Publications by authors named "Sunanda V Kane"

Article Synopsis
  • Patients with inflammatory bowel disease (IBD) face high out-of-pocket costs, reaching up to $41,000 annually, primarily due to expensive biologic medications.
  • Biologics are effective for treating IBD, but their high costs create a need for more affordable alternatives like biosimilars, which are FDA-approved and offer similar therapeutic benefits at a lower price.
  • Despite the advantages of biosimilars, such as increased access and cost-effectiveness, their usage in the U.S. has been limited, prompting a need for better guidance on transitioning to these alternatives in clinical practice.
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Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract, frequently presenting with extraintestinal manifestations. Granulomatosis with polyangiitis is a systemic vasculitis primarily affecting the respiratory tract and kidneys. Extraintestinal Crohn's disease and granulomatosis with polyangiitis may have similar clinical presentations and, in rare occurrences, can coexist.

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Tumor necrosis factor-α (TNF-α) antagonists are highly effective in controlling autoimmune diseases. This has led to speculation that they might also be useful in treating inflammatory placental conditions, such as chronic villitis of unknown etiology (VUE). VUE affects 10-15% of term placentas and is associated with recurrent fetal growth restriction (FGR) and pregnancy loss.

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Background And Aims: Variation in colorectal neoplasia detection limits the effectiveness of screening colonoscopy. By evaluating neoplasia detection rates of individual colonoscopists, we aimed to quantify the effects of pre-procedural knowledge of a positive (+) multi-target stool DNA (mt-sDNA) on colonoscopy quality metrics.

Methods: We retrospectively identified physicians who performed a high volume of + mt-sDNA colonoscopies; colorectal neoplasia at post-mt-sDNA colonoscopy was recorded.

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Article Synopsis
  • Upregulation of tumor necrosis factor-alpha (TNF-α) is linked to immune issues in preeclampsia and inflammatory bowel disease (IBD), prompting a study on anti-TNF therapy during pregnancy.
  • Researchers compared cases of preeclampsia in women with IBD to those with normal pregnancies, analyzing the effects of anti-TNF treatment on preeclampsia risk.
  • Findings indicated that women without preeclampsia had higher anti-TNF therapy exposure, and although not statistically significant, there was a suggested protective effect against preeclampsia for those treated during the third trimester.
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The fields of gastroenterology and hepatology, along with endoscopic practice, have seen significant changes and innovations to practice in just the past few years. These practice changes are not limited to gastroenterology, but maternal fetal medicine and the care of the pregnant person have become increasingly more sophisticated as well. Gastroenterologists are frequently called on to provide consultative input and/or perform endoscopy during pregnancy.

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Background And Aims: SCENIC (International Consensus Statement on Surveillance and Management of Dysplasia in IBD) guidelines recommend that visible dysplasia in patients with longstanding inflammatory bowel disease (IBD) should be endoscopically characterized using a modified Paris classification. This study aimed to determine the interobserver agreement (IOA) of the modified Paris classification and endoscopists' accuracy for pathology prediction of IBD visible lesions.

Methods: One hundred deidentified endoscopic still images and 30 videos of IBD visible colorectal lesions were graded by 10 senior and 4 trainee endoscopists from 5 tertiary care centers.

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Background: Upadacitinib is a selective Janus kinase inhibitor approved for the management of ulcerative colitis and is under evaluation for the management of Crohn's disease [CD] in Phase 3 clinical trials.

Aims: Our goal was to describe our real-world experience with upadacitinib in CD.

Methods: This is a two-centre retrospective cohort study of adult patients with moderate to severe CD on upadacitinib.

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Approximately 50% of patients with inflammatory bowel disease including both Crohn's disease and ulcerative colitis are female with many being diagnosed and treated during their reproductive years. It is important for women to be in remission prior to and during pregnancy. There have been many advances in the treatment of inflammatory bowel disease, including new therapies.

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Background: Emerging data showed patients with chronic inflammatory disorders, including inflammatory bowel disease, are more likely to develop atherosclerotic cardiovascular diseases, heart failure, and atrial fibrillation. This article aims to review the evidence of those associations.

Methods: PubMed was searched from inception to January 2022 using the keywords, including inflammatory bowel diseases, Crohn disease, ulcerative colitis, atherosclerotic cardiovascular disease, coronary artery disease, cardiovascular disease, atrial fibrillation, heart failure, and premature coronary artery disease.

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Background: Menopause, defined by the complete cessation of menstrual cycles for 12 consecutive months, may occur at a younger age in women who have concomitant immune dysregulation. Our aim was to determine whether women with inflammatory bowel disease (IBD) experience an earlier onset of menopause compared to women without IBD.

Methods: This was a retrospective cohort study using resources of the Rochester Epidemiology Project, a collaboration between clinics, hospitals, and medical facilities in Olmsted County, Minnesota.

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Surveillance pouchoscopy is recommended for patients with restorative proctocolectomy with ileal pouch-anal anastomosis in ulcerative colitis or familial adenomatous polyposis, with the surveillance interval depending on the risk of neoplasia. Neoplasia in patients with ileal pouches mainly have a glandular source and less often are of squamous cell origin. Various grades of neoplasia can occur in the prepouch ileum, pouch body, rectal cuff, anal transition zone, anus, or perianal skin.

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Crohn's disease is a chronic and progressive immune-mediated disease with increasing incidence worldwide. There are no curative therapies. The primary agents used in the treatment of Crohn's disease are aminosalicylates, corticosteroids, immunomodulators, and biologics.

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Article Synopsis
  • - The study examines whether using tumor necrosis factor inhibitors (TNFis) before surgery for inflammatory bowel disease (IBD) increases the risk of infections post-surgery.
  • - Conducted across 17 sites, the research included 947 IBD patients and found no significant difference in infection rates between those who had used TNFis within 12 weeks and those who hadn’t.
  • - The findings suggest that preoperative TNFi treatment doesn't contribute to a higher risk of postoperative infections, based on a large-scale analysis.
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