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Article ; Online: Effectiveness of Partial Enteral Nutrition as Add-On to Biologics in Patients With Refractory and Difficult-to-Treat Crohn's Disease: A Pilot Study.

Nardone, Olga Maria / Calabrese, Giulio / La Mantia, Alessia / Testa, Anna / Rispo, Antonio / Alfonsi, Lucia / Pasanisi, Fabrizio / Castiglione, Fabiana

Crohn's & colitis 360

2024 Volume 6, Issue 1, Page(s) otae011

Abstract: Background: Partial enteral nutrition (PEN) is a well-established treatment for children with Crohn's disease (CD). However, its efficacy in adults with CD remains uncertain. We aimed to assess the effectiveness of PEN as an add-on to escalated ... ...

Abstract	Background: Partial enteral nutrition (PEN) is a well-established treatment for children with Crohn's disease (CD). However, its efficacy in adults with CD remains uncertain. We aimed to assess the effectiveness of PEN as an add-on to escalated biological therapy in adults with CD who have lost response to biologics. Methods: We conducted a retrospective observational study including patients who had lost response to biologics and received PEN in combination with escalated treatment, compared to those treated only with escalated therapy. The primary endpoint was steroid-free clinical remission (CR) at 24 weeks. Secondary endpoints included transmural healing (TH) and response (TR) rates along with selected clinical outcomes. Results: Forty-two patients were screened; 12 (28.6%) were excluded for complicated disease and 30 (71.4%) were included in the final analysis. Fourteen (46.7%) patients completed PEN treatment at 8 weeks, while 16 patients (53.3%) discontinued treatment due to intolerance and continued with escalation of biologic (BT group). At 24 weeks, 9 patients (64.3%) in the PEN group achieved CR, compared to 4 patients (25%) in the BT group ( Conclusions: In patients who had lost response to biologics, PEN in combination with escalated biologics was associated with CR and TR and improved nutritional status. Hence, the addition of PEN should be considered for patients with difficult-to-treat CD.
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ISSN	2631-827X
ISSN (online)	2631-827X
DOI	10.1093/crocol/otae011
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Article: Asymptomatic microscopic colitis induced by secukinumab.

Megna, Matteo / De Lucia, Mario / Fornaro, Luigi / Tommasino, Nello / Castiglione, Fabiana / Cacciapuoti, Sara / Testa, Anna

JAAD case reports

2024 Volume 48, Page(s) 11–13

Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Case Reports
ZDB-ID	2834220-3
ISSN	2352-5126
ISSN	2352-5126
DOI	10.1016/j.jdcr.2024.03.017
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Article ; Online: Noninvasive monitoring of inflammatory bowel disease in the post COVID-19 era.

Nardone, Olga Maria / Rispo, Antonio / Castiglione, Fabiana

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2020 Volume 52, Issue 11, Page(s) 1236–1237

MeSH term(s)	Betacoronavirus ; Biomarkers/analysis ; COVID-19 ; Colonoscopy/adverse effects ; Coronavirus Infections ; Endoscopy/adverse effects ; Humans ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/diagnostic imaging ; Inflammatory Bowel Diseases/pathology ; Occult Blood ; Pandemics ; Pneumonia, Viral ; Recurrence ; SARS-CoV-2 ; Ultrasonography
Chemical Substances	Biomarkers
Keywords	covid19
Language	English
Publishing date	2020-07-19
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2020.07.014
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Article ; Online: Therapy in elderly IBD patients.

Castiglione, Fabiana / Imperatore, Nicola / Zingone, Fabiana / D'Incà, Renata

Minerva gastroenterology

2021 Volume 70, Issue 1, Page(s) 89–97

Abstract: Introduction: Appropriate treatment is critical in elderly inflammatory bowel disease (IBD) subjects since they are at higher risk of complications such as infections, malignancies and mortality.: Evidence acquisition: We conducted an extensive ... ...

Abstract	Introduction: Appropriate treatment is critical in elderly inflammatory bowel disease (IBD) subjects since they are at higher risk of complications such as infections, malignancies and mortality. Evidence acquisition: We conducted an extensive PubMed search for guidelines, systematic reviews and primary studies to perform a critical analysis of the existing literature on the efficacy and safety of conventional and biological therapies for elderly IBD patients. Evidence synthesis: Due to the exclusion of elderly population from clinical trials, most evidences comes from real-life studies. While aminosalicylates remain a cornerstone treatment of elderly patients with ulcerative colitis (UC), for their effectiveness and safety, their use in Crohn's disease (CD) should not be further supported. Corticosteroid use should be limited for the induction of remission, while as maintenance treatment it should be avoided, due to the low safety profile. Although as efficacious as in the younger population, immunosuppressant use has been associated with higher risk of infective/malignant issues and further use should be carefully evaluated. Biologics have demonstrated high effectiveness in the elderly. However, due to increased morbidity and mortality described in elderly subjects treated with anti-TNF alpha agents, vedolizumab and ustekinumab should be favoured over anti-TNF alpha agents. Conclusions: Treatment of elderly IBD patients remains challenging, since comorbidities and the risk of adverse events can complicate the effectiveness and safety of therapy. Close monitoring of such patients in a multidisciplinary team is advocated to reduce the risk of infections and optimize the treatment, choosing a suitable agent.
MeSH term(s)	Aged ; Humans ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Remission Induction ; Inflammatory Bowel Diseases/drug therapy ; Crohn Disease/drug therapy ; Colitis, Ulcerative/drug therapy
Chemical Substances	Tumor Necrosis Factor Inhibitors
Language	English
Publishing date	2021-06-23
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062713-8
ISSN	2724-5365
ISSN (online)	2724-5365
DOI	10.23736/S2724-5985.21.02895-3
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Article ; Online: Role of Dietary Supplements and Probiotics in Modulating Microbiota and Bone Health: The Gut-Bone Axis.

de Sire, Alessandro / de Sire, Roberto / Curci, Claudio / Castiglione, Fabiana / Wahli, Walter

Cells

2022 Volume 11, Issue 4

Abstract: Osteoporosis is characterized by an alteration of bone microstructure with a decreased bone mineral density, leading to the incidence of fragility fractures. Around 200 million people are affected by osteoporosis, representing a major health burden ... ...

Abstract	Osteoporosis is characterized by an alteration of bone microstructure with a decreased bone mineral density, leading to the incidence of fragility fractures. Around 200 million people are affected by osteoporosis, representing a major health burden worldwide. Several factors are involved in the pathogenesis of osteoporosis. Today, altered intestinal homeostasis is being investigated as a potential additional risk factor for reduced bone health and, therefore, as a novel potential therapeutic target. The intestinal microflora influences osteoclasts' activity by regulating the serum levels of IGF-1, while also acting on the intestinal absorption of calcium. It is therefore not surprising that gut dysbiosis impacts bone health. Microbiota alterations affect the OPG/RANKL pathway in osteoclasts, and are correlated with reduced bone strength and quality. In this context, it has been hypothesized that dietary supplements, prebiotics, and probiotics contribute to the intestinal microecological balance that is important for bone health. The aim of the present comprehensive review is to describe the state of the art on the role of dietary supplements and probiotics as therapeutic agents for bone health regulation and osteoporosis, through gut microbiota modulation.
MeSH term(s)	Bone Density ; Dietary Supplements ; Humans ; Microbiota ; Osteoporosis/metabolism ; Osteoporosis/therapy ; Probiotics/therapeutic use
Language	English
Publishing date	2022-02-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells11040743
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Article ; Online: Wernicke Encephalopathy in Ulcerative Colitis.

de Sire, Roberto / Rispo, Antonio / Compare, Debora / Tortora, Fabio / Nardone, Gerardo / Castiglione, Fabiana

Inflammatory bowel diseases

2022 Volume 28, Issue 5, Page(s) e70–e71

MeSH term(s)	Colitis, Ulcerative/complications ; Humans ; Wernicke Encephalopathy/diagnosis ; Wernicke Encephalopathy/etiology
Language	English
Publishing date	2022-05-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izab296
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Article ; Online: Rates of Endoscopic Recurrence In Postoperative Crohn's Disease Based on Anastomotic Techniques: A Systematic Review And Meta-Analysis.

Nardone, Olga Maria / Calabrese, Giulio / Barberio, Brigida / Giglio, Mariano Cesare / Castiglione, Fabiana / Luglio, Gaetano / Savarino, Edoardo / Ghosh, Subrata / Iacucci, Marietta

Inflammatory bowel diseases

2023

Abstract: Background: Patients with Crohn's disease (CD) after ileocolic resection may develop an endoscopic postoperative recurrence (ePOR) that reaches 40% to 70% of incidence within 6 months. Recently, there has been growing interest in the potential effect of ...

Abstract	Background: Patients with Crohn's disease (CD) after ileocolic resection may develop an endoscopic postoperative recurrence (ePOR) that reaches 40% to 70% of incidence within 6 months. Recently, there has been growing interest in the potential effect of anastomotic configurations on ePOR. Kono-S anastomosis has been proposed for reducing the risk of clinical and ePOR. Most studies have assessed the association of ileocolonic anastomosis and ePOR individually, while there is currently limited data simultaneously comparing several types of anastomosis. Therefore, we performed a systematic review and meta-analysis to assess the impact of different ileocolonic anastomosis on ePOR in CD. Methods: We searched PubMed and Embase from inception to January 2023 for eligible studies reporting the types of anastomoses and, based on these, the rate of endoscopic recurrence at ≥6 months. Studies were grouped by conventional anastomosis, including side-to-side, end-to-end, and end-to-side vs Kono-S, and comparisons were made between these groups. Pooled incidence rates of ePOR were computed using random-effect modelling. Results: Seventeen studies, with 2087 patients who underwent ileocolic resection for CD were included. Among these patients, 369 (17,7%) Kono-S anastomoses were performed, while 1690 (81,0%) were conventional ileocolic anastomosis. Endoscopic postoperative recurrence at ≥6 months showed a pooled incidence of 37.2% (95% CI, 27.7-47.2) with significant heterogeneity among the studies (P < .0001). In detail, patients receiving a Kono-S anastomosis had a pooled incidence of ePOR of 24.7% (95% CI, 6.8%-49.4%), while patients receiving a conventional anastomosis had an ePOR of 42.6% (95% CI, 32.2%-53.4%). Conclusions: Kono-S ileocolic anastomosis was more likely to decrease the risk of ePOR at ≥6 months compared with conventional anastomosis. Our findings highlight the need to implement the use of Kono-S anastomosis, particularly for difficult to treat patients. However, results from larger randomized controlled trials are needed to confirm these data.
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izad252
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Article ; Online: Escalating dose of adalimumab as monotherapy to treat unusual giant and refractory oral-pharyngeal ulcerations in Crohn's disease.

Fortuna, Giulio / Castiglione, Fabiana / Mignogna, Michele D

Dermatologic therapy

2019 Volume 32, Issue 3, Page(s) e12868

Abstract: Crohn's disease (CD) is a chronic, autoimmune inflammatory disease which may affect the entire gastrointestinal tract, from the oral cavity to the anus. Oral-pharyngeal ulcerations may be significant and persistent in patients with established CD, and ... ...

Abstract	Crohn's disease (CD) is a chronic, autoimmune inflammatory disease which may affect the entire gastrointestinal tract, from the oral cavity to the anus. Oral-pharyngeal ulcerations may be significant and persistent in patients with established CD, and the use of TNF-α inhibitor has demonstrated to be useful. We report a unique case of an unusual manifestation of oral CD characterized only by multiple, giant, long-lasting, relapsing ulcerations successfully treated with an escalating dose of Adalimumab at 40 mg weekly as a monotherapy.
MeSH term(s)	Adalimumab/administration & dosage ; Crohn Disease/complications ; Crohn Disease/drug therapy ; Dose-Response Relationship, Drug ; Humans ; Male ; Oral Ulcer/drug therapy ; Oral Ulcer/etiology ; Pharyngeal Diseases/drug therapy ; Pharyngeal Diseases/etiology ; Tumor Necrosis Factor Inhibitors/administration & dosage ; Young Adult
Chemical Substances	Tumor Necrosis Factor Inhibitors ; Adalimumab (FYS6T7F842)
Language	English
Publishing date	2019-03-18
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	1354801-3
ISSN	1529-8019 ; 1396-0296
ISSN (online)	1529-8019
ISSN	1396-0296
DOI	10.1111/dth.12868
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Article ; Online: Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice.

Fraquelli, Mirella / Castiglione, Fabiana / Calabrese, Emma / Maconi, Giovanni

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2019 Volume 52, Issue 1, Page(s) 9–18

Abstract: Technological improvements and growing sonographers' expertise boost the role of intestinal ultrasound (IUS) in assessing patients with inflammatory bowel diseases (IBD). Non-invasiveness, low cost and good reproducibility make IUS attractive. Leveraging ...

Abstract	Technological improvements and growing sonographers' expertise boost the role of intestinal ultrasound (IUS) in assessing patients with inflammatory bowel diseases (IBD). Non-invasiveness, low cost and good reproducibility make IUS attractive. Leveraging on the Authors' long-term field experience, this review focuses on the IUS role in IBD patients' clinical management. For detecting IBD, particularly Crohn's disease, the IUS parameters - above all the evidence of a thickened bowel wall (BWT) - show very good diagnostic accuracy similar to that of MRI or CT scan. The standard IUS parameters are not accurate enough to detect inflammatory activity, but intravenous contrast-enhanced US (CEUS) is highly accurate in ruling active inflammation out. However, its routinely use remains limited in clinical practice and its parameters need standardization. IUS is accurate in detecting IBD main complications: in particular, fistulae and abscesses. As to stenosis the recent introduction of IUS-based elastographic techniques allows to differentiate prevalently inflammatory from highly fibrotic strictures. IUS proves valid also for monitoring IBD patients. In particular, the evidence of transmural healing, defined as BWT normalization, has got an important prognostic meaning, as associated with better long-term clinical outcomes. Post-surgery CD recurrence can be suggested by early IUS assessment.
MeSH term(s)	Contrast Media/administration & dosage ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnostic imaging ; Intestines/diagnostic imaging ; Prognosis ; Ultrasonography
Chemical Substances	Contrast Media
Language	English
Publishing date	2019-11-13
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2019.10.004
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Article ; Online: Can a transition clinic bridge the gap between paediatric and adult inflammatory bowel disease care models?

Nardone, Olga Maria / Iacucci, Marietta / Ghosh, Subrata / Castiglione, Fabiana

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2020 Volume 52, Issue 5, Page(s) 516–527

Abstract: Transition care in inflammatory bowel disease is increasingly recognized as challenging given the inherent differences between paediatric and adult health care models, disease characteristics and treatment strategies. Transition is a dynamic process ... ...

Abstract	Transition care in inflammatory bowel disease is increasingly recognized as challenging given the inherent differences between paediatric and adult health care models, disease characteristics and treatment strategies. Transition is a dynamic process involving adolescents and young adults that are moving from a paediatric to an adult health care setting, and it should be flexible, continually updated and tailored to each patient. The implementation of a transition clinic is essential given the increasing incidence of the paediatric population with inflammatory bowel disease and the lifelong impact of this disease. The key question is when and how to structure transition according to the adolescent's clinical, psycho-social, educational needs and expectations to ensure continuity of care. In the attempt to improve the management of transition in inflammatory bowel disease and address the wide gap between adult and child care, we provide an update of the transition clinic and we propose a "treat to target" approach in transition to facilitate an effective and successful transition programme. In the changing landscape of the treatment of inflammatory bowel disease, further studies are necessary to determine the role of the transition clinic in determining the choice and strategy of therapy and its monitoring and the adoption of newer strategies such as biomarkers guided treating to target.
MeSH term(s)	Adolescent ; Clinical Competence ; Health Services Needs and Demand ; Humans ; Inflammatory Bowel Diseases/therapy ; Pediatrics ; Psychology, Adolescent ; Transition to Adult Care/organization & administration ; Young Adult
Language	English
Publishing date	2020-03-28
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2020.02.009
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