Publications by authors named "Maurice Lutgens"
A Prediction Model for Successful Increase of Adalimumab Dose Intervals in Patients with Crohn's Disease: Secondary Analysis of the Pragmatic Open-Label Randomised Controlled Non-inferiority LADI Trial.
Dig Dis Sci
June 2024
Article Synopsis
- In the LADI trial, researchers found that extending adalimumab (ADA) dosing intervals was just as effective as standard dosing for Crohn's disease patients in remission.
- The study aimed to create a prediction model to identify patients who could successfully increase their dosing intervals based on trial data.
- Results showed that 60.6% of patients successfully extended their dosing, with certain factors (like smoking and prior surgeries) making success less likely; the model's effectiveness needs further external validation before clinical use.
Article Synopsis
- Colonoscopic surveillance is important for patients with colonic inflammatory bowel disease (IBD) due to their higher risk of colorectal cancer (CRC), and a new prediction model has been developed for assessing this risk.
- The study analyzed data from 6 cohorts across North America and Europe, including 3731 patients, to create and validate this model using predictive variables and a statistical approach known as Cox proportional hazards modeling.
- The model showed good accuracy in predicting advanced colorectal neoplasia (aCRN) over 5-10 years, but further research is needed to validate its effectiveness across different populations and to determine how it impacts surveillance strategies.
The Efficacy of an Over-the-Counter Multivitamin and Mineral Supplement to Prevent Infections in Patients With Inflammatory Bowel Disease in Remission With Immunomodulators and/or Biological Agents: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
Inflamm Bowel Dis
September 2024
Article Synopsis
- Patients with inflammatory bowel disease (IBD) treated with immunomodulators or biologics face a higher risk of infections and often experience malnutrition and vitamin deficiencies.* -
- A clinical trial was conducted with 320 IBD patients to assess if a daily multivitamin and mineral supplement could lower infection rates compared to a placebo over a 24-week period.* -
- The study's results showed no significant difference in infection rates between the two groups, indicating that the supplement did not reduce the risk of infections for patients in remission while on IBD treatments.*
Background: Therapeutic drug monitoring (TDM) has the potential to improve efficacy and diminish side effects. Measuring methotrexate-polyglutamate (MTX-PG) in erythrocytes might enable TDM for methotrexate in patients with Crohn's disease (CD).
Aim: To investigate the relationship between MTX-PGs and methotrexate drug survival, efficacy and toxicity METHODS: In a multicentre prospective cohort study, patients with CD starting subcutaneous methotrexate without biologics were included and followed for 12 months.
Article Synopsis
- The study aimed to evaluate the cost-effectiveness of lengthening adalimumab dosing intervals for patients with Crohn's disease who are in stable remission, compared to the standard two-week interval.
- A total of 174 patients participated, with results showing no significant difference in overall quality of life and total costs between the extended interval and control groups, although medication costs were lower in the extended group.
- Increased dosing intervals were deemed cost-effective if the value of a quality-adjusted life year is below €53,960, suggesting that for higher valuations, the conventional dosing remains more favorable.
Increased versus conventional adalimumab dose interval for patients with Crohn's disease in stable remission (LADI): a pragmatic, open-label, non-inferiority, randomised controlled trial.
Lancet Gastroenterol Hepatol
April 2023
Article Synopsis
- The LADI study investigated the effects of extending adalimumab dosing intervals in stable Crohn's disease patients compared to conventional 2-week dosing, focusing on clinical outcomes and the risk of infections.
- Patients in the intervention group increased their dosing to every 3 weeks and then possibly to every 4 weeks, while the control group maintained the 2-week schedule.
- The primary measure of effectiveness was the incidence of persistent disease flare-ups over 48 weeks, with a specific non-inferiority margin of 15% for comparing outcomes.
Background: Safety of thioguanine in pregnant patients with inflammatory bowel disease [IBD] is sparsely recorded. This study was aimed to document the safety of thioguanine during pregnancy and birth.
Methods: In this multicentre case series, IBD patients treated with thioguanine during pregnancy were included.
Article Synopsis
- Anti-TNF treatment discontinuation in inflammatory bowel disease (IBD) patients can lead to high relapse rates, particularly influenced by endoscopic healing status at the time of withdrawal.
- A study involving 81 patients showed that 49% relapsed within two years, with those having complete endoscopic healing experiencing significantly lower relapse rates compared to those with partial healing.
- Mesalamine treatment was linked to fewer relapses in UC/IBDU patients, and most patients who restarted anti-TNF regained clinical remission within three months.
Background: Patients with inflammatory bowel disease (IBD) undergo surveillance colonoscopies at fixed intervals to reduce the risk of colorectal cancer (CRC). Taking patients' preferences for determining surveillance strategies into account could improve adherence and patient satisfaction. This study aimed to determine patient preferences for CRC surveillance in IBD.
View Article and Find Full Text PDFPatients with inflammatory bowel disease (IBD) are at increased risk of developing colorectal cancer (CRC). Current guidelines recommend frequent surveillance colonoscopies for patients with at least left-sided ulcerative colitis, or Crohn's disease involving more than 30% of the colon. Surveillance allows for early detection and treatment of colorectal dysplasia and cancer.
View Article and Find Full Text PDFBackground: Quality of life (QoL) data for patients with inflammatory bowel disease switched from the reference infliximab to biosimilar CT-P13 is lacking. This study aims to demonstrate noninferiority for QoL and efficacy after switching.
Methods: OoL and clinical efficacy were measured prior to and after 2, 4, and 6 CT-P13 infusions.
Background: Patients suffering from inflammatory bowel diseases (IBD) and treated with originator infliximab are increasingly being switched to biosimilars. Some patients, however, are "reverse switched" to treatment with the originator. Here we assess the prevalence of reverse switching, including its indication and outcomes.
View Article and Find Full Text PDFBackground And Aims: Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer (CRC). We performed a systematic review and meta-analysis to identify all prognostic factors for advanced colorectal neoplasia (aCRN, high-grade dysplasia, or CRC) in patients with IBD.
Methods: A systematic literature search was conducted according to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines.
Background And Aims: The COVID-19 risk and disease course in inflammatory bowel disease [IBD] patients remains uncertain. Therefore, we aimed to assess the clinical presentation, disease course, and outcomes of COVID-19 in IBD patients. Second, we determined COVID-19 incidences in IBD patients and compared this with the general population.
View Article and Find Full Text PDFBackground: Colonoscopic surveillance for neoplasia is recommended for patients with inflammatory bowel disease (IBD)-related colitis. However, data on cost-effectiveness predate current international guidelines.
Objective: To compare cost-effectiveness based on contemporary data between the surveillance strategies of the American Gastroenterological Association (AGA) and British Society of Gastroenterology (BSG).
A rule for determining risk of colorectal cancer in patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol
January 2015
Background & Aims: Surveillance guidelines for inflammatory bowel disease-associated colorectal cancer (IBD-CRC) are based on findings from retrospective studies. We aimed to create and validate a prediction rule to assist clinicians in identifying patients with IBD who are at low and high risk for CRC.
Methods: We performed a retrospective case-control study of 2 cohorts of patients from tertiary care centers (the University Hospital of Leuven, Belgium, and 7 University Medical Centers in The Netherlands).
Background: Recently reported risks of colorectal cancer (CRC) in inflammatory bowel disease (IBD) have been lower than those reported before 2000. The aim of this meta-analysis was to update the CRC risk of ulcerative and Crohn's colitis, investigate time trends, and identify high-risk modifiers.
Methods: The MEDLINE search engine was used to identify all published cohort studies on CRC risk in IBD.
Background: The increased risk of colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) is well established. The incidence of IBD-related CRC however, differs markedly between cohorts from referral centers and population-based studies. In the present study we aimed to identify characteristics potentially explaining these differences in two cohorts of patients with IBD-related CRC.
View Article and Find Full Text PDFBackground: Patients with long-standing colitis carry an increased risk of colorectal cancer and are therefore enrolled in colonoscopic surveillance programs. It is presently not known if endoscopic surveillance of patients with colitis with a closed rectal stump after a subtotal colectomy is justified. Neither is it clear which of these patients might be at increased risk for rectal stump cancer.
View Article and Find Full Text PDFBackground: Latent autoimmune diabetes in adults (LADA) represents a subgroup of diabetes mellitus. LADA is characterised by adult-onset diabetes and circulating autoimmune antibodies. LADA patients may need a different therapeutic approach than the usual type 2 diabetes mellitus.
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