ruth de francisco | University of Oviedo / Universidad de Oviedo (original) (raw)
Papers by ruth de francisco
Revista Espanola De Enfermedades Digestivas, Aug 1, 2004
Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistu... more Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn's disease. We present here the results of retreatment and long-term maintenance therapy. Patients and methods: eighty one consecutive patients with active fistulizing Crohn's disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6). Those patients who failed to respond after the initial cycle (group 1, n= 25), or those who relapsed after having responded (group 2, n=13), received retreatment with three similar doses (weeks 0,2, and 6). Those who responded to retreatment were included in a long-term maintenance programme (n=44), with repeated doses (5 mg/kg i.v. infusions) every eight weeks for 1-2 years. Results: in the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders) presented a complete response, compared to 77% in group 2 (relapsers) (p< 0.0001). In the maintenance treatment, the global response was 88% (39/44). The mean number of doses per patient was 4.4 ± 2 (range 1-9) with a duration of 36 ± 12 weeks (range 8-72). Adverse effects were not significantly increased in either treatment. Conclusions: both retreatment and long-term maintenance therapy with infliximab, are highly effective and well tolerated in fistulizing Crohn's disease patients.
Inflammatory Bowel Diseases
Background and Aims Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease as... more Background and Aims Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease associated with profound metabolic changes. The discovery of novel molecular indicators for unraveling IBD etiopathogenesis and the diagnosis and prognosis of IBD is therefore pivotal. We sought to determine the distinctive metabolic signatures from the different IBD subgroups before treatment initiation. Methods Serum and urine samples from newly diagnosed treatment-naïve IBD patients and age and sex-matched healthy control (HC) individuals were investigated using proton nuclear magnetic resonance spectroscopy. Metabolic differences were identified based on univariate and multivariate statistical analyses. Results A total of 137 Crohn’s disease patients, 202 ulcerative colitis patients, and 338 HC individuals were included. In the IBD cohort, several distinguishable metabolites were detected within each subgroup comparison. Most of the differences revealed alterations in energy and amino ...
Gastroenterología y Hepatología
Gastroenterología y Hepatología
Alimentary Pharmacology & Therapeutics
SummaryBackground and AimsData on the outcomes after switching from adalimumab (ADA) originator t... more SummaryBackground and AimsData on the outcomes after switching from adalimumab (ADA) originator to ADA biosimilar are limited. The aim was to compare the treatment persistence, clinical efficacy, and safety outcomes in inflammatory bowel disease patients who maintained ADA originator vs. those who switched to ADA biosimilar.MethodsPatients receiving ADA originator who were in clinical remission at standard dose of ADA originator were included. Patients who maintained ADA originator formed the non‐switch cohort (NSC), and those who switched to different ADA biosimilars constituted the switch cohort (SC). Clinical remission was defined as a Harvey–Bradshaw index ≤4 in Crohn's disease and a partial Mayo score ≤2 in ulcerative colitis. To control possible confounding effects on treatment discontinuation, an inverse probability treatment weighted proportional hazard Cox regression was performed.ResultsFive hundred and twenty‐four patients were included: 211 in the SC and 313 in the N...
Journal of Crohn's and Colitis
Background Treatment with thiopurines in patients with Inflammatory Bowel Disease (IBD) may be as... more Background Treatment with thiopurines in patients with Inflammatory Bowel Disease (IBD) may be associated with different adverse effects, including acute pancreatitis. Our aims were to evaluate the clinical presentation, severity and management of acute pancreatitis related to thiopurines in patients with IBD. Methods IBD patients with acute pancreatitis secondary to treatment with thiopurines for IBD were identified from the prospectively maintained ENEIDA registry of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU). We included those patients who met the Atlanta diagnostic criteria and had an imaging test that ruled out biliary origin of pancreatitis. Investigators at each participating centre provided additional information on pancreatitis clinical evolution and management. Results We included 290 patients with pancreatitis in 34 centres; 54% were women, 84% had Crohn’s disease and 56% were smokers. Five (1.7%) had had pancreatitis before, but no ...
Gastroenterología y Hepatología, 2023
Journal of Crohn's and Colitis
Background Some patients with Inflammatory Bowel Disease (IBD) who are treated with anti-TNFα the... more Background Some patients with Inflammatory Bowel Disease (IBD) who are treated with anti-TNFα therapy develop a drug-induced psoriasis (IP) as an adverse event. There are some therapeutic approaches, being more frequent to change the biologic therapy to ustekinumab, effective and approved for the treatment of both entities. This could be the best option, but available data are lacking and it could increase the risk of IBD relapse. Our aim is to assess the management of anti-TNF IP in IBD, and the subsequent evolution of both diseases in a large nationwide cohort of patients. Methods Retrospective, observational multicenter study from the prospectively maintained Spanish ENEIDA registry. Participants were patients with IBD and anti-TNFα IP. At baseline, psoriasis severity was classified as mild, moderate or severe, and remission was defined as the resolution of skin lesions, clinical response as an improvement without complete resolution, and no response as the absence of improvement...
Journal of Crohn's and Colitis
Background Immune-mediated inflammatory diseases (IMIDs) involve an increased risk of developing ... more Background Immune-mediated inflammatory diseases (IMIDs) involve an increased risk of developing atherosclerotic cardiovascular disease (ASCVD). However, the association between inflammatory bowel disease (IBD) and ASCVD is not well established. Our aims were to evaluate the frequency of ASCVD [ischemic heart disease (IHD) and cerebrovascular accident (CVA)] after IBD diagnosis and to identify the risk factors associated with its development. Methods Observational, single-centre study which included all patients seen at the IBD Unit of the Hospital Universitario Central de Asturias (Spain) between May 2010 and April 2022. Cardiovascular risk factors and the development of ASCVD were prospectively assessed; in addition, this information was sought selectively prior to IBD diagnosis and patients’ first visit to the unit. Regarding classical risk factors, we analysed hypertension, dyslipidaemia and diabetes mellitus. As possible risk factors related to IBD, we analysed the presence of ...
Journal of Crohn's and Colitis
Background Treatment with thiopurines may be associated with different adverse effects, including... more Background Treatment with thiopurines may be associated with different adverse effects, including acute pancreatitis. Risk factors for developing pancreatitis due to thiopurines in patients with Inflammatory Bowel Disease (IBD) are not clearly identified, with underlying genetic predisposition being a possible cause. Our aim was to evaluate predictive pharmacogenetic risk of pancreatitis in IBD patients treated with thiopurines. Methods IBD patients treated with thiopurines were identified from the prospectively maintained ENEIDA registry of the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU). We included as cases those patients who met the Atlanta diagnostic criteria for pancreatitis and had an imaging test that ruled out biliary origin. We included as controls those patients without pancreatitis after at least two years of treatment with thiopurines. Blood samples were collected, and DNA was extracted from leukocytes for all participants and, subsequently...
Journal of Crohn's and Colitis
Background and Aims There are concerns regarding the potential impact of the COVID-19 outbreak on... more Background and Aims There are concerns regarding the potential impact of the COVID-19 outbreak on patients with inflammatory bowel disease [IBD]. We report on the impact of the COVID-19 outbreak in a European prospective cohort study of patients with IBD Patients and Methods We prospectively collected data from 5457 patients with IBD nested in the ongoing I-CARE project and still followed up in April 2020, with monthly online monitoring of clinical activity, treatment, imaging and endoscopy. Investigators were also contacted to report incidental cases. Results In total, 233 [4.3%] reported COVID-19 and 12 [0.2%] severe COVID-19, with no COVID-19 deaths. The risk of COVID-19 in patients with IBD was not increased compared to the general population (standardized incidence ratio [SIR]: 1.18, 95% confidence interval [CI] [1.03–1.34], p = 0.009), as well as the risk of severe COVID-19 (SIR: 0.69, 95% CI [0.35–1.20], p = 0.93). We did not observe any negative impact of the different IBD-r...
Journal of Crohn's and Colitis, 2022
Background Aims: 1) to compare persistence on adalimumab treatment over time in inflammatory bowe... more Background Aims: 1) to compare persistence on adalimumab treatment over time in inflammatory bowel disease (IBD) patients who maintained adalimumab reference [non-switch cohort (NC)] vs. those who switched from adalimumab reference to adalimumab biosimilar [switch cohort (SC)]; 2) to compare loss of effectiveness of adalimumab treatment in the NC vs. SC; 3) to identify factors associated with discontinuation of adalimumab therapy; 4) to identify the factors associated with relapse in both cohorts; and 5) to evaluate the safety of both strategies. Methods Retrospective, observational, multicentre study. Patients under adalimumab reference who were in clinical remission at standard dose of adalimumab reference, and in whom adalimumab was the first anti-TNF administered, were included. Clinical remission was defined as a Harvey-Bradshaw index ≤4 points in Crohn’s disease, a partial Mayo score ≤2 in ulcerative colitis, and the absence of fistula drainage despite gentle finger compressio...
Journal of Crohn's and Colitis, 2022
Ulcerative proctitis may have a mild and less aggressive course, although evidence is scarce beca... more Ulcerative proctitis may have a mild and less aggressive course, although evidence is scarce because these patients are excluded from participation in randomized controlled clinical trials. The aim is to identify clinical characteristics and complications associated with ulcerative proctitis refractory to conventional therapy. Patients included in the prospectively maintained ENEIDA registry from GETECCU with ulcerative proctitis were included. Socio-demographic data were evaluated. We defined ulcerative proctitis based on ECCO guidelines and immunosuppression as the use of immunomodulators and/or biologics. Logistic regression was used to identify the independent factors associated with immunosuppressive therapy among the different socio-demographic data. From a total of 34.716 patients with ulcerative colitis, 6281 (18%) patients with ulcerative proctitis were identified. Mean age was 53 ±15 years and mean duration of illness was 12 ± 9 years. Surgery was necessary only in 2% of p...
Journal of Crohn's and Colitis, 2018
Table 1: Baseline characteristics. Baseline characteristics n = 18 Median age (IQR) at IBD diagno... more Table 1: Baseline characteristics. Baseline characteristics n = 18 Median age (IQR) at IBD diagnosis and conception (year) 23 (17-w27) / 31 (26-34) Crohn's disease/Ulcerative colitis 12/18(67%) / 6/18 (33%) Median CRP (IQR) before conception (mg/l) 5 (2-13) Median duration (IQR) of VDZ therapy at conception (months) 12 (6-14) IBD medication (<12 weeks of conception) Systemic 5-ASA 3/18 (17%) Immunomodulators 1/18 (6%) Usage during pregnancy Smoking 3/18 (17%) Folic acid supplementation 16/17 (94%) Caesarean section* 5/16 (31%)
Journal of Crohn's and Colitis, 2018
Journal of Crohn's and Colitis, 2018
Journal of Crohn's and Colitis, 2020
Background The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vei... more Background The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vein and/or its intrahepatic branches, mesenteric, splenic and/or suprahepatic veïns is mainly observed, among others, in inflammatory abdominal conditions. Thromboembolic complications are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, characteristics, risk factors and evolution of SVT in patients with IBD. Our aims were to describe the characteristics of SVT in patients with IBD, diagnostic explorations, treatment and evolution. Methods Retrospective, multicentre, descriptive study of the ENEIDA registry with a diagnosis of SVT. In addition to epidemiological and clinical features of IBD, we recorded specifically diagnosis, treatment, disease activity at the time of SVT and outcome of SVT. Results Over 59,000 IBD patients in the ENEIDA registry, only 49 episodes of SVT were identified (35 Crohn’s / 14 Ulcerative Colit...
Journal of Crohn's and Colitis, 2020
Background INFEII registry (ClinicalTrials.gov: NCT02904590) is a prospective study promoted by G... more Background INFEII registry (ClinicalTrials.gov: NCT02904590) is a prospective study promoted by GETECCU to determine the incidence and risk factors of infection in an inception cohort of IBD patients. Despite preventive measures and recommendations of scientific societies, TB remains a problem in patients with IBD treated with immunosuppressants (IMM) and biologics. AIMS To asses: (1) the screening of TB performed at the time of inclusion of a patient in the INFEII registry, (2) the incidence of latent TB; and (3) compliance with national and European recommendations. Methods A longitudinal prospective study of incident cases with IBD, initiated in October 2016 and with a planned follow-up of 5 years. In September 2019, INFEII registry had 1241 patients from 28 centres throughout Spain. The study protocol determines the mandatory fulfilment of TB screening in every patient, leaving to the centre the freedom of decision on what procedures to perform. Guidelines recommend a mandatory ...
Journal of Crohn's and Colitis, 2019
Journal of Crohn's & colitis, Jan 22, 2016
Despite having adopted preventive measures, tuberculosis (TB) in anti-tumor necrosis factor (anti... more Despite having adopted preventive measures, tuberculosis (TB) in anti-tumor necrosis factor (anti-TNF) treated inflammatory bowel disease (IBD) patients may still occur. Data about the causes and characteristics of TB cases in this scenario are lacking. Our aim is to describe the characteristics of TB in anti-TNF treated IBD patients after the publication of the Spanish prevention guidelines and to evaluate the safety of restarting anti-TNF after a TB diagnosis. In this multicenter retrospective descriptive study, TB cases from Spanish hospitals were collected. Continuous variables were reported as mean and standard deviation or median and interquartile range. Categorical variables were described as absolute and relative frequencies and their confidence intervals when necessary. We collected 50 TB cases in anti-TNF treated IBD patients, 60% male, median age 37.3 years (IQR 30.4-47). Median latency between anti-TNF initiation and first TB symptoms was 155.5 days (IQR 88-301); 34% of ...
Revista Espanola De Enfermedades Digestivas, Aug 1, 2004
Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistu... more Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn's disease. We present here the results of retreatment and long-term maintenance therapy. Patients and methods: eighty one consecutive patients with active fistulizing Crohn's disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6). Those patients who failed to respond after the initial cycle (group 1, n= 25), or those who relapsed after having responded (group 2, n=13), received retreatment with three similar doses (weeks 0,2, and 6). Those who responded to retreatment were included in a long-term maintenance programme (n=44), with repeated doses (5 mg/kg i.v. infusions) every eight weeks for 1-2 years. Results: in the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders) presented a complete response, compared to 77% in group 2 (relapsers) (p< 0.0001). In the maintenance treatment, the global response was 88% (39/44). The mean number of doses per patient was 4.4 ± 2 (range 1-9) with a duration of 36 ± 12 weeks (range 8-72). Adverse effects were not significantly increased in either treatment. Conclusions: both retreatment and long-term maintenance therapy with infliximab, are highly effective and well tolerated in fistulizing Crohn's disease patients.
Inflammatory Bowel Diseases
Background and Aims Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease as... more Background and Aims Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease associated with profound metabolic changes. The discovery of novel molecular indicators for unraveling IBD etiopathogenesis and the diagnosis and prognosis of IBD is therefore pivotal. We sought to determine the distinctive metabolic signatures from the different IBD subgroups before treatment initiation. Methods Serum and urine samples from newly diagnosed treatment-naïve IBD patients and age and sex-matched healthy control (HC) individuals were investigated using proton nuclear magnetic resonance spectroscopy. Metabolic differences were identified based on univariate and multivariate statistical analyses. Results A total of 137 Crohn’s disease patients, 202 ulcerative colitis patients, and 338 HC individuals were included. In the IBD cohort, several distinguishable metabolites were detected within each subgroup comparison. Most of the differences revealed alterations in energy and amino ...
Gastroenterología y Hepatología
Gastroenterología y Hepatología
Alimentary Pharmacology & Therapeutics
SummaryBackground and AimsData on the outcomes after switching from adalimumab (ADA) originator t... more SummaryBackground and AimsData on the outcomes after switching from adalimumab (ADA) originator to ADA biosimilar are limited. The aim was to compare the treatment persistence, clinical efficacy, and safety outcomes in inflammatory bowel disease patients who maintained ADA originator vs. those who switched to ADA biosimilar.MethodsPatients receiving ADA originator who were in clinical remission at standard dose of ADA originator were included. Patients who maintained ADA originator formed the non‐switch cohort (NSC), and those who switched to different ADA biosimilars constituted the switch cohort (SC). Clinical remission was defined as a Harvey–Bradshaw index ≤4 in Crohn's disease and a partial Mayo score ≤2 in ulcerative colitis. To control possible confounding effects on treatment discontinuation, an inverse probability treatment weighted proportional hazard Cox regression was performed.ResultsFive hundred and twenty‐four patients were included: 211 in the SC and 313 in the N...
Journal of Crohn's and Colitis
Background Treatment with thiopurines in patients with Inflammatory Bowel Disease (IBD) may be as... more Background Treatment with thiopurines in patients with Inflammatory Bowel Disease (IBD) may be associated with different adverse effects, including acute pancreatitis. Our aims were to evaluate the clinical presentation, severity and management of acute pancreatitis related to thiopurines in patients with IBD. Methods IBD patients with acute pancreatitis secondary to treatment with thiopurines for IBD were identified from the prospectively maintained ENEIDA registry of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU). We included those patients who met the Atlanta diagnostic criteria and had an imaging test that ruled out biliary origin of pancreatitis. Investigators at each participating centre provided additional information on pancreatitis clinical evolution and management. Results We included 290 patients with pancreatitis in 34 centres; 54% were women, 84% had Crohn’s disease and 56% were smokers. Five (1.7%) had had pancreatitis before, but no ...
Gastroenterología y Hepatología, 2023
Journal of Crohn's and Colitis
Background Some patients with Inflammatory Bowel Disease (IBD) who are treated with anti-TNFα the... more Background Some patients with Inflammatory Bowel Disease (IBD) who are treated with anti-TNFα therapy develop a drug-induced psoriasis (IP) as an adverse event. There are some therapeutic approaches, being more frequent to change the biologic therapy to ustekinumab, effective and approved for the treatment of both entities. This could be the best option, but available data are lacking and it could increase the risk of IBD relapse. Our aim is to assess the management of anti-TNF IP in IBD, and the subsequent evolution of both diseases in a large nationwide cohort of patients. Methods Retrospective, observational multicenter study from the prospectively maintained Spanish ENEIDA registry. Participants were patients with IBD and anti-TNFα IP. At baseline, psoriasis severity was classified as mild, moderate or severe, and remission was defined as the resolution of skin lesions, clinical response as an improvement without complete resolution, and no response as the absence of improvement...
Journal of Crohn's and Colitis
Background Immune-mediated inflammatory diseases (IMIDs) involve an increased risk of developing ... more Background Immune-mediated inflammatory diseases (IMIDs) involve an increased risk of developing atherosclerotic cardiovascular disease (ASCVD). However, the association between inflammatory bowel disease (IBD) and ASCVD is not well established. Our aims were to evaluate the frequency of ASCVD [ischemic heart disease (IHD) and cerebrovascular accident (CVA)] after IBD diagnosis and to identify the risk factors associated with its development. Methods Observational, single-centre study which included all patients seen at the IBD Unit of the Hospital Universitario Central de Asturias (Spain) between May 2010 and April 2022. Cardiovascular risk factors and the development of ASCVD were prospectively assessed; in addition, this information was sought selectively prior to IBD diagnosis and patients’ first visit to the unit. Regarding classical risk factors, we analysed hypertension, dyslipidaemia and diabetes mellitus. As possible risk factors related to IBD, we analysed the presence of ...
Journal of Crohn's and Colitis
Background Treatment with thiopurines may be associated with different adverse effects, including... more Background Treatment with thiopurines may be associated with different adverse effects, including acute pancreatitis. Risk factors for developing pancreatitis due to thiopurines in patients with Inflammatory Bowel Disease (IBD) are not clearly identified, with underlying genetic predisposition being a possible cause. Our aim was to evaluate predictive pharmacogenetic risk of pancreatitis in IBD patients treated with thiopurines. Methods IBD patients treated with thiopurines were identified from the prospectively maintained ENEIDA registry of the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU). We included as cases those patients who met the Atlanta diagnostic criteria for pancreatitis and had an imaging test that ruled out biliary origin. We included as controls those patients without pancreatitis after at least two years of treatment with thiopurines. Blood samples were collected, and DNA was extracted from leukocytes for all participants and, subsequently...
Journal of Crohn's and Colitis
Background and Aims There are concerns regarding the potential impact of the COVID-19 outbreak on... more Background and Aims There are concerns regarding the potential impact of the COVID-19 outbreak on patients with inflammatory bowel disease [IBD]. We report on the impact of the COVID-19 outbreak in a European prospective cohort study of patients with IBD Patients and Methods We prospectively collected data from 5457 patients with IBD nested in the ongoing I-CARE project and still followed up in April 2020, with monthly online monitoring of clinical activity, treatment, imaging and endoscopy. Investigators were also contacted to report incidental cases. Results In total, 233 [4.3%] reported COVID-19 and 12 [0.2%] severe COVID-19, with no COVID-19 deaths. The risk of COVID-19 in patients with IBD was not increased compared to the general population (standardized incidence ratio [SIR]: 1.18, 95% confidence interval [CI] [1.03–1.34], p = 0.009), as well as the risk of severe COVID-19 (SIR: 0.69, 95% CI [0.35–1.20], p = 0.93). We did not observe any negative impact of the different IBD-r...
Journal of Crohn's and Colitis, 2022
Background Aims: 1) to compare persistence on adalimumab treatment over time in inflammatory bowe... more Background Aims: 1) to compare persistence on adalimumab treatment over time in inflammatory bowel disease (IBD) patients who maintained adalimumab reference [non-switch cohort (NC)] vs. those who switched from adalimumab reference to adalimumab biosimilar [switch cohort (SC)]; 2) to compare loss of effectiveness of adalimumab treatment in the NC vs. SC; 3) to identify factors associated with discontinuation of adalimumab therapy; 4) to identify the factors associated with relapse in both cohorts; and 5) to evaluate the safety of both strategies. Methods Retrospective, observational, multicentre study. Patients under adalimumab reference who were in clinical remission at standard dose of adalimumab reference, and in whom adalimumab was the first anti-TNF administered, were included. Clinical remission was defined as a Harvey-Bradshaw index ≤4 points in Crohn’s disease, a partial Mayo score ≤2 in ulcerative colitis, and the absence of fistula drainage despite gentle finger compressio...
Journal of Crohn's and Colitis, 2022
Ulcerative proctitis may have a mild and less aggressive course, although evidence is scarce beca... more Ulcerative proctitis may have a mild and less aggressive course, although evidence is scarce because these patients are excluded from participation in randomized controlled clinical trials. The aim is to identify clinical characteristics and complications associated with ulcerative proctitis refractory to conventional therapy. Patients included in the prospectively maintained ENEIDA registry from GETECCU with ulcerative proctitis were included. Socio-demographic data were evaluated. We defined ulcerative proctitis based on ECCO guidelines and immunosuppression as the use of immunomodulators and/or biologics. Logistic regression was used to identify the independent factors associated with immunosuppressive therapy among the different socio-demographic data. From a total of 34.716 patients with ulcerative colitis, 6281 (18%) patients with ulcerative proctitis were identified. Mean age was 53 ±15 years and mean duration of illness was 12 ± 9 years. Surgery was necessary only in 2% of p...
Journal of Crohn's and Colitis, 2018
Table 1: Baseline characteristics. Baseline characteristics n = 18 Median age (IQR) at IBD diagno... more Table 1: Baseline characteristics. Baseline characteristics n = 18 Median age (IQR) at IBD diagnosis and conception (year) 23 (17-w27) / 31 (26-34) Crohn's disease/Ulcerative colitis 12/18(67%) / 6/18 (33%) Median CRP (IQR) before conception (mg/l) 5 (2-13) Median duration (IQR) of VDZ therapy at conception (months) 12 (6-14) IBD medication (<12 weeks of conception) Systemic 5-ASA 3/18 (17%) Immunomodulators 1/18 (6%) Usage during pregnancy Smoking 3/18 (17%) Folic acid supplementation 16/17 (94%) Caesarean section* 5/16 (31%)
Journal of Crohn's and Colitis, 2018
Journal of Crohn's and Colitis, 2018
Journal of Crohn's and Colitis, 2020
Background The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vei... more Background The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vein and/or its intrahepatic branches, mesenteric, splenic and/or suprahepatic veïns is mainly observed, among others, in inflammatory abdominal conditions. Thromboembolic complications are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, characteristics, risk factors and evolution of SVT in patients with IBD. Our aims were to describe the characteristics of SVT in patients with IBD, diagnostic explorations, treatment and evolution. Methods Retrospective, multicentre, descriptive study of the ENEIDA registry with a diagnosis of SVT. In addition to epidemiological and clinical features of IBD, we recorded specifically diagnosis, treatment, disease activity at the time of SVT and outcome of SVT. Results Over 59,000 IBD patients in the ENEIDA registry, only 49 episodes of SVT were identified (35 Crohn’s / 14 Ulcerative Colit...
Journal of Crohn's and Colitis, 2020
Background INFEII registry (ClinicalTrials.gov: NCT02904590) is a prospective study promoted by G... more Background INFEII registry (ClinicalTrials.gov: NCT02904590) is a prospective study promoted by GETECCU to determine the incidence and risk factors of infection in an inception cohort of IBD patients. Despite preventive measures and recommendations of scientific societies, TB remains a problem in patients with IBD treated with immunosuppressants (IMM) and biologics. AIMS To asses: (1) the screening of TB performed at the time of inclusion of a patient in the INFEII registry, (2) the incidence of latent TB; and (3) compliance with national and European recommendations. Methods A longitudinal prospective study of incident cases with IBD, initiated in October 2016 and with a planned follow-up of 5 years. In September 2019, INFEII registry had 1241 patients from 28 centres throughout Spain. The study protocol determines the mandatory fulfilment of TB screening in every patient, leaving to the centre the freedom of decision on what procedures to perform. Guidelines recommend a mandatory ...
Journal of Crohn's and Colitis, 2019
Journal of Crohn's & colitis, Jan 22, 2016
Despite having adopted preventive measures, tuberculosis (TB) in anti-tumor necrosis factor (anti... more Despite having adopted preventive measures, tuberculosis (TB) in anti-tumor necrosis factor (anti-TNF) treated inflammatory bowel disease (IBD) patients may still occur. Data about the causes and characteristics of TB cases in this scenario are lacking. Our aim is to describe the characteristics of TB in anti-TNF treated IBD patients after the publication of the Spanish prevention guidelines and to evaluate the safety of restarting anti-TNF after a TB diagnosis. In this multicenter retrospective descriptive study, TB cases from Spanish hospitals were collected. Continuous variables were reported as mean and standard deviation or median and interquartile range. Categorical variables were described as absolute and relative frequencies and their confidence intervals when necessary. We collected 50 TB cases in anti-TNF treated IBD patients, 60% male, median age 37.3 years (IQR 30.4-47). Median latency between anti-TNF initiation and first TB symptoms was 155.5 days (IQR 88-301); 34% of ...