Article information
Resumen
En la Digestive Disease Week 2011 se han presentado numerosos trabajos sobre la colitis ulcerosa, muchos de ellos con información relevante para la práctica clínica. Se han identificado factores predictores de la necesidad de colectomía en estos pacientes, así como de las complicaciones asociadas al tratamiento quirúrgico. Además, se han aportado nuevos datos sobre la incidencia de displasia y cáncer colorrectal, así como de la correlación entre la actividad clínica y la endoscópica en los pacientes con colitis ulcerosa. Pero sin duda, la mayor parte de la atención la han centrado los estudios sobre el tratamiento de la enfermedad, evaluando la eficacia de nuevos fármacos en la colitis ulcerosa y proponiendo estrategias para la optimización de los tratamientos clásicos, como los 5-aminosalicilatos, las tiopurinas o los esteroides.
Palabras clave:
Adalimumab
Azatioprina
Cáncer colorrectal
Colectomía
Colitis ulcerosa
Displasia
Infliximab
Abstract
Many studies on ulcerative colitis were presented in Digestive Disease Week 2011, some of which reported important information for clinical practice. Some authors have reported predictive factors of colectomy in these patients, as well as the most frequent complications associated with surgical treatment. Other studies provided new data on the incidence of dysplasia and colorectal cancer, as well as on the correlation between clinical activity and endoscopy in patients with ulcerative colitis. In this congress, special attention was drawn to studies evaluating the effectiveness of new drugs in ulcerative colitis, such as adalimumab, and to studies proposing strategies to optimize the effectiveness of the conventional drugs, such as 5-aminosalicylates, thiopurines or steroids.
Keywords:
Adalimumab
Azathioprine
Colorectal cancer
Colectomy
Ulcerative colitis
Dysplasia
Infliximab
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Bibliografía
[1.]
G. Jarnerot, P. Rolny, H. Sandberg-Gertzen.
Intensive intravenous treatment of ulcerative colitis.
Gastroenterology, 89 (1985), pp. 1005-1013
[2.]
L. Targownik, Z. Nugent, C. Bernstein.
A population-based study of prevalence and predictors of hospitalization in UC.
Gastroenterology, 140 (2011), pp. S780
[3.]
S. Kane, D. Huo, J. Aikens, S. Hanauer.
Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis.
Am J Med, 114 (2003), pp. 39-43
[4.]
P.D. Higgins, D.T. Rubin, K. Kaulback, P.S. Schoenfield, S.V. Kane.
Systematic review: impact of non-adherence to 5-aminosalicylic acid products on the frequency and cost of ulcerative colitis flares.
Aliment Pharmacol Ther, 29 (2009), pp. 247-257
[5.]
G.R. Lichtenstein, M.A. Kamm, P. Boddu, N. Gubergrits, A. Lyne, T. Butler, et al.
Effect of once- or twice-daily MMX mesalamine (SPD476) for the induction of remission of mild to moderately active ulcerative colitis.
Clin Gastroenterol Hepatol, 5 (2007), pp. 95-102
[6.]
M.A. Kamm, W.J. Sandborn, M. Gassull, S. Schreiber, L. Jackowski, T. Butler, et al.
Once-daily, high-concentration MMX mesalamine in active ulcerative colitis.
Gastroenterology, 132 (2007), pp. 66-75
[7.]
W. Kruis, G. Kiudelis, I. Racz, I.A. Gorelov, J. Pokrotnieks, M. Horynski, et al.
Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, non-inferiority trial.
Gut, 58 (2009), pp. 233-240
[8.]
A.U. Dignass, B. Bokemeyer, H. Adamek, M. Mross, L. Vinter-Jensen, N. Borner, et al.
Mesalamine once daily is more effective than twice daily in patients with quiescent ulcerative colitis.
Clin Gastroenterol Hepatol, 7 (2009), pp. 762-769
[9.]
A. Hawthorne, R. Stenson, D. Gillespie, E. Swarbrick, A. Dhar, K. Kapur, et al.
Once daily mesalazine as maintenance therapy for ulcerative colitis (UC): a one-year single-blind randomised trial.
Gastroenterology, 140 (2011), pp. S65
[10.]
A. Hawthorne, R. Stenson, D. Gillespie, K. Kapur, K. Hood, C. Probert.
Assessment of adherence to mesalazine maintenance therapy over one year using Mems Monitoring System: A substudy of the CODA trial comparing once versus three times daily Asacol in ulcerative colitis (UC).
Gastroenterology, 140 (2011), pp. S264
[11.]
W. Sandborn, S. Hanauer, G. Lichtenstein, M. Safdi, S. Harris.
Early symptomatic response and mucosal healing with mesalamine suspension therapy in the treatment of active distal ulcerative colitis (UC): Additional results from two controlled, randomized trials.
Gastroenterology, 140 (2011), pp. S262-S263
[12.]
L.R. Sutherland, F. Martin, S. Greer, M. Robinson, N. Greenberger, F. Saibil, et al.
5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis.
Gastroenterology, 92 (1987), pp. 1894-1898
[13.]
M. Safdi, M. DeMicco, C. Sninsky, P. Banks, L. Wruble, J. Deren, et al.
A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis.
Am J Gastroenterol, 92 (1997), pp. 1867-1871
[14.]
W. Sandborn, S. Travis, S. Danese, L. Kupcinskas, O. Alexeeva, L. Moro, et al.
Budesonide MMX 9 mg for induction of remission of mild to moderate ulcerative colitis (UC): data from a multicenter, randomized, double-blind placebo-controlled study in Europe, Russia, Israel and Australia.
Gastroenterology, 140 (2011), pp. S65
[15.]
W. Sandborn, S. Travis, L. Moro, D. Ballard, P. Yeung, P. Bleker, et al.
Budesonide MMX 9 mg for the induction of remission of mild to moderate ulcerative colitis (UC): Data from a multicenter, randomized, double-blind, placebo-controlled study in North America and India.
Gastroenterology, 140 (2011), pp. S124
[16.]
I. Bernal, M. Manosa, E. Domenech, E. Garcia-Planella, M. Navarro, V. Lorenzo-Zuniga, et al.
Predictors of clinical response to systemic steroids in active ulcerative colitis.
Dig Dis Sci, 51 (2006), pp. 1434-1438
[17.]
D. Turner, C.M. Walsh, A.H. Steinhart, A.M. Griffiths.
Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression.
Clin Gastroenterol Hepatol, 5 (2007), pp. 103-110
[18.]
S. Lichtiger, D.H. Present, A. Kornbluth, I. Gelernt, J. Bauer, G. Galler, et al.
Cyclosporine in severe ulcerative colitis refractory to steroid therapy.
N Engl J Med, 330 (1994), pp. 1841-1845
[19.]
G. D’Haens, L. Lemmens, K. Geboes, L. Vandeputte, F. Van Acker, L. Mortelmans, et al.
Intravenous cyclosporine versus intravenous corticosteroids as single therapy for severe attacks of ulcerative colitis.
Gastroenterology, 120 (2001), pp. 1323-1329
[20.]
G. Van Assche, G. D’Haens, M. Noman, S. Vermeire, M. Hiele, K. Asnong, et al.
Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis.
Gastroenterology, 125 (2003), pp. 1025-1031
[21.]
S. Garcia-Lopez, F. Gomollon-Garcia, J. Perez-Gisbert.
Cyclosporine in the treatment of severe attack of ulcerative colitis: a systematic review.
Gastroenterol Hepatol, 28 (2005), pp. 607-614
[22.]
H. Braat, M.P. Peppelenbosch, D.W. Hommes.
Immunology of Crohn's disease.
Ann N Y Acad Sci, 1072 (2006), pp. 135-154
[23.]
C. Hassan, E. Ierardi, O. Burattini, V. De Francesco, A. Zullo, G. Stoppino, et al.
Tumour necrosis factor alpha down-regulation parallels inflammatory regression in ulcerative colitis patients treated with infliximab.
Dig Liver Dis, 39 (2007), pp. 811-817
[24.]
B.E. Sands, W.J. Tremaine, W.J. Sandborn, P.J. Rutgeerts, S.B. Hanauer, L. Mayer, et al.
Infliximab in the treatment of severe, steroid-refractory ulcerative colitis: a pilot study.
Inflamm Bowel Dis, 7 (2001), pp. 83-88
[25.]
C.S. Probert, S.D. Hearing, S. Schreiber, T. Kuhbacher, S. Ghosh, I.D. Arnott, et al.
Infliximab in moderately severe glucocorticoid resistant ulcerative colitis: a randomised controlled trial.
Gut, 52 (2003), pp. 998-1002
[26.]
G. Jarnerot, E. Hertervig, I. Friis-Liby, L. Blomquist, P. Karlen, C. Granno, et al.
Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study.
Gastroenterology, 128 (2005), pp. 1805-1811
[27.]
P. Rutgeerts, W.J. Sandborn, B.G. Feagan, W. Reinisch, A. Olson, J. Johanns, et al.
Infliximab for induction and maintenance therapy for ulcerative colitis.
N Engl J Med, 353 (2005), pp. 2462-2476
[28.]
D. Laharie, A. Bourreille, J. Branche, M. Allez, Y. Bouhnik, J. Filipi, et al.
Cyclosporine versusinfliximab in severe acute ulcerative colitis refractory to intravenous steroids: a randomized trial.
Gastroenterology, 140 (2011), pp. S112
[29.]
Reinisch W, Sandborn WJ, Hommes DW, D’Haens G, Hanauer S, Schreiber S, et al. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut. 60:780-7.
[30.]
W. Sandborn, G. Van Assche, W. Reinisch, J. Colombel, G. D’Haens, D. Wolf, et al.
Induction and maintenance of clinical remission by adalimumab in patients with moderate-to-severe ulcerative colitis.
Gastroenterology, 140 (2011), pp. S123-S124
[31.]
R. Pannaccione, S. Ghosh, S. Middleton, J. Marquez, I. Khalif, L. Flint, et al.
Infliximab, azathioprine, or infliximab plus azathioprine for treatment of moderate to severe ulcerative colitis: The UC Success trial.
Gastroenterology, 140 (2011), pp. S134
[32.]
Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D, et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med. 362:1383-95.
[33.]
J.P. Gisbert, J. Panes.
Loss of response and requirement of infliximab dose intensification in Crohn's disease: a review.
Am J Gastroenterol, 104 (2009), pp. 760-767
[34.]
Guerra I, Chaparro M, Bermejo F, Gisbert JP. Utility of measuring serum concentrations of anti-TNF agents and anti-drug antibodies in inflammatory bowel disease. Curr Drug Metab. 12:594-8.
[35.]
Seow CH, Newman A, Irwin SP, Steinhart AH, Silverberg MS, Greenberg GR. Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis. Gut. 59:49-54.
[36.]
M. Ferrante, V. Ballet, V. Geskens, S. Vermeire, G. Van Assche, A. Gils, et al.
Infliximab for severe iv steroid-refractory ulcerative colitis: can infliximab trough levels guide our management?.
Gastroenterology, 140 (2011), pp. S275-S276
[37.]
L. Targownik, Z. Nugent, C. Bernstein.
The risk of early and late colectomy in patients with ulcerative colitis: Results from a population-based cohort.
Gastroenterology, 140 (2011), pp. S113-S114
[38.]
R. Kachra, M. Bandali, M. Proulx, A. Lim, J. Hubbard, R. Pannaccione, et al.
Long-term complications responsible for hospital readmission following a colectomy for ulcerative colitis: A populationbased analysis.
Gastroenterology, 140 (2011), pp. S770
[39.]
C. Schaufler, T. Lerer, B. Campbell, R. Weiss, J. Cohen, D. Zeiter, et al.
Pre-operative immunosuppression is not associated with increased post-operative complications following colectomy in children with ulcerative colitis.
Gastroenterology, 140 (2011), pp. S91
[40.]
B. Coakley, D. Telem, S. Nguyen, C. Divino.
Prolonged pre-operative hospitalization correlates with worse outcomes after colectomy for acute fulminant ulcerative colitis.
Gastroenterology, 140 (2011), pp. S1004
[41.]
I. Dotan, N. Horowitz, J. Klausner, Z. Halpern, M. Rabau, H. Tulchinsky.
Proctocolectomy and ileal pouch anal anastomosis (IPAA) significantly impairs fertility and pregnancy outcomes in ulcerative colitis (UC) patients.
Gastroenterology, 140 (2011), pp. S788
[42.]
J.A. Eaden, K.R. Abrams, J.F. Mayberry.
The risk of colorectal cancer in ulcerative colitis: a meta-analysis.
Gut, 48 (2001), pp. 526-535
[43.]
J. Gordillo, E. Domènech, J. Panes, F. Gomollon, M. Andreu, M. Peñalva, et al.
Incidence of dysplasia and colorectal cancer in patients with ulcerative colitis included in the Spanish Eneida registry.
Gastroenterology, 140 (2011), pp. S266-S267
[44.]
D. Rubin, P. Koduru, B. Surma, N. Hou.
Frequency of sub-clinical disease activity in ulcerative colitis patients.
Gastroenterology, 140 (2011), pp. S423-S424
[45.]
M. Regueiro, K. Clarke, K. Kip, J. Swoger, M. Saul, A. Barrie, et al.
Endoscopic evidence of active inflammation does not lead physicians to make medication adjustments in ulcerative colitis (UC) patients.
Gastroenterology, 140 (2011), pp. S423
[46.]
M. De Vos, O. Dewit, G. D’Haens, F. Baert, F. Fontaine, S. Vermeire, et al.
Calprotectin as a biomarker for remission in UC patients under IFX therapy.
Gastroenterology, 140 (2011), pp. S276
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