E V Loftus

..Additional epidemiologic studies to define better the burden of illness, explore the mechanism of association with environmental factors, and identify new risk factors are needed...

..The survival rates for IBD-associated and sporadic CRC were similar...

..We assessed the cumulative incidence and clinical spectrum of SpA in patients with Crohn's disease (CD) in a population-based cohort...

..The symptoms are well-documented and can be debilitating. How these chronic gastrointestinal (GI) conditions impact the daily lives of those afflicted is not well documented, especially from a patient's perspective...

..To determine the real-world dosage pattern of adalimumab and predictors for weekly dosing in Crohn's disease (CD)...

..Osteoporosis is common in patients with Crohn's disease, but less is known about their risk of actual fractures...

..This retrospective cohort study compared the risks of developing anxiety disorders and depression and incidences of psychotropic medication use between young CD patients and matched CD-free controls...

..A systematic analysis of risks and benefits of adalimumab versus traditional non-biologic therapies for patients refractory to non-biologic therapy is lacking...

..This study evaluated the cost-effectiveness of adalimumab versus conventional, nonbiologic pharmacotherapies in the maintenance of Crohn's disease...

..The benefits of frequent physician visits and compliance with medication regimens with regard to reduction in colorectal cancer risk are also reviewed...

..Osteopenia is common in patients with ulcerative colitis (UC), but less is known about fracture risk. Previously we were unable to demonstrate increased fractures in a population-based cohort with Crohn's disease...

..We describe colectomy subtypes, follow-up surgical and diagnostic procedures, complications, and direct medical charges occurring within 180 days of colectomy among privately insured patients with ulcerative colitis (UC)...

..To determine whether there is a difference in short-term adverse events in patients with ulcerative colitis treated with mesalazine, olsalazine or balsalazide...

..A randomized trial of ursodeoxycholic acid in PSC showed decreased risk of colorectal neoplasia in patients receiving the drug relative to those on placebo...

..Inflammatory bowel disease associated with primary sclerosing cholangitis (PSC-IBD) may have a high prevalence of rectal sparing, backwash ileitis, and colorectal neoplasia...

..We sought to update the incidence and prevalence of these conditions in our region through 2000...

..Development of such a therapy would, therefore, potentially improve both patient compliance and overall treatment success...

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..Regardless of the exact prevalence, the burden of disease in North America and Europe is significant. Studying the patterns of geographic variation and age and gender distribution may yield important clues to the cause of IBD...

..To quantify, through systematic review, the epidemiology and natural history of Crohn's disease in North America...

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..CONCLUSIONS: Most patients with Crohn's disease and ulcerative colitis initially respond to corticosteroids. At 1 year, 32% of patients with Crohn's disease and 48% with ulcerative colitis are corticosteroid free without operation...

..There is conflicting data regarding the response to medical and surgical therapy for inflammatory bowel disease with respect to age at disease onset...

..Likewise, the sensitivity and diagnostic usefulness of these assays in patients with inflammatory bowel disease (IBD) in the community is unknown...

..The aim of this study was to describe the lifetime clinical course and costs of Crohn's disease in a 24-year population-based inception cohort of patients with Crohn's disease in Olmsted County, Minnesota...

..A history of postinflammatory pseudopolyps appears to be a predictive factor for cancer...

..Immune modifier therapy should be considered for steroid-dependent and steroid-resistant cases...

..Some patients do not tolerate corticosteroid side effects, and a small subset are dependent on or refractory to corticosteroids. We report our experience with azathioprine and 6-mercaptopurine in patients with microscopic colitis...

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..The aim was to determine whether the use of steroids, immunosuppressive agents, or infliximab prior to abdominal surgery for Crohn's disease is associated with an increased rate of early postoperative complications...

..3). In all, 34% of cases were former smokers versus 28% of controls, yielding an odds ratio of 1.6 (95% CI = 0.8-3.2). CONCLUSION: This case-control study was unable to detect an association between cigarette smoking and celiac disease...

..CRP correlates with radiological findings of perienteric inflammation (increased fat density), but not of inflammation limited to the small bowel wall, underscoring the potential role of perienteric inflammation in CRP response in CD...

..Infliximab (IFX), an antitumor necrosis factor-alpha antibody, has demonstrated efficacy in medical management of CUC. The aim of this study is to determine if IFX before IPAA impacts short-term outcomes...

..Natalizumab, a monoclonal antibody to alpha-4 integrin approved for CD, has demonstrated efficacy in randomized clinical trials. We describe our experience with natalizumab in clinical practice at Mayo Clinic Rochester...

..A total of 23 patients were continued on infliximab as maintenance treatment. CONCLUSIONS: This study provides additional evidence that infliximab is safe and beneficial in clinical practice for refractory Crohn's disease...

..Furthermore, since methylation of the Class II transactivator (CIITA) gene may silence HLA expression in tumours, we correlated HLA allele frequencies with CIITA gene methylation and HLA-DR expression...

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..We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC)...

..Human anti-chimeric antibodies (HACAs) and subtherapeutic infliximab concentrations are associated with decreased duration of response. We evaluated the clinical utility of measuring HACA and infliximab concentrations...

..Ulcerative colitis (UC) and Crohn's disease can sometimes relapse and be refractory to standard treatment following orthotopic liver transplantation (OLT) despite post-transplantation immunosuppressive therapy...

..Patients with moderate to severely active Crohn's disease treated with infliximab may have a small but real risk of developing severe infections, opportunistic infections, and non-Hodgkin's lymphoma...

..The MPGS is a tool that can be used in day-to-day management of IBD patients...

..Repifermin (keratinocyte growth factor-2) has been shown to reduce inflammation in animal models of colitis...

..Surveillance in this at-risk population remains challenging. We assessed the methylation status of genes in the non-neoplastic mucosa of UC-CRC patients and controls to identify potential biomarkers of CRC...

..Good pouch function requires long term treatment with infliximab in most patients...

..Mural hyperenhancement and increased mural thickness are the most sensitive CT findings of active Crohn disease...

..We sought to characterize CD patient perceptions of both overall disease course and current symptomatology based on an objective symptom scale and to explore the relationship between perceptions and current symptoms...

..The purpose of this article is to summarize how the examination is performed, and to specify appropriate indications and alternatives, performance characteristics, and anticipated future developments...

..Our aim was to evaluate internet use to gather general health- and disease-specific information in patients presenting to an IBD clinic...

..Although the epidemiology of microscopic colitis has been described in Europe, no such data exist from North America. We studied the incidence, prevalence and temporal trends of microscopic colitis in a geographically defined US population...

..We sought to evaluate the effect of UDCA on colorectal neoplasia in a group of patients with UC and PSC enrolled in a randomized, placebo-controlled trial...

..Our data suggest that the prevalence of PSC in the United States, with its attendant medical burdens, is significantly greater than previously estimated...

..Finally, positron emission tomography is an investigative tool for inflammatory bowel disease that may also aid in the detection of inflammation in these diseases...

..Controlled trials and clinical experience have shown that infliximab is a significant addition to the therapeutic armamentarium for patients with Crohn's disease...

..Current approaches to the detection of colorectal neoplasia associated with inflammatory bowel disease (IBD-CRN) are suboptimal...

..Here we focus on data from clinical trials involving validated pharmacodynamic or patient response outcomes...

..This study was designed to test the hypothesis that patients undergoing definitive surgery for chronic ulcerative colitis have reduced direct medical costs after, as compared with before, total proctocolectomy...

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..We evaluated the effects of adalimumab maintenance therapy on health-related quality of life (HRQOL) in patients with moderate to severe Crohn's disease...

..We also sought to examine the percentage of clinically significant new noninflammatory bowel disease (IBD) related findings in these patients...

..Because UC patients are at increased risk for developing colorectal cancer (CRC), we investigated if there was an association between SNPs in the promoter of the TNF-alpha gene and UC-CRC...

..This comprehensive review summarizes our current knowledge of the natural history of Crohn's disease in adults as reported in population-based studies that include long-term follow-up results...

..However, the extent of radiation exposure in these patients is unknown...

..CONCLUSIONS: Our results show that the practice of surveillance colonoscopy varies greatly among endoscopists, and longer procedure duration is significantly associated with the likelihood of dysplasia diagnosis...

..We sought to assess the evolution of Crohn's disease behavior in an American population-based cohort...

..CONCLUSIONS: In this population-based nested case-control study, no significant association was seen between cholecystectomy or appendectomy and the development of microscopic colitis or its subtypes...

..With the introduction of new techniques to image the small bowel, there remains uncertainty about their role for diagnosing Crohn's disease...

..We determined the prevalence of abnormal hepatic biochemistries and chronic liver disease in a cohort of IBD patients, and we compared patients with normal and abnormal liver biochemistries...

..CONCLUSIONS: Our preliminary results suggest that cyclooxygenase-2 inhibitors may be safe and beneficial in most patients with IBD. A placebo-controlled trial to confirm these preliminary observations is needed...

..Proper selection of candidates for anti-TNF-alpha therapy is critical in maintaining a proper benefit-to-risk ratio...

..Despite scattered case reports, the prevalence of inflammatory bowel disease (IBD) in patients with autoimmune pancreatitis (AIP) is unknown. We sought to better characterize the putative association between the conditions...

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..The Crohn's Disease Activity Index (CDAI) is used to judge efficacy in clinical trials. We explored the effect of CDAI response definitions for induction on study efficiency...

..3)]. CONCLUSIONS: There was a positive association between IBD status (patient vs control) versus EIM, but not AD. A significant positive association between disease type (familial or sporadic) versus either EIM or AD was not detected...

..We sought to determine the appropriateness of CTEs based on clinical indication in patients < or =35 years old, and the potential impact of evolution of practice to alternative magnetic resonance enterography (MRE)...

..These newer modalities add to the armamentarium clinicians can use for evaluation of IBD...

..Magnetic resonance enterography uses principles similar to those for CT enterography, and early results are encouraging...

..This finding emphasizes the need for early steroid-sparing medications in pediatric inflammatory bowel disease...

..Adverse events associated with anti-TNF-a therapy, including infection, infusion reactions, autoimmunity, risk of malignancy, and neurologic events, are reviewed...

..Quantitative measures of mural attenuation are sensitive markers of small bowel inflammation...

..CONCLUSIONS: Adalimumab is well tolerated and appears to be a clinically beneficial option for patients with Crohn's disease who have previously lost their response to, or cannot tolerate infliximab...

..CONCLUSIONS: Small bowel adenocarcinoma is a rare complication of Crohn's disease that typically involves the ileum. Affected patients have symptomatic, advanced malignancies upon diagnosis. No significant risk factors were identified...

..Magnetic resonance enterography is a radiation-free cross-sectional imaging alternative that is comparable to CT enterography in diagnostic accuracy...

..However, clinicians must be vigilant for the occurrence of infrequent but serious events, including serum sickness-like reaction, opportunistic infection and sepsis, and autoimmune disorders...

..CONCLUSIONS: Fistulas in Crohn's disease were common in the community. In contrast to referral-based studies, only 34% of patients developed recurrent fistulas. Surgical treatment was frequently required...

..Serological markers such as anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) may be associated with pouchitis after ileal pouch-anal anastomosis (IPAA)...

..Cancer, a rare complication of perianal disease, must be suspected when lesions persist despite therapy...

..We determined the association between NAT1 genotype and response to mesalamine and sulfasalazine, as well as between NAT2 genotype and toxicity to sulfasalazine, in a population-based cohort of patients with ulcerative colitis...

..The results of this review provided the content for the accompanying treatment guidelines, Clinical Guidelines for the Medical Management of Left-sided Ulcerative Colitis and Ulcerative Proctitis: Summary Statement...

..CONCLUSIONS: Neoplastic progression in patients with UC and LGD is common. Total proctocolectomy should be offered to all patients with flat LGD. Our study illustrates numerous pitfalls in the practice of surveillance...

..However, definitive proof from prospective clinical trials is not available...

..CONCLUSIONS: This population-based cohort study from Olmsted County, Minnesota did not confirm an increased risk of cancer related to fLGD, whereas 22% of patients with ALMs in areas of IBD developed fLGD or DALMs...

..Although our patient may have had IBD-associated constrictive pericarditis, her mesalamine use raises the possibility of a drug-induced constrictive pericarditis...

..The colorectal cancer risk was increased slightly among Crohn's disease patients, who also had a 40-fold excess risk for small-bowel cancer...

..We conducted a nested case-control study of such factors in two well-described IBD cohorts from Copenhagen County, Denmark and Olmsted County, Minnesota...