The Crohn’s Disease-Ulcerative Colitis Clinical AppraisalPart II

Academic Content

Publication Overview Introduction Navigating this Publication See Part I

Step 1 -

Rationale and Definition

Step 2 -

International Clinician Survey Results

Step 3 -

Data Review and Faculty Summary

Step 4 -

International and Faculty Survey Comparison and Faculty Discussion

Step 5 -

Dr. Sandborn’s Observed Future Directions and References

Faculty Presentations

Statement 1 Statement 2 Statements
3a and 3b Statement 4 Statement 5 Statement 6 Statement 7 Statement 8

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Clinical Gastroentrology and Hepatology

Dr. Sandborn’s Observed Future Directions

Additional randomized trials evaluating the steroid-sparing properties of integrin antagonists in patients with CD are needed. The possibility that steroids and integrin antagonists might be synergistic for induction therapy should be evaluated in a trial in which patients are randomized to receive steroid monotherapy, monotherapy with an integrin antagonist, or combination therapy with steroids and an integrin antagonist.

References

[1]

Vavricka SR, Schoepfer AM, Scharl M, et al. Steroid use in Crohn's disease. Drugs 2014;74:313-324.

[2]

Plevy SE. Corticosteroid-sparing treatments in patients with Crohn's disease. Am J Gastroenterol. 2002;97:1607-1617.

[3]

Bultman E, Kuipers EJ, van der Woude CJ. Systematic review: steroid withdrawal in anti-TNF-treated patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2010;32:313-323.

[4]

Sandborn WJ, Feagan BG, Rutgeerts P, et al. Vedolizumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2013;369(8):711-721.

[5]

Sandborn WJ, Colombel JF, Enns R, et al. Natalizumab induction and maintenance therapy for Crohn's disease. N Engl J Med. 2005;353(18):1912-1925.

[6]

Kane SV, Horst S, Sandborn WJ, et al. Natalizumab for moderate to severe Crohn's disease in clinical practice: the Mayo Clinic Rochester experience. Inflamm Bowel Dis. 2012;18(12):2203-2208.

[7]

Sakuraba A, Keyashian K, Correia C, et al. Natalizumab in Crohn's disease: Results from a US tertiary inflammatory bowel disease center. Inflamm Bowel Dis. 2013;19:621-626.

[8]

Bloomgren G, Richman S, Hotermans C, et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N Engl J Med. 2012;366:1870-1880.

[9]

Parikh A, Fox I, Leach T, et al. Long-term clinical experience with vedolizumab in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:1691-1699.

[10]

Colombel JF, Sands BE, Rutgeerts P, et al. The safety of vedolizumab for ulcerative colitis and Crohn’s disease. Gut 2016; doi: 10.1136/gutjnl-2015-311079. [Epub ahead of print]

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