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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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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...
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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...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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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...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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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...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

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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...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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

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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...
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Refractory Checkpoint Inhibitor Colitis Responsive to Ustekinumab.

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Immune checkpoint inhibitors can cause severe colitis. Ustekinumab effectively treated a refractory case of pembrolizumab-induced colitis after other therapies failed, offering new hope for patients.

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Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) revolutionized cancer therapy but can induce immune-related adverse events, notably colitis.
  • Checkpoint inhibitor colitis (CIC) can be severe, leading to complications like intestinal perforation and death.
  • Standard treatments include steroids and TNF-alpha inhibitors (e.g., infliximab), with vedolizumab and fecal microbiota transplantation for refractory cases.

Observation:

  • This report details a patient with Stage IV anaplastic thyroid carcinoma treated with pembrolizumab.
  • The patient developed steroid-refractory checkpoint inhibitor-induced colitis.
  • Previous treatments with infliximab, vedolizumab, and fecal microbiota transplantation were unsuccessful.

Findings:

  • Ustekinumab, a biologic targeting IL-12/23, was administered to the patient with refractory CIC.
  • Successful resolution of severe colitis was achieved with ustekinumab treatment.
  • This represents the first reported case of ustekinumab successfully treating ICI-induced colitis.

Implications:

  • Ustekinumab may represent a novel therapeutic option for refractory immune checkpoint inhibitor colitis.
  • This finding could expand treatment strategies for severe immune-related adverse events associated with ICIs.
  • Further research is warranted to explore ustekinumab's efficacy and safety in a broader patient population with refractory CIC.