Publications by authors named "Yerushalmy-Feler A"
Background: The pharmacokinetics of biologic agents can differ between children and adults with inflammatory bowel disease (IBD), often necessitating modified paediatric dosing strategies.
Aims: To define the exposure-response relationship of vedolizumab in the paediatric IBD VedoKids cohort including the effect of baseline clearance on deep biochemical remission (normal C-reactive protein [CRP]/erythrocyte sedimentation rate [ESR] and steroid-free remission) at 30 weeks, and to use population pharmacokinetic models to find the best matches between adult and paediatric pharmacokinetic profiles.
Methods: We sought a pharmacokinetic model on 312 serum vedolizumab concentrations from 129 children, assisted by a published adult model as a Bayesian prior.
Background And Aims: Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U.
Methods: In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled.
Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gut affecting both adults and children. Neutrophil extracellular traps (NETs) are structures released by activated neutrophils, potentially contributing to tissue damage in various diseases. This study aimed to explore the presence and role of NETs in pediatric IBD.
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- Curcumin and Qing Dai (QD) are herbal treatments found effective for ulcerative colitis (UC) in children, used since 2016 in a combination called CurQD.
- A study involving 30 pediatric patients showed significant improvements, with over 50% experiencing a substantial reduction in disease activity and fecal calprotectin levels during treatment.
- Follow-up results indicated that while 33% experienced a flare-up, many regained remission or responded well to adjustments in their treatment regimen, suggesting CurQD is both effective and safe for managing mild to moderate UC.
The no-biopsy approach to diagnose celiac disease (CD), introduced in the 2012 European Society for Gastroenterology and Hepatology and Nutrition guidelines, requires an anti-endomysial antibody (EMA) confirmatory serology test following a high-positive immunoglobulin A anti-tissue transglutaminase-2 (anti-TG2) antibody ≥10 times the upper limit of normal (ULN). The aim of this retrospective study is to compare EMA positivity and high-positive anti-TG2 in patients who had their confirmatory test within 2 months of their first high-positive anti-TG2 test. Among 933 patients who had high-positive anti-TG2 serology more than 10 times the ULN in their first sample, all had both high-positive anti-TG2 and positive EMA, most of them with very high EMA titers (99.
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- A nationwide study assessed the link between high eosinophil counts (PBE) and long-term outcomes in patients with inflammatory bowel diseases (IBD).
- The analysis included over 28,000 patients, revealing that PBE occurred more frequently in individuals with ulcerative colitis and in pediatric patients compared to adults.
- Results indicated that PBE is a significant predictor of severe disease progression, increased hospitalization, and higher medication needs in IBD patients, highlighting its potential as a marker for adverse outcomes and target for therapies.
Article Synopsis
- The study assessed how being overweight or obese affects treatment response and relapse rates in children with inflammatory bowel disease (IBD) undergoing anti-TNF therapy.
- Conducted across 22 centers in 14 countries, it involved 637 children, with a comparison between those who were overweight/obese and those of normal weight.
- Findings showed no difference in loss of response to treatment initially, but overweight/obese children had higher relapse rates by the end of follow-up, indicating a potential long-term risk associated with their weight status.
Objectives: This study described disease characteristics and long-term outcomes in patients diagnosed with very early onset inflammatory bowel disease (VEOIBD) (diagnosed before 6 years of age) and infantile-IBD (before 2 years).
Methods: Cases from 21 centers worldwide diagnosed with VEOIBD (2008-2018), with minimum 2 years of follow-up, were retrospectively reviewed.
Results: The cohort included 243 patients (52% males, median follow-up of 5.
Acute pancreatitis in children with inflammatory bowel disease: Risk factors, clinical course, and prognosis.
J Pediatr Gastroenterol Nutr
August 2024
Article Synopsis
- This study aimed to compare the clinical course of acute pancreatitis (AP) in children with inflammatory bowel disease (IBD) versus those without, while also identifying risk factors for AP among IBD patients.
- The research analyzed data from 68 pediatric patients hospitalized for AP between 2005 and 2019, finding that 13 had a co-diagnosis of IBD, and they experienced milder pancreatitis with no need for invasive treatment.
- The only significant risk factor for developing AP among IBD patients was the presence of IBD-associated arthritis, while other factors related to IBD and medication showed no significant links to AP development.
Objective: A constitutional disease-causing variant (DCV) in the SMAD4 or BMPR1A genes is present in 40%-60% of patients with juvenile polyposis syndrome (JPS). The aim of this study was to characterize the clinical course and polyp burden in children with DCV-positive JPS compared to DCV-negative JPS.
Methods: Demographic, clinical, genetic, and endoscopic data of children with JPS were compiled from eight international centers in the ESPHGAN/NASPGHAN polyposis working group.
Background And Objectives: Current data on ustekinumab therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBDU) are limited. We aimed to evaluate the effectiveness and safety of ustekinumab in pediatric UC and IBDU.
Methods: This multicenter retrospective study included 16 centers affiliated with the IBD Interest and Porto groups of ESPGHAN.
Article Synopsis
- The study investigates the characteristics and natural history of primary sclerosing cholangitis related to inflammatory bowel disease (PSC-IBD) diagnosed before age 6, referred to as very early onset IBD (VEO-IBD) compared to those diagnosed later.
- A total of 69 children were analyzed, finding that while most had ulcerative colitis, the VEO-PSC-IBD group had a higher incidence of PSC/autoimmune hepatitis overlap syndrome.
- Results suggest that VEO-PSC-IBD has similar initial characteristics to later-onset PSC-IBD but presents with a milder disease course, particularly regarding biliary complications.
Clock gene disruption has been reported in inflammatory and autoimmune diseases. Specifically, it has been shown that clock gene expression is down-regulated in intestinal tissue and peripheral blood mononuclear cells of patients with inflammatory bowel disease (IBD). We aimed to determine the systemic expression of the circadian clock genes in newly diagnosed untreated, young patients with celiac disease (CeD).
View Article and Find Full Text PDFThiopurines Maintenance Therapy in Children With Ulcerative Colitis: A Multicenter Retrospective Study.
J Pediatr Gastroenterol Nutr
October 2023
Background And Aims: Thiopurines are an established treatment for pediatric ulcerative colitis (UC). However, data regarding safety and efficacy are lacking. We aimed to determine short and long-term outcome following thiopurines use in children with UC.
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- Ulcerative proctitis (UP) is a rare form of ulcerative colitis in children, with the study analyzing clinical features and outcomes of 196 diagnosed patients aged under 18 from 2016 to 2020.
- Most patients presented with symptoms like bloody stools and abdominal pain, and the study found that higher initial disease activity scores (PUCAI) were linked to worse outcomes, including the need for more aggressive treatments.
- By the end of the study, nearly half of the patients showed disease progression, and only a small percentage required colectomy, highlighting the challenges in managing UP in pediatric patients.
Inflammatory bowel disease (IBD) is a chronic systemic immune-mediated disorder. The disease is triggered and perpetuated by a complex interplay between genetic predisposition, dysregulated immune responses, and environmental factors. Pediatric IBD is considered to be more aggressive compared with adult-onset IBD, and commonly requires more intensive pharmacological and surgical treatments.
View Article and Find Full Text PDFTo investigate factors associated with pediatric feeding disorders (PFD) among children of parents that reported to have had feeding disorders during their own childhood compared to children with PFD with no history of parental PFD. We retrospectively reviewed the medical records of children diagnosed with PFD according to the recent WHO-based definition. The demographic and clinical characteristics of children with PFD with a parental history of PFD were compared to those of children with a PFD with no history of parental PFD.
View Article and Find Full Text PDFBackground: Current data on dual biologic therapy in children are limited. This multicenter study aimed to evaluate the effectiveness and safety of dual therapy in pediatric patients with inflammatory bowel disease (IBD).
Methods: A retrospective study from 14 centers affiliated with the Pediatric IBD Interest and Porto Groups of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition.
Background: Changes in the expression of clock genes have been reported in inflammatory bowel disease (IBD) patients.
Aims: We aimed to investigate whether reduced inflammation restores clock gene expression to levels of healthy controls.
Methods: This was a prospective study.
Background: Celiac disease (CD) in children and adolescents has been linked with increased susceptibility for cardiometabolic disease in adulthood. We explored the interaction between body composition and metabolic syndrome (MetS) components in pediatric CD.
Methods: We conducted a retrospective observational study of patients with CD followed at our Pediatric Endocrine and Gastroenterology Units between 1/2018-1/2022.
The Yield of Routine Tissue Sampling in Pediatric Gastrointestinal Endoscopy.
J Pediatr Gastroenterol Nutr
April 2023
Article Synopsis
- The study evaluates the effectiveness of routine tissue sampling in children undergoing esophagogastroduodenoscopy and ileocolonoscopy, exploring the agreement between endoscopic and histopathological findings.
- It analyzed data from 541 endoscopies conducted in 2019, revealing varying sensitivities and specificities across different gastrointestinal regions, with ileocolonoscopy showing higher agreement than esophagogastroduodenoscopy.
- The findings indicate that while endoscopic results are specific for detecting histological issues, a lack of visible abnormalities does not reliably predict normal histology, supporting the recommendation for routine biopsies in pediatric procedures.
Background: Idiopathic thrombocytopaenic purpura [ITP] is an acquired haematological disorder with an incidence of 1-6 per 100 00/year. ITP and inflammatory bowel disease [IBD] comorbidity has been reported in the literature, but insights regarding the course, outcome and optimal management are limited by its rarity. The current study aimed to evaluate the clinical presentation and outcome of ITP in patients with IBD.
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- The study aimed to evaluate the immune response in infants exposed to anti-TNFα or azathioprine due to their mothers' inflammatory bowel disease, focusing on T and B cell distribution and function.
- Conducted from 2014 to 2017, the research involved measuring anti-TNFα levels in cord blood and analyzing T-cell function and immunoglobulin levels in infants at 3 and 12 months.
- Findings indicated that infants exposed to anti-TNFα had normal immune responses, with adequate B-cell counts and no severe infections, but further research with untreated controls is necessary for confirmation.
Objectives: Escalation of the ustekinumab (UST) maintenance dosage was effective in adults with Crohn disease (CD), but no data are available for children. We evaluated the effectiveness and safety of dose escalation of UST in pediatric CD.
Methods: This was a retrospective multicenter study from 25 centers affiliated with the IBD Interest and Porto groups of ESPGHAN.
Both catechin polyphenols and caffeine have been shown to have beneficial effects on weight control in the adult population. However, the influence of tea or coffee supplementation on body weight in adolescents has never been tested. The aim of the present study was to investigate the effect of tea and coffee consumption on body weight and body fat in adolescents with obesity.
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