A series of workshops entitled “Advanced endoscopy in the management of inflammatory digestive disease” was held at the 97th to 100th biannual meeting of the Japan Gastroenterological Endoscopy ...Society. During these core sessions, research findings concerning various endoscopic practices in the field of inflammatory bowel disease (IBD) were presented, and meaningful discussions were shared on the evolving role and future challenges of endoscopy in IBD. This article reviews these core sessions and discusses current topics on the role of endoscopy, focusing on the diagnosis, disease monitoring, mucosal healing assessments, cancer surveillance, and therapeutic interventions in IBD.
Of PBO-treated pts who were not in clinical response at Wk12 and received GUS treatment (PBO IV→GUS IV), clinical response rate at Wk24 (69.7%) was similar to that at Wk12 for pts randomized to GUS ...at BL (61.5%). Adverse events 138 (49.3%) 208 (49.4%) 65 (39.4%) 56 (44.8%) 292 (49.8%) Serious adverse events 20 (7.1%) 12 (2.9%) 3 (1.8%) 3 (2.4%) 18 (3.1%) Adverse events leading to discontinuation of study agent 11 (3.9%) 7 (1.7%) 7 (4.2%) 5 (4.0%) 19 (3.2%) Infectionse 43 (15.4%) 67 (15.9%) 26 (15.8%) 18 (14.4%) 104 (17.7%) Serious infectionse 1 (0.4%) 3 (0.7%) 1 (0.6%) 2 (1.6%) 6 (1.0%) Adverse events within 1 hour of infusionf 1 (0.4%) 6 (1.4%) 1 (0.6%) 3 (2.4%) 10 (1.7%) Note: Includes only pts with modified Mayo score 5-9 at induction baseline. aIncludes data up to Week 12 for subjects who received treatment at Week 12. Includes all data through final safety visit (12 weeks after the last dose of study intervention) for subjects who did not receive treatment at Week 12. bIncludes data from Week 12 onward. cFrom the first guselkumab dose onward. dAll reported deaths were cardiovascular in nature and the patient in GUS arm had substantial cardiovascular risk factors. eInfections were defined as any adverse event which was coded to the MedDRA system organ class 'Infections and infestations.’ fNo AEs within 1 hour of infusion were serious or resulted in treatment discontinuation.
Introduction: Abdominal pain and bowel urgency are prevalent, burdensome symptoms experienced by patients (pts) with ulcerative colitis (UC) that impact daily life, including social activities. ...Conclusion: Pts receiving GUS showed clinically meaningful improvements in health-related quality of life measures related to abdominal pain and bowel urgency, including both the symptoms of bowel urgency and impact on pts’ lives. P-values were based on the Cochran-Mantel-Haenszel (CMH) chi-square Row Mean Score test, stratified by ADT-failure status (Yes/No) and concomitant use of corticosteroids at baseline (Yes/No).
Background
Clinical evidence regarding intestinal Behçet’s disease (BD) management is lacking and intestinal lesions are a poor prognostic factor. In 2007, the Japan consensus statement for diagnosis ...and management of intestinal BD was developed. Recently, the efficacy of anti-tumor necrosis factor (TNF)α monoclonal antibodies (mAbs), and infliximab (IFX) was reported and adalimumab (ADA) was approved for intestinal BD in Japan. This study renewed consensus-based practice guidelines for diagnosis and treatment of intestinal BD focusing on the indication of anti-TNFα mAbs.
Methods
An expert panel of Japanese gastroenterology and rheumatology specialists was involved. Clinical statements for ratings were extracted from the literature, a professional group survey, and by an expert panel discussion, which rated clinical statements on a nine-point scale. After the first round of ratings, a panelist meeting discussed areas of disagreement and clarified areas of uncertainty. The list of clinical statements was revised after the panelist meeting and a second round of ratings was conducted.
Results
Fifteen relevant articles were selected. Based on the first edition consensus statement, improved clinical statements regarding indications for anti-TNFα mAbs use were developed. After a two-round modified Delphi approach, the second edition of consensus statements was finalized.
Conclusions
In addition to standard therapies in the first edition, anti-TNFα mAbs (ADA and IFX) should be considered as a standard therapy for intestinal BD. Colchicines, thalidomide, other pharmacological therapy, endoscopic therapy, and leukocytapheresis were deemed experimental therapies.
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