Publications by authors named "Fernandez-Clotet A"
Background And Aims: Inflammatory pouch disorders exhibit a heterogeneous clinical spectrum and therapeutic requirements have not been properly studied.
Methods: This retrospective, multicentre study included ulcerative colitis patients with ileal pouch construction and were later diagnosed with an inflammatory pouch disorder between 1995 and 2020. Classifications, behaviour and therapies applied were recorded and compared in the long-term.
Article Synopsis
- Ustekinumab is approved for treating ulcerative colitis (UC), and this study evaluated its long-term effectiveness and tolerability in real clinical settings.
- In a multicenter analysis of 620 UC patients, 25% discontinued treatment, with baseline anemia, steroid use, and severe disease linked to higher discontinuation rates.
- At 16 weeks, 40% of patients were in steroid-free remission, and treatment was generally safe with no adverse effects on other conditions, indicating good long-term durability for difficult-to-treat cases.
Background & Aims: Transmural healing (TH) is emerging as a potential Crohn's disease (CD) treatment target. Early biological treatment seems to be associated with improved disease outcomes, but its impact on TH remains unclear. We aimed to assess the impact of early biological treatment initiation on TH and its influence on CD prognosis.
View Article and Find Full Text PDFBackground: some patients with inflammatory bowel disease (IBD) treated with antiTNF develop drug-induced psoriasis (antiTNF-IP). Several therapeutic strategies are possible.
Aims: to assess the management of antiTNF-IP in IBD, and its impact in both diseases.
Background And Aims: It is uncertain whether ulcerative colitis leads to accumulated bowel damage on cross-sectional image. We aimed to characterise bowel damage in patients with ulcerative colitis using magnetic resonance imaging [MRI], and to determine its relation with duration of disease and the impact on patients' quality of life.
Methods: In this prospective study, patients with ulcerative colitis [UC] in endoscopic remission underwent MRI without bowel cleansing, and completed quality-of-life questionnaires.
Article Synopsis
- Autologous haematopoietic stem cell transplantation (AHSCT) is a treatment for Crohn's disease that can be tough because of side effects from chemotherapy.
- In this study, 14 patients had a new approach that didn’t use cyclophosphamide (Cy), and they were given a different medication to help their bodies prepare for the transplant.
- The results showed that the treatment was safe, most patients did well after the transplant, but some had to go back on Crohn's disease medicine later on.
Background And Aims: Magnetic resonance enterography (MRE) depicts transmural changes in response to biological treatment for Crohn's disease (CD); however, the long-term prognostic significance of these findings is unknown. The primary objective of this study was to identify findings on MRE 46 weeks after initiating biological treatment that predict adverse long-term outcomes.
Methods: Patients with CD underwent MRE 46 weeks after initiating biological treatment and were prospectively followed for 2 years.
Article Synopsis
- 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.*
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.
Aims: Methotrexate (MTX) is used to induce and maintain remission in patients with steroid-dependent Crohn's disease (CD). Despite its proven efficacy, its use is limited due to associated adverse events. Polymorphisms involving folate pathway genes might influence MTX efficacy and toxicity.
View Article and Find Full Text PDFNew biologic agents for Crohn disease (CD) create a need for noninvasive disease markers. DWI may assess bowel inflammation without contrast agents. The purpose of this study was to evaluate ADC values for identifying bowel inflammation and therapeutic response in patients with CD treated with biologic therapy.
View Article and Find Full Text PDFBackground And Objectives: Combination therapy with an immunomodulator (IMM) and an anti-TNF is commonly recommended in Crohn's disease (CD) and ulcerative colitis (UC) patients. However, little is known about relapse rates after therapeutic de-escalation. This study aimed to evaluate the risk of relapse in a cohort of UC and CD patients with long-standing clinical remission after discontinuation of IMM or anti-TNF and to identify predictive factors for relapse.
View Article and Find Full Text PDFBackground: 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: Crohn's disease (CD) is a chronic inflammatory bowel disorder that progresses to bowel damage (BD) over time. An image-based index, the Lémann index (LI), has been developed to measure cumulative BD.
Aim: To characterize the long-term progression of BD in CD based on changes in the LI and to determine risk factors for long-term progression.
(1) Background: Fecal calprotectin (FC) correlates well with colonic inflammatory activity of Crohn’s disease (CD); data about relation of FC and small bowel (SB) lesions are still contradictory. The main aim was to analyze the relationship between FC levels and SB inflammatory activity in patients with established or suspected Crohn’s disease, assessed by small bowel capsule endoscopy (SBCE) or magnetic resonance enterography (MRE). (2) Methods: Two cohorts of patients were included: 1.
View Article and Find Full Text PDFBackground: Anti-TNF agents are the only effective biological agents for the prevention of postoperative recurrence (POR) in Crohn's disease (CD). However, they are contraindicated or have been shown to fail in some patients. Although ustekinumab and vedolizumab were licensed for CD some years ago, data in this setting are scarce.
View Article and Find Full Text PDFBackground: Vedolizumab is a humanized monoclonal antibody targeting the αβ integrin used for the treatment of ulcerative colitis. Few biomarkers related to vedolizumab response have been identified. The aim of this work was to assess whether baseline circulating CD4 and CD8 memory T-lymphocyte subpopulations could help to identify patients with response to vedolizumab treatment in ulcerative colitis.
View Article and Find Full Text PDFBackground And Aims: Patients with colonic inflammatory bowel disease (IBD) have a high risk of colorectal cancer (CRC). Current guidelines recommend endoscopic surveillance, yet epidemiological studies show poor compliance. The aims of our study were to analyse adherence to endoscopic surveillance, its impact on advanced colorectal lesions, and risk factors of non-adherence.
View Article and Find Full Text PDFArticle Synopsis
- This study looked at how doctors can tell if treatment is working for patients with Crohn's disease using a special imaging test called MRE.
- The researchers wanted to see if using a contrast dye in the images helped or if the images without the dye were just as good.
- They found that both types of images were good at showing how well the treatment was working, so patients might not need to have the dye put in anymore.
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab.
Aims: To evaluate the impact of biologics on the risk of PC.
Background: Crohn's disease (CD) with upper gastrointestinal involvement (UGI) may have a more aggressive and refractory course. However, evidence on this phenotype of patients is scarce.
Aims: To identify the clinical characteristics, therapeutic requirements and complications associated with UGI in CD METHODS: Nationwide study of cases (UGI, UGI plus ileal/ileocolonic involvement) paired with controls (ileal/ileocolonic involvement) from the ENEIDA registry.
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.
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].