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Papers by Gerassimos Mantzaris

Research paper thumbnail of The role of coexisting cardiovascular disease on disease severity in patients with inflammatory bowel disease

European Journal of Gastroenterology & Hepatology, May 1, 2020

Research paper thumbnail of The Effect of Early vs Delayed Initiation of Adalimumab on Remission Rates in Patients With Crohn’s Disease With Poor Prognostic Factors: The MODIFY Study

Crohn's & colitis 360, Sep 4, 2021

Research paper thumbnail of S1354 Diabetes as a Risk Factor of Liver Fibrosis in Patients With Non-Alcoholic Fatty Liver Disease

The American Journal of Gastroenterology, Oct 1, 2022

Research paper thumbnail of Editorial: an expert consensus to standardise the assessment of histologic disease activity in Crohn's disease clinical trials—a missing link

Alimentary Pharmacology & Therapeutics

LINKED CONTENTThis article is linked to Almradi et al paper. To view this article, visit https://... more LINKED CONTENTThis article is linked to Almradi et al paper. To view this article, visit https://doi.org/10.1111/apt.16248

Research paper thumbnail of The Inflammatory Bowel Disease—Disk Tool for Assessing Disability in Inflammatory Bowel Disease Patients: Validation of the Greek Version

Journal of Clinical Medicine

Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that ... more Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that evaluates the functional status of patients with Inflammatory Bowel Disease (IBD). The aim of our study was to validate the content of the IBD-Disk in a Greek cohort of IBD patients. Methods: Two questionnaires [the IBD Disk and the IBD-Disability Index (IBD-DI)] were translated into Greek and administered to IBD patients at baseline visit, after 4 weeks and 6 months. Validation of the IBD Disk included measuring of concurrent validity, reproducibility, and internal consistency. Results: A total of 300 patients were included at baseline and 269 at follow-up. There was a good correlation between the total scores of the IBD-Disk and IBD-DI at baseline (Pearson correlation 0.87, p < 0.001). Reproducibility of the total IBD-Disk score was very good [intra-class correlation coefficient (ICC), 95% confidence interval (CI) 0.89 (0.86–0.91)]. Cronbach’s coefficient alpha for all items achieve...

Research paper thumbnail of Tu1549: IMPLEMENTATION AND SHORT-TERM ADVERSE EVENTS OF ANTI-SARSCOV-2 VACCINES IN INFLAMMATORY BOWEL DISEASE PATIENTS: AN INTERNATIONAL WEB-BASED SURVEY

Research paper thumbnail of Difficult-to-treat inflammatory bowel disease: results from a global IOIBD survey

The Lancet Gastroenterology & Hepatology

Research paper thumbnail of Pattern and Risk Factors of Liver Injury among Hospitalized Covid-19 Patients: The Experience of a Greek Referral Hospital

Journal of Pharmacy and Pharmacology, 2021

Background: Although the new coronavirus (SARS-COV-2) affects predominantly the respiratory syste... more Background: Although the new coronavirus (SARS-COV-2) affects predominantly the respiratory system, concomitant liver manifestations are common among COVID-19 patients. Aim: To investigate the prevalence and pattern of liver impairment (hepatocellular, cholestatic, mixed) and identify risk factors potentially associated with the liver injury in hospitalized patients with Covid-19. Materials and Methods: This retrospective study enrolled consecutive patients with Covid-19 who had evidence of liver injury on admission and/or during hospitalization in a tertiary hospital. Patient demographic, clinical and laboratory data were captured from the hospital's electronic data monitoring system. Univariate and multivariate logistic regression analysis were applied to identify risk factors for liver injury.

Research paper thumbnail of Endpoints for extraintestinal manifestations in inflammatory bowel disease trials: the EXTRA consensus from the International Organization for the Study of Inflammatory Bowel Diseases

The Lancet Gastroenterology & Hepatology, 2022

Extraintestinal manifestations occur frequently in patients with inflammatory bowel disease (IBD)... more Extraintestinal manifestations occur frequently in patients with inflammatory bowel disease (IBD) and remain a diagnostic and therapeutic challenge. The aim of the Endpoints for Extraintestinal Manifestations in Inflammatory Bowel Disease Trials (EXTRA) initiative was to achieve international expert consensus on how to assess these manifestations in IBD trials. A systematic literature review was done to identify methods to diagnose extraintestinal manifestations in patients with IBD and measure treatment outcomes. A consensus meeting involving a panel of 41 attendees, including gastroenterologists and referral specialists, was held on March 31, 2021, as part of an International Organization for the Study of Inflammatory Bowel Diseases initiative. The panel agreed that a specialist's expertise is needed to confirm the diagnosis of extraintestinal manifestations before the inclusion of a patient in IBD trials, except for axial spondyloarthritis, for which typical symptoms and MRI can be sufficient. Easy-to-measure endpoints were identified to assess the response of extraintestinal manifestations to treatment without needing specialist involvement. For uveitis, peripheral spondyloarthritis, and arthralgia, endpoint measurements need specialist expertise. The timing of endpoint measurements was discussed for individual extraintestinal manifestations. The EXTRA consensus proposes guidelines on how to thoroughly evaluate extraintestinal manifestations within IBD trials, and recommends that these guidelines are implemented in future trials to enable prospective assessment of these manifestations and comparison between studies.

Research paper thumbnail of Implementation and Short-term Adverse Events of Anti-SARS-CoV-2 Vaccines in Inflammatory Bowel Disease Patients: An International Web-based Survey

Journal of Crohn's and Colitis, 2022

Introduction Anti-SARS-CoV-2 vaccine clinical trials did not include patients with immune-mediate... more Introduction Anti-SARS-CoV-2 vaccine clinical trials did not include patients with immune-mediated conditions such as inflammatory bowel disease [IBD]. We aimed to describe the implementation of anti-SARS-CoV-2 vaccination among IBD patients, patients’ concerns, and the side effect profile of the anti-SARS-CoV-2 vaccines, using real-world data. Methods An anonymous web-based self-completed survey was distributed in 36 European countries between June and July 2021. The results of the patient characteristics, concerns, vaccination status, and side effect profile were analysed. Results In all 3272 IBD patients completed the survey, 79.6% had received at least one dose of anti-SARS-CoV-2 vaccine, and 71.7% had completed the vaccination process. Patients over 60 years old had a significantly higher rate of vaccination [p < 0.001]. Patients’ main concerns before vaccination were the possibility of having worse vaccine-related adverse events due to their IBD [24.6%], an IBD flare after ...

Research paper thumbnail of 22 Real-World Effectiveness of First-Line Biologic Vedolizumab in Crohn's Disease: Analysis of Higher Treatment Effect Subpopulation from the Evolve Study

Research paper thumbnail of COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract

World Journal of Gastroenterology, 2020

The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (... more The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid (RNA) has been isolated from patient stools, suggesting a possible gastrointestinal (GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms’ mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the “gastroenteritis” type symptoms predominate.

Research paper thumbnail of Su1859 – Real-World Effectiveness and Safety of Vedolizumab and Anti-TNF in Biologic-Naive Crohn’s Disease Patients: Results from the Evolve Study

Research paper thumbnail of Sa1793 – Evaluation of the 10-Year Cardiovascular Disease Death Risk in Greek Patients with Inflammatory Bowel Disease

Research paper thumbnail of Efficacy of IL12/23 Blockade Expands Our Therapeutic Targets and Challenges the Old Dogma in Ulcerative Colitis

Research paper thumbnail of P750 Association between the use of antihypertensive agents and disease severity in patients with inflammatory bowel disease

Journal of Crohn's and Colitis, 2019

Research paper thumbnail of Holt-Oram Syndrome in a Patient with Crohn's Disease: a Rare Case Report and Literature Review

Research paper thumbnail of Surgical Management of Fistula-in-ano Among Patients With Crohn’s Disease: Analysis of Outcomes After Fistulotomy or Seton Placement—Single-Center Experience

Scandinavian Journal of Surgery, 2016

Background and Aim: Fistula-in-ano is a common problem among patients with Crohn’s disease and ca... more Background and Aim: Fistula-in-ano is a common problem among patients with Crohn’s disease and carries significant morbidity. We aimed to study the outcomes of surgical treatment of fistula-in-ano after fistulotomy or seton placement in patients with perianal fistulizing Crohn’s disease. Material and Methods: A retrospective observational study of 59 patients diagnosed with Crohn’s disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department. The assessment of disease complexity included a detailed physical examination, magnetic resonance imaging of the rectum, and examination under anesthesia. Outcomes for analysis included wound healing rate and postoperative incontinence. Results: High transsphincteric fistula was found in 44% of the patients, while mid or low transsphincteric fistulas were found in 51%. Three women (5%) had a rectovaginal fistula. All patients with high transsphincteric fistulas were treated with loose seton placement. Patients...

Research paper thumbnail of Serum Proteomic Analysis of Patients with Irritable Bowel Syndrome

Research paper thumbnail of Predictors of tissue healing in ulcerative colitis patients treated with anti-TNF

Digestive and Liver Disease, 2017

Research paper thumbnail of The role of coexisting cardiovascular disease on disease severity in patients with inflammatory bowel disease

European Journal of Gastroenterology & Hepatology, May 1, 2020

Research paper thumbnail of The Effect of Early vs Delayed Initiation of Adalimumab on Remission Rates in Patients With Crohn’s Disease With Poor Prognostic Factors: The MODIFY Study

Crohn's & colitis 360, Sep 4, 2021

Research paper thumbnail of S1354 Diabetes as a Risk Factor of Liver Fibrosis in Patients With Non-Alcoholic Fatty Liver Disease

The American Journal of Gastroenterology, Oct 1, 2022

Research paper thumbnail of Editorial: an expert consensus to standardise the assessment of histologic disease activity in Crohn's disease clinical trials—a missing link

Alimentary Pharmacology & Therapeutics

LINKED CONTENTThis article is linked to Almradi et al paper. To view this article, visit https://... more LINKED CONTENTThis article is linked to Almradi et al paper. To view this article, visit https://doi.org/10.1111/apt.16248

Research paper thumbnail of The Inflammatory Bowel Disease—Disk Tool for Assessing Disability in Inflammatory Bowel Disease Patients: Validation of the Greek Version

Journal of Clinical Medicine

Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that ... more Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that evaluates the functional status of patients with Inflammatory Bowel Disease (IBD). The aim of our study was to validate the content of the IBD-Disk in a Greek cohort of IBD patients. Methods: Two questionnaires [the IBD Disk and the IBD-Disability Index (IBD-DI)] were translated into Greek and administered to IBD patients at baseline visit, after 4 weeks and 6 months. Validation of the IBD Disk included measuring of concurrent validity, reproducibility, and internal consistency. Results: A total of 300 patients were included at baseline and 269 at follow-up. There was a good correlation between the total scores of the IBD-Disk and IBD-DI at baseline (Pearson correlation 0.87, p < 0.001). Reproducibility of the total IBD-Disk score was very good [intra-class correlation coefficient (ICC), 95% confidence interval (CI) 0.89 (0.86–0.91)]. Cronbach’s coefficient alpha for all items achieve...

Research paper thumbnail of Tu1549: IMPLEMENTATION AND SHORT-TERM ADVERSE EVENTS OF ANTI-SARSCOV-2 VACCINES IN INFLAMMATORY BOWEL DISEASE PATIENTS: AN INTERNATIONAL WEB-BASED SURVEY

Research paper thumbnail of Difficult-to-treat inflammatory bowel disease: results from a global IOIBD survey

The Lancet Gastroenterology & Hepatology

Research paper thumbnail of Pattern and Risk Factors of Liver Injury among Hospitalized Covid-19 Patients: The Experience of a Greek Referral Hospital

Journal of Pharmacy and Pharmacology, 2021

Background: Although the new coronavirus (SARS-COV-2) affects predominantly the respiratory syste... more Background: Although the new coronavirus (SARS-COV-2) affects predominantly the respiratory system, concomitant liver manifestations are common among COVID-19 patients. Aim: To investigate the prevalence and pattern of liver impairment (hepatocellular, cholestatic, mixed) and identify risk factors potentially associated with the liver injury in hospitalized patients with Covid-19. Materials and Methods: This retrospective study enrolled consecutive patients with Covid-19 who had evidence of liver injury on admission and/or during hospitalization in a tertiary hospital. Patient demographic, clinical and laboratory data were captured from the hospital's electronic data monitoring system. Univariate and multivariate logistic regression analysis were applied to identify risk factors for liver injury.

Research paper thumbnail of Endpoints for extraintestinal manifestations in inflammatory bowel disease trials: the EXTRA consensus from the International Organization for the Study of Inflammatory Bowel Diseases

The Lancet Gastroenterology & Hepatology, 2022

Extraintestinal manifestations occur frequently in patients with inflammatory bowel disease (IBD)... more Extraintestinal manifestations occur frequently in patients with inflammatory bowel disease (IBD) and remain a diagnostic and therapeutic challenge. The aim of the Endpoints for Extraintestinal Manifestations in Inflammatory Bowel Disease Trials (EXTRA) initiative was to achieve international expert consensus on how to assess these manifestations in IBD trials. A systematic literature review was done to identify methods to diagnose extraintestinal manifestations in patients with IBD and measure treatment outcomes. A consensus meeting involving a panel of 41 attendees, including gastroenterologists and referral specialists, was held on March 31, 2021, as part of an International Organization for the Study of Inflammatory Bowel Diseases initiative. The panel agreed that a specialist's expertise is needed to confirm the diagnosis of extraintestinal manifestations before the inclusion of a patient in IBD trials, except for axial spondyloarthritis, for which typical symptoms and MRI can be sufficient. Easy-to-measure endpoints were identified to assess the response of extraintestinal manifestations to treatment without needing specialist involvement. For uveitis, peripheral spondyloarthritis, and arthralgia, endpoint measurements need specialist expertise. The timing of endpoint measurements was discussed for individual extraintestinal manifestations. The EXTRA consensus proposes guidelines on how to thoroughly evaluate extraintestinal manifestations within IBD trials, and recommends that these guidelines are implemented in future trials to enable prospective assessment of these manifestations and comparison between studies.

Research paper thumbnail of Implementation and Short-term Adverse Events of Anti-SARS-CoV-2 Vaccines in Inflammatory Bowel Disease Patients: An International Web-based Survey

Journal of Crohn's and Colitis, 2022

Introduction Anti-SARS-CoV-2 vaccine clinical trials did not include patients with immune-mediate... more Introduction Anti-SARS-CoV-2 vaccine clinical trials did not include patients with immune-mediated conditions such as inflammatory bowel disease [IBD]. We aimed to describe the implementation of anti-SARS-CoV-2 vaccination among IBD patients, patients’ concerns, and the side effect profile of the anti-SARS-CoV-2 vaccines, using real-world data. Methods An anonymous web-based self-completed survey was distributed in 36 European countries between June and July 2021. The results of the patient characteristics, concerns, vaccination status, and side effect profile were analysed. Results In all 3272 IBD patients completed the survey, 79.6% had received at least one dose of anti-SARS-CoV-2 vaccine, and 71.7% had completed the vaccination process. Patients over 60 years old had a significantly higher rate of vaccination [p < 0.001]. Patients’ main concerns before vaccination were the possibility of having worse vaccine-related adverse events due to their IBD [24.6%], an IBD flare after ...

Research paper thumbnail of 22 Real-World Effectiveness of First-Line Biologic Vedolizumab in Crohn's Disease: Analysis of Higher Treatment Effect Subpopulation from the Evolve Study

Research paper thumbnail of COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract

World Journal of Gastroenterology, 2020

The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (... more The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid (RNA) has been isolated from patient stools, suggesting a possible gastrointestinal (GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms’ mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the “gastroenteritis” type symptoms predominate.

Research paper thumbnail of Su1859 – Real-World Effectiveness and Safety of Vedolizumab and Anti-TNF in Biologic-Naive Crohn’s Disease Patients: Results from the Evolve Study

Research paper thumbnail of Sa1793 – Evaluation of the 10-Year Cardiovascular Disease Death Risk in Greek Patients with Inflammatory Bowel Disease

Research paper thumbnail of Efficacy of IL12/23 Blockade Expands Our Therapeutic Targets and Challenges the Old Dogma in Ulcerative Colitis

Research paper thumbnail of P750 Association between the use of antihypertensive agents and disease severity in patients with inflammatory bowel disease

Journal of Crohn's and Colitis, 2019

Research paper thumbnail of Holt-Oram Syndrome in a Patient with Crohn's Disease: a Rare Case Report and Literature Review

Research paper thumbnail of Surgical Management of Fistula-in-ano Among Patients With Crohn’s Disease: Analysis of Outcomes After Fistulotomy or Seton Placement—Single-Center Experience

Scandinavian Journal of Surgery, 2016

Background and Aim: Fistula-in-ano is a common problem among patients with Crohn’s disease and ca... more Background and Aim: Fistula-in-ano is a common problem among patients with Crohn’s disease and carries significant morbidity. We aimed to study the outcomes of surgical treatment of fistula-in-ano after fistulotomy or seton placement in patients with perianal fistulizing Crohn’s disease. Material and Methods: A retrospective observational study of 59 patients diagnosed with Crohn’s disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department. The assessment of disease complexity included a detailed physical examination, magnetic resonance imaging of the rectum, and examination under anesthesia. Outcomes for analysis included wound healing rate and postoperative incontinence. Results: High transsphincteric fistula was found in 44% of the patients, while mid or low transsphincteric fistulas were found in 51%. Three women (5%) had a rectovaginal fistula. All patients with high transsphincteric fistulas were treated with loose seton placement. Patients...

Research paper thumbnail of Serum Proteomic Analysis of Patients with Irritable Bowel Syndrome

Research paper thumbnail of Predictors of tissue healing in ulcerative colitis patients treated with anti-TNF

Digestive and Liver Disease, 2017