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A Case of Severe Microscopic Colitis With Ensuing Hepatic Portal Venous Gas (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_700; The patient began 9mg Budesonide daily with close GI follow-up resolving his abdominal sequelae...The severe MC likely caused excessive mucosal damage allowing for extravasation of gas from the lumen to track up the mesenteric vasculature and into the portal venous system. Expedient work up once HPVG is observed is key to securing positive patient outcomes as this may designate life threating processes.
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A Fractured Colon: An Unusual Macroscopic Finding in Microscopic Colitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_413; In this patient’s case, the budesonide taper ultimately resolved the symptoms. However, if this were ineffective or symptoms recur, it would be reasonable to discontinue other possibly offending agents such as alendronate.Figure: Mucosal fracture in the sigmoid colon, found to be collagenous microscopic colitis.
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A Rare Case of Statin-Induced Autoimmune Hepatitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_249; She has shown marked improvement in her LFTs and symptoms with budesonide and mycophenolate mofetil...Since literature dating back the 1950s, there have only been 16 other cases of statin induced AIH. Given how ubiquitous statins are prescribed by physicians, more data is needed to understand the mechanism of injury to prevent severe hepatotoxic complications in the future.
- |||||||||| Avastin (bevacizumab) / Roche, Opdivo (nivolumab) / Ono Pharma, BMS
Immune Checkpoint Inhibitors in Patients With Microscopic Colitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_109; His cancer was treated with pembrolizumab, and bevacizumab was also given...His gastrointestinal (GI) symptoms recurred over a year later, thus, pembrolizumab was briefly held and he was treated with budesonide...Case 2: A 64-year-old Caucasian female patient with MC diagnosed with stage IV lung adenocarcinoma was treated with nivolumab and dexamethasone daily for brain metastases...Case 3: A 70-year-old Caucasian female with MC and stage IV small cell lung cancer began course of atezolizumab, etoposide, carboplatin, and dexamethasone...After the first dose, she developed GI toxicity, requiring treatment with prednisone...The use of ICIs and corticosteroids concomitantly may have a protective effect against colitis while also resulting in decreased efficacy of ICIs. Given the efficacy of ICI therapy in treating life-threatening cancers and the ability to easily discontinue ICIs and therapeutically treat colitis flares, the benefits of trialing ICIs in patients with pre-existing MC may outweigh the risks.
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Wich is the Altitude Sickness Treatment? (Posters) - Sep 7, 2021 - Abstract #EUSEM2021EUSEM_795; Conclusion Relating to AS and BS the only evidenced preventive action is the acetazolamide. Regarding to therapy, the oxygen and descending, along with the dexamethasone, are the only evidenced methods in the case of AS.
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Journal: Predictors for short bowel syndrome in Crohn's disease. (Pubmed Central) - Sep 3, 2021 Montreal B1 behavior, IV steroids and budesonide use are influencing predictors for this complication. These predictors should be assessed in daily clinical practice to prevent SBS occurrence.
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Journal: Antiviral Effect of Budesonide against SARS-CoV-2. (Pubmed Central) - Sep 1, 2021 We demonstrate a dose-dependent inhibition of SARS-CoV-2 that was comparable between all viral variants tested while cell viability remains unaffected. Our results are encouraging as they could indicate a multimodal mode of action of budesonide against SARS-CoV-2 and COVID-19, which could contribute to an improved clinical performance.
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Journal: Mannitol Polymorphs as Carrier in DPIs Formulations: Isolation Characterization and Performance. (Pubmed Central) - Aug 29, 2021 This work aimed at crystallizing kinetically stable D-mannitol polymorphs and at investigating their aerosolization performance when used in adhesive mixtures with two model drugs (salbutamol sulphate, SS, and budesonide, BUD) using a median and median/high resistance inhaler...Recrystallized mannitol, but also PVA and PVP, proved to be safe excipients toward lung cell lines. We concluded that, also for mannitol, the physicochemical properties stemming from different crystal structures represent a tool for modulating carrier-drug interaction and, in turn, aerosolization performance.
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Clinical, Journal: Dilemma in post-IBD patients with IBS-D symptoms; A 2020 overview. (Pubmed Central) - Aug 27, 2021 We also discuss observations that post-IBD IBS-D patients harbor significantly increased colon mucosal eosinophils and appear to respond to a GI-hypoallergenic diet and budesonide therapy...In addition to current theories regarding the pathophysiology of this condition such as alterations in mucosal inflammation, the microbiota, mucosal permeability, and gut-brain interactions. This new avenue of eosinophilic colopathy and therapy directed towards food-derived immune response in patients with post-IBD IBS-D deserves additional investigation.
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Journal: SARS-CoV-2-triggered lymphocytic colitis. (Pubmed Central) - Aug 26, 2021 The work-up confirmed a new diagnosis of lymphocytic colitis, and the patient responded favourably to a course of oral budesonide. Clinicians should become vigilant to the possibility of triggered IBD in patients with persistent diarrhoea following a SARS-CoV-2 infection.
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Journal: Refractory celiac disease type 2: how to diagnose and treat? (Pubmed Central) - Aug 26, 2021 A case of a 41 year old female patient with refractory celiac disease type 2 is reported. She was treated with oral budesonide for six months, achieving histological remission.
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Journal: Recent insights on the use of topical steroids in eosinophilic esophagitis. (Pubmed Central) - Aug 13, 2021 Current evidence suggests that maintenance therapy with long-term topical steroids decreases the risk of relapse and progression to fibrostenotic disease. While uncertainty over the dose and duration of maintenance topical steroids and their potential side effects exists, long-term maintenance therapy with topical steroids appears to be the way forward to improve long-term outcomes in patients with EoE.
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Journal: Predictive Capacity of Pulmonary Function Tests for Acute Mountain Sickness. (Pubmed Central) - Aug 11, 2021 Spirometry did not demonstrate statistically significant changes on ascent to high altitude, nor were there significant associations with incidence of AMS or severe AMS. Low-altitude spirometry did not accurately predict development of AMS, and it should not be recommended for risk stratification.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Journal, Adverse events: Anti-PD-1 induced collagenous colitis in metastatic melanoma: a rare severe adverse event. (Pubmed Central) - Aug 7, 2021 However, worsening of digestive symptoms during tapering of corticosteroid dose required the permanent discontinuation of nivolumab. Due to the very low number of cases reported to date and their different evolution under corticosteroids, it is not clear whether or not immune checkpoint inhibitors can be restarted in these patients.
- |||||||||| tanimilast (CHF6001) / Chiesi
Clinical, Journal: Efficacy and safety of CHF6001, a novel inhaled PDE4 inhibitor in COPD: the PIONEER study. (Pubmed Central) - Aug 4, 2021 P2 CHF6001 had no effect in the primary lung function analysis, although was well-tolerated with no gastrointestinal adverse event signal. Post-hoc analyses focused on exacerbation risk indicate specific patient subgroups who may receive particular benefit from CHF6001.
- |||||||||| Clinical, Journal: Complex analysis of the personalized pharmacotherapy in the management of COVID-19 patients and suggestions for applications of predictive, preventive, and personalized medicine attitude. (Pubmed Central) - Jul 27, 2021
Fourteen drugs (ritonavir, daclatasvir, prednisone, dexamethasone, ribavirin, HCQ, ceftriaxone, zinc, interferon beta-1a, remdesivir, levofloxacin, lopinavir, human immunoglobulin G and losartan) showed significantly different pharmacogenomic characteristics in relation to the ethnic origin of the patient...In summary, the proposed PPPM/3 PM attitude should be obligatory considered for the overall COVID-19 management. The online version contains supplementary material available at 10.1007/s13167-021-00247-0.
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J
[VIRTUAL] GANGRENOUS PYODERMA IN ULCERATIVE COLITIS - AN EXUBERANT AND PAINFUL COMPLICATION (Poster Exhibition) - Jul 20, 2021 - Abstract #UEGW2021UEGW_5273; She is clinically stable with favorable evolution of cutaneous lesions, which are already in the healing phase, being smaller and without inflammatory signs. Gangrenous pyoderma is a chronic inflammatory dermatosis, of unknown etiology, characterized by the existence of painful, deep and rapidly progressive ulcerous-necrotic lesions.The authors, highlighting the rarity of the case and the iconographic exuberance, intend to sensitize clinicians to this entity, since the early diagnosis and treatment are fundamental, and can significantly influence the prognosis.
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[VIRTUAL] A CASE OF COELIAC DISEASE AND COMMON VARIABLE IMMUNODEFICIENCY (Poster Exhibition) - Jul 20, 2021 - Abstract #UEGW2021UEGW_5249; The fact that she improved with a GFD and not with budesonide made CD the most plausible cause.The duodenal lymphogram can be helpful. In CD the most common pattern is the increase of CD3+TCRγδ+, while in CVID the typical finding is the presence of TCRαβ+ lymphocytes.
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