  Profile of Belgian Pediatric Crohn's Disease Patients: Associations between variables at diagnosis; ; et al in Gastroenterology (2011), 140(5), 787 Detailed reference viewed: 10 (2 ULg)Profile of Belgian Pediatric Crohn's Disease Patients: Associations between variables at diagnosis; ; et al in Acta Gastro-Enterologica Belgica (2011), 74 Detailed reference viewed: 3 (1 ULg)Profile of Belgian Pediatric Crohn's Disease Patients: Associations between variables at diagnosis; ; et al in Journal of Crohn’s and Colitis [=JCC] (2011), 5(1), 156 Detailed reference viewed: 9 (0 ULg)Profile of Belgian Pediatric Crohn's Disease Patients: Presentation and diagnostic features; ; et al in Gastroenterology (2011), 140(5), 786 Detailed reference viewed: 9 (1 ULg)Profile of Belgian Pediatric Crohn's Disease Patients: Presentation and diagnostic features; ; et al in Acta Gastro-Enterologica Belgica (2011), 74 Detailed reference viewed: 9 (2 ULg)Profile of Belgian Pediatric Crohn's Disease Patients: Presentation and diagnostic features; ; et al in Journal of Crohn’s and Colitis [=JCC] (2011), 5(1), 155 Detailed reference viewed: 5 (1 ULg) The efficacy of shortening the dosing interval to once every six weeks in Crohn's patients losing response to maintenance dose of infliximab.; ; et al in Alimentary Pharmacology & Therapeutics (2010) Background Patients treated with infliximab for Crohn's disease (CD) frequently require intensified dosage due to loss of response. There are scant data regarding the efficacy of shortening the dosing ... [more ▼] Background Patients treated with infliximab for Crohn's disease (CD) frequently require intensified dosage due to loss of response. There are scant data regarding the efficacy of shortening the dosing interval to 6 weeks. Aim We sought to investigate the efficacy of a once every 6 weeks' strategy compared with dose-doubling. Methods This work was a multicentre retrospective study of infliximab-treated CD patients who required dose escalation. The clinical outcome of patients treated by intensification to 5 mg/kg/6 weeks (6-week group) was compared with the outcome of patients whose infliximab was double-dosed (10 mg/kg/8 weeks or 5 mg/kg/4 weeks). Results Ninety-four patients (mean age: 29.8 years) were included in the study, 55 (59%) in the 6-week group and 39 (41%) in the double-dose group. Demographics and disease characteristics were similar between the two groups, although patients with re-emerging symptoms 5-7 weeks postinfusion were more likely to receive 5 mg/kg/6 weeks dosing (OR: 3.4, 95% CI: 1.4-8.8, P < 0.01). Early response to dose-intensification occurred in 69% of patients in the 6-week group and 67% in the double-dose group (P = N.S.). Regained response was maintained for 12 months in 40% compared with 29% of the patients respectively (P = N.S.). Conclusion In CD patients who lost response to standard infliximab dose, especially when symptoms re-emerge 5-7 weeks postinfusion, shortening the dosing interval to 6 weeks appears to be at least as effective as doubling the dose to 10 mg/kg or halving the infusion intervals to once in 4 weeks. [less ▲] Detailed reference viewed: 9 (3 ULg)Vaccinations in patients with immune-mediated inflammatory diseases.; Moutschen, Michel  ; et alin Rheumatology (2010) Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with ... [more ▼] Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with immunomodulatory or immunosuppressive drugs. In spite of their elevated risk for vaccine-preventable disease, vaccination coverage in IMID patients is surprisingly low. This review summarizes current literature data on vaccine safety and efficacy in IMID patients treated with immunosuppressive or immunomodulatory drugs and formulates best-practice recommendations on vaccination in this population. Especially in the current era of biological therapies, including TNF-blocking agents, special consideration should be given to vaccination strategies in IMID patients. Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given. Although the reduced quality of the immune response in patients under immunotherapy may have a negative impact on vaccination efficacy in this population, adequate humoral response to vaccination in IMID patients has been demonstrated for hepatitis B, influenza and pneumococcal vaccination. Vaccination status is best checked and updated before the start of immunomodulatory therapy: live vaccines are not contraindicated at that time and inactivated vaccines elicit an optimal immune response in immunocompetent individuals. [less ▲] Detailed reference viewed: 22 (5 ULg) |
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