Publications by authors named "Irit Avni Biron"
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.
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).
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.!
Introduction: 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 & Aims: To date, it is unclear how environmental factors influence Crohn's disease (CD) risk and how they interact with biological processes. This study investigates the association between environmental exposures and CD risk and evaluates their association with pre-disease biomarkers.
Methods: We studied 4289 healthy first-degree relatives (FDRs) of patients with CD from the Crohn's and Colitis Canada - Genetic, Environmental, Microbial (CCC-GEM) project.
Background: 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: Recruitment for randomized controlled trials [RCTs] in inflammatory bowel diseases [IBD] has substantially dropped over time. This study aimed to assess reasons why IBD patients are not included in sponsored multicentre phase IIb-III RCTs.
Methods: All IOIBD members [n = 58] were invited to participate.
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 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.
Background: Inflammatory bowel disease (IBD) can have an impact on pregnancy outcomes due to the effect of the disease activity and medication use. This study aimed to evaluate the pregnancy outcomes in IBD patients treated at a multidisciplinary clinic.
Methods: This study was a retrospective cohort study including consecutive pregnant patients with IBD having a singleton gestation attending a multidisciplinary clinic between 2012 and 2019.
Background And Aims: Patients with inflammatory bowel disease [IBD] are often affected during their reproductive years and may have many perinatal queries that require the comprehensive perspectives of a multidisciplinary team [MDT]. The purpose of this topical review is to assess the scientific evidence and provide expert opinion related to nutritional, psychological and supportive care of women and their infants throughout the prenatal, antenatal and infant periods.
Methods: A consensus expert panel of a paediatrician, gastroenterologists, nurses and dietitians was convened by the European Crohn's and Colitis Organisation.
Introduction: Regulatory agencies supported vaccination of pregnant women with SARS-CoV-2 mRNA vaccines, including patients with IBD. No data exist regarding these vaccines in IBD during pregnancy.
Aim: To assess the serologic response to two doses of the mRNA SARS-CoV-2 BNT162b2 vaccine in pregnant women with IBD vaccinated during pregnancy, compared to that of pregnant women without IBD, and non-pregnant women with IBD.
Introduction: Whether fecal calprotectin (FC) and quality of life (QoL) questionnaires reflect change in disease activity in patients with a J-pouch is unknown.
Methods: Patients with acute pouchitis were prospectively treated with a 2-week course of antibiotics. The full Pouchitis Disease Activity Index, FC, and QoL questionnaires were measured at baseline and after antibiotic therapy.
Background: Women with inflammatory bowel diseases (IBD) often receive biologics to maintain remission during pregnancy.
Aims: To assess maternal and neonatal outcomes in patients with IBD treated with ustekinumab (UST) during pregnancy METHODS: In a multicentre, prospective cohort study, we recruited women with IBD treated with UST during pregnancy between 2019 and 2021. Outcomes were compared among patients treated with UST, anti-tumour necrosis factor α, (anti-TNF) and non-UST, non-anti-TNF therapies.
Article Synopsis
- The study aimed to evaluate the immune response in infants exposed to anti-TNFα or azathioprine due to their mothers' inflammatory bowel disease, focusing on T and B cell distribution and function.
- Conducted from 2014 to 2017, the research involved measuring anti-TNFα levels in cord blood and analyzing T-cell function and immunoglobulin levels in infants at 3 and 12 months.
- Findings indicated that infants exposed to anti-TNFα had normal immune responses, with adequate B-cell counts and no severe infections, but further research with untreated controls is necessary for confirmation.
Background: Pregnant patients with inflammatory bowel diseases (IBDs) are frequently treated with immunomodulatory agents and may be at increased risk of adverse outcomes, including peripartum infections. We sought to examine the risk for peripartum infections in patients with IBD compared with control subjects and identify potential risk factors associated with peripartum infections in these patients.
Methods: This retrospective cohort study compared peripartum infection rates and associated risk factors between pregnant women with and without IBD.
Article Synopsis
- A study examined the effectiveness of biologic early prophylaxis for preventing endoscopic post-operative recurrence (ePOR) in Crohn's disease patients after ileocecal resection (ICR).
- It included 297 patients and found that ePOR occurred in about 41.8% of cases within one year, with varying rates across treatment groups: 40.2% for anti-TNF, 33% for vedolizumab (VDZ), and 61.8% for ustekinumab (UST).
- The results indicated no significant differences in ePOR risk between the anti-TNF therapy and the other biologics after adjusting for patient factors, suggesting early prevention was effective for around 60% of patients regardless of
Patients with inflammatory bowel disease (IBD) treated with anti-tumor-necrosis factor-alpha (TNFα) exhibited lower serologic responses one-month following the second dose of the COVID-19 BNT162b2 vaccine compared to those not treated with anti-TNFα (non-anti-TNFα) or to healthy controls (HCs). We comprehensively analyzed long-term humoral responses, including anti-spike (S) antibodies, serum inhibition, neutralization, cross-reactivity and circulating B cell six months post BNT162b2, in patients with IBD stratified by therapy compared to HCs. Subjects enrolled in a prospective, controlled, multi-center Israeli study received two BNT162b2 doses.
View Article and Find Full Text PDFBackground And Aim: Minimal data are available regarding the performance of video capsule endoscopy (VCE) in patients who underwent bariatric surgery. We aimed to report indications, feasibility, and safety of VCE performed after bariatric surgery, specifically focusing on diagnosis rates of Crohn's disease (CD) in this population.
Methods: A retrospective analysis of all VCE procedures was performed between January 2015 and December 2019.
Aims: i] To evaluate the evolution of pregnancies and offspring after inflammatory bowel disease [IBD] surgery during pregnancy; and ii] to describe the indications, the surgical techniques, and the frequency of caesarean section concomitant with surgery.
Methods: Patients operated on due to IBD during pregnancy after 1998 were included. Participating clinicians were asked to review their databases to identify cases.
Background: Crohn's disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated inflammatory bowel diseases (IBD) affecting millions of people worldwide. IBD therapies, designed for continuous immune suppression, often render patients more susceptible to infections. The effect of the immune suppression on the risk of coronavirus disease-19 (COVID-19) is not fully determined yet.
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- * In a cohort of 164 patients, it was found that those who switched due to immunogenic failure had a significant association with increased immunogenicity to the new therapy, particularly when switching from infliximab to adalimumab.
- * Although starting immunomodulators (IMMs) with the new anti-TNFα did not lower the risk of immunogenicity, it was linked to longer retention of the medication, and older age at the time of switching was