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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...
134
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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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

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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...
126
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

149
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...
149
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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潰瘍性大腸炎に対するリサンキズマブ: 2つのランダム化臨床試験

Edouard Louis1, Stefan Schreiber2, Remo Panaccione3

  • 1Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital CHU of Liège, Liège, Belgium.

JAMA
|July 22, 2024
PubMed
まとめ
この要約は機械生成です。

リサンキズマブは,プラセボと比較して,誘導療法と維持療法の両方で,潰瘍性大腸炎患者の臨床寛解率を有意に改善しました. 52週を超えた長期的な効果を評価するには,さらなる研究が必要である.

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Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
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科学分野:

  • 胃腸内科
  • 免疫学
  • 薬理学について

背景:

  • 潰瘍性大腸炎 (UC) は慢性炎症性腸疾患で,治療の選択肢は限られている.
  • 選択的IL-23阻害剤であるリサンキズマブは,炎症性疾患の治療に有望であることが示されています.

研究 の 目的:

  • 中度から重度の潰瘍性大腸炎の誘導および維持療法としてのリサンキズマブの有効性と安全性を評価する.
  • 12週 (誘導) と52週 (維持) の臨床寛解率を決定する.

主な方法:

  • 中度から重度のUCを患った患者で実施された3期ランダム化臨床試験 (誘導および維持).
  • 患者は,誘導のために静脈内リサンキズマブまたはプラセボを受け,その後,維持のために皮下リサンキズマブまたはプラセボを受けました.
  • 主なアウトカムは,特定の便の頻度,直腸出血,および内視基準によって定義された臨床寛解でした.

主要な成果:

  • 誘導試験では,リサンキズマブを投与された患者の20. 3%が12週後に臨床寛解を達成し,プラセボを受けた患者の6. 2%でした.
  • 52週間の維持試験では,リサンキズマブの臨床寛解率は40. 2% (180 mg) と37. 6% (360 mg) であり,プラセボは25. 1%でした.
  • リサンキズマブ治療で新たな安全リスクは認められませんでした.

結論:

  • リサンキズマブは中等から重度の潰瘍性大腸炎患者の臨床寛解に有意な効果を示した.
  • この薬はよく耐えており,試験期間中,安全性に関する新たな懸念は認められませんでした.
  • 52週を超えたUCにおけるリサンキズマブの長期的な有効性および安全性プロフィールを理解するために,さらなる研究が必要である.