Publications by authors named "Geert R A M D'Haens"
Background And Aims: Previous literature suggests that faecal calprotectin (FC) discriminates Crohn's disease perianal fistulas from cryptoglandular fistulas, irrespective of luminal disease. This study aims to prospectively validate this and analyse if increased local fistula calprotectin levels are associated with fistula characteristics.
Methods: In this prospective study, all consecutive patients with an active perianal fistula undergoing examination under anaesthesia were included.
Endoscopic endpoints in biologic clinical trials and beyond: the case for Crohn's Disease.
Expert Opin Biol Ther
December 2024
Article Synopsis
- Standardized evaluation of endoscopic disease activity is essential for effective clinical trials targeting Crohn's disease (CD) since achieving endoscopic remission improves long-term patient outcomes.
- Various endoscopic indices have been developed, with CDEIS and SES-CD showing decent reliability, but they have limitations such as complexity, time consumption, and variability.
- The SES-CD is recommended for use in future trials because it's simpler and correlates well with the more complex CDEIS, and further research is needed to define endoscopic response and remission cutoff values.
Background & Aims: Fecal microbiota transplantation (FMT) can induce remission in patients with ulcerative colitis, yet its efficacy needs improvement. We conducted a comprehensive evaluation of the current literature on microbial factors affecting outcome, as well as a meta-analysis on some of the largest datasets regarding composition.
Methods: MEDLINE, Embase, and Cochrane were systematically searched through August 2024 for relevant studies.
: Incidences of perianal fistulas (PAFs) as a first manifestation of Crohn's disease (CD) vary widely in the literature. Aim: To analyse the percentage of patients with a PAF preceding CD diagnosis and assess the time to diagnosis. : A systematic literature search was conducted.
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- The study explores how patients on immunosuppressants (ISPs) respond to SARS-CoV-2 infections compared to healthy controls, particularly looking at antibody levels post-infection.
- Patients with immune-mediated inflammatory diseases (IMIDs) on different ISP therapies showed variable antibody responses, with those on anti-CD20 and sphingosine-1 phosphate therapies having lower antibody levels.
- Despite lower antibody titers, the breakthrough infections in these patients were mostly mild, indicating that ISPs may not severely impede the overall immune response to SARS-CoV-2.
Background: The use of concomitant azathioprine may improve efficacy and pharmacokinetic (PK) properties of infliximab (IFX) but is also associated with an increased risk of adverse events. Proactive therapeutic drug monitoring (pTDM) of IFX monotherapy is an alternative strategy to improve PK. The aim of this study was to evaluate whether IFX with an immunomodulator (combo) has PK benefits over IFX-pTDM (mono) in pediatric Crohn's disease (CD).
View Article and Find Full Text PDFShort-term anti-TNF therapy with surgical closure versus anti-TNF therapy alone for Crohn's perianal fistulas (PISA-II): long-term outcomes of an international, multicentre patient preference, randomised controlled trial.
EClinicalMedicine
July 2023
Article Synopsis
- The PISA-II trial found that using short-term anti-TNF therapy followed by surgical closure results in better healing of perianal fistulas in Crohn's disease patients compared to anti-TNF therapy alone after 18 months.
- This study involved long-term follow-up of patients from the PISA-II trial, with data collected from 91 participants across multiple hospitals in the Netherlands and Italy, focusing on the effectiveness of each treatment method.
- Findings indicated that over a median follow-up period of 5.7 years, healing rates remained similar in both treatment groups, with a high percentage of participants remaining in the study.
Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs.
Methods: IMID patients on active treatment with ISPs and controls (i.
For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine.
View Article and Find Full Text PDFThe non-pathogenic T17 subset of helper T cells clears fungal infections, whereas pathogenic T17 cells cause inflammation and tissue damage; however, the mechanisms controlling these distinct responses remain unclear. Here we found that fungi sensing by the C-type lectin dectin-1 in human dendritic cells (DCs) directed the polarization of non-pathogenic T17 cells. Dectin-1 signaling triggered transient and intermediate expression of interferon (IFN)-β in DCs, which was mediated by the opposed activities of transcription factors IRF1 and IRF5.
View Article and Find Full Text PDFBackground And Aims: Adequate endoscopic scoring in Crohn's disease [CD] is crucial, as it dictates the need for initiating postoperative medical therapy and is utilized as an outcome parameter in clinical trials. Here we aimed to observe anastomotic wound healing in relation to endoscopic scoring of both inverted and everted stapled lines in side-to-side anastomoses.
Methods: Two prospective patient cohorts were included: ileocolic resection [ICR] for CD, and right-sided colon resection for colorectal cancer [CRC].
Objectives: To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.
Methods: Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included.
Background: Anti-tumor necrosis factor (TNF) therapy is effective for the treatment of Crohn's disease. Cessation may be considered in patients with a low risk of relapse. We aimed to externally validate and update our previously developed prediction model to estimate the risk of relapse after cessation of anti-TNF therapy.
View Article and Find Full Text PDFBackground: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.
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- - The study investigates how specific immunosuppressive therapies affect the immune response to SARS-CoV-2 vaccination in patients with immune-mediated inflammatory disorders, focusing on the humoral immune response.
- - Conducted in the Netherlands with over 3,200 participants, the research compares the immune responses of patients on immunosuppressants to controls, including healthy individuals and those without systemic immunosuppressants.
- - Findings indicate that certain immunosuppressive treatments, like anti-CD20 therapy and S1P modulators, result in lower chances of achieving adequate immunity post-vaccination, regardless of the type of immune disorder present.
Background: It has been suggested that eosinophils may be a prognostic marker of disease outcome in ulcerative colitis (UC), but conflicting data exist. The objective was to investigate the extent of mucosal eosinophils and peripheral blood eosinophil count in newly diagnosed UC patients and to investigate its predictive value in short- and long-term disease outcomes.
Methods: The degree of eosinophilia in baseline colonic biopsies and blood of newly diagnosed UC patients was retrospectively analyzed.
Background: Studies have suggested incremental short-term adverse events (AE) after repeated vaccination. In this report, we assessed occurrence and risk factors for short-term AEs following repeated SARS-CoV-2 vaccination in patients with various immune-mediated inflammatory diseases (IMIDs).
Methods: Self-reported daily questionnaires on AEs during the first 7 days after vaccination were obtained of 2259 individuals (2081 patients and 178 controls) participating in an ongoing prospective multicenter cohort study on SARS-CoV-2 vaccination in patients with various IMIDs in the Netherlands (T2B-COVID).
Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn's disease: Results of the HOT-TOPIC trial after 1-year follow-up.
United European Gastroenterol J
March 2022
Background: Previously published short-term results (week 16) of this trial showed a significant improvement in clinical, radiologic and biochemical outcomes in Crohn's disease patients with therapy-refractory perianal fistulas after treatment with hyperbaric oxygen therapy.
Objective: To assess the long-term (week 60) efficacy, safety and feasibility of hyperbaric oxygen therapy in perianal fistula in Crohn's disease.
Methods: Crohn's disease patients with high perianal fistula(s) failing conventional treatment >6 months were included.
Background: Positive effects of hyperbaric oxygen on perianal fistulas in Crohn's disease have been reported.
Aim: To assess efficacy, safety and feasibility of hyperbaric oxygen in Crohn's disease patients with therapy-refractory perianal fistulas.
Methods: Twenty consecutive patients were recruited at the out-patient fistula clinic of the Amsterdam UMC.
Background: The neutrophil fecal biomarkers, calprotectin (FCP) and lactoferrin (LCT), and peripheral blood neutrophil CD64 surface receptor (nCD64) are biomarkers for mucosal inflammation in inflammatory bowel disease (IBD). Although FCP has been evaluated as a biomarker for mucosal healing, cut points for LCT and nCD64 are less known. We aimed to identify the cut points for LCT and nCD64 that were associated with FCP remission, with a secondary aim to evaluate the relationship between biochemical outcomes and infliximab (IFX) trough concentrations.
View Article and Find Full Text PDFBackground & Aims: Endoscopic healing, an important target of treatment for Crohn's disease (CD), requires ileocolonoscopy, which is costly and burdensome. We investigated whether published noninvasive models (based on symptoms and biomarkers) to evaluate CD activity have sufficient accuracy to replace ileocolonoscopy.
Methods: We performed a systematic review of published noninvasive diagnostic models to evaluate CD activity that used endoscopic features of activity (endoscopic activity) or healing as the reference standard.
Background: Structured evaluation of magnetic resonance imaging (MRI) is important to guide clinical decisions of perianal fistulas in Crohn's disease (CD) patients.
Purpose: To evaluate the recently developed modified Van Assche index to assess clinical responses to anti-tumor necrosis factor (TNF) therapy in patients with perianal fistulizing CD.
Methods: A search of medical records identified patients with fistulizing perianal CD who underwent baseline and follow-up MRI while receiving anti-TNF treatment.