Tight control using fecal calprotectin and early disease intervention increase the rates of transmural remission in Crohn's disease.

Background: Increasing evidence supports the use of transmural remission as a treatment target in Crohn's disease (CD), but it is seldom achieved in clinical practice. Tight monitoring of inflammation using fecal calprotectin with reactive treatment escalation may potentially improve these results.

Aims: To evaluate if treatment escalation based on fecal calprotectin can improve the rates of transmural remission in CD.

Transmural remission improves clinical outcomes up to 5 years in Crohn's disease.

Introduction: Evidence supporting transmural remission (TR) as a long-term treatment target in Crohn's disease (CD) is still unavailable. Less stringent but more reachable targets such as isolated endoscopic (IER) or radiologic remission (IRR) may also be acceptable options in the long-term.

Methods: Multicenter retrospective study including 404 CD patients evaluated by magnetic resonance enterography and colonoscopy.

Proactive infliximab is more effective than vedolizumab in inducing fecal calprotectin remission in inflammatory bowel disease.

Background: Current evidence suggests vedolizumab (VDZ) may be as effective as Infliximab (IFX) in inflammatory bowel disease. It is unknown if proactive therapeutic drug monitoring (PTDM) of IFX may improve these results.

Methods: Case-control study including consecutive patients with primary response to conventional IFX ( = 70), proactive IFX ( = 148), and VDZ ( = 95).

Proactive therapeutic drug monitoring is more effective than conventional management in inducing fecal calprotectin remission in inflammatory bowel disease.

Background: Proactive therapeutic drug monitoring (pTDM) may improve treatment outcomes in inflammatory bowel disease.

Aims And Methods: We compared 135 patients following a prospective pTDM protocol aiming at an infliximab trough level (IFXTL) between 5 and 10 μg/ml with sequential measurements of Fc, with 108 patients from a retrospective group under conventional management. We evaluated the rates of Fc remission (<250 μg/g) and other clinical outcomes at 2-year of follow-up.

Proactive Infliximab Drug Monitoring Is Superior to Conventional Management in Inflammatory Bowel Disease.

Background: Increasing evidence supports the use of reactive therapeutic drug monitoring (TDM) in Crohn's disease (CD) and ulcerative colitis (UC) following secondary loss of response. It is still unknown if proactive TDM can improve clinical outcomes.

Methods: Consecutive patients completing infliximab (IFX) induction therapy were prospectively allocated into a proactive TDM protocol (pTDM).

Predicting the Course of Disease in Hospitalized Patients With Acute Severe Ulcerative Colitis.

Background: Up to one-third of patients with acute severe ulcerative colitis (ASUC) will fail intravenous steroid (IVS) treatment, requiring rescue therapy with cyclosporin (Cys), infliximab (IFX), or colectomy. Although several scores for predicting response to IVS exist, formal comparison is lacking.

Methods: We performed a single-center retrospective analysis including 489 patients with ulcerative colitis.

Intraductal papillary mucinous neoplasm presenting with recurrent pancreatitis: a report of a painful 3-decade-long history.

Intraductal papillary mucinous neoplasm represents the most common pancreatic cystic neoplasm and harbours significant malignant potential. Duct obliteration can lead to recurrent episodes of pancreatic inflammation mimicking acute and chronic pancreatitis. We report a case of a patient with multiple episodes of idiopathic pancreatitis occurring over a period of three decades.

Acute cholangitis in an old patient with Crigler-Najjar syndrome type II - a case report.

Background: Crigler-Najjar syndrome (CN) is a very rare genetic disorder characterized by an inability to conjugate bilirubin. Contrary to CN type I, patients with CN II exhibit residual capacity to conjugate bilirubin and may present a normal life expectancy.

Case Presentation: We report an unusual late diagnosis of CN type II in an 80-year-old female admitted with severe acute cholangitis.

IL23R polymorphisms influence phenotype and response to therapy in patients with ulcerative colitis.

Objective: We aimed to identify the clinical and genetic [IL23 receptor (IL23R) single nucleotide polymorphisms (SNPs)] predictors of response to therapy in patients with ulcerative colitis.

Patients And Methods: A total of 174 patients with ulcerative colitis, 99 women and 75 men, were included. The mean age of the patients was 47±15 years and the mean disease duration was 11±9 years.