Montserrat Aceituno

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

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María Esteve

Mútua Terrassa

Julían Panés

Hospital Clínic de Barcelona

Yamile Zabana

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Fernando Fernández‐Bañares

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Xavier Calvet

Deleted Institution

ÍO

Íngrid Ordás

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Elena Ricart

Hospital Clínic de Barcelona

Javier P. Gisbert

Hospital Universitario de La Princesa

Fernando Gomollón

Hospital Clínico Universitario Lozano Blesa

Orlando García-Bosch

Hospital de Sant Joan Despí Moisès Broggi

Cooperative Institutions

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

229

Universitat de Barcelona

146

Centro de Investigación Biomédica en Red

121

Universidad Autónoma de Madrid

112

Hospital Universitario de La Princesa

Instituto de Salud Carlos III

Hospital Clínic de Barcelona

Universitat Autònoma de Barcelona

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

Mútua Terrassa

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Inflammatory Bowel Diseases (2011)

Fernándo Muñoz Fernando Gomollón Yago González‐Lama Joaquín Hinojosa M. Iglesias

BackgroundCrohn disease (CD) is a chronic inflammatory bowel process which primarily affects young adults. The disabilities related to the symptoms and complications of CD affect the physical, social, and emotional well-being of patients, and significantly decrease the health-related quality of life (HRQoL). HRQoL is associated with the disease activity, surgery and medical treatment, the degree of patient's concern, and the productivity among others. The aim of our study was to determine how CD affects HRQoL, work productivity and psychological wellbeing in a large sample of CD patients in Spain.

Affect

Work productivity

10.1097/00054725-201112002-00061

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Steroid-refractory ulcerative colitis: Predictive factors of response to cyclosporine and validation in an independent cohort

Inflammatory Bowel Diseases (2007)

Montserrat Aceituno Esther García-Planella Carolina Heredia Yamile Zabana Faust Feu

One-third of patients with steroid-refractory ulcerative colitis (UC) do not respond to cyclosporine and require colectomy. Since alternative pharmacological treatments for this condition are available, it is pertinent to identify factors that predict response. The objective of this study was to determine predictive factors of response prior to cyclosporine administration, with validation in an independent cohort.The 2 cohorts of patients were identified from prospectively established databases. All patients had received 1 mg/kg/day prednisolone or equivalent for at least 5 days before cyclosporine. The efficacy measure was need of early surgery (within 3 months).From 1998 to 2005, 34 patients were treated in 1 institution (derivation cohort) and 38 patients in the second institution (validation cohort). Eleven patients in the derivation cohort and 9 patients in the validation cohort underwent early colectomy. Univariate analysis in the derivation cohort demonstrated a significant association of colectomy with C-reactive protein (P = 0.012) and the Ho index before initiation of cyclosporine (P = 0.013). Regression analysis showed that only the Ho index (P = 0.011) had an independent predictive value. The Ho index predicted need of colectomy, with an area under the characteristic receiver operating curve of 0.79 (95% confidence interval [CI], 0.59-0.99) in the derivation cohort and 0.74 (95% CI, 0.53-0.96) in the validation cohort. The cutoff point with the best sensitivity and specificity ratio was > or =5.The Ho-based predictive score is a good predictor of response to cyclosporine and avoidance of colectomy, and may aid in the indication of this treatment for management of steroid-resistant UC.

Refractory (planetary science)

10.1002/ibd.20322

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P174. Diagnostic value of a novel combination score of disease activity in a real-life IBD cohort.

Journal of Crohn s and Colitis (2015)

Albert Villoría V. García Angelina Dosal Laura Moreno‐Galarraga Montserrat Aceituno

Background: Fatigue is a common and bothersome symptom that inflammatory bowel disease (IBD) patients have to face even in remission.Many psychological and biological factors have been related to fatigue.The aim of the study is to determine the role of different biological and psychological factors in IBD-related fatigue.Methods: All IBD patients followed at our Gastroenterology Day Hospital between January and December 2013 were included.Patients complete Functional Assessment of Chronic Illness Therapy-Fatigue score (FACITC-F) as well as psychological scores (Beck for depression, Stai for anxiety, Epworth for sleep disturbances and IBDQ-9 for quality of life) and IBD activity scores.Biological parameters (Interleukin 5, 8, 12, complete blood count, ferritin, C-reactive protein, erythrocyte sedimentation rate and micronutrients) were tested by appropriate blood tests.Results: A total of 219 were studied and at the end of the study 177 patients (mean age, 39 ± 12 years, 28% ulcerative colitis and 72% crohn's disease) were included for the analysis.The median Fatigue score (38, range (1-52)) was lower that than in general population.Twenty-eight (16%) patients had moderate-to-severe fatigue determined as fatigue score of 22 or lower.In the univariate analysis, fatigue differed significatively with gender, type of IBD, Harvey and Mayo score, articular disease, body mass Index (BMI), psychological tests, thiopurine and biological treatment.All these variables were included in the multivariate analysis.Female gender (ß -6.61, p<0.001),BMI (ß -0.61, p<0.001) and higher depression (ß -0.43, p<0.001) and anxiety (ß -0.18, p<0.001) scores were predictors of increased fatigue.IBDQ-9 (ß 0.51, p<0.001) was independently related to lower fatigue.Conclusions: Fatigue was prevalent in our IBD patients and was related to high levels of anxiety and depression and low quality of life.None of the biological factors evaluated including pro-inflammatory interleukins or micronutrient deficiencies was associated with fatigue.

Value (mathematics)

10.1093/ecco-jcc/jju027.291

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Erratum to: Effectiveness of adalimumab for the treatment of ulcerative colitis in clinical practice: comparison between anti-tumour necrosis factor-naïve and non-naïve patients

Journal of Gastroenterology (2016)

Marisa Iborra Javier P. Gisbert Marta Maia Bosca‐Watts Alicia López‐García Valle García-Sánchez

Faecal calprotectin

Colorectal Surgery

Surgical oncology

10.1007/s00535-016-1293-y

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Citations (51)

M2073 NOD2/CARD15, Toll-Like Receptor 4, and Toll-Like Receptor 9 Gene Polymorphisms in Spanish and Dutch Patients with Inflammatory Bowel Disease

Gastroenterology (2008)

Miquel Sans Carolina Figueroa Bart Crusius Marta Artieda Ad A. van Bodegraven

10.1016/s0016-5085(08)62166-6

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Citations (1)

Prevalence and Natural History of Microscopic Colitis: A Population-Based Study With Long-term Clinical Follow-up in Terrassa, Spain

Journal of Crohn s and Colitis (2016)

Fernando Fernández‐Bañares Yamile Zabana Montserrat Aceituno Laura Ruiz Azucena Salas

Few studies have assessed the prevalence of microscopic colitis (MC) and the natural history of this disease is not well known. The aim of this study was to evaluate the prevalence rate of MC, the burden of disease in terms of loss of health and the long-term natural history of MC in a population-based cohort study. Cases were obtained from the pathology department registry Hospital Universitari Mutua Terrassa. Belonging to the catchment area, maintaining residence in that area, and being alive on August 31, 2014 were confirmed for each case. Adjusted prevalence rates were calculated. Current active drugs for MC and diarrhoea persistence in every patient were recorded. The prevalence rate of MC was 107 per 10 5 inhabitants. The rate of patients with active disease, i.e. those representing the true burden of the disease in terms of loss of health, was 31 per 10 5 inhabitants. After a follow-up of 7.8±0.38 years from diagnosis, 75% of the patients experienced prolonged disease remission, defined as clinical remission without requiring drugs for 1 year or more. The only variable associated with prolonged MC remission was how clinical remission was achieved (spontaneous 93.3%, drug-induced, 60.5%; odds ratio 8.4, 95% confidence interval 2.7–26). The rate of patients with MC and active disease, which represents the true disease burden in terms of loss of health, is low. Most patients with MC experience prolonged disease remission, with key differences between spontaneous and drug-induced clinical remission.

Lymphocytic Colitis

Rate ratio

10.1093/ecco-jcc/jjw037

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Citations (22)

Fe de errores a «Tratamiento del brote grave de colitis ulcerosa»

Gastroenterología y Hepatología (2015)

Montserrat Aceituno Yamile Zabana María Esteve

10.1016/j.gastrohep.2015.03.005

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P273 A cross-sectional observational study of clinical and demographical factors affecting work disability and health related quality of life in Crohn's disease patients

Journal of Crohn s and Colitis (2012)

Montserrat Aceituno F. Gomollón Garcia Yago González Lama Joaquín Hinojosa M. Iglesias

short (=12 weeks) and long (=52 weeks) term. Adverse events were registered as well. Results: Thirty patients were recruited (age 34.5±15 yrs) 17 females, 43.3% smokers & ex-smokers. Median follow-up was 36 months (range 3 84 weeks). Mayo scores at the beginning of infliximab was 8±2 and after induction therapy, within a period of 12 weeks the score decreased to 3±2. Twenty one patients (70%) had short term complete response. Sixteen of the initial responders (55.7%) maintained long term complete clinical remission without steroids, while 4 of them (13.8%) had partial response. Dose intensification was required in 8 patients (26.7%), 5 patients (17.3%) did not respond and therapy was changed. Five adverse events were detected in 4 patients: serum sickness (1), and infectious complications (4). Only one event was serious. No infusion reactions were experienced in this group. Short and long term response in active smokers and ex-smokers was 83.3% (10 patients) and 58.3% (7 patients), respectively. Endoscopic evaluation performed at two time points demonstrated mucosal healing in five patients (16.7%), and partial endoscopic improvement in 10 patients (33.3%) Mucosal healing correlated with clinical response. Infliximab average trough levels detected during maintenance were 2.41mg/ml. Correlation between trough levels and clinical response existed in 16 patients (53.3%). Conclusions: Infliximab is an effective and safe treatment for moderate to severe, steroid refractory/dependent UC. Smoking is a positive predictive factor for initial response to infliximab in UC patients. Significant correlation was found between clinical response, endoscopic parameters and serum infliximab levels.

Cross-sectional study

10.1016/s1873-9946(12)60293-1

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Work productivity and activity impairment in Spanish Crohnʼs disease patients

Inflammatory Bowel Diseases (2011)

Yago González‐Lama Fernando Gomollón Joaquín Hinojosa M. Iglesias Marisa Maroto

Crohn's disease (CD) is usually diagnosed in early adult life, a peak time of work productivity, and may interfere with the patient's ability to work and perform daily activities. It often requires hospitalizations and surgery which imply work absences and disability. The relation between CD and the health related quality of life (HRQoL) has been extensively explored, but data about work productivity are scarce. The aim of our study was to determine how CD affects work productivity in a large sample of CD patients in Spain. Spanish multicenter, cross-sectional observational study. CD patients were recruited between 2009 and 2010 through the Spanish CD patient association and by gastroenterologists. Patients provided socio-demographic and clinical information. They completed the “Work Productivity and Activity Impairment Questionnaire” (WPAI) and the “Inflammatory Bowel Disease Questionnaire” (IBDQ9) to assess the HRQoL. The “Overall Work Productivity Loss” (OWPL) and “Daily Activities Impairment” (DAI) were measured. Multivariable analysis was performed to correlate clinical, socio-demographics and HRQoL with work productivity. A total of 1688 patients were recruited: 64% members of a CD association, 51% females, mean age 42.5 years (SD 11.2). At the time of the survey 32% of patients at working age were unemployed or pensioners, and 59% were employed: The mean loss of working time was 3.5 hours (range 0-64, SD 9.59) in the previous week (34% lost >1h/week), and 11% received complaints regarding their work performance. The mean OWPL was 27% (SD 31.3) and the mean DAI index was 35% (SD 31.3). 50% of patients had more than 10% of OWPL and 20% of DAI. There was a significant relationship between IBDQ9 and the components of productivity (p<0.05 in all cases): OWPL, DAI, presenteeism and absenteeism (r=-0.6, -0.7, -0.5 & -0.6 respectively). OWPL and DAI were directly related with the illness activity at the time of the study and surgical interventions in the previous 2 years (p<0.05), and inversely related with the degree of knowledge about their illness (p<0.05). CD affects work productivity and daily activity, which deteriorate the HRQoL. Physicians can improve all these factors by providing comprehensive information and proper control of the illness.

Work productivity

10.1097/00054725-201112002-00059

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[Prevalence of protein-energy malnutrition in gastroenterologic patients].

PubMed (1986)

E. Cabré Montserrat Aceituno Lúcio Vilar A. Abad Gassull Ma

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