Publications by authors named "Flavio Caprioli"
Introduction: IBD-Disk is a simple, easy-to-use, and self-administered analogue visual tool for assessing disability in patients with Inflammatory Bowel Disease (IBD). However, it has not yet been validated in Italian. This study aims to validate IBD-Disk in an Italian cross-sectional multicentre study.
View Article and Find Full Text PDFColorectal cancer (CRC) is a multifaceted disease whose development and progression varies depending on tumor location, age of patients, infiltration of immune cells within cancer lesions, and the tumor microenvironment. These pathophysiological characteristics are additionally influenced by sex-related differences. The gut microbiome plays a role in initiation and progression of CRC, and shapes anti-tumor immune responses but how responsiveness of the immune system to the intestinal microbiota may contribute to sexual dimorphism of CRC is largely unknown.
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- * A survey involved 47 out of 128 Italian centers, revealing a CIF prevalence of about 1%, with higher rates in academic settings and only a small percentage of centers routinely conducting necessary assessments.
- * Although 12 centers used the medication teduglutide (TED) with a reported success rate of over 50%, overall management of SBS and CIF was found to be inadequate in the participating centers.
The interaction between the gut microbiota and invariant Natural Killer T (iNKT) cells plays a pivotal role in colorectal cancer (CRC). The pathobiont influences the anti-tumor functions of CRC-infiltrating iNKT cells. However, the impact of other bacteria associated with CRC, like , on their activation status remains unexplored.
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- A phase 3b clinical trial was conducted to compare the effectiveness and safety of risankizumab and ustekinumab in patients with moderate-to-severe Crohn's disease who didn't respond to anti-TNF therapy.
- The study evaluated two primary outcomes: clinical remission at week 24 and endoscopic remission at week 48, with risankizumab being tested for noninferiority and superiority, respectively.
- Results showed that risankizumab was not only noninferior to ustekinumab for clinical remission but also superior for endoscopic remission, with significant improvements reported in patients receiving risankizumab.
Article Synopsis
- Clostridioides difficile infection (CDI) is a major cause of hospital-related deaths and can worsen with broad-spectrum antibiotics, leading to more recurrences.
- Fidaxomicin, a more targeted antibiotic, shows promise in preventing CDI recurrences and protecting gut health, but its high cost limits its use.
- An expert panel used Delphi methodology to reach consensus on managing CDI, focusing on identifying at-risk patients and optimizing the use of fidaxomicin to enhance clinical practices and cost-effective treatments in resource-limited settings like Italy.
(1) : Inflammatory bowel disease (IBD) is frequently associated to other immune-mediated inflammatory diseases (IMIDs). This study aims at assessing physicians' awareness of the issue and the current status of IMID management. (2) : A web-based survey was distributed to all 567 physicians affiliated to IG-IBD.
View Article and Find Full Text PDFBackground: Tofacitinib is an oral Janus kinase inhibitor recently approved to induce and maintain remission in ulcerative colitis (UC).
Aims: Considering the number of anti-TNF non-responders, this study aims to assess the effectiveness and safety of tofacitinib in a cohort of multi-failure patients with moderate-to-severe UC at 52 weeks.
Methods: From January 2021 to March 2023, we performed a prospective multicenter study observing adult patients with moderate-to-severe UC starting tofacitinib after an anti-TNF failure for a 52-week-long period.
Spondyloarthritis (SpA) is the most frequent extraintestinal manifestation in patients with inflammatory bowel diseases (IBD). When IBD and spondyloarthritis coexist, musculoskeletal and intestinal disease features should be considered when planning a therapeutic strategy. Treatment options for IBD and SpA have expanded enormously over the last few years, but randomized controlled trials with specific endpoints focused on SpA are not available in the IBD setting.
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- A study compared the effectiveness of tofacitinib and ustekinumab as third-line treatments for patients with moderate to severe ulcerative colitis (UC) who did not respond to earlier therapies (anti-TNF and vedolizumab).
- Out of 117 patients followed for about 11.6 months, 54% experienced disease progression, with ustekinumab being associated with a higher risk of progression compared to tofacitinib.
- While tofacitinib showed better results in preventing disease progression, no major differences were noted in secondary outcomes or adverse events, highlighting the need for more extensive clinical trials to validate these findings.
Purpose: Stomach and esophageal cancers are among the highest mortality from cancers worldwide. Microbiota has an interplaying role within the human gastrointestinal (GI) tract. Dysbiosis occurs when a disruption of the balance between the microbiota and the host happens.
View Article and Find Full Text PDFBackground And Aims: Pragmatic studies designed to test interventions in everyday clinical settings can successfully complement the evidence from registration and explanatory clinical trials. The European consensus project PRACTICE-IBD was developed to identify essential criteria and address key methodological issues needed to design valid, comparative, pragmatic studies in inflammatory bowel diseases [BDs].
Methods: Statements were issued by a panel of 11 European experts in IBD management and trial methodology, on four main topics: [I] study design; [II] eligibility, recruitment and organisation, flexibility; [III] outcomes; [IV] analysis.
Introduction: Patients with ulcerative colitis (UC) receiving immunosuppressive drugs are at substantial risk of colectomy. We aimed to assess the risk of postoperative complications of tofacitinib exposure before colectomy in comparison with biologics.
Methods: A multicenter, retrospective, observational study was conducted in patients with UC who underwent total colectomy for medically refractory disease, exposed to tofacitinib or a biologic before surgery.
Background: The RIDART I study found a 13.6% prevalence of anemia in Italian patients with inflammatory bowel disease (IBD); most cases were due to iron-deficiency anemia (IDA).
Aims: To evaluate changes in hemoglobin concentration during a 24-week follow-up of anemic patients with IBD.
Background: Transition is a crucial process in the care of IBD patients, although it remains largely heterogeneous.
Aims: To provide an overview of the transition process in Italy and to investigate the perspective of the paediatric and adult physicians.
Methods: An online survey was developed by the Italian Group for Inflammatory Bowel Diseases (IG-IBD) and the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition (SIGENP).
Background: The vaccination status of patients with inflammatory bowel disease (IBD) should be investigated before starting any treatment, and patients should eventually be vaccinated against vaccine-preventable diseases (VPDs). Patients with IBD may have suboptimal vaccination rates. The aim of this study was to evaluate the vaccination coverage, attitude towards vaccinations, and determinants among an Italian cohort of patients with IBD.
View Article and Find Full Text PDFBackground: Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBDs) with a rapidly growing worldwide incidence. The last decades presented rapid progress in pharmacological treatment leading in many cases to clinical and endoscopic remission, including biological treatment with anti-TNF agents.
Aim: The exact timing of introduction, optimization and maintenance of anti-TNF therapy in IBDs is not thoroughly covered in current guidelines.
Background And Aims: Endoscopic activity is associated with an increased risk of surgery in patients with ulcerative colitis [UC]. Transmural activity, as defined by Milan Ultrasound Criteria [MUC] > 6.2, reliably detects endoscopic activity in patients with UC.
View Article and Find Full Text PDFPrevalence of Disease-Related Malnutrition and Micronutrients Deficit in Patients with Inflammatory Bowel Disease: A Multicentric Cross-Sectional Study by the GSMII (Inflammatory Bowel Disease Study Group).
Inflamm Bowel Dis
July 2024
Article Synopsis
- The study aimed to determine the prevalence of disease-related malnutrition (DRM) and micronutrient deficiencies in patients with inflammatory bowel disease (IBD), while also identifying related risk factors.
- Among the 295 IBD patients assessed, 23% were found to have DRM, with no significant difference between those with Crohn's disease and those with ulcerative colitis.
- Factors such as low body mass index (BMI), recent hospitalizations, and disease activity were linked to DRM, highlighting that malnutrition and micronutrient deficiencies are common in the IBD population and relate to health complications.
Bowel-associated arthritis-dermatosis syndrome (BADAS) is a rare neutrophilic dermatosis that was first described in 1971 in patients who underwent bypass surgery for obesity. Over the years, the number of reported cases associated with medical gastroenterological conditions, particularly inflammatory bowel disease (IBD), has progressively increased. To date, there are no systematic reviews in the literature on BADAS.
View Article and Find Full Text PDFBackground: The administration of biological drugs in inflammatory bowel diseases (IBD) is increasingly moving from intravenous to subcutaneous formulations.
Aims: To evaluate the efficacy and safety of vedolizumab subcutaneous administration after switching from intravenous administration in ulcerative colitis (UC) patients in corticosteroid-free clinical remission.
Methods: An observational, multicentre, prospective study was conducted by the Italian Group for the study of IBD (IG-IBD).
Article Synopsis
- IFNγ-producing ex-Th17 cells, referred to as Th1/17, are significant in causing experimental colitis and are prevalent in the intestines of patients with Crohn's disease (CD).
- A novel subset of Th17 cells, known as CCR5+ Th17 (pTh17), was identified in human intestines, co-expressing T-bet and RORC/γt, and was found to be linked to intestinal inflammation in CD, particularly responsive to the bacteria Escherichia coli associated with CD.
- Successful treatments, like anti-TNF therapy and anti-IL-23 therapy, reduced pTh17 cell levels, highlighting their role as pro-inflammatory and potentially pathogenic in the context