A large-scale study of medical claims data shows that introducing sophisticated biologic therapies early in the course of treatment for Crohn's disease improves response to medication and reduces the need for surgery. There is no known cure for Crohn's disease, and traditional treatment is focused on a "step-up" strategy of managing inflammatory symptoms, starting with simpler and less costly oral medications such as aminosalicylates (5-ASAs) and corticosteroids, and escalating through a series of steps to more expensive biological therapies that target specific proteins in the immune system's inflammatory response. David Rubin, MD, associate professor of medicine and co-director of the University of Chicago Medicine's Inflammatory Bowel Disease Center, studied a newer "top-down" strategy that reverses this order of treatment.
Inflammatory bowel disease is relatively rare in Canadian First Nations people but common in white people, possibly due to different genetic variants, according to a new study in CMAJ (Canadian Medical Association Journal) that helps improve understanding of the mechanisms of the disease. Inflammatory bowel disease (IBD), a painful chronic immune disease that includes Crohn disease and ulcerative colitis, has a genetic predisposition. Studies in Manitoba in the 1990s found significantly lower prevalence rates of Crohn disease (16/100 000 people) and ulcerative colitis (56/100 000) than non-First Nations people: 209/100 000 people and 176/100 000 people respectively. However, they have higher rates of other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis (the latter is often found with IBD in other populations).
Researchers at the University of Central Florida have developed a novel technique that may give doctors a faster and more sensitive tool to detect pathogens associated with inflammatory bowel disease, including Crohn's disease. The new nanoparticle-based technique also may be used for detection of other microbes that have challenged scientists for centuries because they hide deep in human tissue and are able to reprogram cells to successfully evade the immune system. The microbes reappear years later and can cause serious health problems such as seen in tuberculosis cases. Current testing methods to find these hidden microbes exist, but require a long time to complete and often delay effective treatment for weeks or even months. UCF Associate Professor J. Manuel Perez and Professor Saleh Naser and their research team have developed a method using nanoparticles coated with DNA markers specific to the elusive pathogens.
Patients with inflammatory bowel disease (IBD) and other gastrointestinal (GI) disorders may be exposed to significant doses of diagnostic radiation, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association. "Our results show that significant increases in radiation exposure in the last decade have paralleled the increased use of computed tomography imaging, " said Alan N. Desmond, MB, BMedSc, MRCPI, of the Cork University Hospital, Ireland, and lead author of this study. "While cumulative exposure is highest in patients with Crohn's disease, high exposure may also occur in patients with other gastrointestinal disorders." Researchers analyzed data from 2, 590 patients who were diagnosed with GI disorders at a tertiary gastroenterology center from January 1999 to January 2009.
Glucocorticoid-Induced Osteoporosis: Management Strategies To Prevent Bone Loss And Related Fractures In High-Risk Patients
Oral glucocorticoids are commonly prescribed for a wide variety of disorders, most commonly for rheumatoid arthritis, obstructive pulmonary disease and inflammatory bowel diseases. However, the use of these medications can result in rapid bone loss during the first three to six months of therapy, leading to increased risk of fragility fractures. Although awareness of glucocorticoid-induced osteoporosis (GIO) has grown in recent years, it still remains vastly under-diagnosed and under-treated. As a result, and despite the availability of effective treatment options to reduce the risk of fractures, millions of patients around the world are left at risk of potentially serious fractures. In an effort to address this serious problem, the International Osteoporosis Foundation (IOF) and the European Calcified Tissue Society (ECTS) have published a guidance document* which provides a framework for the development of national assessment and treatment guidelines.