Publications by authors named "Alyson L Ross"
Article Synopsis
- Crohn's disease strictures are typically managed with a single endoscopic balloon dilation (EBD), but researchers explored the effectiveness of repeat EBD combined with needle-knife stricturotomy (NKSt) alongside aggressive drug therapy.
- In a study of 21 patients, those receiving intensive treatment (multiple EBDs and/or NKSt) showed a higher symptom improvement rate (72%) compared to those with a single EBD (40%).
- The findings suggest that repeat dilations and NKSt are safe and potentially more effective for treating strictures, especially when paired with enhanced drug treatment for inflammation.
Background: Exposure to maternal inflammation is associated with an increased risk of neurocognitive and developmental disorders in offspring. Early diagnosis and intervention improves childhood motor and cognitive functioning. Neonatal cerebral MRI and remote app-based generalised movement assessments (GMAs) are both predictive of adverse neurocognitive outcomes but have only been used in infants at significantly increased risk for these outcomes, rather than following in utero exposure to maternal inflammatory disorders.
View Article and Find Full Text PDFBackground & Aims: Vedolizumab and ustekinumab pharmacokinetics in pregnancy and the infant after in utero exposure remain incompletely defined. We aim to define the antenatal stability of ustekinumab and vedolizumab levels and the time at which infant drug levels become undetectable.
Methods: This multicenter prospective observational cohort study recruited pregnant or preconception women with inflammatory bowel disease receiving vedolizumab or ustekinumab.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) remains the preferred surgical option for medically refractory ulcerative colitis. Management of individuals with an IPAA prior to and during pregnancy presents challenges that can have serious consequences. Infertility, mechanical obstructive and inflammatory pouch complications are frequently encountered in pregnant women with an IPAA.
View Article and Find Full Text PDFBackground: Ustekinumab is increasingly used in pregnant women with inflammatory bowel disease (IBD). Existing safety data are reassuring, but the stability of ustekinumab levels in pregnancy, degree of transfer to the infant and time to infant clearance are unknown.
Methods: In this prospective observational study, ustekinumab-exposed women with IBD had trough levels measured in each trimester of pregnancy and at delivery.
Article Synopsis
- Strictures commonly occur in Crohn's disease, and while surgery and endoscopic dilation are standard treatments, this study investigates if intensive drug therapy can effectively treat strictures with inflammatory components, challenging the idea that drug therapy is contraindicated.
- An open-label, single-centre randomised controlled trial in Australia involved patients aged 18 or older with de novo or postoperative intestinal strictures, assessing the effectiveness of intensive high-dose adalimumab combined with thiopurine versus standard adalimumab therapy.
- The trial aimed to measure the primary endpoint of improvement in obstructive symptoms after 12 months; 123 patients were screened, with 77 participating in the study, which was registered and completed
Background: There is considerable interest in improving the education and care of women with inflammatory bowel disease (IBD) to improve pregnancy outcomes. Despite increased awareness, not all women with IBD have access to pregnancy-related education and the quality of counseling is variable. We aimed to assess the effectiveness of a simple educational intervention for improving pregnancy-related knowledge and to evaluate the effect of education on patient outcomes including anxiety, depression, and quality of life in women with IBD.
View Article and Find Full Text PDFBackground: Azathioprine and mercaptopurine are considered safe during pregnancy. However, the pharmacokinetic effects of pregnancy on thiopurine metabolism are undefined.
Aims: To characterise thiopurine metabolism in pregnancy and measure infant metabolite levels and outcomes.
Background And Aims: Strictures are the commonest complication in Crohn's disease. Surgery and endoscopic dilation are the mainstays of treatment, while drug therapy has often been considered contraindicated. The benefit of nonsurgical treatments, particularly drug and endoscopic therapy, need to be defined.
View Article and Find Full Text PDFBackground: The impact of pregnancy on levels of biologic agents in patients with IBD is undefined and time to elimination in vedolizumab-exposed infants is unknown.
Aims: To determine the effect of pregnancy on infliximab, adalimumab and vedolizumab levels and to study infant vedolizumab clearance METHODS: In a prospective observational study, maternal drug levels were measured pre-conception, in each trimester, at delivery and postpartum. The association between drug levels and gestation in weeks was assessed using generalised estimating equation modelling.
Background And Aims: Inflammatory bowel disease [IBD] affects women during their childbearing years. Gastrointestinal ultrasonography [GIUS] accurately identifies disease activity in non-pregnant patients with IBD. The utility of GIUS in pregnancy has not been established.
View Article and Find Full Text PDFBackground And Aims: Strictures are the most common Crohn's disease complication, but their natural history is unknown. This study aimed to characterize inflammation, predict prognosis, and understand the impact of drug therapy using magnetic resonance enterography (MRE).
Methods: Patients with a stricture diagnosed on MRE over a 5-year period were reviewed for MRE disease extent and inflammation, clinical course, C-reactive protein, response to anti-TNF therapy, endoscopic dilatation, hospitalization, and surgery.