Publications by authors named "N Mahmmod"
Background: Intracellular methotrexate polyglutamates (MTX-PGs) concentrations are measurable in red blood cells (RBCs) during MTX treatment. MTX-PG concentrations correlate with efficacy in patients with Crohn's disease (CD). Since RBCs are not involved in pathogenesis of CD and lack extended MTX metabolism, we determined MTX-PGs accumulation in peripheral blood mononuclear cells (PBMCs: effector cells) and intestinal mucosa (target cells) and compared those with RBCs as a potential more precise biomarker.
View Article and Find Full Text PDFBackground: 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
- 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.
Article Synopsis
- A study investigated the effects of stopping immunomodulators like thiopurines or methotrexate in patients with inflammatory bowel disease (IBD) who were on anti-TNF therapies, comparing outcomes of withdrawal versus continuation of treatment.
- The research included 614 treatment episodes from 543 patients, revealing that withdrawing immunomodulators did not increase the risk of losing response to treatment, although it did lead to a higher frequency of anti-drug antibodies.
- Key findings highlighted that being in clinical remission at the time of withdrawal lowered the risk of losing treatment response, while higher drug levels before stopping the immunomodulators reduced the chances of developing anti-drug antibodies.
Article Synopsis
- Inflammatory bowel disease (IBD) treatment with anti-TNFα shows a significant loss of response in the first year (17.2% annually) compared to after four years (4.8% annually), indicating that long-term treatment may improve patient stability.
- A study of 844 treatment episodes found that the overall incidence of anti-TNFα discontinuation and dose escalations also decreased significantly from the first year to after four years.
- Factors influencing loss of response included having ulcerative colitis (UC) over Crohn's disease (CD), specific disease types in CD, and gender, while using immunomodulators appeared to reduce the risk of developing anti-drug antibodies.