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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

229
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
229
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

223
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
223
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

258
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
258
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

197
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
197
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

301
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
301
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

175
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
175

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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
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Racial Difference in Efficacy of Golimumab in Ulcerative Colitis.

Ruby Greywoode1, Francesca Petralia2, Thomas A Ullman1

  • 1Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Inflammatory Bowel Diseases
|August 1, 2022
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Summary

Racial minority groups with ulcerative colitis showed lower response rates to golimumab, a biologic treatment. These findings highlight potential disparities in IBD treatment outcomes.

Keywords:
TNF antagonistbiologicsinflammatory bowel diseaserace

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Area of Science:

  • Gastroenterology
  • Clinical Pharmacology
  • Health Disparities

Background:

  • Previous research indicates racial variations in inflammatory bowel disease (IBD) genetics, clinical features, and patient outcomes.
  • The impact of race on the efficacy of biologic therapies for IBD remains largely undetermined.

Purpose of the Study:

  • This study aimed to investigate whether race influences the response to golimumab in patients with ulcerative colitis.
  • A post hoc analysis of clinical trial data was conducted to evaluate racial differences in treatment response.

Main Methods:

  • Individual-level data from phase 2 and 3 randomized clinical trials of golimumab in ulcerative colitis were pooled and analyzed.
  • Clinical response, remission, and endoscopic healing were assessed using multivariable logistic regression, comparing White participants with racial minority groups.

Main Results:

  • Racial minority groups (18% in induction, 17% in maintenance trials) demonstrated significantly lower rates of clinical response, remission, and endoscopic healing compared to White participants at both week 6 and week 30.
  • No significant racial differences were observed in placebo response rates, suggesting a specific effect on golimumab efficacy.

Conclusions:

  • Patients with ulcerative colitis from racial minority groups experienced diminished clinical response, remission, and endoscopic healing with golimumab treatment.
  • Further research is essential to elucidate the underlying reasons for these racial disparities in therapeutic response within IBD management.