Monoclonal antibodies (MAbs) have revolutionized the treatment of many chronic inflammatory diseases, including inflammatory bowel disease (IBD). IBD is a term that comprises two quite similar, yet distinctive, disorders—Crohn’s disease (CD) and ulcerative colitis (UC). Two blockbuster MAbs, infliximab (IFX) and adalimumab (ADL), transformed the pharmacological approach of treating CD and UC. However, due to the complex interplay of pharmacology and immunology, MAbs face challenges related to their immunogenicity, effectiveness, and safety. To ease the burden of IBD and other severe diseases, biosimilars have emerged as a cost-effective alternative to an originator product. According to the current knowledge, biosimilars of IFX and ADL in IBD patients are shown to be as safe and effective as their originators. The future of biosimilars, in general, is promising due to the potential of making the health care system more sustainable. However, their use is accompanied by misconceptions regarding their effectiveness and safety, as well as by controversy regarding their interchangeability. Hence, until a scientific consensus is achieved, scientific data on the long-term effectiveness and safety of biosimilars are needed.

https://www.mdpi.com/1999-4923/14/9/1766/pdf?version=1661422260

Under the Umbrella of Clinical Pharmacology: Inflammatory Bowel Disease, Infliximab and Adalimumab, and a Bridge to an Era of Biosimilars

Previous studies have shown that a typical kind of oolong tea, Tieguanyin, has multiple health benefits, while there is no research investigating its effects on inflammatory bowel disease (IBD). In this study, we aimed to explore the alleviation effects of Tieguanyin water (TWE) and ethanol (TES) extracts on IBD. Physiological activity status, colitis severity (disease activity index (DAI), colon and spleen weight), inflammatory cytokines (interleukin (IL)-4, interferon-γ (IFN-γ), IL-17, transforming growth factor-β (TGF-β), and IL-10) and microbiota composition were measured in experimental colitis mice induced by dextran sulfate sodium (DSS). TWE and TES exerted remarkable protective effects against experimental colitis, showing decreased colitis severity and improved colon morphology. TES also suppressed colonic inflammation via downregulation of pro-inflammatory cytokines (IL-4, IFN-γ, IL-17, and TGF-β) and upregulation of the anti-inflammatory cytokine IL-10. In addition, TWE and TES treatment caused significant alterations in the gut microbiota. Oolong tea extract treatment reduced the community abundance of pernicious bacteria Escherichia-Shigella from 21.6% (DSS) to 0.9% (TES) and 1.2% (TWE), and elevated that of probiotics Lachnospiraceae_NK4A136_group from 2.2% to 15.2% (TES) and 11.9% (TWE). Therefore, TWE and TES both remarkably ameliorated DSS-induced colitis, which suggested oolong extracts could be a candidate for IBD treatment.

Tieguanyin extracts ameliorated DSS-induced mouse colitis by suppressing inflammation and regulating intestinal microbiota.

Assessment of nutritional status and eating behaviours in patients with chronic inflammatory bowel disease: a pilot study

Les Maladies Inflammatoires Chroniques de l’Intestin (MICI) comprennent la maladie de Crohn (MC) et la rectocolite hemorragique (RCH). Ce sont des inflammations chroniques du tube digestif dont les causes sont inconnues. Une meilleure connaissance de leur epidemiologie pourrait orienter vers des pistes etiologiques. Jusqu’a la creation du Registre EPIMAD en 1988, il n’existait en France aucune donnee d’incidence. Nous avons cree en 1988 une etude prospective d’incidence des MICI, reconnu «Registre» par l’Inserm et l’InVS en 1992. Le territoire couvert par Epimad comporte le Nord, le Pas-de-Calais, la Somme et la Seine-Maritime avec pres de 6 millions d’habitants soit 9,3% de la population francaise. La collection des cas repose sur une collaboration multidisciplinaire incluant les gastroenterologues (GE) (liberaux, hospitaliers, adultes et pediatres; n=262), les services d’Epidemiologie de Lille et Rouen, la plateforme d’aide methodologique en Biostatistiques du CHRU de Lille et les Centres Hospitalo-Universitaires de Lille, Amiens et Rouen. Neuf enqueteurs se deplacent sur les lieux de consultation des GE et recueillent les informations necessaires a la validation des diagnostics. Deux GE experts revoient chaque dossier independamment et posent le diagnostic final de MC ou RCH certaine, probable ou possible, de colite indeterminee, de colite aigue ou de colite inclassee. Pour les cas atypiques et non classes, un suivi systematique est effectue pour le classement definitif (MICI ou non MICI). Un croisement des bases du Registre et des bases hospitalieres est effectue une fois par an pour mesurer l’exhaustivite. 80% des cas incidents sont diagnostiques par les GE liberaux, 13% par les GE des hopitaux generaux et 7% par les GE universitaires. Entre 1988 et 2008, l’incidence moyenne des MICI etait de 11,3/105 habitants (6,4 pour la MC, 4,4 pour la RCH et 0,5 pour IBDU). Pendant cette periode, l’incidence de la MC a augmente de 30% (100% chez l’adolescent) alors que celle de la RCH est restee stable. Le delai diagnostique median etait de 3 mois dans la MC et de 2 mois dans la RCH. Le pourcentage de patients ayant un diagnostic pose plus de 9 mois apres l’apparition des symptomes a diminue avec le temps. La validite diagnostique dans les cas non classant d’emblee a ete assuree par un suivi de 2 ans et a montre que seul l’âge 60 ans au diagnostic. Grâce a un nombre eleve de cas incidents, une heterogeneite spatiale de l’incidence des MICI a ete montree dans les zones agricoles et suburbaines sans lien avec le niveau social des populations. En utilisant la methode des statistiques de scan rajoutant la dimension temporelle a l’analyse spatiale, nous avons trouve plusieurs clusters de sur et sous incidence constants dans le temps. Nos perspectives sont: 1)…

Epidémiologie des maladies inflammatoires chroniques de l'Intestin en France : apport du registre EPIMAD : Epidemiology of inflammatory bowel diseases : new insights from a French population-based registry (EPIMAD)

Inflammatory bowel disease (IBD) is an autoimmune disorder affecting the gastrointestinal tract. It is generally categorized into Crohn’s disease (CD) and ulcerative colitis (UC). These disease processes are more recently thought of as a disease continuum, with distinct features as well as substantial overlap (Cleynen, et al. Lancet 387(10014):156–167, 2016). There is no single test that can definitely establish the diagnosis of IBD or reliably distinguish between the two disease states of CD and UC. Additionally, IBD can present atypically or overlap with other disease processes. As a result of the complexity involved in making this diagnosis, there still remain substantial delays from the onset of symptoms to the diagnosis. A recent US study found an average delay of 9.5 months from symptoms to diagnosis for Crohn’s disease and 3.1 months for ulcerative colitis (Nguyen, et al. Inflamm Bowel Dis 23(10):1825–1831, 2017). This additional time to diagnosis for Crohn’s is borne out in several other international studies (Novacek, et al. Wien Klin Wochenschr 131(5–6):104–112, 2019; Zaharie, et al. J Crohns Colitis 10(3):306–314, 2016; El Mouzan, et al. Saudi J Gastroenterol 25:257–261, 2019). Intervening early in the disease course has significant implications on prognosis (Halme, et al. World J Gastroenterol 12(23):3668–3672, 2006), as early treatment can restore baseline function, while delays often result in permanent structural damage.

Diagnosis and Monitoring in Inflammatory Bowel Disease: Who, When, Where, and How

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Diagnosis and Monitoring in Inflammatory Bowel Disease: Who, When, Where, and How