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      Enhancing Predictive Models for Ustekinumab Effectiveness in Crohn’s Disease: Suggestions for Improved Clinical Applicability [Letter]

      letter
      1 , 2 , 1
      Journal of Inflammation Research
      Dove

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          Azithromycin and metronidazole versus metronidazole-based therapy for the induction of remission in mild to moderate paediatric Crohn’s disease : a randomised controlled trial

          Crohn’s disease (CD) pathogenesis associated with dysbiosis and presence of pathobionts in the lumen, intracellular compartments and epithelial biofilms. Azithromycin is active in all three compartments. Our goal was to evaluate if azithromycin-based therapy can improve response and induce remission compared with metronidazole alone in paediatric CD. This blinded randomised controlled trial allocated children 5–18 years with 10 12.5 or remission using intention to treat analysis. 73 patients (mean age 13.8±3.1 years) were enrolled, 35 to group 1 and 38 to group 2. Response and remission rates at week 8 were identical 23/35 (66%) in group 1 and 17/38 (45%) and 15/38 (39%) in group 2 (P=0.07 and P=0.025, respectively). The needed to treat for remission was 3.7. Faecal calprotectin declined significantly in group 1 (P=0.003) but not in group 2 (p=0.33), and was lower at week 8 (P=0.052). Additional therapy was required in 6/35(17%) from group 1 versus 16/38(42%) in group 2 (P=0.027) by week 8. Among 12 failures in group 2, open-label azithromycin led to remission in 10/12 (83%). The combination of azithromycin and metronidazole failed to improve response but was superior for induction of remission and reduction in calprotectin. NCT01596894 .
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            Real-World Treatment Patterns and Healthcare Resource Use for Ulcerative Colitis and Crohn’s Disease in Italy

            Introduction Real-world data are used to inform decision-makers and optimise therapeutic management for patients with ulcerative colitis (UC) and Crohn’s disease (CD). We analysed data on the epidemiology (by using proxies of prevalence and incidence), patient characteristics, treatment patterns and associated healthcare direct costs for the management of patients with UC and patients with CD in Italy. Methods This retrospective observational study used administrative databases from eight Local Health Units geographically distributed across Italy. Adult patients with a hospitalisation and/or an exemption for UC or CD were included. Study outcomes were summarised descriptively, and limited statistical tests were performed. Results At baseline, 9255 adults with UC and 4747 adults with CD were included. Mean (standard deviation) age at inclusion was 54.0 (18.4)/48.6 (18.1) years, for UC/CD. The estimated average incidence of UC and CD for the period 2013–2020 was 36.5 and 18.7 per 100,000, respectively. The most frequently prescribed drug category for patients with UC/CD was conventional treatment [mesalazine and topical corticosteroids (67.4%/61.1%), immunomodulators and systemic corticosteroids (43.2%/47.7%)], followed by biologic treatments (2.1%/5.1%). The mean annual total direct cost per patient was 7678 euro (€), for UC and €6925 for CD. Conclusion This analysis, carried-out in an Italian clinical setting, may help to optimise therapy for patients with UC and CD and provide relevant clinical practice data to inform decision-makers. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-024-02840-x. Data from clinical practice can be used to guide healthcare decisions and optimise treatment for patients with ulcerative colitis and Crohn’s disease. This study used anonymised patient information from almost four million individuals across Italy to describe the epidemiology, patient characteristics, treatment patterns and healthcare costs of patients with ulcerative colitis and Crohn’s disease. Adults with an Italian National Health System code in their records associated with the diagnosis of ulcerative colitis or Crohn’s disease were included. Baseline characteristics were balanced between groups and rates of perceived incidence were numerically similar to the results reported in similar Italian studies. This study found that patients with ulcerative colitis and Crohn’s disease were most often prescribed conventional treatments, and biological treatments were least-commonly prescribed. More than half of patients with ulcerative colitis and nearly half of those with Crohn’s disease were persistent with first (index) treatment of mesalazine and topical corticosteroids and with biologic index treatment during the follow-up period. Switch occurred in up to approximately a quarter of patients with ulcerative colitis and Crohn’s disease. The main factors that predicted switch were index biologic for ulcerative colitis and baseline comorbidities for Crohn’s disease. The average direct cost per patient in 1 year was 7678 euro (€) for ulcerative colitis and €6925 for Crohn’s disease. The results of this analysis may help to optimise therapy for patients with ulcerative colitis and Crohn’s disease, and to inform decision-makers in healthcare systems on which treatment options provide value for money and benefit patients. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-024-02840-x.
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              Use of glucagon-like peptide-1 receptor agonists for type 2 diabetes mellitus and outcomes of inflammatory bowel disease.

              Glucagon-like peptide-1 receptor agonists (GLP-1RA) show anti-inflammatory properties.

                Author and article information

                Journal
                J Inflamm Res
                J Inflamm Res
                jir
                Journal of Inflammation Research
                Dove
                1178-7031
                28 December 2024
                2024
                : 17
                : 11755-11756
                Affiliations
                [1 ]College of Integrated Traditional Chinese and Western Medicine, Southwest Medical University , Luzhou City, Sichuan Province, People’s Republic of China
                [2 ]The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University , Luzhou, Sichuan Province, People’s Republic of China
                Author notes
                Correspondence: Xiangdong Yang, College of Integrated Traditional Chinese and Western Medicine, Southwest Medical University , Luzhou City, Sichuan Province, 646000, People’s Republic of China, Email y-xd@vip.163.com
                Article
                510503
                10.2147/JIR.S510503
                11694019
                39749004
                409c1239-7779-45f6-a152-9c4ec797ecff
                © 2024 Hu et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 05 December 2024
                : 14 December 2024
                Page count
                Figures: 0, References: 6, Pages: 2
                Categories
                Letter

                Immunology
                Immunology

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