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| 1 | Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review显示文摘BACKGROUND Despite the advent of biological drugs, conventional therapy continues to be used in moderate to severe inflammatory bowel disease(MS-IBD). This study hypothesized that as a standard of treatment and the primary alternative to biologics, conventional therapy should present robust effectiveness results in IBD outcomes.AIM To investigate the effectiveness of conventional therapy for MS-IBD.METHODS A systematic review with no time limit was conducted in July 2017 through the Cochrane Collaboration, MEDLINE, and LILACS databases. The inclusion criteria encompassed meta-analyses, systematic reviews, randomized clinical trials, observational and case-control studies concerning conventional therapy in adult patients with MS-IBD, including Crohn's disease(CD) and ulcerative colitis(UC). Corticosteroids(prednisone, hydrocortisone, budesonide, prednisolone,dexamethasone), 5-aminosalicylic acid(5-ASA) derivatives(mesalazine and sulfasalazine) and immunosuppressants [azathioprine(AZA), methotrexate(MTX), mycophenolate, cyclosporine, tacrolimus, 6-mercaptopurine(6-MP)] were considered conventional therapy. The exclusion criteria were sample size below50; narrative reviews; specific subpopulations(e.g., pregnant women,comorbidities); studies on postoperative IBD; and languages other than English,Spanish, French or Portuguese. The primary outcome measures were clinical remission(induction or maintenance), clinical response and mucosal healing. As secondary outcomes, fecal calprotectin, hospitalization, death, and surgeries were analyzed. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation criteria.RESULTS The search strategy identified 1995 citations, of which 27 were considered eligible(7 meta-analyses, 20 individual studies). For induction of clinical remission, four meta-analyses were selected(AZA and 6-MP showed no advantage over placebo,MTX or 5-ASA in CD; MTX showed no statistically significant difference versus placebo, 6-MP, or 5-ASA in UC; tacrolimus was superior to placebo for UC in two meta-analyses). Only one meta-analysis evaluated clinical remission maintenance, showing no statistically significant difference between MTX and placebo, 5-ASA, or 6-MP in UC. AZA and 6-MP had no advantage over placebo in induction of clinical response in CD. Three meta-analyses showed the superiority of tacrolimus vs placebo for induction of clinical response in UC. The clinical response rates for cyclosporine were 41.7% in randomized controlled trials(RCTs) and 55.4% in non-RCTs for UC. For induction of mucosal healing,one meta-analysis showed a favorable rate with tacrolimus versus placebo for UC. For secondary outcomes, no meta-analyses specifically evaluated fecal calprotectin, hospitalization or death. Two meta-analyses were retrieved evaluating colectomy rates for tacrolimus and cyclosporine in UC. Most of the twenty individual studies retrieved contained a low or very low quality of evidence.CONCLUSION High-quality evidence assessing conventional therapy in MS-IBD treatment is scarce, especially for remission maintenance, mucosal healing and fecal calprotectin. | Adérson Omar Mourao Cintra Damiao Matheus Freitas Cardoso de Azevedo Alexandre de Sousa Carlos Marcela Yumi Wada Taciana Valéria Marcolino Silva Flávio de Castro Feitosa | 2019 | World Journal of Gastroenterology2019，25，9： | 13 |
| 2 | How to manage inflammatory bowel disease during the COVID-19 pandemic:A guide for the practicing clinician显示文摘Managing inflammatory bowel disease(IBD)during the coronavirus disease 2019(COVID-19)pandemic has been a challenge faced by clinicians and their patients,especially concerning whether to proceed with biologics and immunosuppressive agents in the background of a global outbreak of a highly contagious new coronavirus(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2).The knowledge about the impact of this virus on patients with IBD,although it is still scarce,is rapidly evolving.In particular,concerns surrounding medications’impact for IBD on the risk of acquiring SARS-CoV-2 infection or developing COVID-19,and potentially exacerbate viral replication and the COVID-19 course,are a current thinking of both practicing clinicians and providers caring for patients with IBD.Managing patients with IBD infected with SARS-CoV-2 depends on both the clinical activity of the IBD and the occasional development and severity of COVID-19.In this review,we summarize the current data regarding gastrointestinal involvement by SARS-CoV-2 and pharmacologic and surgical management for IBD concerning this infection,and the COVID-19 impact on both the patient's psychological functioning and endoscopy services,and we concisely summarize the telemedicine roles during the COVID-19 pandemic. | Júlio Maria Fonseca Chebli Natália Sousa Freitas Queiroz Adérson Omar Mourão Cintra Damião Liliana Andrade Chebli Márcia Henriques de Magalhães Costa Rogério Serafim Parra | 2021 | World Journal of Gastroenterology2021，27，11： | 2 |
| 3 | Prospective randomized dou- ble blind placebo- controlled evaluation of azithromycin for treatment of cat- scratch disease显示文摘 | Bass JW Freitas BC Freitas AD | 1998 | Pediatr Infect Dis1998，17，： | 1 |
| 4 | Effect of aerobic exercise training on regional blood flow and vascular resistance in diabetic rats 显示文摘 | Freitas SC Harthmann Ad Rodrigues B | 2015 | Diabetol Metab Syndr2015，7，： | 1 |
| 5 | Clonal multidrug-resistant Corynebacterium striatum within a nosocomial environment, Rio de Janeiro, Brazil显示文摘 | Baio PV Mota HF Freitas AD | 2013 | Mem Inst Oswaldo Cruz2013，108，： | 1 |
| 6 | Thrombolytie therapy impact on prognosis after twelve months of firt acute myocardial infarction 显示文摘 | Caires G Pereira D Freitas AD | 2000 | Rev Port Cardiol2000，19，： | 1 |
| 7 | et al, Prospeclive randomized double blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch diseaser J显示文摘 | Bass JW Freitas AD | 1998 | Pediatr Infect Dis J1998，17，6： | 1 |
| 8 | MiR-21 regulates chronic hypoxia-induced pulmonary vascular remodeling显示文摘 | Yang S Banerjee S Freitas Ad | 2012 | Am J Physiol Lung Cell Mol Physiol2012，302，6： | 1 |
| 9 | Prospective randomized double blind placebo-controlled evaluation of azithromycin for treament of Cat-scratch disease显示文摘 | Bass JW Freitas BC Freitas AD | 1998 | Pediatr Infect Dis J1998，17，6： | 1 |
| 10 | Role of muscarinic and nicotinic cholinergic receptors in an experimental model of epilepsy-induced analgesia显示文摘 | de Oliveira RC de Carvalho AD | 2004 | Pharmacol Biochem Behav2004，79，2： | 1 |
| 11 | Prospective randomized double blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch disease显示文摘 | Bass J W Freitas BC Freitas AD | 1998 | Pediatr Infect Dis J1998，17，6： | 1 |
| 12 | Risk stratification and geographical mapping of Brazilian inflammatory bowel disease patients during the COVID-19 outbreak:Results from a nationwide survey显示文摘BACKGROUND Coronavirus disease 2019(COVID-19)pandemic is still evolving globally,and Brazil is currently one of the most affected countries.It is still debated whether patients with inflammatory bowel disease(IBD)are at a higher risk for developing COVID-19 or its complications.AIM To assess geographical distribution of IBD patients at the highest risk and correlate these data with COVID-19 mortality rates in Brazil.METHODS The Brazilian IBD Study Group(Grupo de Estudos da Doença Inflamatória Intestinal do Brasil)developed a web-based survey adapted from the British Society of Gastroenterology guidelines.The included categories were demographic data and inquiries related to risk factors for complications from COVID-19.Patients were categorized as highest,moderate or lowest individual risk.The Spearman correlation test was used to identify any association between highest risk and mortality rates for each state of the country.RESULTS A total of 3568 patients(65.3%females)were included.Most participants were from the southeastern and southern regions of Brazil,and 84.1%were using immunomodulators and/or biologics.Most patients(55.1%)were at moderate risk,23.4%were at highest risk and 21.5%were at lowest risk of COVID-19 complications.No association between the proportion of IBD patients at highest risk for COVID-19 complications and higher mortality rates was identified in different Brazilian states(r=0.146,P=0.467).CONCLUSION This study indicates a distinct geographical distribution of IBD patients at highest risk for COVID-19 complications in different states of the country,which may reflect contrasting socioeconomic,educational and healthcare aspects.No association between high risk of IBD and COVID-related mortality rates was identified. | Natália Sousa Freitas Queiroz Fábio Vieira Teixeira Marina Pamponet Motta Liliana Andrade Chebli Adriano Akira Ferreira Hino Camilla de Almeida Martins Abel Botelho Quaresma Alexandre Augusto de Paula da Silva Adérson Omar Mourão Cintra Damião Rogerio Saad-Hossne Paulo Gustavo Kotze | 2021 | World Journal of Gastroenterology2021，27，12： | 0 |
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