Publications by authors named "Manuel Barreiro de Acosta"

This study investigates whether subclinical inflammation in asymptomatic inflammatory bowel disease (IBD) patients leads to increased medication use. In a multicenter, retrospective analysis of patients diagnosed with incidental ulcerative colitis or Crohn's disease during colorectal cancer screening (2010-2021), medication use was compared with symptomatic patients and healthy non-IBD controls. Asymptomatic patients showed a higher use of cardiovascular, antiparasitic, musculoskeletal, respiratory, and sensory organ medications up to five years before diagnosis.

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Introduction: Crohn's disease (CD) varies by location, potentially affecting therapy efficacy and surgery risk, although research on this topic is conflicting. This study aims to investigate the independent association between CD location and therapeutic patterns.

Methods: We analyzed patients with CD diagnosed from January 2005 to May 2023 registered in the nationwide ENEIDA registry.

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Inflammatory Bowel Disease (IBD) is a chronic digestive condition that requires continuous monitoring by healthcare professionals to determine appropriate therapy and manage short- and long-term complications. Telemedicine has become an essential approach for managing chronic conditions such as IBD, improving care accessibility and continuity, decreasing hospitalization rates, and optimizing patient follow-up. It enables rapid treatment adjustments and encourages patient self-management.

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Cardiovascular diseases (CVD) are the leading cause of death worldwide. Therefore, it is essential to understand their relationship and prevalence in different diseases that may present specific risk factors for them. The objective of this document is to analyze the specific prevalence of CVD in patients with inflammatory bowel disease (IBD), describing the presence of classical and non-classical cardiovascular risk factors in these patients.

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Introduction: Real-world data on the effectiveness of upadacitinib for inflammatory bowel disease (IBD) are limited. To assess upadacitinib persistence, effectiveness, and safety in a real-world scenario.

Methods: Retrospective multicenter study of patients with IBD who received upadacitinib before 31st December 2022 and at least 12 weeks before the recruitment date.

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Background: Mucosal healing (MH) is an established treatment goal in inflammatory bowel disease (IBD). However, various definitions of MH exist. We aimed to identify how MH is defined in randomized controlled trials (RCTs) in ulcerative colitis (UC) and Crohn's disease (CD).

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Article Synopsis
  • Ustekinumab is approved for treating ulcerative colitis (UC), and this study evaluated its long-term effectiveness and tolerability in real clinical settings.
  • In a multicenter analysis of 620 UC patients, 25% discontinued treatment, with baseline anemia, steroid use, and severe disease linked to higher discontinuation rates.
  • At 16 weeks, 40% of patients were in steroid-free remission, and treatment was generally safe with no adverse effects on other conditions, indicating good long-term durability for difficult-to-treat cases.
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Background: Telemonitoring for inflammatory bowel disease (IBD) has not consistently demonstrated superiority over standard care; however, noninferiority may be an acceptable outcome if remote care proves to be more efficient.

Objective: This study aims to compare the remission time and quality of life of patients with active IBD managed through standard care versus the TECCU (Telemonitoring of Crohn Disease and Ulcerative Colitis) app.

Methods: A 2-arm, randomized, multicenter trial with a noninferiority design was conducted across 24 hospitals in Spain.

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Introduction: Identifying novel treatment strategies for patients with ulcerative colitis (UC) and at risk of relapse is critical. The objective of this study was to assess the efficacy of beclomethasone dipropionate (BDP) in lowering fecal calprotectin (FC) levels in UC patients in clinical remission and at risk of relapse.

Methods: This multicenter study comprised a double-blind, randomized, placebo-controlled phase (part I) and an open-label, non-randomized phase (part II).

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Purpose: Metadata for data dIscoverability aNd study rEplicability in obseRVAtional studies (MINERVA), a European Medicines Agency-funded project (EUPAS39322), defined a set of metadata to describe real-world data sources (RWDSs) and piloted metadata collection in a prototype catalogue to assist investigators from data source discoverability through study conduct.

Methods: A list of metadata was created from a review of existing metadata catalogues and recommendations, structured interviews, a stakeholder survey, and a technical workshop. The prototype was designed to comply with the FAIR principles (findable, accessible, interoperable, reusable), using MOLGENIS software.

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Background And Objective: Probiotics show promise in inflammatory bowel disease (IBD), yet knowledge gaps persist. We performed an overview of systematic reviews and an updated metanalysis of randomized controlled trials (RCT) assessing the effect of probiotics on Crohn's disease (CD) and ulcerative colitis (UC).

Methods: MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched up to September 2023.

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Background: Ulcerative proctitis (UP) can have a milder, less aggressive course than left-sided colitis or extensive colitis. Therefore, immunosuppressants tend to be used less in patients with this condition. Evidence, however, is scarce because these patients are excluded from randomised controlled clinical trials.

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Purpose: Crohn's disease (CD) is a progressive disorder leading to cumulative bowel damage. The Lémann index is a validated tool that can help in monitoring the progression of the disease and evaluating the effectiveness of different therapies. Our aim was to describe the main radiological findings in incidentally diagnosed CD and to evaluate bowel damage in this subgroup compared to patients diagnosed at later stages.

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Article Synopsis
  • Markers for personalized treatment options for patients with inflammatory bowel diseases (IBD) remain unidentified, prompting a study on real-life treatment trends.
  • The study analyzed data from 10,009 patients from the ENEIDA registry, revealing that anti-TNF drugs were the most commonly used first-line treatments, but their usage declined over time in Crohn's disease (CD) while remaining stable in ulcerative colitis (UC).
  • Despite exploring Machine Learning for treatment pattern prediction, researchers found that these models were ineffective, indicating distinct treatment approaches for CD and UC and highlighting the rising importance of drugs like ustekinumab and vedolizumab.
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Objective: Granulocyte-monocyte apheresis (GMA) has shown to be safe and effective in ulcerative colitis (UC), also in combination with biologics, mainly with anti-TNF. The aim of this study was to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to ustekinumab (UST) in patients with UC.

Patients And Methods: A retrospective study was performed in 12 IBD Units, including all patients with refractory UC or unclassified IBD (IBD-U) who received combined GMA plus UST.

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Article Synopsis
  • The study evaluates the effectiveness and safety of biological therapies for inflammatory bowel disease (IBD) in patients aged 65 and older, addressing a gap in existing research primarily focused on younger populations.
  • A total of 1,090 elderly patients were included, with findings showing that a significant portion achieved clinical remission after treatment, particularly by the 52-week mark.
  • Although the therapies were generally safe, there was a notable occurrence of oncological events, with variations in incidence rates depending on the specific treatment used.
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Background: The immune dysregulation underlying inflammatory bowel disease (IBD) can start years before the diagnosis, but the role of triggering factors and environmental exposures during this period is still uncertain.

Methods: This single-center case-control study included asymptomatic subjects with an incidental diagnosis of IBD during the colorectal cancer screening program. Twenty-two minerals and 17 metals were determined at diagnosis in hair samples and compared 1:2 to healthy controls.

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Article Synopsis
  • Limited data exist on the outcomes of inflammatory bowel disease (IBD) in patients who undergo solid organ transplantation (SOT), and this study examines both pre-existing IBD and newly developed IBD post-transplant.
  • The study included 177 patients, of which 106 had pre-existing IBD, and found that 32% of these patients experienced disease progression after a median of 2.2 years, while 55% of those with de novo IBD progressed within 1.9 years.
  • Key risk factors for progression in pre-existing IBD included having active disease at the time of SOT and extraintestinal manifestations, indicating a significant impact on patient outcomes post-transplant.*
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Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders.

Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders.

Design: This was a retrospective and multicentre study.

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The treatment of inflammatory bowel disease has undergone a significant transformation following the introduction of biologic drugs. Thanks to these drugs, treatment goals have evolved from clinical response and remission to more ambitious objectives, such as endoscopic or radiologic remission. However, even though biologics are highly effective, a significant percentage of patients will not achieve an initial response or may lose it over time.

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Objective: Granulocyte-monocyte apheresis (GMA) has shown to be safe and effective in treating ulcerative colitis (UC), also in combination with biologics. The objective of this study is to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to tofacitinib (TOFA) in patients with UC.

Patients And Methods: Retrospective study including all patients with refractory UC who received GMA plus TOFA.

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Objective: The recommendations of the Spanish Ministry of Health on vaccination in risk groups include mesalazine among the treatments with a possible negative effect on its effectiveness. However, this is not the recommendation of most experts. Our objective was to evaluate the effect of mesalazine on the humoral response to the SARS-CoV-2 vaccine in patients with inflammatory bowel disease (IBD).

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