Publications by authors named "Henit Yanai"
Background: Patients with ulcerative colitis (UC) undergoing proctocolectomy and ileal pouch-anal anastomosis (IPAA) may eventually require biologic therapy. Factors associated with biologic therapy after IPAA have not been previously studied.
Methods: All patients with UC after total proctocolectomy and IPAA who were followed at Rabin Medical Center comprehensive pouch clinic and who consented to prospective observational follow-up were included.
Objectives: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short, intermediate, and long-term post-discharge complications among these patients.
Methods: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged.
Introduction: Complicated perianal disease (cPD) may be the sole presentation of Crohn's disease (CD). The role of small-bowel capsule endoscopy (SBCE) in the diagnostic algorithm of cPD is unclear. We aimed to evaluate the role of SBCE as a diagnostic tool, in patients with cPD, after a negative standard workup for CD.
View Article and Find Full Text PDFBackground & Aims: Janus kinase (JAK) inhibitors are used for treating inflammatory bowel diseases (IBD). We aimed to identify molecular effects of JAK inhibition in human intestinal mucosa, considering IBD location and phenotype.
Methods: Colonic and ileal explants from patients with ulcerative colitis (UC), Crohn's disease (CD), and non-IBD controls (NC) were assessed for phosphorylated signal transducers and activators of transcription (p-STAT) levels and Inflammatory genes expression panel in response to ex-vivo JAK inhibitor (tofacitinib).
Background: Ocular manifestations (OMs) in patients with inflammatory bowel disease (IBD) are uncommon, particularly in children. We aimed to explore the prevalence and characteristics of IBD-associated OM in a large cohort study.
Methods: A cross-sectional study was performed using the Maccabi Healthcare Services (MHS) database.
Article Synopsis
- The objective was to create a web-based AI tool that predicts drug sustainability (DS) for infliximab and vedolizumab in patients with moderate-to-severe Ulcerative Colitis (UC), addressing a gap in reliable prediction methods.!
- The study included data from three Israeli medical centers, analyzing patients treated for over 54 weeks without corticosteroids, hospitalizations, or surgeries, using machine learning for accurate predictions based on baseline clinical data.!
- The developed model showed strong predictive performance with an area under the ROC curve of 0.86 and accuracy ranging from 65.5% to 76.9%, promising improvements in clinical decision-making for managing UC while enhancing precision medicine practices.!
This article is the second in a series of two publications on the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of Crohn's disease. The first article covers medical management; the present article addresses surgical management, including preoperative aspects and drug management before surgery. It also provides technical advice for a variety of common clinical situations.
View Article and Find Full Text PDFIntroduction: Real-world data on tofacitinib's effectiveness is limited and mainly retrospective or registry-based. We elected to conduct a pragmatic prospective study to assess the efficacy of tofacitinib for moderate to severe ulcerative colitis (UC), aiming to evaluate the ability of intestinal ultrasound (IUS) to discriminate responders vs. non-responders in real-time.
View Article and Find Full Text PDFBackground: Data on predictors of complicated ulcerative colitis (UC) course from unselected populations cohorts are scarce. We aimed to utilize a nationwide cohort to explore predictors at diagnosis of disease course in children and adults with UC.
Methods: Data of patients diagnosed with UC since 2005 were retrieved from the nationwide epi-IIRN cohort.
Background: Since data on predictors of complicated Crohn's disease (CD) from unselected populations are scarce, we aimed to utilize a large nationwide cohort, the epi-IIRN, to explore predictors of disease course in children and adults with CD.
Methods: Data of patients with CD were retrieved from Israel's 4 health maintenance organizations, whose records cover 98% of the population (2005-2020). Time-to-event modeled a complicated disease course, defined as CD-related surgery, steroid-dependency, or the need for >1 class of biologics.
Background: We examined corticosteroid use among Israeli patients with Inflammatory Bowel Disease (IBD), focusing on demographic, disease-related, and psychosocial factors. The objective was to contribute to the development of strategies minimizing corticosteroid dependence and improving patient outcomes, given the adverse effects associated with prolonged corticosteroid use.
Methods: A comprehensive analysis was conducted on data collected from adult IBD patients attending six gastroenterological outpatient clinics in Israel.
Article Synopsis
- Postoperative recurrence (POR) is common in Crohn's disease patients after surgery, but can be reduced with preventive treatment; however, there is insufficient data on the best treatment options and timing.
- A clinical study compared the effectiveness of early treatment with 6-mercaptopurine (6-MP) versus adalimumab in patients after ileocecectomy, finding that adalimumab significantly reduced endoscopic recurrence rates at both 32 and 58 weeks post-surgery.
- Factors like increased size of the resected bowel, lower body mass index (BMI), and specific lab results were linked to a higher risk of endoscopic recurrence, indicating that adalimumab may be a more effective choice for
Aim: Remission rates of medically and surgically treated complex perianal fistulas in Crohn's disease are low. Recently, trials have demonstrated the potential for long-term remission with local injection of allogeneic adipose-derived mesenchymal stem cells (darvadstrocel). Our aim was to analyse outcomes from our real-world experience with this new treatment.
View Article and Find Full Text PDFDietary therapy is increasingly recognized for the management of Crohn's disease (CD) over recent years, including the use of exclusive enteral nutrition (EEN) as first-line therapy for pediatric CD according to current guidelines. The Crohn's disease exclusion diet (CDED) is a whole-food diet designed to reduce exposure to dietary components that are potentially pro-inflammatory, mediated by negative effects on the gut microbiota, immune response, and the intestinal barrier. The CDED has emerged as a valid alternative to EEN with cumulative evidence, including randomized controlled trials, supporting use for induction of remission and possibly maintenance in children and adults.
View Article and Find Full Text PDFBackground: Real-world data on outcomes of patients with newly diagnosed Crohn's disease (ndCD) is limited. We aimed to assess the achievement of corticosteroid-free clinical remission (CS-free CR) and other therapeutic targets 1 year after diagnosis in a cohort of patients with ndCD treated by a multidisciplinary team (MDT).
Methods: A prospective observational cohort study was conducted on consecutive treatment-naïve adults with ndCD.
Background And Aims: Surveillance colonoscopies are crucial for high-risk patients with inflammatory bowel diseases (IBD) to detect colorectal carcinoma (CRC). However, there is no established quality metric for dysplasia detection rate (DDR) in IBD surveillance. This study assessed the DDR in a dedicated surveillance program at a tertiary referral center for IBD.
View Article and Find Full Text PDFBackground And Aims: Tofacitinib (TFB) appears to be effective in the treatment of ulcerative colitis (UC); however, available real-world studies are limited by cohort size. TFB could be an option in the treatment of acute severe ulcerative colitis (ASUC). We aimed to investigate efficacy and safety of TFB in moderate-to-severe colitis and ASUC.
View Article and Find Full Text PDFBackground: Crohn's perianal fistula is a disabling manifestation of Crohn's disease. However, the additional burden of perianal fistula on patients with only Crohn's disease remains to be addressed. This patient-reported survey considered outcomes of two domains: "diagnosis" (eg, symptoms) and "living with the disease" (eg, quality of life, well-being, and relationships).
View Article and Find Full Text PDFArticle Synopsis
- Vaccines play a crucial role in controlling the COVID-19 pandemic, but patients with inflammatory bowel diseases (IBDs) on anti-TNF-α treatments show weaker immune responses after vaccinations.
- A study involving 319 participants found that while a third dose of the Pfizer/BioNTech vaccine led to significant antibody levels in all groups, those on anti-TNF-α therapies experienced a drop in these levels three months later.
- Despite no significant adverse effects or disease flare-ups, the lower antibody response after the third dose indicates a potential risk for infections, suggesting that a fourth dose might be necessary for this population.
Background And Aim: Drug sustainability (DS) is a surrogate marker for treatment efficacy. We aimed to compare the DS of two main biologics used to treat moderate-to-severe ulcerative colitis (UC), infliximab (IFX) and vedolizumab (VDZ), in a real-world setting.
Methods: We conducted a retrospective cohort study at a tertiary medical center in Israel.