Publications by authors named "Carlos Gonzalez-Munoza"
Introduction: Crohn's disease (CD) varies by location, potentially affecting therapy efficacy and surgery risk, although research on this topic is conflicting. This study aims to investigate the independent association between CD location and therapeutic patterns.
Methods: We analyzed patients with CD diagnosed from January 2005 to May 2023 registered in the nationwide ENEIDA registry.
Background: Endoscopic evaluation 6-12 months after ileocolonic resection (ICR) in Crohn's disease (CD) is advised to assess the development of postoperative recurrence (POR) but no further recommendations are available for long-term monitoring if no POR is noticed.
Methods: Prospective, open-label, study including asymptomatic patients with CD and ICR in whom no POR was observed at the last endoscopic evaluation. Patients were followed-up for two years and ileocolonoscopy was performed by means of a faecal calprotectin (FC)-based strategy.
Background: Ulcerative proctitis (UP) can have a milder, less aggressive course than left-sided colitis or extensive colitis. Therefore, immunosuppressants tend to be used less in patients with this condition. Evidence, however, is scarce because these patients are excluded from randomised controlled clinical trials.
View Article and Find Full Text PDFBackground And Aims: Familial inflammatory bowel disease (IBD) history is a controversial prognostic factor in IBD. We aimed to evaluate the impact of a familial history of IBD on the use of medical and surgical treatments in the biological era.
Methods: Patients included in the prospectively maintained ENEIDA database and diagnosed with IBD after 2005 were included.
Background: The diagnosis of coeliac disease (CD) in adults is based on clinical, serological and histological criteria. The inappropriate performance of intestinal biopsies, non-specificity of mild histological lesions and initiation of a gluten-free diet (GFD) before biopsy may hamper the diagnosis. In these situations, determining the intraepithelial lymphogram of the duodenum by flow cytometry (IEL-FC) can be helpful.
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- A study was conducted to evaluate the effectiveness and safety of ustekinumab and vedolizumab in treating complex perianal fistula in patients with Crohn's disease.
- Out of 155 patients analyzed, ustekinumab achieved a remission rate of 54%, while vedolizumab had a remission rate of 46%, with some patients relapsing during the follow-up period.
- Both medications exhibited mild adverse events and showed favorable safety profiles, indicating their potential effectiveness in managing this condition.
Article Synopsis
- Markers for personalized treatment options for patients with inflammatory bowel diseases (IBD) remain unidentified, prompting a study on real-life treatment trends.
- The study analyzed data from 10,009 patients from the ENEIDA registry, revealing that anti-TNF drugs were the most commonly used first-line treatments, but their usage declined over time in Crohn's disease (CD) while remaining stable in ulcerative colitis (UC).
- Despite exploring Machine Learning for treatment pattern prediction, researchers found that these models were ineffective, indicating distinct treatment approaches for CD and UC and highlighting the rising importance of drugs like ustekinumab and vedolizumab.
Introduction: In the treatment of inflammatory bowel disease (IBD), we have biologic therapies administered intravenously and subcutaneously. Recently, some drugs can be administered by either of these routes. The real impact that intravenous administration has on the perception of the disease and the personal and work life of the patient is unknown.
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- Limited data exist on the outcomes of inflammatory bowel disease (IBD) in patients who undergo solid organ transplantation (SOT), and this study examines both pre-existing IBD and newly developed IBD post-transplant.
- The study included 177 patients, of which 106 had pre-existing IBD, and found that 32% of these patients experienced disease progression after a median of 2.2 years, while 55% of those with de novo IBD progressed within 1.9 years.
- Key risk factors for progression in pre-existing IBD included having active disease at the time of SOT and extraintestinal manifestations, indicating a significant impact on patient outcomes post-transplant.*
Introduction: Risk factors for developing pancreatitis due to thiopurines in patients with inflammatory bowel disease (IBD) are not clearly identified. Our aim was to evaluate the predictive pharmacogenetic risk of pancreatitis in IBD patients treated with thiopurines.
Methods: We conducted an observational pharmacogenetic study of acute pancreatitis events in a cohort study of IBD patients treated with thiopurines from the prospectively maintained ENEIDA registry biobank of GETECCU.
Background: Herpes zoster (HZ) is a prevalent disease caused by the reactivation of the varicella-zoster virus (VZV) and associated with chronic morbidity, particularly with post-herpetic neuralgia (PHN). Inflammatory bowel disease (IBD) has been associated with an increased risk of HZ, mainly when immunosuppressive treatment (IMT) is used. However, studies assessing the risk of HZ in IBD are scarce.
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- Infliximab is considered the most effective anti-TNF treatment for ulcerative colitis (UC), but there is limited information on its use as a second anti-TNF option.
- This study analyzed 473 UC patients to compare outcomes between those receiving their first anti-TNF treatment via intravenous (IV) versus subcutaneous (SC) routes.
- Results showed similar clinical response and remission rates after 14 and 52 weeks, suggesting that while a second anti-TNF can be effective, prior failure of the first anti-TNF significantly impacts long-term success.
Background: Thromboembolic events are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, features and outcomes of splanchnic vein thrombosis (SVT) in patients with IBD.
Aims: To describe the clinical features and outcomes of SVT in patients with IBD and to perform a systematic review of these data with published cases and series.
Background And Objectives: Smoking can worsen inflammatory bowel disease (IBD), although evidence regarding the duration of cessation is scarce. The objectives of the study were to determine the duration of abstinence and identify the characteristics of relapse in IBD patients.
Patients And Methods: Using the local database of a nationwide registry of patients with IBD, we identified patients who were active smokers at the time of IBD diagnosis and invited them to participate in the study.
Background: Both vedolizumab and ustekinumab are approved for the management of Crohn's disease [CD]. Data on which one would be the most beneficial option when anti-tumour necrosis factor [anti-TNF] agents fail are limited.
Aims: To compare the durability, effectiveness, and safety of vedolizumab and ustekinumab after anti-TNF failure or intolerance in CD.
Introduction: The objective of this study was to assess the durability, short-term and long-term effectiveness, and safety of tofacitinib in ulcerative colitis (UC) in clinical practice.
Methods: This is a retrospective multicenter study including patients with UC who had received the first tofacitinib dose at least 8 weeks before the inclusion. Clinical effectiveness was based on partial Mayo score.
Introduction: The prevalence of penetrating complications in Crohn's disease (CD) increases progressively over time, but evidence on the medical treatment in this setting is limited. The aim of this study was to evaluate the effectiveness of biologic agents in CD complicated with internal fistulizing disease.
Methods: Adult patients with CD-related fistulae who received at least 1 biologic agent for this condition from the prospectively maintained ENEIDA registry were included.
Background And Aim: In inflammatory bowel disease (IBD), diet can be perceived as a trigger for relapses or clinical worsening, dietary modifications are frequent and not derived from professional advice. The aim of this study was to evaluate the perception of the need for dietary advice in patients with IBD, to know the dietary modifications adopted and, it's effect on IBD.
Methods: An anonymous structured questionnaire with a visual analog scale (0-10) was distributed to consecutive outpatients from our IBD unit.
Background: In spite of the lack of evidence regarding the clinical benefits of oral 5-aminosalicylic acid (5-ASA) compounds in Crohn's disease (CD), these drugs are frequently used in daily clinical practice, particularly for colonic CD. Our aim is to assess the use and clinical outcomes of 5-ASA of those patients with colonic CD treated with 5-ASA as monotherapy.
Methods: Patients diagnosed with isolated colonic CD and treated with 5-ASA but never exposed to immunosuppressants or biologicals were identified from the local databases of five referral centres.
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.
View Article and Find Full Text PDFBackground And Aims: Crohn's disease [CD] can develop penetrating complications at any time during the disease course. Enterocutaneous fistulae [ECF] are disease-related complications with an important impact on quality of life. Our aim was to describe the outcomes of this complication, including its medical and/or surgical management and their temporal trends.
View Article and Find Full Text PDFBackground: Older age has been reported as a risk factor for severe SARS-CoV-2 disease (COVID-19). The impact of immunosuppressants (IMS) on COVID-19 is still under debate.
Aim: To describe the incidence and severity of COVID-19 in elderly patients with inflammatory bowel disease (IBD) in relation to the use of IMS.
Article Synopsis
- A study was conducted to evaluate the long-term effects of stopping anti-TNF treatment in patients with inflammatory bowel disease (IBD), focusing on relapse rates after discontinuation during clinical remission.
- The study involved 1,055 patients and revealed a 12% yearly relapse rate, with 50% experiencing a relapse within five years, while many managed to regain remission after retreatment or switching therapies.
- Overall, the findings suggest that while many patients remain in remission post-discontinuation, retreatment with the same anti-TNF is often effective for those who relapse, and alternative therapies can also lead to remission in non-responders.
Background And Aims: The development programm UNIFI has shown promising results of ustekinumab in ulcerative colitis [UC] treatment which should be confirmed in clinical practice. We aimed to evaluate the durability, effectiveness, and safety of ustekinumab in UC in real life.
Methods: Patients included in the prospectively maintained ENEIDA registry, who received at least one intravenous dose of ustekinumab due to active UC [Partial Mayo Score [PMS]>2], were included.