Publications by authors named "Antonio Lopez-SanRoman"
Background: Approximately half of patients with Crohn's disease require ileocolonic resection. Of these, 50% will subsequently have endoscopic disease recurrence within 1 year. We aimed to evaluate the efficacy and safety of vedolizumab to prevent postoperative recurrence of Crohn's disease.
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- The study evaluates the effectiveness and safety of biological therapies for inflammatory bowel disease (IBD) in patients aged 65 and older, addressing a gap in existing research primarily focused on younger populations.
- A total of 1,090 elderly patients were included, with findings showing that a significant portion achieved clinical remission after treatment, particularly by the 52-week mark.
- Although the therapies were generally safe, there was a notable occurrence of oncological events, with variations in incidence rates depending on the specific treatment used.
Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders.
Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders.
Design: This was a retrospective and multicentre study.
Background And Aims: Despite novel medical therapies, colectomy has a role in the management of patients with ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBDU). This study aimed to determine the incidence of unplanned surgery and initiation of immunomodulatory or biologic therapy (IMBT) after colectomy in patients with UC or IBDU, and identify associated factors.
Methods: Data of patients with preoperative diagnosis of UC or IBDU who underwent colectomy and were followed up at a single tertiary centre was retrospectively collected.
Background And Aims: Clinical trials and real-life studies with ustekinumab in Crohn's disease [CD] have revealed a good efficacy and safety profile. However, these data are scarcely available in elderly patients. Therefore, we aim to assess the effectiveness and safety of ustekinumab in elderly patients with CD.
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- This study assesses the risk of tuberculosis (TB) in patients with inflammatory bowel disease (IBD) undergoing anti-TNF therapy and evaluates various latent TB infection (LTBI) screening methods.
- Out of 7,594 patients screened, 19% had LTBI, with findings indicating that combining early screening and dual tests (TST and IGRA) significantly improved detection rates, particularly in patients not on immunomodulatory treatment.
- The best results for diagnosing LTBI came from using early screening alongside dual screening strategies, highlighting the effectiveness of these approaches in managing TB risk in IBD patients.
Background And Aims: Immunomediated adverse events [IAEs] are the most frequently reported infliximab [IFX]-related adverse events. Combination therapy may reduce their incidence, although this strategy is not recommended in elderly patients. We aimed to compare the rates of IFX-related IAEs and loss of response [LOR] in elderly and younger patients.
View Article and Find Full Text PDFBackground: Polypharmacy can complicate the course and management of chronic diseases, and has been little explored in patients with inflammatory bowel disease (IBD) to date.
Aim: The aim of this study was to determine the prevalence of polypharmacy in a series of IBD patients, describing associated factors and its correlation with poor disease outcomes.
Materials And Methods: Retrospective study of a single-center series.
Article Synopsis
- Anti-TNF-α agents are found to be more effective than thiopurines in preventing postoperative recurrence of Crohn's disease after ileocolonic resection, based on a meta-analysis of data from 645 participants.
- The study showed significant reductions in both endoscopic and clinical recurrence rates with anti-TNF-α treatment compared to thiopurines, with no variations in effectiveness across different patient subgroups.
- Key factors affecting the risk of recurrence included past exposure to anti-TNF-α and characteristics of the disease, confirming the benefits of anti-TNF-α in both low- and high-risk groups.
Fecal microbiota transplantation (FMT) is an effective procedure against infection (CDI), with promising but still suboptimal performance in other diseases, such as ulcerative colitis (UC). The recipient's mucosal immune response against the donor's microbiota could be relevant factor in the effectiveness of FMT. Our aim was to design and validate an individualized immune-based test to optimize the fecal donor selection for FMT.
View Article and Find Full Text PDFBackground: Methotrexate can be used to maintain remission in Crohn's disease patients who are intolerant to thiopurines. Data on its use as monotherapy in other scenarios are limited.
Aim: To assess the effectiveness of methotrexate monotherapy in Crohn's disease patients after previous failure to anti-tumour necrosis factor (anti-TNFα) drugs.
Background: drug-induced pancreatitis is an unexplored entity.
Methods: a retrospective cohort study was performed at a referral center. Patients with drug-induced acute pancreatitis between 2008 and 2018 were included.
Aim: To evaluate the effectiveness and safety of tofacitinib in ulcerative colitis [UC] in real life.
Methods: Patients from the prospectively maintained ENEIDA registry and treated with tofacitinib due to active UC were included. Clinical activity and effectiveness were defined based on Partial Mayo Score [PMS].
The use of Janus kinase (JAK) inhibitors is a new approach in the therapy of inflammatory diseases with immune base. Tofacitinib is one of these inhibitors targeting JAK1 and JAK3, and its efficacy has been demonstrated in the treatment of moderate to severe ulcerative colitis (UC). It is a small synthetic molecule administered orally, with a fast bioavailability and elimination rate, predictable pharmacokinetics and lack of immunogenicity, which are convenient characteristics for both efficacy and safety.
View Article and Find Full Text PDFBackground/aims: Few data on the evolution of endoscopic findings are available in patients with acute severe ulcerative colitis (ASUC). The aim of this study was to describe this evolution in a prospective cohort.
Methods: Patients admitted for a steroid-refractory ASUC and included in a randomized trial comparing infliximab and cyclosporine were eligible if they achieved steroid-free clinical remission at day 98.
Background And Aim: Biological therapies may be changing the natural history of inflammatory bowel diseases (IBDs), reducing the need for surgical intervention. We aimed to assess whether the availability of anti-TNF agents impacts the need for early surgery in Crohn's disease (CD) and ulcerative colitis (UC).
Methods: Retrospective, cohort study of patients diagnosed within a 6-year period before and after the licensing of anti-TNFs (1990-1995 and 2007-2012 for CD; 1995-2000 and 2007-2012 for UC) were identified in the ENEIDA Registry.
Article Synopsis
- Tacrolimus is a medicine used to help prevent organ rejection in transplant patients and may also help people with inflammatory bowel disease (IBD).
- A study in Spain looked at 143 adult patients with IBD who took tacrolimus for 3 months, and many showed improvement in their symptoms.
- Some patients had side effects, and 84% stopped taking the medicine because it stopped working for them, with a small number developing serious issues like cancer.
Background: Idiopathic acute pancreatitis (IAP) in patients with inflammatory bowel disease (IBD) is not well characterized. Our purpose was to better understand this condition and its natural history.
Methods: Retrospective cohort study conducted at nine Spanish IBD referral centers.
Background: Increasing the interval of administration of anti-TNF agents over the duration specified in the data sheet is not common in inflammatory bowel disease (IBD).
Aim: To evaluate the outcomes of IBD patients treated with this strategy.
Methods: Patients with IBD who were treated with infliximab or adalimumab at intervals > 8 weeks or > 2 weeks, respectively, because of persistent clinical remission, were identified at local databases of the ENEIDA registry (a nationwide registry promoted by the Spanish Working Group in Crohn's disease and Ulcerative Colitis-GETECCU) of two referral centers.
Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures.
View Article and Find Full Text PDFJavier P. Gisbert was listed incorrectly as Javier Pérez-Gisbert.
View Article and Find Full Text PDFBackground: There is no information regarding the outcome of Crohn's disease (CD) patients treated with endoscopic balloon dilation (EBD) in non-referral hospitals, nor on the efficacy of EBD in ulcerative colitis (UC). We report herein the results of the largest series published to date.
Aim: To assess the efficacy and safety of EBD for inflammatory bowel disease (IBD) stenosis performed in 19 hospitals with different levels of complexity and to determine factors related to therapeutic success.
Article Synopsis
- Primary sclerosing cholangitis (PSC) is often linked with inflammatory bowel disease (IBD) and is associated with a higher risk of cancers, especially colorectal cancer (CRC) and cholangiocarcinoma (CCA).
- A study of 277 PSC-IBD patients revealed a PSC incidence rate of 61 cases per 100,000 IBD patient-years, with the majority treated using ursodeoxycholic acid and some requiring liver transplants.
- The findings indicate that PSC symptoms at diagnosis increase CRC risk, with CCA found primarily in patients with intra- and extrahepatic PSC, leading to poorer survival compared to those without CCA.
Corticosteroids are frequently used in the management of Inflammatory Bowel Disease. Although they can be very useful, their potential adverse effects have to be kept in mind. One of the situations in which these drugs should be avoided, if possible, is the perioperative setting.
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