Publications by authors named "Adriaan Volkers"
Article Synopsis
- The study evaluated the cost-effectiveness of therapeutic drug monitoring (TDM)-guided mercaptopurine treatment for ulcerative colitis (UC) patients who didn’t respond to traditional medication compared to a placebo.
- Data was collected from a controlled trial and analyzed over one year, considering various costs related to healthcare and societal impacts.
- Results suggested that while mercaptopurine had slightly higher costs per additional patient achieving remission, it provided significant societal cost savings and had an 80% chance of being cost-effective within a specific budget for healthcare spending.
Background: Despite impaired humoral response in patients treated with immunosuppressants (ISPs), recent studies found similar severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection compared to controls. One potential explanation is the rapid generation of humoral response on infection, but evidence is lacking.
Objectives: We investigated the longitudinal dynamics of the SARS-CoV-2 antibody repertoire after SARS-CoV-2 delta and omicron breakthrough infection in patients with immune-mediated inflammatory diseases (IMIDs) receiving ISP therapy and controls.
Background: The noninflammatory immunoglobulin G4 (IgG4) is linked to tolerance and is unique to humans. Although poorly understood, prolonged antigenic stimulation and IL-4-signaling along the T helper 2-axis may be instrumental in IgG4 class switching. Recently, repeated SARS-CoV-2 mRNA vaccination has been linked to IgG4 skewing.
View Article and Find Full Text PDFArticle Synopsis
- SARS-CoV-2-specific CD8 T cells play a crucial role in protecting against viral variants and reducing disease severity, especially in patients lacking cross-reactive antibodies.
- mRNA vaccines elicit strong immune responses, but the effectiveness among patients with chronic immune-mediated inflammatory disorders (IMIDs), particularly those on TNF inhibitors (TNFi), is less understood.
- Analysis revealed that both TNFi-treated and untreated inflammatory bowel disease (IBD) patients generate strong spike-specific CD8 T cell responses after mRNA vaccination, comparable to healthy individuals, indicating that vaccination is beneficial regardless of treatment status.
Article Synopsis
- A study was conducted to evaluate a new point-of-care test (POCT) device that measures inflammation markers and drug levels in patients with inflammatory bowel disease (IBD) by comparing it to standard reference methods.
- The study involved 285 patients and focused on testing infliximab (IFX), adalimumab (ADL), C-reactive protein (CRP), and fecal calprotectin (FCP) levels using various blood and stool samples.
- Results indicated that the POCT showed good agreement with reference methods, with some slight discrepancies; IFX and ADL levels were higher in POCT, while CRP and FCP levels were lower, suggesting the POCT is effective but may require further
Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs.
Methods: IMID patients on active treatment with ISPs and controls (i.
Background And Aims: Scepticism about the efficacy of thiopurines for ulcerative colitis [UC] is rising. This study aimed to evaluate mercaptopurine treatment for UC.
Methods: In this prospective, randomized, double-blind, placebo-controlled trial, patients with active UC, despite treatment with 5-aminosalicylates [5-ASA], were randomized for therapeutic drug monitoring [TDM]-guided mercaptopurine treatment or placebo for 52 weeks.
For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine.
View Article and Find Full Text PDFObjectives: To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.
Methods: Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included.
Background: Subcutaneous (SC) vedolizumab is effective in inflammatory bowel diseases (IBD) when administered after induction with two infusions.
Aim: To assess the effectiveness, safety and pharmacokinetics of a switch from intravenous (IV) to SC maintenance vedolizumab in patients with IBD METHODS: In this prospective cohort study, patients with IBD who had ≥4 months IV vedolizumab were switched to SC vedolizumab. We studied the time to discontinuation of SC vedolizumab, adverse events (AEs), changes in clinical and biochemical outcomes and vedolizumab concentrations at baseline, and weeks 12 and 24.
Background: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.
View Article and Find Full Text PDFArticle Synopsis
- - The study investigates how specific immunosuppressive therapies affect the immune response to SARS-CoV-2 vaccination in patients with immune-mediated inflammatory disorders, focusing on the humoral immune response.
- - Conducted in the Netherlands with over 3,200 participants, the research compares the immune responses of patients on immunosuppressants to controls, including healthy individuals and those without systemic immunosuppressants.
- - Findings indicate that certain immunosuppressive treatments, like anti-CD20 therapy and S1P modulators, result in lower chances of achieving adequate immunity post-vaccination, regardless of the type of immune disorder present.
Background: Studies have suggested incremental short-term adverse events (AE) after repeated vaccination. In this report, we assessed occurrence and risk factors for short-term AEs following repeated SARS-CoV-2 vaccination in patients with various immune-mediated inflammatory diseases (IMIDs).
Methods: Self-reported daily questionnaires on AEs during the first 7 days after vaccination were obtained of 2259 individuals (2081 patients and 178 controls) participating in an ongoing prospective multicenter cohort study on SARS-CoV-2 vaccination in patients with various IMIDs in the Netherlands (T2B-COVID).
Article Synopsis
- A study was conducted to evaluate the effectiveness of pan-enteric capsule endoscopy (pan-CE) in measuring mucosal changes in Crohn's disease patients undergoing biologic treatment.
- Twenty-two patients participated, with results showing that 27% achieved endoscopic remission and 59% showed an endoscopic response after treatment.
- The median scores of disease activity significantly decreased, indicating that pan-CE is an effective tool for monitoring mucosal disease activity in Crohn's patients without reported adverse events.