Gastrointestinal Diseases

Does measuring antibodies to infliximab help?

Antibodies to infliximab (ATIs) have been associated with loss of clinical response and lower serum infliximab (IFX) levels in some studies of patients with inflammatory bowel disease (IBD). Presumable lower levels mean less effectiveness, but it needs to be proven. It may be clinically useful to be able to  assess and predict diminishing response. A recent meta-analysis of all available studies concluded that the presence of ATIs is associated

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Antibodies to inflixumab

Antibodies to infliximab (ATIs) have been associated with loss of clinical response and lower serum infliximab (IFX) levels in some studies of patients with inflammatory bowel disease (IBD). Lower drug levels can mean less effect ont eh disease.  It is clinically useful to be able to  assess and predict diminishing response. A recent meta-analysis concluded that the presence of ATIs is associated with a significantly higher risk of loss of clinical

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Atelvia and gastrointestinal toxicity – pro

Risedronic acid(Atelvia)  is a bisphosphonate used to strengthen bone, treat or prevent osteoporosis, and treat Paget's disease of bone. It is recommended that risedronate be taken with the body upright, and followed by a glass of water. Moreover, it is recommended that no food or drink other than water be taken for 2 hours before and 30 minutes after taking risedronate. Risedronate has a faster esophageal transit time and a different chemical chain

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Sandostatin for angiodysplasia and bleeding

Angiodysplasias are usually asymptomatic but they can cause of intestinal bleedingare a more common problem in the elderly. It is notoriously difficult to treat. A number of reports suggest that itcan help to decrease bleeding. There are no supportive guidelines to my knowledge a recent review concluded: "A significant number of patients with bleeding gastrointestinal angiodysplasia respond to treatment with octreotide by reducing the need for

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Octreotide in gastrointentinal angiodysplasia – pro

Angiodysplasias are usually asymptomatic but they can cause of GI bleeding in 3–6% of all patients and are a more common cause of beeeding in the elderly. It is notoriously difficult to treat. A number of reports suggest that it is a valuable adjunct in the treatment of gastro-inestinal dysplasia and can decrease bleeding. There are no supportive guidelines to my knowledge but the role of somatostatin analogues for refractory bleeding GI angiodysplasias

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Incivik

Telaprevir(Incivik) is the first hepatitis C drug that has demonstrated activity in patients who have failed prior therapy. In patients who received peginterferon alfa-2a and ribavirin for a year, the addition of telapravir for 24 weeks achieved a sustained virologic response(SVR) of 53% compared to 14% in patients who did not receive telapravir.It is thought that some patients who accomplish this outcome may be cured of Hepatitis, a feat rarely

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Primary Sclerosing Cholangitis (PSC)

Primary sclerosing cholangitis (PSC) is a chronic, liver disease characterized by bile stasis within bile ducts and liver inflammation and fibrosis. It is thought to be an immune mediated, progressive disorder that eventually develops into liver cirrhosis, portal hypertension and hepatic decompensation, in the majority of patients. How does one follow the activity of this disease? Guidelines do not recommend routine MRCP or ERCP to screen for screening

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Humira for Ulcerative Colitis

Adalimumab (Humira) is an anti-tumor necrosis factor (TNF) agent that is approved for both inducing and maintaining remission in moderately to severely active Crohn's disease. Small open-label trials and case reports suggest that it can induce responses in both patients who had been treated with this class of drugs and those who had not been so treated, and anti-TNF-treated patients with active ulcerative colitis. This led to a phase III trial

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Routine MCP or ERCP Surveillance for Cholagniocarcinoma or Liver Cancer in Patients with Primary Biliary Cirrhosis.

Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease characterized by inflammation and fibrosis of both intrahepatic and extrahepatic bile ducts. It is thoughtto be an immune mediated, progressive disorder that eventually develops into cirrhosis, portal hypertension and hepatic decompensation, in the majority of patients. Guidelines do not recommend routine MRCP or ERCP to screen for chalngiocarcinoma or hepatocellular carcinoma.

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