sebkova L, Lauria A, Piergallini S, Pranzo G, Ricciardelli C, Zampaletta C, Elisei W, Picchio M. Infliximab biosimilar CT-P13 is effective and safe in treating inflammatory bowel diseases: a real-life multicenter, observational study in Italian primary inflammatory bowel disease centers. Ann Gastroenterol 2019; 32:392-399. [PMID: 31263362 PMCID: PMC6595921 DOI: 10.20524/aog.2019.0377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/13/2019] [Accepted: 04/01/2019] [Indexed: 12/24/2022] Open
Abstract
Background The purpose of this study was to assess the efficacy and safety of biosimilar infliximab (IFX) CT-P13 in treating outpatients with inflammatory bowel disease (IBD) in Italian primary gastroenterology centers. Methods Consecutive IBD outpatients who completed the induction treatment were evaluated retrospectively. Clinical activity was scored according to the Mayo score for ulcerative colitis (UC) and to the Harvey-Bradshaw Index (HBI) for Crohn’s disease (CD). The primary endpoint was the achievement of clinical remission (Mayo score ≤2 in UC and HBI ≤5 in CD). Secondary endpoints were clinical response to treatment, achievement of mucosal healing, and safety. Results One hundred forty-one patients (96 UC and 45 CD) were enrolled. Previous treatment with anti-tumor necrosis factor (TNF)α had been provided to 26% of UC patients and 28.9% of CD patients. Remission was achieved in 57.3% UC patients and in 75.6% CD patients during a median (interquartile range) follow up of 24 (6-24) months. Clinical response and mucosal healing were achieved in 87.5% and 75.0% of UC patients and in 84.4% and 84.2% of CD patients, respectively. By both univariate and multivariate analysis, age >40 years, presence of comorbidities, and naivety to anti-TNFα were significantly related to remission. Only one (0.7%) adverse event was reported in the CD group. Surgery was performed in 2.1% of UC patients and 6.7% of CD patients. Switching from IFX originator to biosimilar did not influence the maintenance of the clinical remission. Conclusion This study confirmed the long-term efficacy and safety of CT-P13 therapy in IBD, in both naïve patients and those switching from IFX originator.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria (Antonio Tursi)
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari (Giammarco Mocci)
| | - Roberto Faggiani
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo (Roberto Faggiani, Sara Gallina, Costantino Zampaletta)
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina, LE (Leonardo Allegretta)
| | - Nicola Della Valle
- Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia (Nicola Della Valle)
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina (Nicola Della Valle, Giacomo Forti)
| | - Marilisa Franceschi
- Digestive Endoscopy Unit, ULSS7 Pedemontana, Santorso (VI) (Marilisa Franceschi, Antonio Ferronato)
| | - Antonio Ferronato
- Digestive Endoscopy Unit, ULSS7 Pedemontana, Santorso (VI) (Marilisa Franceschi, Antonio Ferronato)
| | - Sara Gallina
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo (Roberto Faggiani, Sara Gallina, Costantino Zampaletta)
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro (Tiziana Larussa, Francesco Luzza)
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro (Tiziana Larussa, Francesco Luzza)
| | - Roberto Lorenzetti
- Division of Gastroenterology, PTP "Nuovo Regina Margherita", Rome (Roberto Lorenzetti)
| | - Antonio Penna
- Division of Gastroenterology, "S. Paolo" Hospital, Bari (Antonio Penna)
| | - Stefano Rodino
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro (Stefano Rodino, Ladislava Sebkova)
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro (Stefano Rodino, Ladislava Sebkova)
| | - Angelo Lauria
- Division of Gastroenterology, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria (Angelo Lauria)
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo (Simona Piergallini)
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA) (Giuseppe Pranzo)
| | - Cristina Ricciardelli
- Division of Gastroenterology, "Veris Delli Ponti" Hospital, Scorrano (LE) (Cristina Ricciardelli)
| | - Costantino Zampaletta
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo (Roberto Faggiani, Sara Gallina, Costantino Zampaletta)
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma 6, Albano Laziale, Rome (Walter Elisei)
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri, Rome (Marcello Picchio), Italy
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Tursi A, Elisei W, Faggiani R, Allegretta L, Valle ND, Forti G, Franceschi M, Ferronato A, Gallina S, Larussa T, Luzza F, Lorenzetti R, Mocci G, Penna A, Rodino’ S, Sebkova L, de Medici A, Pranzo G, Ricciardelli C, Grasso G, Scorza S, Zampaletta C, Picchio M. Effectiveness and safety of adalimumab to treat outpatient ulcerative colitis: A real-life multicenter, observational study in primary inflammatory bowel disease centers. Medicine (Baltimore) 2018; 97:e11897. [PMID: 30142791 PMCID: PMC6112877 DOI: 10.1097/md.0000000000011897] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Adalimumab (ADA) was approved in Italy for the treatment of ulcerative colitis (UC) unresponsive to standard treatments in 2014, but no data from real life are currently available. The aim of the present study was to assess the real-life efficacy and safety of ADA in managing UC outpatients in some Italian primary inflammatory bowel disease (IBD) centers after approval of ADA reimbursement.Consecutive UC outpatients with at least 3-month follow-up were retrospectively evaluated. The primary end point was the induction and maintenance of remission in UC, defined as Mayo score ≤2.One hundred seven patients were included. At 3-month follow-up, obtained in 102 (95.3%) patients, 56 (54.9%) patients achieved a clinical remission. At univariate analysis, both Mayo partial score >7 and Mayo subscore for endoscopy = 3 at entry showed to be significantly associated with the lack of remission induction.During a median (95% confidence interval [CI]) follow-up of 18 (12-24) months, 56.6% of patients were under clinical remission; clinical response was achieved in 89.2% of cases. Mucosal healing was achieved in 66 (76.7%) patients, and colectomy occurred in 3 (2.8%) patients. Both C-reactive protein and fecal calprotectin values significantly decreased during follow-up. Steroids discontinuation occurred in 67 (66.7%) patients, and ADA dose escalation was adopted in 9 (16.1%) patients under remission. No factor was significantly related to the maintenance of clinical remission.This first Italian experience found ADA safe and effective to induce and maintain remission in real-life UC outpatients.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma 6, Albano Laziale (Roma)
| | | | - Leonardo Allegretta
- Division of Gastroenterology, “Santa Caterina Novella” Hospital, Galatina (LE)
| | | | - Giacomo Forti
- Division of Digestive Endoscopy, “S. Maria Goretti” Hospital, Latina
| | | | | | - Sara Gallina
- Division of Gastroenterology, A.O. “Ospedali Riuniti,” Foggia
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro
| | | | | | - Antonio Penna
- Division of Gastroenterology, “S. Paolo” Hospital, Bari
| | - Stefano Rodino’
- Division of Gastroenterology, “Ciaccio-Pugliese” Hospital, Catanzaro
| | - Ladislava Sebkova
- Division of Gastroenterology, “Ciaccio-Pugliese” Hospital, Catanzaro
| | | | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, “Valle D’Itria” Hospital, Martina Franca (TA)
| | | | - Giuseppina Grasso
- Division of Gastroenterology, “Santa Caterina Novella” Hospital, Galatina (LE)
| | - Stefano Scorza
- Division of Gastroenterology, A.O. “Ospedali Riuniti,” Foggia
| | | | - Marcello Picchio
- Division of General Surgery, “P. Colombo” Hospital, ASL Roma 6, Velletri (Roma), Italy
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14
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Tursi A, Allegretta L, Buccianti N, Della Valle N, Elisei W, Forti G, Faggiani R, Gallina S, Hadad Y, Larussa T, Lauria A, Luzza F, Lorenzetti R, Mocci G, Penna A, Polimeni N, Pranzo G, Ricciardelli C, Zampaletta C, Picchio M. Effectiveness and Safety of Golimumab in Treating Outpatient Ulcerative Colitis: A Real-Life Prospective, Multicentre, Observational Study in Primary Inflammatory Bowel Diseases Centers. J Gastrointestin Liver Dis 2018; 26:239-244. [PMID: 28922435 DOI: 10.15403/jgld.2014.1121.263.trs] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Golimumab (GOL) has been recently approved in Italy for the treatment of ulcerative colitis (UC) unresponsive to standard treatments. Our aims were to assess the real-life efficacy and safety of GOL in managing UC outpatients in Italian primary Inflammatory Bowel Diseases (IBD) centres. METHODS Consecutive UC outpatients with at least 3-months follow-up were enrolled. Primary end-point was the induction and maintenance of remission in UC, defined as Mayo score </=2, at 6-month follow-up. RESULTS Ninety-three patients were enrolled. At 6-month follow-up, remission was obtained in 34 (36.5%) patients. Shorter duration of disease was the only significant predictive factor of remission. Clinical response was achieved in 60 (64.5%) patients, while mucosal healing (MH) was obtained in 18 (19.3%) patients. Sixteen (47.0%) patients under remission were still under therapy with steroids. C-reactive protein and fecal calprotectin significantly dropped during the follow-up (plt;0.001 for both proteins). Adverse events occurred in 4 (4.3%) patients and 3 of them stopped treatment. Colectomy was performed in only one patient (1.1%). CONCLUSIONS Golimumab seems to be safe and effective in inducing and maintaining remission in real life UC outpatients.
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Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, ASL BAT, Andria, Italy. antotursi@tiscali
| | - Leonardo Allegretta
- Div. Gastroenterology, Santa Caterina Novella Hospital, Galatina (LE), Italy
| | - Nello Buccianti
- Div. Internal Medicine, Madonna delle Grazie Hospital, Matera, Italy
| | | | - Walter Elisei
- Div.Gastroenterology, ASL Roma 6, Albano Laziale, Roma, Italy
| | - Giacomo Forti
- Div.Digestive Endoscopy, S. Maria Goretti Hospital, Latina, Italy
| | | | - Sara Gallina
- Div.Gastroenterology, Belcolle Hospital, Viterbo, Italy
| | - Yusef Hadad
- Div.Internal Medicine, Card. Panico Hospital, Tricase (LE), Italy
| | - Tiziana Larussa
- Depart.Health Science, University of Catanzaro, Catanzaro, Italy
| | - Angelo Lauria
- Div. Gastroenterology, A.O. Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Francesco Luzza
- Depart.Health Science, University of Catanzaro, Catanzaro, Italy
| | | | | | - Antonio Penna
- Div. Gastroenterology, S. Paolo Hospital, Bari, Italy
| | - Natale Polimeni
- Div. Gastroenterology, A.O. Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, Valle D'Itria Hospital, Martina Franca (TA), Italy
| | | | | | - Marcello Picchio
- Div. General Surgery, P. Colombo Hospital, ASL Roma 6, Velletri, Roma, Italy
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15
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Tursi A, Brandimarte G, Di Mario F, Annunziata ML, Bafutto M, Bianco MA, Colucci R, Conigliaro R, Danese S, De Bastiani R, Elisei W, Escalante R, Faggiani R, Ferrini L, Forti G, Latella G, Graziani MG, Oliveira EC, Papa A, Penna A, Portincasa P, Søreide K, Spadaccini A, Usai P, Bonovas S, Scarpignato C, Picchio M, Lecca PG, Zampaletta C, Cassieri C, Damiani A, Desserud KF, Fiorella S, Landi R, Goni E, Lai MA, Pigò F, Rotondano G, Schiaccianoce G. Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study. United European Gastroenterol J 2015; 4:604-13. [PMID: 27536372 DOI: 10.1177/2050640615617636] [Citation(s) in RCA: 27] [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: 09/13/2015] [Accepted: 10/22/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. AIMS We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available. METHODS For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis; months of follow-up; therapy taken during the follow-up to maintain remission (if any); occurrence/recurrence of diverticulitis; need of surgery. RESULTS We enrolled 1651 patients (793 M, 858 F, mean age 66.6 ± 11.1 years): 939 (56.9%) patients were classified as DICA 1, 501 (30.3%) patients as DICA 2 and 211 (12.8%) patients as DICA 3. The median follow-up was 24 (9-38) months. Acute diverticulitis (AD) occurred/recurred in 263 (15.9%) patients; surgery was necessary in 57 (21.7%) cases. DICA was the only factor significantly associated to the occurrence/recurrence of diverticulitis and surgery either at univariate (χ(2 )= 405.029; p < 0.0001) or multivariate analysis (hazard ratio = 4.319, 95% confidence interval (CI) 3.639-5.126; p < 0.0001). Only in DICA 2 patients was therapy effective for prevention of AD occurrence/recurrence with a hazard ratio (95% CI) of 0.598 (0.391-0.914) (p = 0.006, log rank test). Mesalazine-based therapies reduced the risk of AD occurrence/recurrence and needs of surgery with a hazard ratio (95% CI) of 0.2103 (0.122-0.364) and 0.459 (0.258-0.818), respectively. CONCLUSIONS DICA classification is a valid parameter to predict the risk of diverticulitis occurrence/recurrence in patients suffering from diverticular disease of the colon.
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Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, Azienda Sanitaria Locale Barletta-Andria-Trani, Andria, Italy
| | - Giovanni Brandimarte
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - Francesco Di Mario
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Maria L Annunziata
- Division of Gastroenterology, Istituto di Rocovero e Cura a Carattere Scientifico San Donato, San Donato Milanese, Italy
| | - Mauro Bafutto
- Instituto Goiano de Gastroenterologia e Endoscopia digestiva, Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Brasil
| | - Maria A Bianco
- Division of Gastroenterology, T. Maresca Hospital, Torre del Greco, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, San Matteo degli Infermi Hospital, Spoleto, Italy
| | - Rita Conigliaro
- Division of Digestive Endoscopy, Sant'Agostino Estense Hospital, Baggiovara, Italy
| | - Silvio Danese
- Humanitas University, IBD Center, Humanitas Clinical and Research Hospital, Via Manzoni, Rozzano, Milan, Italy
| | | | - Walter Elisei
- Division of Gastroenterology, Azienda Sanitaria Locale Azienda Sanitaria Locale Roma H., Rome, Italy
| | - Ricardo Escalante
- Loira Medical Center, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Luciano Ferrini
- Service of Gastroenterology and Digestive Endoscopy, Villa dei Pini Home Care, Civitanova, Marche, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, S. Maria Goretti Hospital, Latina, Italy
| | - Giovanni Latella
- Division of Gastroenterology, S. Salvatore Hospital, L'Aquila, Italy
| | - Maria G Graziani
- Service of Digestive Endoscopy, S. Camillo Hospital, Rome, Italy
| | - Enio C Oliveira
- Department of Surgery, Federal University of Goiás, Goiânia, Brasil
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, C.I. Columbus Catholic University, Rome, Italy
| | - Antonio Penna
- Division of Gastroenterology, S. Paolo Hospital, Bari, Italy
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
| | - Kjetil Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, University of Bergen, Bergen, Norway
| | - Antonio Spadaccini
- Division of Gastroenterology and Digestive Endoscopy, Padre Pio Hospital, Vasto, Italy
| | - Paolo Usai
- Division of Gastroenterology, Monserrato University Hospital, University of Cagliari, Cagliari, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Piera G Lecca
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | | | - Claudio Cassieri
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - Alberto Damiani
- Service of Gastroenterology and Digestive Endoscopy, Villa dei Pini Home Care, Civitanova, Marche, Italy
| | - Kari F Desserud
- Department of Gastrointestinal Surgery, Stavanger University Hospital, University of Bergen, Bergen, Norway
| | - Serafina Fiorella
- Division of Gastroenterology and Digestive Endoscopy, Padre Pio Hospital, Vasto, Italy
| | - Rosario Landi
- Division of Internal Medicine and Gastroenterology, C.I. Columbus Catholic University, Rome, Italy
| | - Elisabetta Goni
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Maria A Lai
- Division of Gastroenterology, Monserrato University Hospital, University of Cagliari, Cagliari, Italy
| | - Flavia Pigò
- Division of Digestive Endoscopy, Sant'Agostino Estense Hospital, Baggiovara, Italy
| | - Gianluca Rotondano
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - Giuseppe Schiaccianoce
- Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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16
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Tursi A, Brandimarte G, Di Mario F, Andreoli A, Annunziata ML, Astegiano M, Bianco MA, Buri L, Cammarota G, Capezzuto E, Chilovi F, Cianci M, Conigliaro R, Del Favero G, Di Cesare L, Di Fonzo M, Elisei W, Faggiani R, Farroni F, Forti G, Germanà B, Giorgetti GM, Giovannone M, Lecca PG, Loperfido S, Marmo R, Morucci P, Occhigrossi G, Penna A, Rossi AF, Spadaccini A, Zampaletta C, Zilli M, Zullo A, Scarpignato C, Picchio M. Development and validation of an endoscopic classification of diverticular disease of the colon: the DICA classification. Dig Dis 2014; 33:68-76. [PMID: 25531499 DOI: 10.1159/000366039] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A validated endoscopic classification of diverticular disease (DD) of the colon is lacking at present. Our aim was to develop a simple endoscopic score of DD: the Diverticular Inflammation and Complication Assessment (DICA) score. METHODS The DICA score for DD resulted in the sum of the scores for the extension of diverticulosis, the number of diverticula per region, the presence and type of inflammation, and the presence and type of complications: DICA 1 (≤ 3), DICA 2 (4-7) and DICA 3 (>7). A comparison with abdominal pain and inflammatory marker expression was also performed. A total of 50 videos of DD patients were reassessed in order to investigate the predictive role of DICA on the outcome of the disease. RESULTS Overall agreement in using DICA was 0.847 (95% confidence interval, CI, 0.812-0.893): 0.878 (95% CI 0.832-0.895) for DICA 1, 0.765 (95% CI 0.735-0.786) for DICA 2 and 0.891 (95% CI 0.845-0.7923) for DICA 3. Intra-observer agreement (kappa) was 0.91 (95% CI 0.886-0.947). A significant correlation was found between the DICA score and C-reactive protein values (p = 0.0001), as well as between the median pain score and the DICA score (p = 0.0001). With respect to the 50 patients retrospectively reassessed, occurrence/recurrence of disease complications was recorded in 29 patients (58%): 10 (34.5%) were classified as DICA 1 and 19 (65.5%) as DICA 2 (p = 0.036). CONCLUSIONS The DICA score is a simple, reproducible, validated and easy-to-use endoscopic scoring system for DD of the colon.
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17
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Tursi A, Elisei W, Picchio M, Penna A, Lecca PG, Forti G, Giorgetti G, Faggiani R, Zampaletta C, Pelecca G, Brandimarte G. Managing ambulatory ulcerative colitis patients with infliximab: a long term follow-up study in primary gastroenterology centers. Eur J Intern Med 2014; 25:757-61. [PMID: 25086677 DOI: 10.1016/j.ejim.2014.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Infliximab (IFX) is the key treatment for ulcerative colitis (UC) unresponsive to standard treatments. The aim of the present study was to assess the efficacy and safety of IFX in treating ambulatory UC patients in primary gastroenterology centers. METHODS One hundred and eighteen patients (65 M, 63 F, median age 34 years, range 19-71 years), affected by UC, were treated with IFX. Clinical efficacy, safety, mucosal healing (MH), and histological healing (HH) were assessed at a scheduled follow-up of 42 months. RESULTS Percentage of patients with clinical remission persistence at 42-month follow-up was 70.4%. Colectomy occurred in only 3 patients (2.7%). At 42-month follow-up percentage of patients with MH was 44.6%, and percentage of patients with HH was 24.3%. HH at 6-month follow-up occurred in 13 out of 34 patients (38.2%) with C-reactive protein (CRP) <3 and in 8 out of 76 patients (10.5%) with CRP ≥ 3 (p=0.002). Side effects were reported in 16 patients (13.6%): infusion reactions occurred in 7 patients, other severe side-effects occurred in 3 patients, and opportunistic infections occurred in 3 patients (2.5%). Finally, 3 cancers (2.5%) occurred during the follow-up period (1 breast, 1 kidney and 1 rectal cancer). Both univariate and multivariate analyses showed Hb <11.5 g/dL and HH at 6-month follow-up to be significantly associated with treatment failure during follow-up. CONCLUSIONS IFX seems to be effective and safe in long-term treatment of outpatients affected by UC.
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Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, ASL BAT, Andria, BT, Italy.
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma H, Albano Laziale, Rome, Italy
| | - Marcello Picchio
- Division of Surgery, "P. Colombo" Hospital, Velletri, Rome, Italy
| | - Antonio Penna
- Division of Gastroenterology, "San Paolo" Hospital, Bari, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "Santa Maria Goretti" Hospital, Latina, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy
| | | | - Giorgio Pelecca
- Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy
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18
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Tursi A, Elisei W, Picchio M, Zampaletta C, Faggiani R, Brandimarte G. Letter: infliximab vs. adalimumab in treating ambulatory perianal fistulising Crohn's disease. Aliment Pharmacol Ther 2014; 40:218-20. [PMID: 24946069 DOI: 10.1111/apt.12828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 12/08/2022]
Affiliation(s)
- A Tursi
- Gastroenterology Service, ASL BAT, Andria, BT, Italy.
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19
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Tursi A, Elisei W, Picchio M, Penna A, Lecca PG, Forti G, Giorgetti G, Faggiani R, Zampaletta C, Pelecca G, Brandimarte G. Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres. Eur J Intern Med 2014; 25:485-90. [PMID: 24631020 DOI: 10.1016/j.ejim.2014.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Infliximab (IFX) and adalimumab (ADA) are the key treatments for Crohn's Disease (CD), unresponsive to standard treatments. Our aim was to compare the efficacy and safety of IFX and ADA in treating CD in clinical practice. METHODS One hundred and twenty-six patients (61 M, 65 F, mean age 36.2 years, range 19-67 years), affected by CD, were treated with infliximab (IFX, 59 patients) or adalimumab (ADA, 66 patients). Clinical efficacy, mucosal healing (MH), histological healing (HH), and safety were assessed. MH was defined complicated if healing of ulcers occurred with deformation of bowel profile and/or complete colonoscopy was impossible because of scars. RESULTS Patients were followed-up for 36 months. No difference was found between IFX and ADA in maintaining long-term clinical remission, MH and HH. Complicated MH was present in 17 (28.8%) patients in IFX group and in 7 (10.6%) patients in ADA group (p=0.012). In 9 (15.2%) patients in IFX group and 2 (3.0%) patients in ADA group colonoscopy was incomplete without cecal intubation or terminal ileum exploration (p=0.024). Side effects were similar in both groups. CONCLUSIONS Both IFX and ADA seem to be effective and safe in long-term outpatient treatment of CD in clinical practice.
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Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, ASL BAT, Andria, BT, Italy.
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma H, Albano Laziale, Rome, Italy
| | - Marcello Picchio
- Division of Surgery, "P. Colombo" Hospital, Velletri, Rome, Italy
| | - Antonio Penna
- Division of Gastroenterology, "San Paolo" Hospital, Bari, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "Santa Maria Goretti" Hospital, Latina, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy
| | | | - Giorgio Pelecca
- Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy
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20
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Tursi A, Elisei W, Picchio M, Forti G, Giorgetti G, Faggiani R, Zampaletta C, Brandimarte G. Letter: diverticulosis in inflammatory bowel diseases. Aliment Pharmacol Ther 2014; 39:899-900. [PMID: 24635315 DOI: 10.1111/apt.12656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 01/22/2014] [Accepted: 01/23/2014] [Indexed: 12/08/2022]
Affiliation(s)
- A Tursi
- Gastroenterology Service, ASL BAT, Andria, Italy.
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21
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Tursi A, Elisei W, Picchio M, Penna A, Forti G, Giorgetti GM, Faggiani R, Zampaletta C, Pelecca G, Brandimarte G. Effectiveness of adalimumab for ambulatory ulcerative colitis patients after failure of infliximab treatment: a first "real-life" experience in primary gastroenterology centers in Italy. Ann Gastroenterol 2014; 27:369-373. [PMID: 25331091 PMCID: PMC4188935] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 07/11/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Adalimumab (ADA) is the key treatment for ulcerative colitis (UC) unresponsive or intolerant to standard treatments. Our aim was to assess the efficacy and safety of ADA in treating ambulatory UC patients in primary gastroenterology centers. METHODS Fifteen patients (6 male, median age 29.9 years, range 22.8-39.9 years) were enrolled. All were previously treated with infliximab (IFX). Clinical activity and endoscopic severity were scored according to the Crohn's disease activity index (CDAI) score and Mayo subscore for endoscopy, respectively. Patients were clinically assessed at weeks 4, 8, and thereafter at weeks 16, 24, 32, 40, 48, and 54. Colonoscopy was performed before starting treatment, at weeks 24 and 54. The co-primary endpoints were clinical remission at 24 and 54 weeks. The secondary endpoints included: 1) sustained clinical remission; 2) steroid-sparing effect; 3) mucosal healing; 4) need for colectomy. Induction dose of ADA was 160 mg at week 0, and then 80 mg at week 2, while ADA maintenance treatment was 40 mg every two weeks. RESULTS Clinical remission was obtained in 11 (73.3%) and 15 (100%) patients at weeks 24 and 54 respectively. Ten patients (66.7%) were able to discontinue steroids and were under corticosteroid-free remission at week 54. No patients underwent to colectomy. Eight patients (53.33%) at week 24 and 9 patients (60%) at week 54 achieved complete mucosal healing (Mayo endoscopic score 0). Side effects were reported in 2 of 15 patients (13.3%); none of those patients stopped treatment. CONCLUSION ADA seems to be effective and safe in UC outpatients affected by UC, and previously treated with IFX.
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Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, ASL BAT, Andria, BT (Antonio Tursi), Italy
| | - Walter Elisei
- Division of Gastroenterology, ASL Roma H, Albano Laziale, Rome (Walter Elisei), Italy
| | - Marcello Picchio
- Division of Surgery, “P. Colombo” Hospital, Velletri, Rome (Marcello Picchio), Italy
| | - Antonio Penna
- Division of Gastroenterology, “San Paolo” Hospital, Bari (Antonio Penna), Italy
| | - Giacomo Forti
- Digestive Endoscopy Unit, “Santa Maria Goretti” Hospital, Latina (Giacomo Forti), Italy
| | - Gian Marco Giorgetti
- Digestive Endoscopy and Nutrition Unit, “S. Eugenio” Hospital, Rome (Gian Marco Giorgetti), Italy
| | - Roberto Faggiani
- Division of Gastroenterology, “Belcolle Hospital”, Viterbo (Roberto Faggiani, Costantino Zampaletta, Giorgio Pelecca), Italy
| | - Costantino Zampaletta
- Division of Gastroenterology, “Belcolle Hospital”, Viterbo (Roberto Faggiani, Costantino Zampaletta, Giorgio Pelecca), Italy
| | - Giorgio Pelecca
- Division of Gastroenterology, “Belcolle Hospital”, Viterbo (Roberto Faggiani, Costantino Zampaletta, Giorgio Pelecca), Italy
| | - Giovanni Brandimarte
- Division of Gastroenterology, “Cristo Re” Hospital, Rome (Giovanni Brandimarte), Italy
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22
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Abstract
A case of granulomatous interstitial nephritis (GIN) associated with Crohn's disease (CD) was reported. GIN is a rare pathological finding in renal biopsy specimens. In a patient affected by CD, granulomas may be found in various tissues and organs such as lymph nodes, mesentery, liver, and lungs and occasionally in bones, joints, and skeletal muscle. Few cases of granuloma have been reported in the kidney, and it is not always possible to relate the presence of granuloma to CD, to other interstitial granulomatosis diseases, or to a drug-induced reaction. The issue has a remarkable clinical effect; indeed, the answer requires a completely different therapeutic approach. The diagnosis analysis on the basis of clinical-pathological evidences and on reports from literature is discussed.
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Affiliation(s)
- Rosaria Polci
- Department of Nephrology and Dialysis, Belcolle Hospital, Viterbo, Italy.
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23
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Urgesi R, Pastorelli A, Zampaletta C, Masini A, Pelecca G, Faggiani R, Anti M. Obscure-occult bleeding: resolution of unexplained chronic sideropenic anaemia by colonoscopic removal of a colonic leiomyoma. BMJ Case Rep 2011; 2011:2011/jan29_1/bcr1120092455. [PMID: 22714624 DOI: 10.1136/bcr.11.2009.2455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Although leiomyomas of the stomach or small intestine are relatively common, those of the colon or rectum are rare. Several cases of endoscopic resection of colorectal leiomyomas have been described. However, conventional polypectomy of leiomyomas can result in perforation. To reduce the risk of perforation, submucosal injection can be performed before removal. We report a case of chronic sideropenic anaemia in a patient affected by leiomyoma of the sigmoid colon in which after complete endoscopic enucleation of the lesion we obtained the stable resolution of anaemia.
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24
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Urgesi R, Zampaletta C, Masini A, Pelecca G, Pastorelli A, De Lorenzo A, Faggiani R. Spontaneous right ventricular thrombus in a patient with active ulcerative colitis and protein C deficiency: a review with a case report. Eur Rev Med Pharmacol Sci 2010; 14:455-463. [PMID: 20556925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is an idiopathic condition of gastrointestinal tract whose pathogenesis results from the complex interaction of genetic susceptibility and environmental influences. Is well known how IBD patients have an increased risk of thrombosis. OBJECTIVES To assess the frequency and characteristics of thromboembolic events (TEE) in IBD and the role of certain etiopathological factors in such thrombotic patients. MATERIAL AND METHODS We report the case of a young woman affected by protein C deficiency, who during a clinical recurrence of ulcerative colitis (UC), developed a spontaneous right ventricular thrombus and pulmonary embolism. Then, we made a review of literature that documented thromboembolic events in IBD patients. RESULTS A search using the PubMed database identified 65 case reports documenting thromboembolic events in patients with known UC and 7 documenting thromboembolic events in known Crohn's disease. DISCUSSION The data of the literature confirm that IBD patients have an approximately three fold greater risk for developing a TEE compared with the general population. The risk for thrombosis correlates well with disease activity in Crohn's disease, and to lesser extent in ulcerative colitis.
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Affiliation(s)
- R Urgesi
- Gastroenterology Unit, BelColle Hospital, Viterbo, Italy.
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25
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Sabates-Bellver J, Van der Flier LG, de Palo M, Cattaneo E, Maake C, Rehrauer H, Laczko E, Kurowski MA, Bujnicki JM, Menigatti M, Luz J, Ranalli TV, Gomes V, Pastorelli A, Faggiani R, Anti M, Jiricny J, Clevers H, Marra G. Transcriptome profile of human colorectal adenomas. Mol Cancer Res 2008; 5:1263-75. [PMID: 18171984 DOI: 10.1158/1541-7786.mcr-07-0267] [Citation(s) in RCA: 370] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Colorectal cancers are believed to arise predominantly from adenomas. Although these precancerous lesions have been subjected to extensive clinical, pathologic, and molecular analyses, little is currently known about the global gene expression changes accompanying their formation. To characterize the molecular processes underlying the transformation of normal colonic epithelium, we compared the transcriptomes of 32 prospectively collected adenomas with those of normal mucosa from the same individuals. Important differences emerged not only between the expression profiles of normal and adenomatous tissues but also between those of small and large adenomas. A key feature of the transformation process was the remodeling of the Wnt pathway reflected in patent overexpression and underexpression of 78 known components of this signaling cascade. The expression of 19 Wnt targets was closely correlated with clear up-regulation of KIAA1199, whose function is currently unknown. In normal mucosa, KIAA1199 expression was confined to cells in the lower portion of intestinal crypts, where Wnt signaling is physiologically active, but it was markedly increased in all adenomas, where it was expressed in most of the epithelial cells, and in colon cancer cell lines, it was markedly reduced by inactivation of the beta-catenin/T-cell factor(s) transcription complex, the pivotal mediator of Wnt signaling. Our transcriptomic profiles of normal colonic mucosa and colorectal adenomas shed new light on the early stages of colorectal tumorigenesis and identified KIAA1199 as a novel target of the Wnt signaling pathway and a putative marker of colorectal adenomatous transformation.
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Affiliation(s)
- Jacob Sabates-Bellver
- Institute of Molecular Cancer Research, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
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Amodio PM, Faggiani R, Pastorelli A, Bigonzoni E, Consolo S, Bruni V, Goglia A, Piccioni E, Piciollo M, Anti M, Palmieri RM. Selected treatments for duodenal perforation after ERCP. A report of three cases. Chir Ital 2007; 59:343-6. [PMID: 17663374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Perforation is one of the most serious complications of endoscopic sphincterotomy. In the last decade, the management has shifted towards a more selective approach. Three cases are reported here involving three different treatments. In one case, the patient was submitted to a surgical procedure, while a conservative strategy was preferred in the other two, consisting in a naso-biliary drain and endoscopic clip placement, respectively. In this way, the safety of surgical and nonsurgical management of ERCP-related duodenal perforations was tested.
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Faggiani R, Lippert B, Lock CJL, Rosenberg B. Hydroxo-bridged platinum(II) complexes. 2. Crystallographic characterization and vibrational spectra of cyclo-tri-.mu.-hydroxo-tris[cis-diammineplatinum(II)]nitrate. Inorg Chem 2002. [DOI: 10.1021/ic50171a043] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Faggiani R, Lippert B, Lock CJL. Heavy transition metal complexes of biologically important molecules. 4. Crystal and molecular structure of pentahydrodioxonium chloro(uracilato-N(1))(ethylenediamine)platinum(II) chloride, (H5O2)[PtCl(NH2CH2CH2NH2)(C4H5N2O2)]Cl, and chloro(thyminato-N(1))(ethylenediamine)platinum(II), PtCl(NH2CH2CH2NH2)(C5H5N2O2). Inorg Chem 2002. [DOI: 10.1021/ic50204a004] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faggiani R, Gillespie RJ, Kapoor R, Lock CJL, Vekris JE. Preparation and solid-state and solution studies of three compounds of the tetraiodine dication I42+: I42+(AsF6-)2, I42+(SbF6-)2, and I42+(Sb3F14-)(SbF6-). Inorg Chem 2002. [DOI: 10.1021/ic00297a005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faggiani R, Lippert B, Lock CJL, Speranzini RA. Model complexes of possible crosslinking products of cis-Pt(NH3)22+ with cytosine and guanine bases of DNA: x-ray structures of three mixed-ligand complexes of cis-diammineplatinum(II) with 1-methylcytosine and neutral and anionic 9-ethylguanine. Inorg Chem 2002. [DOI: 10.1021/ic00138a057] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Faggiani R, Lippert B, Lock CJL, Rosenberg B. Hydroxo-bridged platinum(II) complexes. 3. Bis[cyclo-tri-.mu.-hydroxo-tris(cis-diammineplatinium(II)] trisulfate hexahydrate. Crystallographic characterization and vibrational spectra. Inorg Chem 2002. [DOI: 10.1021/ic50185a049] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Faggiani R, Lock CJL, Lippert B. An unexpected G-G base pairing caused by the coordination of platinum(II) at the N(7) position of 9-ethylguanine. J Am Chem Soc 2002. [DOI: 10.1021/ja00536a062] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faggiani R, Lippert B, Lock CJL, Speranzini RA. Unusual platinum complexes of deprotonated 1-methylcytosine: bis(.mu.-1-methylcytosinato-N3,N4)-bis(cis-diammineplatinum(II)) dinitrate dihydrate, [(NH3)2Pt(C5H6N3O)2Pt(NH3)2](NO3)2.2H2O, and [diaquahydrogen(1+)][bis(.mu.-1-methylcytosinato-N3,N4)-bis(cis-nitrodiammineplatinum)(Pt-Pt) dinitrate, (H5O2)[(NH3)2(NO2)Pt(C5H6N3O)2Pt(NH3)2(NO2)](NO3)2. J Am Chem Soc 2002. [DOI: 10.1021/ja00395a020] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abrams MJ, Picker DH, Fackler PH, Lock CJL, Howard-Lock HE, Faggiani R, Teicher BA, Richmond RC. Synthesis and structure of bis[rhodamine 123] tetrachloroplatinate dihydrate: the first tetrachloroplatinate(II) salt with anticancer activity. Inorg Chem 2002. [DOI: 10.1021/ic00242a031] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Birchall T, Denes G, Faggiani R, Frampton CS, Gillespie RJ, Kapoor R, Vekris JE. Crystal and molecular structure and Raman and iodine-127 Moessbauer spectra of iodine(III) bis(fluorosulfate) iodide, I(OSO2F)2I. Inorg Chem 2002. [DOI: 10.1021/ic00333a017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Faggiani R, Lippert B, Lock CJL, Rosenberg B. Hydroxo-bridged platinum(II) complexes. 1. Di-.mu.-hydroxo-bis[diammineplatinum(II)] nitrate, [(NH3)2Pt(OH)2Pt(NH3)2](NO3)2. Crystalline structure and vibrational spectra. J Am Chem Soc 2002. [DOI: 10.1021/ja00445a019] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faggiani R, Lippert B, Lock CJL. Bis(1-methylcytosine) complexes of cis-diammineplatinum(II) and the x-ray structure of a platinum complex with covalently and hydrogen-bonded 1-methylcytosine, cis-diamminebis(1-methylcytosine-N3)platinum(II) dinitrate-1-methylcytosine, cis-[Pt(NH3)2(C5N7N3O)2](NO3)2.(C5H7N3O). Inorg Chem 2002. [DOI: 10.1021/ic00138a056] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abrams MJ, Davison A, Faggiani R, Jones AG, Lock CJL. Chemistry and structure of hexakis(thiourea-S)technetium(III) trichloride tetrahydrate, [Tc(SC(NH2)2)6]Cl3.4H2O. Inorg Chem 2002. [DOI: 10.1021/ic00189a003] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bell RA, Faggiani R, Hunter HN, Lock CJL. Synthesis, C-13 NMR, and X-ray crystal structure of N6,N9-octamethylenepurinecyclophane. CAN J CHEM 1992. [DOI: 10.1139/v92-030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The synthesis and structure determination of N6,N9-octamethylenepurine cyclophane by single crystal X-ray diffraction is reported. The cyclophane was prepared from 6-chloropurine and 8-aminooctanoic acid as starting materials. The aminooctyl fragment was first attached to N9 of 6-chloropurine by means of the Mitsunobu reaction and cyclization to the cyclophane effected by nucleophilic attack of the amino group at the C6 position and displacement of chloride ion. Reversing the reaction strategy did not result in formation of the cyclophane. Crystals of the cyclophane were monoclinic, P2/n, a = 9.620(3), b = 12.266(3), c = 11.994(2), Å, β = 111.25(2)°, Z = 4. Intensities were measured with a Nicolet P3 diffractometer and MoKα radiation at room temperature. The structure was solved by direct methods and refined to R = 0.0683, Rw = 0.0493 based on 1730 reflections. The molecule shows some strain, but bond lengths and angles are normal. Attempts to relieve the strain are made by a small distortion of the purine rings and bending of the N6 and C8′ atoms out of the planes to which they are attached (0.314(4), 0.459(5) Å). Further, the N6,H6,Cl′ group is twisted by 30° from the pyrimidine plane and the torsion angles in the aliphatic chain are distorted from the idealized 60, 120, 180° (average, 13.6°; range 5.1–24.9°). These distortions result in some weakening of the π-bonding in the adenine moiety. Keywords: purinophane synthesis, nucleophilic aromatic substitution, conformational analysis, crystal structure.
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Faggiani R, Howard-Lock HE, Lock CJL, Orgias R. 2R,4S-2-(2′-Methyl-3′-hydroxy-5′-hydroxymethylenepyridine-C4′)-5,5-dimethylthiazolidine-4-carboxylic acid, the product of the reaction of D-penicillamine and vitamin B6. CAN J CHEM 1991. [DOI: 10.1139/v91-001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have studied the reaction of both D- and L-penicillamine with pyridoxal hydrochloride and examined the products by single crystal X-ray diffraction. The structure of the title compound, A, formed by the reaction of D-penicillamine and pyridoxal was determined. Crystals are orthorhombic, P212121, with cell dimensions a = 9.507(5), b = 19.185(5), c = 7.766(2) Å and Z = 4. The structure was solved by standard methods and refined to R = 0.088, Rw = 0.079 for 2433 independent reflections. A exists as a zwitterion, and bond lengths and angles are normal. In the solid state, A and the corresponding product obtained from L-penicillamine, B, have identical geometrical structure but are of opposite chirality; that is, D-penicillamine produces the 2R,4S diastereomer and L-penicillamine produces the 2S,4R diastereomer (with no S,S and R,R components). In solution, however, NMR spectra show the presence of both pairs of diastereomers (2R,4S and 2S,4S; 2S,4R and 2R,4R). In neutral or alkaline solution there appears to be a rapid epimerization at the thiazolidine carbon atom attached to the pyridoxal moiety. Features of the mass, 1H NMR, vibrational, and electronic spectra are also discussed. Key words: D-penicillamine, vitamin B6, pyridoxal hydrochloride, therapeutic uses, bischemical reactions, structures.
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Faggiani R, Lock CJL, Epps LA, Kramer AV, Brune HD. {2,2'-Dimethyl-1,1'-[(N,N'-2H2)-ethylenediamino]dipropane-2-thiolato-N,N',S,S'}oxotechnetium(V) chloride monodeuterate. Acta Crystallogr C 1990. [DOI: 10.1107/s0108270190004085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Faggiani R, Gillespie RJ, Sawyer JF, Vekris JE. Structures of nonadecasulfur(2+) bis[hexafluoroantimonate(1–)] S19(SbF6)2, octasulfur(2+) di-μ-fluoro-dodecafluorotriantimonate(1–) hexafluoroantimonate(1–) S8(Sb3F14)(SbF6), and tetrasulfur(2+) di-μ-fluoro-difluorodiantimony(2+) μ-fluoro-tetrafluorodiantimony(1+) pentakis[hexafluoroantimonate(1–)] S4(Sb2F4)(Sb2F5)(SbF6)5. Acta Crystallogr C 1989. [DOI: 10.1107/s0108270189003550] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Brook MA, Faggiani R, Lock CJL, Seebach D. U,l-4a,5,6,7,8,8a-Hexahydro-4-phenyl-8a-(trimethylsiloxy)-4H-1,2-benzoxazine 2-oxide. Acta Crystallogr C 1988. [DOI: 10.1107/s0108270188006730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Duhlev R, Brown ID, Faggiani R. Structure of calcium zinc tetrabromide pentahydrate. Acta Crystallogr C 1988. [DOI: 10.1107/s010827018800188x] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Faggiani R, Lock CJ, Epps LA, Kramer AV, Brune D. (3,6-Dimethyl-3,6-diazaoctan-1,8-dithiolato-S1,N3,N6,S8)oxotechnetium(V) pertechnetate. Acta Crystallogr C 1988; 44 ( Pt 5):777-9. [PMID: 3271076 DOI: 10.1107/s0108270188000253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
[TcO(C8H18N2S2)]TcO4, Mr = 484.2, monoclinic, P2(1)/c, a = 7.447 (2), b = 16.952 (8), c = 12.236 (3) A, beta = 99.63 (2) degrees, V = 1523 (1) A3, Z = 4, D chi = 2.112, Dm = 2.09 (1) Mg m-3, lambda(Mo K alpha) = 0.71069 A, mu = 2.06 mm-1, F(000) = 952, T = 295 (1) K, final R = 0.071 for 2496 significant reflections and 173 parameters. The Tc atom is bound to the oxo group and the N and S atoms of the complex ligand in a rough square pyramid. The Tc atom lies 0.770 (3) A out of the S,N,N',S' plane. This plane is significantly distorted such that N and N' lie nearly 0.25 A out of the plane on opposite sides. The Tc-S bonds [2.238 (3), 2.266 (3) A] are short but other bond lengths and angles are normal.
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Affiliation(s)
- R Faggiani
- Department of Chemistry, McMaster University, Hamilton, ON, Canada
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Brown BE, Faggiani R, Hughes D, Lock CJL. Platinum complexes with sterically demanding ligands: trans-bis(2,7-diazatetracyclo[6.3.0.04,9.05,11]undecane-N, N′)platinum(II) dichloride tetrahydrate. CAN J CHEM 1987. [DOI: 10.1139/v87-474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The complex [Pt(C9H14N2)2]Cl2•4H2O was isolated from a reaction mixture containing K2[PtCl4] and a norbornane-based diamine, C9H14N2. This product was analyzed with use of elemental analysis, nuclear magnetic resonance spectroscopy, and X-ray crystallography. [Pt(C9H14N2)2]Cl2•4H2O crystallized in the triclinic system, space group [Formula: see text], a = 9.437(1) Å, b = 9.975(1) Å, c = 6.888(1) Å, a = 109.54(1)°, β = 109.71(1)°, 7 = 93.63(1)°, Z = 1. The X-ray data were collected with use of a Syntex P21 diffractometer and MoKα radiation and the structure solved by the heavy atom method. Based on 1983 reflections, the structure was refined to R = 0.0310 and Rw = 0.0408. The platinum resides on an inversion center and is coordinated to the nitrogen atoms of the secondary amines. The chelating N—Pt—N angle is 79° but otherwise the bond lengths and angles agree well with values for similar structures.
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