Efficacy of biological agents in stricturing Crohn’s disease: a retrospective cohort study
AuthorsMahmoud Alchlaihawi, Sriharan Selvaratnam, Sudarshan Paramsothy,
Rupert Leong
JournalINTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH
AbstractABSTRACT
Background/Aim: Despite the effectiveness of Endoscopic balloon dilatation (EBD) in treating intestinal stricture in Crohn’s disease, there is still a high recurrence rate which leads to high rates of re-dilatation and sometimes leads to failure of the procedure. The aim is to determine whether biological agents affect the efficacy, safety and longevity following Crohn’s disease intestinal stricture dilatation.
Materials and Methods: A retrospective single-center analysis was performed of all patients who underwent EBD between 2010 and 2018 for the management of intestinal strictures due to CD. Patients were analyzed according to whether they received concurrent treatment with biological agents at the time of EBD or not. Short-term efficacy was defined by the initial technical success rate, whilst long-term efficacy was defined by cumulative surgery-free and re-dilatation-free survival rates.
Results: Twenty-eight consecutive subjects were recruited comprising of 13 with anastomotic stricture (AS, 13 strictures) and 15 with primary stricture (PS, 21 strictures). There was no difference between the AS and PS cohorts in patients’ demographics and disease characteristics apart from non-statistically significant difference in the presence of fistulas and need for surgery. EBD initial technical success rate was significantly higher for PS (98%) versus AS (70%, p = 0.037). The use of biological agents did not influence either the re-dilatation and surgery-free survival in either AS (HR: 2.07, 95%CI: 0.41–10.36, p = 0.38) or PS (HR: 0.55, 95%CI: 0.11–2.68, p = 0.46) cohorts.
Conclusions: EBD is effective and safe. Biological agents did not improve re-dilatation and surgery free survival.
Serum Levels of Copper in Patients with Peptic Ulcer Disease and H.pylori Infections in Najaf Governorate
AuthorsZAHRAA HAMZAH ABDULZAHRA
, ALI NAJI A. ALNAJEM, MAHMOUD AZIZA M. ALCHLAIHAWI AND MOHAUMAN MOHAMMAD M. AL-RUFAIE*
JournalAnnals of Agri-Bio Research
AbstractABSTRACT
A portion from the crucial function of micronutrients such as copper in the body enzymes roles, it appears
that altering in these biomarkers in the serum levels may take a function in the peptic ulcer pathogenesis.
The goal of this study was to calculate the levels of copper in serum, with peptic ulcer. In sixty consecutive
patients with peptic ulcer all ages in the range of 18-85 years, the copper serum levels were calculated in
round patients and control individuals. The information was statistically analyzed. All subjects were
subjected to gastrointestinal endoscopy and case of helical bacteria by means of endoscopy devices. In the
peptic ulcer patients, the copper levels in serum were 0.000067±0.000027 (PPM). In the healthy group,
the copper levels in serum were 0.0001±0.0008 (PPM). The average of copper amounts in patient’s serum
was considerably higher than in healthy ones (P<0.001).
Key words : Copper, serum levels, peptic ulcer, H. pylori, Najaf
Evaluation of serum levels of zinc in the cases of peptic ulcers in Najaf governorate
AuthorsZahraa Hamzah Abdulzahra, Mohauman Mohammad M. AL-Rufaiea, Mahmoud Azeez M. Alchlaihawib, Suhad Rashed Majeed
JournalIranian Journal of Organic Chemistry
AbstractAbstract: The peptic ulcer pathogenesis is multifactorial as well as increases from imponderables between attacker agents as well as protective. This paper pursued toestimate thepotential protective function of the serum zinc concentration in patients with peptic ulcer illness and announces anyrelation between H. pylori inflammation and serum zinc concentration .Sixty sequentially patients with principalities observation for peptic ulcer illness were implicated. All experienced entire clinical estimation laboratory investigations, upper gastrointestinal endoscopy. The blood level from the zinc has been calculated for every one patient in addendum to for both females and males and for ages between 18-85 years. We found a minimum zinc level in patient blood who were significantly projected in compared to healthy control (P = 0.0003).On the another side, no considerable variation was uncovered in the serum zinc levels between H. pylori negative and positive patients (P>0.05). Zinc may take a protective function versus gastric additionally duodenal mucosal membrane damage.
Comparison of infusion reactions to infliximab and
vedolizumab: A retrospective analysis
AuthorsWebber Chan, G COLLINS, E LEE, A MAHMOUD
R LEONG
JournalJournal of gastroenterology and hepatology
AbstractBackground: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal
antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively,
and are indicated in the treatment of inflammatory bowel disease (IBD).
Both are administered by intravenous infusion and may be associated with
different types of infusion reactions.
Aims: To compare the incidence of infusion reactions in adult patients with
IBD receiving IFX and VDZ treatment and to identify when these infusion
reactions happened.
Methods: We performed a retrospective review of all IFX and VDZ infusions
performed at Concord Repatriation General Hospital and Macquarie
University Hospital, Sydney, from January 2012 through March 2017.
Fisher exact test and receiver operating characteristics (ROC) curve analysis
were used.
Results: A total of 157 consecutive patients who received 1921 IFX infusions
and 61 patients who received 509 VDZ infusions were evaluated.
All patients received intravenous hydrocortisone before IFX and VDZ infusion.
Most patients were on concurrent immunomodulators (azathioprine
or methotrexate). The overall incidence of infusion reactions to IFX was
1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the
overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting
1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2%
(23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of
mild-to-moderate reaction happened in VDZ infusion, but no severe reactions
were observed. Compared with VDZ, IFX was associated with more
mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia,
and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference
for severe reaction (such as significant hypotension, and severe dyspnea)
was not statistically significant. Based on ROC curve analysis (Figure 1),
the optimal number of IFX infusions after which infusion reactions were
less likely to happen was eight (P < 0.01) and that for VDZ was not statistically
significant.
Conclusion: IFX is associated with more mild-to-moderate infusion reactions
compared withVDZ, suggesting that IFX is associated with more
immunogenicity.
Comparison of infusion reactions to infliximab and
vedolizumab: A retrospective analysis
AuthorsWebber Chan, G COLLINS, E LEE, A MAHMOUD
R LEONG
JournalJournal of gastroenterology and hepatology
AbstractBackground: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal
antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively,
and are indicated in the treatment of inflammatory bowel disease (IBD).
Both are administered by intravenous infusion and may be associated with
different types of infusion reactions.
Aims: To compare the incidence of infusion reactions in adult patients with
IBD receiving IFX and VDZ treatment and to identify when these infusion
reactions happened.
Methods: We performed a retrospective review of all IFX and VDZ infusions
performed at Concord Repatriation General Hospital and Macquarie
University Hospital, Sydney, from January 2012 through March 2017.
Fisher exact test and receiver operating characteristics (ROC) curve analysis
were used.
Results: A total of 157 consecutive patients who received 1921 IFX infusions
and 61 patients who received 509 VDZ infusions were evaluated.
All patients received intravenous hydrocortisone before IFX and VDZ infusion.
Most patients were on concurrent immunomodulators (azathioprine
or methotrexate). The overall incidence of infusion reactions to IFX was
1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the
overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting
1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2%
(23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of
mild-to-moderate reaction happened in VDZ infusion, but no severe reactions
were observed. Compared with VDZ, IFX was associated with more
mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia,
and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference
for severe reaction (such as significant hypotension, and severe dyspnea)
was not statistically significant. Based on ROC curve analysis (Figure 1),
the optimal number of IFX infusions after which infusion reactions were
less likely to happen was eight (P < 0.01) and that for VDZ was not statistically
significant.
Conclusion: IFX is associated with more mild-to-moderate infusion reactions
compared withVDZ, suggesting that IFX is associated with more
immunogenicity.
Comparison of infusion reactions to infliximab and
vedolizumab: A retrospective analysis
AuthorsWebber Chan, G COLLINS, E LEE, A MAHMOUD
R LEONG
JournalJournal of gastroenterology and hepatology
AbstractBackground: Infliximab (IFX) and vedolizumab (VDZ) are monoclonal
antibodies targeting tumor necrosis factor-α and α4β7 integrin, respectively,
and are indicated in the treatment of inflammatory bowel disease (IBD).
Both are administered by intravenous infusion and may be associated with
different types of infusion reactions.
Aims: To compare the incidence of infusion reactions in adult patients with
IBD receiving IFX and VDZ treatment and to identify when these infusion
reactions happened.
Methods: We performed a retrospective review of all IFX and VDZ infusions
performed at Concord Repatriation General Hospital and Macquarie
University Hospital, Sydney, from January 2012 through March 2017.
Fisher exact test and receiver operating characteristics (ROC) curve analysis
were used.
Results: A total of 157 consecutive patients who received 1921 IFX infusions
and 61 patients who received 509 VDZ infusions were evaluated.
All patients received intravenous hydrocortisone before IFX and VDZ infusion.
Most patients were on concurrent immunomodulators (azathioprine
or methotrexate). The overall incidence of infusion reactions to IFX was
1.3% (25/1921 infusions), affecting 14.6% of patients (23/157); and the
overall incidence of infusion reactions to VDZ was 0.2% (1/509), affecting
1.6% (1/61). Mild-to-moderate and severe acute reactions occurred in 1.2%
(23/1921) and 0.1% (2/1921) of IFX infusions, respectively. One case of
mild-to-moderate reaction happened in VDZ infusion, but no severe reactions
were observed. Compared with VDZ, IFX was associated with more
mild-to-moderate infusion reactions (such as rash, arthralgia, tachycardia,
and diaphoresis) (P = 0.0425 per infusion, Table 1), whereas the difference
for severe reaction (such as significant hypotension, and severe dyspnea)
was not statistically significant. Based on ROC curve analysis (Figure 1),
the optimal number of IFX infusions after which infusion reactions were
less likely to happen was eight (P < 0.01) and that for VDZ was not statistically
significant.
Conclusion: IFX is associated with more mild-to-moderate infusion reactions
compared withVDZ, suggesting that IFX is associated with more
immunogenicity.
