Multidonor intensive faecal #microbiota transplantation for active ulcerative #colitis: a randomised placebo-controlled trial
http://thelancet.com/journals/lancet/article/PIIS0140-6736(17)30182-4/fulltext
Intensive-dosing, multidonor, faecal microbiota transplantation induces clinical remission and endoscopic improvement in active ulcerative colitis and is associated with distinct microbial changes that relate to outcome. Faecal microbiota transplantation is, thus, a promising new therapeutic option for ulcerative colitis. Future work should focus on precisely defining the optimum treatment intensity and the role of donor–recipient matching based on microbial profiles.
http://thelancet.com/journals/lancet/article/PIIS0140-6736(17)30182-4/fulltext
Intensive-dosing, multidonor, faecal microbiota transplantation induces clinical remission and endoscopic improvement in active ulcerative colitis and is associated with distinct microbial changes that relate to outcome. Faecal microbiota transplantation is, thus, a promising new therapeutic option for ulcerative colitis. Future work should focus on precisely defining the optimum treatment intensity and the role of donor–recipient matching based on microbial profiles.
#Budesonide Multimatrix Is Efficacious for Mesalamine-refractory, Mild to Moderate Ulcerative #Colitis: A Randomised, Placebo-controlled Trial
https://academic.oup.com/ecco-jcc/article-abstract/doi/10.1093/ecco-jcc/jjx032/3061890/Budesonide-Multimatrix-Is-Efficacious-for?redirectedFrom=fulltext
Budesonide multimatrix was safe and efficacious for inducing clinical and endoscopic remission for mild to moderate ulcerative colitis refractory to oral mesalamine therapy.
https://academic.oup.com/ecco-jcc/article-abstract/doi/10.1093/ecco-jcc/jjx032/3061890/Budesonide-Multimatrix-Is-Efficacious-for?redirectedFrom=fulltext
Budesonide multimatrix was safe and efficacious for inducing clinical and endoscopic remission for mild to moderate ulcerative colitis refractory to oral mesalamine therapy.
Single Delivery of High-Diversity Fecal Single Delivery of High-Diversity Fecal #Microbiota Preparation by Colonoscopy Is Safe and Effective in Increasing Microbial Diversity in Active Ulcerative #Colitis Microbiota Preparation by Colonoscopy Is Safe and Effective in Increasing Microbial Diversity in Active Ulcerative Colitis
http://journals.lww.com/ibdjournal/pages/articleviewer.aspx?year=9000&issue=00000&article=98583&type=abstract
Background: Recent trials suggest fecal microbiota transplantation (FMT) with repeated enemas and high-diversity FMT donors is a promising treatment to induce remission in ulcerative colitis.
The microbiome of recipients post-transplant was more similar to the donor FMP than the pretransplant recipient sample in both responders and nonresponders. Notably, donor composition correlated with clinical response. Mucosal CD4+ T-cell analysis revealed a reduction in both Th1 and regulatory T-cells post-FMT.
Conclusions: High-diversity, 2-donor FMP delivery by colonoscopy seems safe and effective in increasing fecal microbial diversity in patients with active ulcerative colitis. Donor composition correlated with clinical response and further characterization of immunological parameters may provide insight into factors influencing clinical outcome.
http://journals.lww.com/ibdjournal/pages/articleviewer.aspx?year=9000&issue=00000&article=98583&type=abstract
Background: Recent trials suggest fecal microbiota transplantation (FMT) with repeated enemas and high-diversity FMT donors is a promising treatment to induce remission in ulcerative colitis.
The microbiome of recipients post-transplant was more similar to the donor FMP than the pretransplant recipient sample in both responders and nonresponders. Notably, donor composition correlated with clinical response. Mucosal CD4+ T-cell analysis revealed a reduction in both Th1 and regulatory T-cells post-FMT.
Conclusions: High-diversity, 2-donor FMP delivery by colonoscopy seems safe and effective in increasing fecal microbial diversity in patients with active ulcerative colitis. Donor composition correlated with clinical response and further characterization of immunological parameters may provide insight into factors influencing clinical outcome.
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Second-Look #Endoscopy in Hospitalized Severe Ulcerative #Colitis: A Retrospective Cohort Study
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy282/5094888?redirectedFrom=fulltext
Our study included 49 patients (mean age, 42 years; 52% women). Just under one-third of patients (30%) were noted to have improved endoscopic appearance at the second sigmoidoscopy, at a median of 9 days after initial exam. None of the patients who had improvement on the second endoscopy underwent in-hospital colectomy, compared with 46% of those with worsening or persistent disease (P = 0.002). Similar differences in the improved group persisted at 3 months (P = 0.007) and 6 months (P = 0.027). Histologic severity at the first endoscopy was associated with increased risk of colectomy in-hospital (odds ratio, 3.8; 95% confidence interval, 1.02–14.21) and at 3 and 6 months.
Conclusions
After a median interval of 9 days, endoscopic improvement was noted in 30% of patients with ASUC undergoing a second sigmoidoscopy, which predicted lower rates of colectomy in-hospital and at 3 and 6 months.
Second-Look #Endoscopy in Hospitalized Severe Ulcerative #Colitis: A Retrospective Cohort Study
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy282/5094888?redirectedFrom=fulltext
Our study included 49 patients (mean age, 42 years; 52% women). Just under one-third of patients (30%) were noted to have improved endoscopic appearance at the second sigmoidoscopy, at a median of 9 days after initial exam. None of the patients who had improvement on the second endoscopy underwent in-hospital colectomy, compared with 46% of those with worsening or persistent disease (P = 0.002). Similar differences in the improved group persisted at 3 months (P = 0.007) and 6 months (P = 0.027). Histologic severity at the first endoscopy was associated with increased risk of colectomy in-hospital (odds ratio, 3.8; 95% confidence interval, 1.02–14.21) and at 3 and 6 months.
Conclusions
After a median interval of 9 days, endoscopic improvement was noted in 30% of patients with ASUC undergoing a second sigmoidoscopy, which predicted lower rates of colectomy in-hospital and at 3 and 6 months.
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Safety of #Tofacitinib for Treatment of Ulcerative #Colitis, Based on 4.4 Years of Data From Global Clinical Trials
https://www.cghjournal.org/article/S1542-3565(18)31278-3/fulltext
In the maintenance cohort, IRs for select adverse events were similar among treatment groups, except for a numerically higher IR of herpes zoster infection among patients who received tofacitinib 5 mg twice daily (2.1; 95% CI, 0.4–6.0) and statistically higher IR among patients who received tofacitinib 10 mg twice daily (IR, 6.6; 95% CI, 3.2–12.2) vs placebo (IR, 1.0, 95% CI, 0.0–5.4). For the overall cohort (84% received average dose of tofacitinib 10 mg twice daily), IRs were: death, 0.2 (95% CI, 0.1–0.6); serious infections, 2.0 (95% CI, 1.4–2.8); opportunistic infections, 1.3 (95% CI, 0.8–2.0); herpes zoster infection, 4.1 (95% CI, 3.1–5.2); malignancy (excluding non-melanoma skin cancer), 0.7; 95% CI, 0.3–1.2); non-melanoma skin cancer, 0.7 (95% CI, 0.3–1.2); major adverse cardiovascular events, 0.2 (95% CI, 0.1–0.6); and gastrointestinal perforations, 0.2 (95% CI, 0.0–0.5).
Conclusions
In a safety analyses of patients with moderate to severe UC treated with tofacitinib, we observed a dose relationship with herpes zoster infection. Although follow-up time was relatively short, the safety profile of tofacitinib for patients with UC appeared similar to that reported for patients with rheumatoid arthritis and for patients with UC treated with biologic agents, except for the higher IR of herpes zoster infection.
Safety of #Tofacitinib for Treatment of Ulcerative #Colitis, Based on 4.4 Years of Data From Global Clinical Trials
https://www.cghjournal.org/article/S1542-3565(18)31278-3/fulltext
In the maintenance cohort, IRs for select adverse events were similar among treatment groups, except for a numerically higher IR of herpes zoster infection among patients who received tofacitinib 5 mg twice daily (2.1; 95% CI, 0.4–6.0) and statistically higher IR among patients who received tofacitinib 10 mg twice daily (IR, 6.6; 95% CI, 3.2–12.2) vs placebo (IR, 1.0, 95% CI, 0.0–5.4). For the overall cohort (84% received average dose of tofacitinib 10 mg twice daily), IRs were: death, 0.2 (95% CI, 0.1–0.6); serious infections, 2.0 (95% CI, 1.4–2.8); opportunistic infections, 1.3 (95% CI, 0.8–2.0); herpes zoster infection, 4.1 (95% CI, 3.1–5.2); malignancy (excluding non-melanoma skin cancer), 0.7; 95% CI, 0.3–1.2); non-melanoma skin cancer, 0.7 (95% CI, 0.3–1.2); major adverse cardiovascular events, 0.2 (95% CI, 0.1–0.6); and gastrointestinal perforations, 0.2 (95% CI, 0.0–0.5).
Conclusions
In a safety analyses of patients with moderate to severe UC treated with tofacitinib, we observed a dose relationship with herpes zoster infection. Although follow-up time was relatively short, the safety profile of tofacitinib for patients with UC appeared similar to that reported for patients with rheumatoid arthritis and for patients with UC treated with biologic agents, except for the higher IR of herpes zoster infection.
Dietary #Fructose Alters the Composition, Localization and Metabolism of Gut #Microbiota in Association with Worsening #Colitis
https://2medical.news/2020/10/10/dietary-fructose-alters-the-composition-localization-and-metabolism-of-gut-microbiota-in-association-with-worsening-colitis/
The incidence of inflammatory bowel diseases has increased over the last half century, suggesting a role for dietary factors. Fructose consumption has increased in recent years. Recently, a high fructose diet (HFrD) was shown to enhance DSS-induced colitis in mice. The primary objectives of the current study were to elucidate the mechanism(s) underlying the pro-colitic effects of dietary fructose and to determine whether this effect …
https://2medical.news/2020/10/10/dietary-fructose-alters-the-composition-localization-and-metabolism-of-gut-microbiota-in-association-with-worsening-colitis/
The incidence of inflammatory bowel diseases has increased over the last half century, suggesting a role for dietary factors. Fructose consumption has increased in recent years. Recently, a high fructose diet (HFrD) was shown to enhance DSS-induced colitis in mice. The primary objectives of the current study were to elucidate the mechanism(s) underlying the pro-colitic effects of dietary fructose and to determine whether this effect …
Computational drug repositioning of #atorvastatin for ulcerative #colitis
https://2medical.news/2021/09/24/computational-drug-repositioning-of-atorvastatin-for-ulcerative-colitis/
https://2medical.news/2021/09/24/computational-drug-repositioning-of-atorvastatin-for-ulcerative-colitis/
2Medical.News
Computational drug repositioning of #atorvastatin for ulcerative #colitis
Ulcerative colitis (UC) is a chronic inflammatory disorder with limited effective therapeutic options for long-term treatment and disease maintenance. We hypothesized that a multi-cohort analysis o…