Measuring severity of disease and defining treatment benefit using the Simple Endoscopic Activity Score (SES-CD)
|
|
|
- Janel Stanley
- 7 years ago
- Views:
Transcription
1 Measuring severity of disease and defining treatment benefit using the Simple Endoscopic Activity Score (SES-CD) Jean-Frederic COLOMBEL Icahn Medical School at Mount Sinai, New York
2 J-F Colombel has served as consultant or advisory board member for Abbvie, ABScience, Amgen, Bristol Meyers Squibb, Celltrion, Danone, Ferring, Genentech, Giuliani SPA, Given Imaging, Janssen, Immune Pharmaceuticals, Medimmune, Merck & Co., Millenium Pharmaceuticals Inc., Neovacs, Nutrition Science Partners Ltd., Pfizer Inc. Prometheus Laboratories, Protagonist, Receptos, Sanofi, Schering Plough Corporation, Second Genome, Shire, Takeda, Teva Pharmaceuticals, Tigenix, UCB Pharma, Vertex, Dr. August Wolff GmbH & Co. J-F Colombel has served as speaker for Abbvie, Falk, Ferring, Janssen, Merck & Co., Nutrition Science Partners Ltd., Takeda. 2
3 The CDEIS Deep ulcerations 12 points Superficial ulcerations 6 points Surface of ulcerations (0-10 cm) Surface of lesions* (0-10 cm) Ileum 0 or 12 0 or Right colon 0 or 12 0 or Transverse 0 or 12 0 or Left colon 0 or 12 0 or Rectum 0 or 12 0 or TOTAL (sum of all cases) TOTAL/number of explored segments N/ if ulcerated stenosis if nonulcerated stenosis 0-3 CDEIS : 0 to 44 Mary JY et al. Gut 1989 N : pseudopolyp healed ulcer frank erythema frankly swollen mucosa aphtoid ulcers : 2-3mms 3
4 Development of SES-CD The Simple Endoscopic Score for Crohn s Disease (SES-CD), was developed in 2004 and was: an attempt to simplify the CDEIS based on importance and reproducibility of the most relevant endoscopic characteristics of CD. Daperno M et al. Gastrointest. Endosc
5 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Definition - scoring of elementary lesions considered SES-CD values (evaluated for each of the 5 ileo-colonic segments) Variable Size of ulcers Ulcerated surface Affected surface Presence of narrowings Unaffected segment Daperno et al. Gastrointest Endosc
6 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Definition - scoring of elementary lesions considered SES-CD values (evaluated for each of the 5 ileo-colonic segments) Variable Size of ulcers Aphtous ulcers ( 0.1 to 0.5 cm) Large ulcers ( 0.5 to 2 cm) Very large ulcers ( >2 cm) Ulcerated surface Affected surface Unaffected segment Presence of narrowings Daperno et al. Gastrointest Endosc
7 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Definition - scoring of elementary lesions considered SES-CD values (evaluated for each of the 5 ileo-colonic segments) Variable Size of ulcers Aphtous ulcers ( 0.1 to 0.5 cm) Large ulcers ( 0.5 to 2 cm) Very large ulcers ( >2 cm) Ulcerated surface <10% 10-30% >30% Affected surface Presence of narrowings Unaffected segment Daperno et al. Gastrointest Endosc
8 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Definition - scoring of elementary lesions considered SES-CD values (evaluated for each of the 5 ileo-colonic segments) Variable Size of ulcers Aphtous ulcers ( 0.1 to 0.5 cm) Large ulcers ( 0.5 to 2 cm) Very large ulcers ( >2 cm) Ulcerated surface <10% 10-30% >30% Affected surface Presence of narrowings Unaffected segment <50% 50-75% >75% Daperno et al. Gastrointest Endosc
9 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Definition - scoring of elementary lesions considered SES-CD values (evaluated for each of the 5 ileo-colonic segments) Variable Size of ulcers Aphtous ulcers ( 0.1 to 0.5 cm) Large ulcers ( 0.5 to 2 cm) Very large ulcers ( >2 cm) Ulcerated surface <10% 10-30% >30% Affected surface Unaffected segment <50% 50-75% >75% Presence of narrowings Single, can be passed Multiple, can be passed Cannot be passed Daperno et al. Gastrointest Endosc 2004 Daperno et al. Gastrointest Endosc 2004; 60:
10 THE SIMPLE ENDOSCOPIC SCORE FOR CD (SES-CD) Ileum Right colon Transverse colon Left colon Rectum Total Presence and size of ulcers (0-3) Extent of ulcerated surface (0-3) Extent of affected surface (0-3) Presence and type of narrowings (0-3) SES-CD = 0-56 Daperno et al. Gastrointest Endosc
11 Correlation between CDEIS and SES-CD Sipponen T et al. Inflam Bowel Dis
12 Definition of endoscopic severity using SES-CD Endoscopic severity with SES-CD (in 4 of 11 studies)* : remission (inactive) (0-2) mild inflammation (3-6) moderate inflammation (7-15) severe inflammation (> or =16) * In total 6 different cut-off definitions, but 6 of 11 studies used similar cutoffs Vuiiton L et al. in preparation 12
13 SES-CD grading vs CDEIS grading SES-CD overestimates severity vs CDEIS in inactive / mild CD Sipponen T et al. Inflam Bowel Dis
14 Definition of endoscopic response with SES-CD Authors Journal Year Definition of response Sipponen et al. Scand J Gastroenterol 2010 A partial response as a one-class change in the SES-CD (inactive 0-2; mild 3-6; moderate 7-15; severe > or =16) Ferrante et al. (SONIC post hoc) Gastroenterology 2013 Decrease from baseline in SES-CD of at least 50%. Grover et al. J Gastroenterol 2014 Absolute score SES-CD 0-3 was defined as a response 14
15 Endoscopic response at wk 26 predicts corticoid-free remission at wk 50 in CD (SONIC) Roc Curve for detecting corticoid-free remission at wk 50 using the SES-CD % reduction from baseline to wk 26 Roc Curve for detecting corticoid-free remission at wk 50 using the CDEIS % reduction from baseline to wk 26 Endoscopic response (defined as a decrease from baseline in SES-CD or CDEIS of at least 50%) at week 26 identified patients most likely to be in CFREM at week 50 Ferrante M, et al. Gastroenterology;
16 Definition of endoscopic response with SESCD Endoscopic response using SES-CD* A decrease from baseline in SES-CD of at least 50%. 1 * In total 3 different definitions in 3 studies 1 Ferrante et al. GASTROENTEROLOGY
17 Definition of endoscopic remission using SES-CD Authors Journal Year Definition of Remission Moskovitz et al. Gastroenterology 2007 score 0 Sipponen et al. Aliment Pharmacol Ther 2008 score <3 Baert et al. Gastroenterology 2010 score 0 Sipponen et al. Scand J Gastroenterol 2010 score 0 2 or a two- or three-class decrease in the SES-CD from the baseline score ( i.e. change from endoscopically severely active disease to mildly active or inactive or from moderately active to inactive). Aomatsu et al. Aliment Pharmacol Ther 2011 score 0 Aomatsu et al. Dig Dis Sci 2011 score 0 af Björkesten et al. Scand J Gastroenterol 2013 score 0-2 Molander et al. J Crohns Colitis 2013 score 0-2 Beigel et al. PLoS One 2014 score 0 Fukuchi et al. BMC Gastroenterol 2014 score 0 Yüksel et al. Turk J Gastroenterol 2014 score 0-2 Yu et al. J Dig Dis 2014 score 0 Schaffer et al. J Crohns Colitis 2014 score 0-3 Dignass et al. J Crohns Colitis 2014 score 0 17
18 Definition of endoscopic remission/mh using SES-CD Endoscopic remission/mh most frequently defined as* SES-CD score 0 (8 studies) or SES-CD score 0-2 (4 studies) * In total 4 different cut-off definitions in 14 studies 18
19 IOIBD recommendations on endoscopic indices Methods of the IOIBD Consensus 12 IBD experts from 9 countries Literature reviewing Extracted definitions of endoscopic outcome parameters for remission and response in UC and CD Delphi process based on an internet survey At each voting step, participants blinded from others Vuiiton L et al. in preparation 19
20 IOIBD recommendations on endoscopic response For the definition of endoscopic response in CD retained for vote were : 1. Any improvement in edema, erythema, ulcers and strictures 2. Only mucosal patchy erythema or superficial ulceration ; 3. Near complete healing: erosions if previous large ulcers/partial healing if >33% reduction in ulcer size 4. Decrease in CDEIS (with no definition) 5. Decrease in CDEIS > 5 6. Decrease in SES-CD (ND) 7. Decrease in CDEIS of at least 3 points 8. >75 % decrease in CDEIS 9. > 50% decrease in SES-CD or CDEIS 10. Decrease in CDEIS > 4 or 5 20
21 IOIBD recommendations on endoscopic response For the 10 proposed definitions of endoscopic response in CD at the first vote 11 out of 12 investigators ranked first > 50% decrease in SES-CD No second round was organized due to the high agreement in the first voting round. 21
22 IOIBD recommendations on endoscopic remission 1. For definition of endoscopic remission in CD: 1. Physician assessment of endoscopic healing 2. Absence of edema, erythema, ulcers and strictures 3. No lesion, only scarred lesions, or minor lesions with no deep ulceration 4. Normal mucosa, scarring or pseudo polyps 5. Complete healing : no endoscopic lesion 6. Near complete healing: only aphtous ulcers <5mm 7. Endoscopic remission :CDEIS < 6 / Complete endoscopic remission : CDEIS <3 8. Absence of ulceration 9. Complete healing: resolution of all lesions/ Near complete healing :occasional aphthae, residual erosion, thickened folds 10. SES-CD : CDEIS score of 4 or less 12. CDEIS < 6 or 7 * No proposed definition of SES-CD = 0 22
23 IOIBD recommendations on endoscopic remission For the 12 proposed definitions of endoscopic remission in CD, the four definitions with the highest rank after the 1 st vote were : (1) SES-CD 0-2 (2) remission: CDEIS < 6 / complete remission : CDEIS <3 (3) absence of ulceration (4) CDEIS score of 4 or less. At the second vote the highest median score was : SES-CD 0-2 (median1, mean1.33, SD 0.49), with 100 % of the experts ranking this definition first or second. 23
Choosing Outcome Measures in Pediatric IBD. Anne M Griffiths, MD Hospital for Sick Children University of Toronto Toronto, Canada
Choosing Outcome Measures in Pediatric IBD Anne M Griffiths, MD Hospital for Sick Children University of Toronto Toronto, Canada Disclosures The content of this presentation reflect my personal opinions
Evidence of Crohn s Disease. Case Presentation
Witt Wait to Treat tutiled Until Endoscopic Evidence of Crohn s Disease Raymond Cross, MD, MS, AGAF Associate Professor of Medicine Director, IBD Program University of Maryland School of Medicine Co-Director,
Endoscopy is an important diagnostic and therapeutic
ORIGINAL ARTICLE Appropriateness and Diagnostic Yield of Colonoscopy in the Management of Patients with Ulcerative Colitis: A Prospective Study in an Open Access Endoscopy Service Gianpiero Manes, MD,
Ulcerative colitis patients with low grade dysplasia should undergo frequent surveillance colonoscopies
Ulcerative colitis patients with low grade dysplasia should undergo frequent surveillance colonoscopies David T. Rubin, MD, FACG, AGAF Associate Professor of Medicine Co-Director, Inflammatory Bowel Disease
Decision systems in quality registries
Decision systems in quality registries Stockholm Dec 9 th, 2014 Jonas Halfvarson, MD, PhD Dept of Gastronterology, Faculty of Medicine and Health, Örebro University 1 Quality registries for chronic diseases
TREAT TO TARGET: A PROPOSED NEW PARADIGM FOR THE MANAGEMENT OF CROHN S DISEASE. Universitaire Pontchaillou et université de Rennes 1, Rennes, France
TREAT TO TARGET: A PROPOSED NEW PARADIGM FOR THE MANAGEMENT OF CROHN S DISEASE Short title: Treat to target in Crohn s disease Guillaume Bouguen 1,2, Barrett G. Levesque 1, Brian G. Feagan 3, Arthur Kavanaugh
IBD: Ulcerative Colitis Monday, February 10, 2014 The Fairmont Royal York Toronto, ON
IBD: Ulcerative Colitis Monday, February 10, 2014 The Fairmont Royal York Toronto, ON Accreditation This event has been approved as an accredited (Section1) group learning activity as defined by the Maintenance
TREATING INFLAMMATORY BOWEL DISEASE (IBD) BACKGROUNDER
Press information for journalists only TREATING INFLAMMATORY BOWEL DISEASE (IBD) BACKGROUNDER Why treat IBD? IBD describes a range of chronic diseases of the gastrointestinal system, encompassing Ulcerative
What are the Unmet Needs in the Management of IBD?
23/6/214 What are the Unmet Needs in the Management of IBD? Shane Devlin, MD, FRCPC Inflammatory Bowel Disease Group The University of Calgary Some Real Cases: #1 32 yo male with pan UC. Grumbling phenotype
Inflammatory Bowel Disease 2012
Inflammatory Bowel Disease 2012 Caren Corrigan, NP C Suburban Gastroenterology Naperville, Illinois Diagnostic Evaluation of Crohn s Disease and Ulcerative Colitis Objectives 1. Describe and differentiate
Proposal to Establish the Crohn s and Colitis Center at the University of Miami Miller School of Medicine
Proposal to Establish the Crohn s and Colitis Center at the University of Miami Miller School of Medicine Contents Mission... 1 Background... 2 Services and Programs... 2 Clinical Care... 2 IBD Specialists...
Risk stratification for colorectal cancer especially: the difference between sporadic disease and polyposis syndromes. Dr. med. Henrik Csaba Horváth
Risk stratification for colorectal cancer especially: the difference between sporadic disease and polyposis syndromes Dr. med. Henrik Csaba Horváth Why is risk stratification for colorectal cancer (CRC)
Telemedinsk udvikling
F A C UL T Y O F HE AL T H A ND ME D I C A L S C I E N C E S U N I V E R S I T Y O F C O P E N H A G E N Telemedinsk udvikling Motivational Interviewing Sygeplejerskens rolle - i centrum af ehealth Fagligt
Crohn s and Colitis Foundation of Canada / Vertex Pharmaceuticals. Sponsored Research Program in Inflammatory Bowel Disease
Crohn s and Colitis Foundation of Canada / Vertex Pharmaceuticals Sponsored Research Program in Inflammatory Bowel Disease Presentation Overview Background on inflammatory bowel disease Partner Overview
11/10/2014. New Treatments in IBD: When, Whom and How. Background. Background. Options. Disease Assessment. What is the evidence?
New Treatments in IBD: When, Whom and How. Background Options Disease Assessment What is the evidence? Kofi Clarke MD, FACP,FRCP (Lond) Clinical Associate Professor, Chief, Gastroenterology, Hepatology
Leukapheresis for inflammatory bowel disease
Issue date: June 2005 Leukapheresis for inflammatory bowel disease Understanding NICE guidance information for people considering the procedure, and for the public Information about NICE Interventional
Understanding Colitis and Crohn s Disease
Improving life for people affected by Colitis and Crohn s Disease Understanding Colitis and Crohn s Disease 1 Understanding Colitis and Crohn s Disease Understanding Ulcerative Colitis and Crohn s Disease...
ESD for colorectal lesions I am in favour. Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy
ESD for colorectal lesions I am in favour Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy Surgery for early colonic lesions 51 pts referred for lap colectomy
How To Treat Colitis With A Combination Of Antibiotics
18 Simposio annuale ELAS-LIGAND LIGAND ASSAY 2012 LE MALATTIE INFIAMMATORIE INTESTINALI Aspetti Fisiopatologici e Clinici Giovanni Maconi Cattedra di Gastroenterologia Dipartimento di Scienze Biomediche
Top Down vs. Step Up Therapy Biologics in IBD: Treatment Algorithms. Stephen B. Hanauer, M.D. University of Chicago
Top Down vs. Step Up Therapy Biologics in IBD: Treatment Algorithms Stephen B. Hanauer, M.D. University of Chicago Treatment Goals c.2008 Induce and maintain response/remission Prevent complications Disease
Gastrointestinal Bleeding
Gastrointestinal Bleeding Introduction Gastrointestinal bleeding is a symptom of many diseases rather than a disease itself. A number of different conditions can cause gastrointestinal bleeding. Some causes
an average period of 16 months, varying from three to 55 months. Pain was rarely severe and was a prominent symptom but it was not possible to
Gut, 1970, 11, 1001-1006 Crohn's disease of the stomach and duodenum J. F. FIELDING, D. K. M. TOYE, D. C. BETON, AND W. T. COOKE The Nutritional and Intestinal Unit and the Department of Radiology, The
6 th Proactive GCP Compliance Effective Risk- Based Approaches for Optimizing Clinical Quality
6 th Proactive GCP Compliance Effective Risk- Based Approaches for Optimizing Clinical Quality March 24-25, 2015 Wyndham Philadelphia Historic District, Philadelphia, PA www.exlevents.com/gcp Sponsors
Early Colonoscopy in Patients with Acute Diverticulitis Simon Bar-Meir, M.D.
Early Colonoscopy in Patients with Acute Diverticulitis Simon Bar-Meir, M.D. Professor of Medicine Germanis Kaufman Chair of Gastroenterology Director, Dept. of Gastroenterology Chaim Sheba Medical Center,
Complications that may occur with ulcerative colitis:
Ulcerative Colitis What is ulcerative colitis? Ulcerative colitis is one of the major forms of inflammatory bowel disease. The other major form is Crohn s disease. Ulcerative colitis is felt to be due
Medical Therapy for IBD
CHILDREN S DIGESTIVE HEALTH & NUTRITION FOUNDATION NORTH AMERICAN SOCIETY FOR PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION Medical Therapy for IBD I. INTRODUCTION The treatment of Crohn s disease
Evolution of Barrett s esophagus
Endoscopic Treatment and Surveillance of Esophageal Cancer: GI Perspective Charles J. Lightdale, MD Columbia University New York, NY Evolution of Barrett s esophagus Squamous esophagus Chronic inflammation
improving lives through collaborative medicine
improving lives through collaborative medicine ImproveCareNow is a collaborative chronic care network of 77 care centers in 35 states and the District of Columbia and England, where clinicians, researchers,
2. FRAGESTELLUNGEN DER VORGESTELLTEN ARBEITEN 26. 3.1 Wirksamkeit der Akupunktur bei ausgewählten Schmerzerkrankungen
2. FRAGESTELLUNGEN DER VORGESTELLTEN ARBEITEN 26 3 RELEVANTE ORIGINALARBEITEN 3.1 Wirksamkeit der Akupunktur bei ausgewählten Schmerzerkrankungen Brinkhaus B, Becker-Witt C, Jena S, Linde K, Streng A,
Learning Luncheon 7: Endoscopic Mucosal Resection: When, Where and How?
Endoscopic Mucosal Resection (EMR): When, Where, and Charles J. Lightdale, MD Columbia University New York, NY Endoscopic Mucosal Resection (EMR) EMR developed for removal of sessile or flat neoplasms
These parameters cannot, at the present time, be determined by non-invasive imaging techniques.
Endoscopic Mucosal Resection for Upper Gastrointestinal Lesions Kenneth K. Wang, M.D. Chairman, WEO Publication and Guidelines Committee Professor of Medicine, Mayo Clinic Rochester, Minnesota Upper gastrointestinal
In vitro co-culture model of the inflamed intestinal mucosa
In vitro co-culture model of the inflamed intestinal mucosa Berlin, December 13, 2011 Eva-Maria Collnot, e.collnot@mx.uni-saarland.de Helmholtz Institute for Pharmaceutical Research Saarland Departement
CHEM-E4140 Selectivity 12. Pharma Business
CHEM-E4140 Selectivity 12. Pharma Business Prof. Ari Koskinen Laboratory of Organic Chemistry C318 Pharma Business Total volume ca 1100 G$ (Shell 421G$; Walmart 486G$; Toyota 252 G$). Annually approx 25
Optional Friday Courses / ACG s 2015 Three-Day Clinical Review
GI Pathophysiology Course Friday, October 16, 2015 6:30 am 11:30 am 310 Theater Course Director: Michael F. Vaezi, MD, PhD, MSc(Epi), FACG ACG Members/Fellows: $200 ACG Resident/Trainee/Candidate Members:
Crohn's disease and pregnancy.
Gut, 1984, 25, 52-56 Crohn's disease and pregnancy. R KHOSLA, C P WILLOUGHBY, AND D P JEWELL From the Gastroenterology Unit, Radcliffe Infirmary, Oxford SUMMARY Infertility and the outcome of pregnancy
Colorectal Cancer Screening: Update on Bowel Preps
Colorectal Cancer Screening: Update on Bowel Preps What we don t want What we want Frank Friedenberg, MD, MS (Epi) Professor, Gastroenterology t Temple University School of Medicine 5 Modified Aronchick
Inflammatory Bowel Disease. (Ulcerative Colitis and Crohn s Disease)
Ministry of Defence Synopsis of Causation Inflammatory Bowel Disease (Ulcerative Colitis and Crohn s Disease) Authors: Dr Hazel Younger, Ninewells Hospital and Medical School, Dundee and Dr Craig Mowat,
Colorectal cancer is the second leading cause of cancer-related. Colonoscopic Miss Rates for Right-Sided Colon Cancer: A Population-Based Analysis
GASTROENTEROLOGY 2004;127:452 456 Colonoscopic Miss Rates for Right-Sided Colon Cancer: A Population-Based Analysis BRIAN BRESSLER,* LAWRENCE F. PASZAT,, CHRISTOPHER VINDEN,, CINDY LI, JINGSONG HE, and
Focus Biobank Inflammatory Bowel Disease
Focus Biobank Inflammatory Bowel Disease University Hospitals Leuven KU Leuven Isabelle Cleynen, PhD Inflammatory Bowel Disease Crohn s disease (CD) Entire GI tract Transmural Fistulas and/or strictures
AMERICAN VENOUS FORUM
Revised Venous Clinical Severity Score AMERICAN VENOUS FORUM Pain : 0 Mild: 1 or other discomfort (ie, aching, heaviness, fatigue, soreness, burning) origin Occasional pain or other discomfort (ie, not
Quality Colonoscopy in US and Europe: How Are They Moving?
Symposium Symposium III - Lower GI : Quality Colonoscopy Quality Colonoscopy in US and Europe: How Are They Moving? Jae Myung Cha Department of Internal Medicine, Kyung Hee University Hospital at Gangdong,
ACT-RAY and MRI substudy
Tocilizumab as Monotherapy or in Combination With Methotrexate associated with Early Reductions in Tissue Inflammation: 12-Week Results From a Magnetic Resonance Imaging Substudy of a Randomized Controlled
Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP
SCREENING EXAMINATION & COUNSELING UPMC Health Plan Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Annually Physical Exam and Counseling 1 Blood Pressure 2 At each visit. At least
Crohn s Disease. What is Crohn s Disease? ho gets Crohn s Disease? hat are the symptoms? What causes Crohn s Disease?
In association with: Primary Care Society for Gastroenterology INFORMATION ABOUT Crohn s Disease What is Crohn s Disease? ho gets Crohn s Disease? What causes Crohn s Disease? hat does it do to the intestine?
EMR Can anyone do this?
EMR Can anyone do this? Norio Fukami, MD University of Colorado Piecemeal resection? 1 Endoscopic mucosal resection (EMR) and Endoscopic submucosal dissection (ESD) Endoscopic removal of premalignant or
JAK1 and beyond. Investor Presentation January 2014. Copyright 2014 Galapagos NV
JAK1 and beyond Investor Presentation January 2014 Copyright 2014 Galapagos NV Disclaimer This presentation has been prepared by Galapagos and is furnished to you by Galapagos solely for your information.
Terapia con farmaci biologici e non nella. Sandro Ardizzone. Azienda Ospedaliera Fatebenefratelli e. Ospedale di Rilievo Nazionale Milan
Terapia con farmaci biologici e non nella Colite Ulcerosa Severa/Refrattaria Sandro Ardizzone Gastrointestinal Unit Azienda Ospedaliera Fatebenefratelli e Oftalmico Ospedale di Rilievo Nazionale Milan
Diseases of the Colon. Jack Bragg, D.O., F.A.C.O.I.
Diseases of the Colon Jack Bragg, D.O., F.A.C.O.I. Inflammatory Bowel Disease ULCERATIVE COLITIS CROHN S DISEASE Transmural Inflammation Mucosal Ulceration in Colon Ileitis Ileocolitis Colitis Inflammatory
Laparoscopic Surgery of the Colon and Rectum (Large Intestine) A Simple Guide to Help Answer Your Questions
Laparoscopic Surgery of the Colon and Rectum (Large Intestine) A Simple Guide to Help Answer Your Questions What are the Colon and Rectum? The colon and rectum together make up the large intestine. After
Colonoscopy Data Collection Form
Identifier: Sociodemographic Information Type: Zip Code: Gender: Height: (inches) Race: Ethnicity Inpatient Outpatient Male Female Birth Date: Weight: (pounds) American Indian (Native American) or Alaska
Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome
Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome Andrew T. Gewirtz et al N A T U R E VOL 519 5 M A R C H 2 0 1 5 Background Incidence of IBD Fact 1: increasing
Acute Lower Gastrointestinal Bleeding in Crohn s Disease: Characteristics of a Unique Series of 34 Patients
THE AMERICAN JOURNAL OF GASTROENTEROLOGY Vol. 94, No. 8, 1999 1999 by Am. Coll. of Gastroenterology ISSN 0002-9270/99/$20.00 Published by Elsevier Science Inc. PII S0002-9270(99)00347-0 Acute Lower Gastrointestinal
How to report Upper GI EMR/ESD specimens
Section of Pathology and Tumour Biology How to report Upper GI EMR/ESD specimens Dr.H.Grabsch Warning. Most of the criteria, methodologies, evidence presented in this talk are based on studies in early
Management of the new antiplatelets and anticoagulants
Management of the new antiplatelets and anticoagulants Session No.: 1 Name: C. Boustiere, T Ponchon Guidelines : Anti-thrombotic agents and digestive endoscopy 2006 : French guideline (SFED) 2007 : Japanese
Briefing Document. Food and Drug Administration. Center for Drug Evaluation and Research
Briefing Document Food and Drug Administration Center for Drug Evaluation and Research Meeting: Joint Meeting of the Gastrointestinal Drugs Advisory Committee (GIDAC) and the Drug Safety and Risk Management
The Forzani MacPhail Colon Cancer Screening Centre Frequently Asked Questions. What is the Forzani MacPhail Colon Cancer Screening Centre?
The Forzani MacPhail Colon Cancer Screening Centre Frequently Asked Questions What is the Forzani MacPhail Colon Cancer Screening Centre? The Forzani and MacPhail Colon Cancer Screening Centre (CCSC) is
Research in IBD at University of Colorado Denver
Research in IBD at University of Colorado Denver Blair Fennimore, MD Assistant Professor of Medicine Division of Gastroenterology and Hepatology UCH Crohn s and Colitis Center Mucosal Inflammation Program
www.ijramr.com International Journal of Recent Advances in Multidisciplinary Research Vol. 02, Issue 12, pp.1016-1022, December, 2015
sz www.ijramr.com International Journal of Recent Advances in Multidisciplinary Research Vol. 02, Issue 12, pp.1016-1022, December, 2015 RESEARCH ARTICLE EVALUATION OF VALIDITY OF ULCERATIVE COLITIS ENDOSCOPIC
Clinical question: what is the role of colonoscopy in the diagnosis of ischemic colitis?
Clinical question: what is the role of colonoscopy in the diagnosis of ischemic colitis? Filtered resources,, which appraise the quality of studies and often make recommendations for practice, include
Classification of gastritis. Pieter Demetter Department of Pathology Erasme University Hospital, Brussels
Classification of gastritis Pieter Demetter Department of Pathology Erasme University Hospital, Brussels The broad spectrum of gastritis General agreement on morphological aspects Great variety of names
Probiotics for the Treatment of Adult Gastrointestinal Disorders
Probiotics for the Treatment of Adult Gastrointestinal Disorders Darren M. Brenner, M.D. Division of Gastroenterology Northwestern University, Feinberg School of Medicine Chicago, Illinois What are Probiotics?
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Multiple Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Multiple Technology Appraisal Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional
http://www.ncbi.nlm.nih.gov/pubmedhealth/pmh0001295/?report=printable
of 13 Crohn's disease - PubMed Health PubMed Health. A service of the National Library of Medicine, National Institutes of Health. A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011. Crohn's disease
A Phase 2 Study of Interferon Beta-1a (Avonex ) in Ulcerative Colitis
A Phase 2 Study of (Avonex ) in Ulcerative Colitis - Study Results - ClinicalTrials.gov A Phase 2 Study of (Avonex ) in Ulcerative Colitis This study has been completed. Sponsor: Biogen Idec Information
Change in Incidence of Crohn s Disease and Ulcerative Colitis in Denmark. A Study Based on the National Registry of Patients, 1981 1992
International Journal of Epidemiology International Epidemiological Association 1997 Vol. 26, No. 5 Printed in Great Britain Change in Incidence of Crohn s Disease and Ulcerative Colitis in Denmark. A
Low-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity
Low-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Disclosures : None 77-year-old woman, mild dyspnea
Arthritis and Rheumatology Clinics of Kansas Patient Education. Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis
Arthritis and Rheumatology Clinics of Kansas Patient Education Reactive Arthritis (ReA) / Inflammatory Bowel Disease (IBD) Arthritis Introduction: For as long as scientists have studied rheumatic disease,
ID: C13006 Study of Vedolizumab (MLN0002) in Patients With Moderate to Severe Ulcerative Colitis NCT00783718 Results Preview Close
Home > Record Summary > Results Section ID: C13006 Study of Vedolizumab (MLN0002) in Patients With Moderate to Severe Ulcerative Colitis NCT00783718 Results Preview Close Hide All Participant Flow Participants
The utility of endoscopic ultrasonography and endoscopy in the endoscopic mucosal resection of early gastric cancer
Gut 1999;45:599 604 599 The utility of endoscopic ultrasonography and endoscopy in the endoscopic mucosal resection of early gastric cancer S Ohashi, K Segawa, S Okamura, M Mitake, H Urano, M Shimodaira,
EVIDENCE BASED TREATMENT OF CROHN S DISEASE. Dr E Ndabaneze
EVIDENCE BASED TREATMENT OF CROHN S DISEASE Dr E Ndabaneze PLAN 1. Case presentation 2. Topic on Evidence based Treatment of Crohn s disease - Introduction pathology aetiology - Treatment - concept of
Classification of Inflammation Activity in Ulcerative Colitis by Confocal Laser Endomicroscopy
nature publishing group ORIGINAL CONTRIBUTIONS 1391 Classification of Inflammation Activity in Ulcerative Colitis by Confocal Laser Endomicroscopy Chang-Qing Li, PhD1, X i ang - Ju n X i e, PhD 1, 2, Ta
Crohn s Disease. What I need to know about. U.S. Department of Health and Human Services
What I need to know about Crohn s Disease NATIONAL INSTITUTES OF HEALTH National Digestive Diseases Information Clearinghouse U.S. Department of Health and Human Services What I need to know about Crohn
Clinical Report. Copyright 2007 by Lippincott Williams & Wilkins.Unauthorized reproduction of this article is prohibited.
Journal of Pediatric Gastroenterology and Nutrition 44:653 674 # 2007 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,
Bridging Techniques. What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS
Bridging Techniques What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS Associate Professor of Surgery Assistant Program Director, General Surgery Residency Disclosures
PHARMACOLOGIC MANAGEMENT FOR INFLAMMATORY BOWEL DISEASE: ULCERATIVE COLITIS & CROHN S DISEASE
PHARMACOLOGIC MANAGEMENT FOR INFLAMMATORY BOWEL DISEASE: ULCERATIVE COLITIS & CROHN S DISEASE Joseph Reilly, B.S., Pharm.D. Residency Program Director / Clinical Specialist AtlantiCare Regional Medical
CROHN S DISEASE: THE INDIAN PERSPECTIVE
CROHN S DISEASE: THE INDIAN PERSPECTIVE 8 : 1 Sanjay Bandyopadhyay, Kolkata INTRODUCTION Crohn s disease (CD) encompasses a multisystem group of disorders with specific clinical and pathological features
By Anne C. Travis, M.D., M.Sc. and John R. Saltzman, M.D., FACG Brigham and Women's Hospital Harvard Medical School Boston, MA
SMALL BOWEL BLEEDING: CAUSES, DIAGNOSIS AND TREATMENT By Anne C. Travis, M.D., M.Sc. and John R. Saltzman, M.D., FACG Brigham and Women's Hospital Harvard Medical School Boston, MA 1. What is the small
Cancer of the Cardia/GE Junction: Surgical Options
Cancer of the Cardia/GE Junction: Surgical Options Michael A Smith, MD Associate Chief Thoracic Surgery Center for Thoracic Disease St Joseph s Hospital and Medical Center Phoenix, AZ Michael Smith, MD
American College of Gastroenterology Educational Affairs Committee 2015 Conflicts of Interest
American College of Gastroenterology Educational Affairs Committee 2015 Conflicts of Interest The American College of Gastroenterology (ACG) is accredited by the Accreditation Council for Continuing Medical
IBS TREATMENT CENTER
IBS TREATMENT CENTER NEWSLETTER JUNE 2010 IN THIS ISSUE 1...Treating Ulcerative Colitis and Crohn s Diseaase 2...Treating UC and Crohn s continued 2...Announcements 3...Annoucements 4...Dr. Wangen s Scheduled
Lawyers / Attorneys: Evaluation of Nationwide Accutane Accidents, Injuries & Death
The Fox Law Firm is Reviewing Potential ACCUTANE Claims. In the United States, jury trials have awarded at least $33 million dollars to patients as compensation for injuries attributed to Accutane use.
UPDATED INVESTOR PRESENTATION June 2015
UPDATED INVESTOR PRESENTATION June 2015 Forward-looking Statements All statements in this presentation other than those of historical fact, including statements regarding our clinical development plans
Crohn's disease and ulcerative colitis
Crohn's disease and ulcerative colitis Summary Crohn s disease and ulcerative colitis are collectively known as inflammatory bowel disease (IBD). Crohn s disease can appear in any part of a person s digestive
Physician. Patient COLECTOMY COLECTOMY. Treatment Options Risks and Benefits Experience and Skill
COLECTOMY Physician Treatment Options Risks and Benefits Experience and Skill Patient Personal Preferences Values and Concerns Lifestyle Choices Shared Decision Making A process of open communication.
Crohn s Disease. From research to bedside
Crohn s Disease From research to bedside Primary Care Of The Crohn s Disease Patient Primary Physician s Concerns Vaccination Cancer Cervical Skin Osteoporosis Problems Associated With Vaccinating The
Objective tumor response and RECIST criteria in cancer clinical trials Jian Yu, I3, Indianapolis, Indiana
Paper PO01 Objective tumor response and RECIST criteria in cancer clinical trials Jian Yu, I3, Indianapolis, Indiana Abstract Objective tumor response is one of primary endpoints for efficacy in cancer
BOLT Hem/Onc Thought Leader Panel #38 Cancer Immunotherapy 2014-05
Syndicated Thought Leader Insight Healthcare & Pharmaceutical Research Cancer Immunotherapy Melanoma, Non- Small Cell Lung Cancer, Renal Cell Carcinoma Thought Leader Panel #38 2014-05 Therapeutic Area:
Pharma working capital performance highly variable
April 2014 Pharma working capital performance highly variable 41 Billion in Excess Working Capital We last completed this survey in 2012. We expected that there would be a broad improvement across the
Wireless Capsule Endoscopy Corporate Medical Policy
Wireless Capsule Endoscopy Corporate Medical Policy File name: Wireless Capsule Endoscopy File code: UM.DIAG.06 Origination: 10/2004 Last Review: 03/2014 (ICD-10 remediation and CPT update only) Next Review:
Citation Intestinal Research, 2015, v. 13 n. 3, p. 208-212. Creative Commons: Attribution 3.0 Hong Kong License
Title Optimization of Inflammatory Bowel Disease Cohort Studies in Asia Author(s) Leung, WK Citation Intestinal Research, 2015, v. 13 n. 3, p. 208-212 Issued Date 2015 URL http://hdl.handle.net/10722/211825
Roche s RoACTEMRA improved rheumatoid arthritis signs and symptoms significantly more than adalimumab as single-agent therapy
Media Release Basel, 6 June 2012 Roche s RoACTEMRA improved rheumatoid arthritis signs and symptoms significantly more than adalimumab as single-agent therapy Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced
Approach to Cut Up Large Intestine. Prof Geraint Williams Wales College of Medicine Cardiff University
Approach to Cut Up Large Intestine Prof Geraint Williams Wales College of Medicine Cardiff University Inflammatory Conditions Neoplasia Resection Specimens Polyps and Local Resections Before You Start
GUIDELINE Sinusitis. David M. Poetker MD, MA Associate Professor. Division of Rhinology and Sinus Surgery
GUIDELINE Sinusitis David M. Poetker MD, MA Associate Professor Division of Rhinology and Sinus Surgery Guideline Fokkens et al. The European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinology.
Opportunistic Infections Related to Immune Suppressant and Biologic Drug Therapy in IBD
Opportunistic Infections Related to Immune Suppressant and Biologic Drug Therapy in IBD Raymond Cross, M.D., M.S., AGAF Associate Professor of Medicine Director of the Inflammatory Bowel Disease Program
New Research in Ulcerative Colitis: Optimizing 5-ASA Administration for Efficacy and Adherence
J a n u a r y 2 0 1 0 w w w. c l i n i c a l a d v a n c e s. c o m V o l u m e 6, I s s u e 1, S u p p l e m e n t 1 New Research in Ulcerative Colitis: Optimizing 5-ASA Administration for Efficacy and
Histopathology of Crohn s disease and ulcerative colitis
18 Histopathology of Crohn s disease and ulcerative colitis K. Geboes SUMMARY BOX Goal To review the important histologic features required for the diagnosis, assessment of disease activity and early detection
Inflammatory Bowel Disease
Inflammatory Bowel Disease Laboratory Support of Diagnosis and Management CLINICAL BACKGROUND Inflammatory bowel disease (IBD), which includes Crohn disease (CD) and ulcerative colitis (UC), is characterized
Colocutaneous Fistula. Disclosures
Colocutaneous Fistula Madhulika G. Varma MD Associate Professor Chief, Colorectal Surgery University of California, San Francisco Honoraria Applied Medical Covidien Disclosures 1 Colocutaneous Fistula
What is Barrett s esophagus? How does Barrett s esophagus develop?
Barrett s Esophagus What is Barrett s esophagus? Barrett s esophagus is a pre-cancerous condition affecting the lining of the esophagus, the swallowing tube that carries foods and liquids from the mouth
Key Findings. Use this report to... The Autoimmune Market Outlook to 2013
Key Findings The global autoimmune market generated sales of $31.9bn in, an increase of 14.4% over 2006 sales. The market is forecast to grow at a CAGR of 8.1% to reach a total value of $51.0bn in 2013.