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您的检索式：作者名="Simon Ghaly"
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| 1 | Higher infliximab and adalimumab trough levels are associated with fistula healing in patients with fistulising perianal Crohn’s disease显示文摘BACKGROUND Tumor necrosis factor-alpha inhibitors,including infliximab and adalimumab,are effective medical treatments for perianal fistulising Crohn’s disease(CD),but not all patients achieve fistula healing.AIM To determine the correlation between perianal fistula healing and closure with infliximab and adalimumab trough levels.METHODS In this multicentre retrospective study conducted across four tertiary inflammatory bowel disease centres in Australia,we identified CD patients with perianal fistulae on maintenance infliximab or adalimumab who had a trough level within twelve weeks of clinical assessment.Data collected included demographics,serum infliximab and adalimumab trough levels(mg/L)within 12 wk before or after their most recent clinical assessment and concomitant medical or surgical therapy.The primary outcome was fistula healing,defined as cessation in fistula drainage.The secondary outcome was fistula closure,defined as healing and closure of all external fistula openings.Differences between patients who did or did not achieve fistula healing were compared using the chi-square test,t test or Mann-Whitney U test.RESULTS One hundred and fourteen patients(66 infliximab,48 adalimumab)were included.Forty-eight(72.7%)patients on maintenance infliximab achieved fistula healing and 18(27.3%)achieved fistula closure.Thirty-seven(77%)patients on maintenance adalimumab achieved fistula healing and 17(35.4%)achieved fistula closure.Patients who achieved fistula healing had significantly higher infliximab and adalimumab trough levels than patients who did not[infliximab:6.4(3.8-9.5)vs 3.0(0.3-6.2)mg/L,P=0.003;adalimumab:9.2(6.5-12.0)vs 5.4(2.5-8.3)mg/L,P=0.004].For patients on infliximab,fistula healing was associated with lower rates of detectable anti-infliximab antibodies and younger age.For patients on adalimumab,fistula healing was associated with higher rates of combination therapy with an immunomodulator.Serum trough levels for patients with and without fistula closure were not significantly different for infliximab[6.9(4.3-10.2)vs 5.5(2.5-8.3)mg/L,P=0.105]or adalimumab[10.0(6.6-12.0)vs 7.8(4.2-10.0)mg/L,P=0.083].CONCLUSION Higher maintenance infliximab and adalimumab trough levels are associated with perianal fistula healing in CD. | Bonita Gu Kavya Venkatesh Astrid-Jane Williams Watson Ng Crispin Corte Ali Gholamrezaei Simon Ghaly Wei Xuan Sudarshan Paramsothy Susan Connor | 2022 | World Journal of Gastroenterology2022，28，23： | 2 |
| 2 | Vedolizumab for ulcerative colitis: Real world outcomes from a multicenter observational cohort of Australia and Oxford显示文摘BACKGROUND Vedolizumab(VDZ),a humanised monoclonal antibody that selectively inhibits alpha4-beta7 integrins is approved for use in adult moderate to severe ulcerative colitis(UC)patients.AIM To assess the efficacy and safety of VDZ in the real-world management of UC in a large multicenter cohort involving two countries and to identify predictors of achieving remission.METHODS A retrospective review of Australian and Oxford,United Kingdom data for UC patients.Clinical response at 3 mo,endoscopic remission at 6 mo and clinical remission at 3,6 and 12 mo were assessed.Cox regression models and Kaplan Meier curves were performed to assess the time to remission,time to failure and the covariates influencing them.Safety outcomes were recorded.RESULTS Three hundred and three UC patients from 14 centres in Australia and United Kingdom,[60%n=182,anti-TNF naïve]were included.The clinical response was 79%at 3 mo with more Australian patients achieving clinical response compared to Oxford(83%vs 70%P=0.01).Clinical remission for all patients was 56%,62%and 60%at 3,6 and 12 mo respectively.Anti-TNF naive patients were more likely to achieve remission than exposed patients at all the time points(3 mo 66%vs 40%P<0.001,6 mo 73%vs 46%P<0.001,12 mo 66%vs 51%P=0.03).More Australian patients achieved endoscopic remission at 6 mo compared to Oxford(69%vs 43%P=0.01).On multi-variate analysis,anti-TNF naïve patients were 1.8(95%CI:1.3-2.3)times more likely to achieve remission than anti-TNF exposed(P<0.001).32 patients(11%)had colectomy by 12 mo.CONCLUSION VDZ was safe and effective with 60%of UC patients achieving clinical remission at 12 mo and prior anti-TNF exposure influenced this outcome. | Samba Siva Reddy Pulusu Ashish Srinivasan Krupa Krishnaprasad Daniel Cheng Jakob Begun CharlotteKeung Daniel Van Langenberg Lena Thin Tamara Mogilevski Peter De Cruz Graham Radford-Smith Emma Flanagan Sally Bell Soleiman Kashkooli Miles Sparrow Simon Ghaly Peter Bampton Elise Sawyer Susan Connor Quart-ul-ain Rizvi Jane M Andrews Gillian Mahy Paola Chivers Simon Travis Ian Craig Lawrance | 2020 | World Journal of Gastroenterology2020，26，30： | 2 |
| 3 | Type 2 autoimmune pancreatitis associated with severe ulcerative colitis: Three case reports显示文摘BACKGROUND Type two autoimmune pancreatitis is a rare and difficult to diagnose,steroid responsive non-IgG4 inflammatory pancreatopathy that can be associated with inflammatory bowel disease.CASE SUMMARY This case series describes three cases with varied clinical presentations and representations of autoimmune pancreatitis,and all associated with an aggressive course of ulcerative colitis.The pancreatopathy was independent of bowel disease activity and developed in one case following colectomy.CONCLUSION Clinician awareness about this condition is important to allow early diagnosis,treatment and avoid unnecessary pancreatic surgery. | Mark Ghali Karen Bensted David B Williams Simon Ghaly | 2022 | World Journal of Clinical Cases2022，10，24： | 0 |
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