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Article ; Online: Ultrasound muscle assessment for sarcopenia detection in inflammatory bowel disease: A prospective study.

Mulinacci, Giacomo / Pirola, Lorena / Gandola, Davide / Ippolito, Davide / Viganò, Chiara / Laffusa, Alice / Gallo, Camilla / Invernizzi, Pietro / Danese, Silvio / Massironi, Sara

United European gastroenterology journal

2024

Abstract: Background: Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population.: Methods: 153 ... ...

Abstract	Background: Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population. Methods: 153 consecutive patients were included, 100 in the training cohort and 53 in the study cohort. Three superficial muscles (rectus femoris = RF, rectus abdominis = RA, and biceps brachii = BB) were selected for the detection of sarcopenia using muscle ultrasound (US). The training cohort consisted of consecutive patients with or without IBD and was used to evaluate the feasibility and inter- and intra-observer variability of the US measurement. The study cohort consisted of only IBD patients and served to test US diagnostic accuracy. In the latter, muscle US, bioelectrical impedance analysis (BIA), and magnetic resonance imaging (MRI) were used to measure muscle parameters. Results: Sarcopenia prevalence in IBD patients was 50%. Muscle US showed excellent inter-rater and intra-rater reliability (ICC >0.95) and a good diagnostic accuracy in detecting sarcopenia compared to BIA with area under the receiver operating characteristic curve (AUROC) values of 80% and 85% for RA and BB thickness, respectively. Moreover, an Ultrasound Muscle Index (USMI) was defined as the sum of the RA, BB, and RF thickness divided by the square of the patient's height, resulting in an AUROC of 81%. Muscle thresholds for sarcopenia were detected, with RA and USMI values correlated with the highest positive (84.3%) and negative (99%) predictive values, respectively. Additionally, the agreement between the US and MRI measurements of RA was excellent (ICC 0.96). Conclusions: The findings of this study emphasize the potential of muscle US as a reliable diagnostic tool for assessing sarcopenia in IBD patients. This research has significant implications for disease management in IBD patients and underscores the need for further investigations to validate these findings in larger cohorts.
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2728585-6
ISSN	2050-6414 ; 2050-6406
ISSN (online)	2050-6414
ISSN	2050-6406
DOI	10.1002/ueg2.12566
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Article ; Online: Inflammation and malnutrition in inflammatory bowel disease.

Massironi, Sara / Viganò, Chiara / Palermo, Andrea / Pirola, Lorena / Mulinacci, Giacomo / Allocca, Mariangela / Peyrin-Biroulet, Laurent / Danese, Silvio

The lancet. Gastroenterology & hepatology

2023 Volume 8, Issue 6, Page(s) 579–590

Abstract: Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, has become increasingly prevalent worldwide in the past decade. The nutritional status of patients with IBD is often impaired, with malnutrition presenting as ... ...

Abstract	Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, has become increasingly prevalent worldwide in the past decade. The nutritional status of patients with IBD is often impaired, with malnutrition presenting as imbalanced energy or nutrient intake, including protein-energy malnutrition, disease-related malnutrition, sarcopenia, and micronutrient deficiency. Additionally, malnutrition can manifest as overweight, obesity, and sarcopenic obesity. Malnutrition can lead to disturbances in gut microbiome composition that might alter homoeostasis and cause a dysbiotic state, potentially triggering inflammatory responses. Despite the clear link between IBD and malnutrition, little is known about the pathophysiological mechanisms beyond protein-energy malnutrition and micronutrient deficiencies that could promote inflammation through malnutrition, and vice versa. This Review focuses on potential mechanisms that trigger a vicious cycle between malnutrition and inflammation, and their clinical and therapeutic implications.
MeSH term(s)	Humans ; Protein-Energy Malnutrition/complications ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/therapy ; Malnutrition/complications ; Malnutrition/therapy ; Inflammation/complications ; Obesity/complications ; Micronutrients
Chemical Substances	Micronutrients
Language	English
Publishing date	2023-03-15
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(23)00011-0
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Article ; Online: Systematic review-pancreatic involvement in inflammatory bowel disease.

Massironi, Sara / Fanetti, Ilaria / Viganò, Chiara / Pirola, Lorena / Fichera, Maria / Cristoferi, Laura / Capurso, Gabriele / Invernizzi, Pietro / Danese, Silvio

Alimentary pharmacology & therapeutics

2022 Volume 55, Issue 12, Page(s) 1478–1491

Abstract: Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated disorder of the gut with frequent extra-intestinal complications. Pancreatic involvement in IBD is not uncommon and comprises a heterogeneous group of conditions, ... ...

Abstract	Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated disorder of the gut with frequent extra-intestinal complications. Pancreatic involvement in IBD is not uncommon and comprises a heterogeneous group of conditions, including acute pancreatitis (AP), chronic pancreatitis (CP), autoimmune pancreatitis (AIP) and pancreatic exocrine insufficiency (PEI); however, data on such an association remain sparse and heterogeneous. Method: PubMed/MEDLINE and EMBASE databases were searched for studies investigating pancreatic involvement in patients with IBD. Results: Four thousand one hundred and twenty-one records were identified and 547 screened; finally, 124 studies were included in the review. AP is the most frequent pancreatic manifestation in IBD; the majority of AP cases in IBD are due to gallstones and drugs but cases of idiopathic AP are increasingly reported. AIP is a rare disease, but a strong association with IBD has been demonstrated, especially for type 2 and ulcerative colitis. The pathogenetic link between IBD and AIP remains unclear, but an immune-mediated pathway seems plausible. An association between CP and PEI with IBD has also been suggested, but data are to date scarce and conflicting. Conclusion: This is the first systematic review of the association between IBD and pancreatic diseases. Gallstones and drugs should be considered the most probable causes of AP in IBD, with type 2 AIP also being possible.
MeSH term(s)	Acute Disease ; Autoimmune Diseases/complications ; Autoimmune Diseases/pathology ; Chronic Disease ; Colitis, Ulcerative/complications ; Exocrine Pancreatic Insufficiency ; Gallstones/complications ; Humans ; Inflammatory Bowel Diseases/complications ; Pancreatitis, Chronic
Language	English
Publishing date	2022-05-03
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.16949
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Article ; Online: Use of IBD Drugs in Patients With Hepatobiliary Comorbidities: Tips and Tricks.

Massironi, Sara / Pirola, Lorena / Mulinacci, Giacomo / Ciaccio, Antonio / Viganò, Chiara / Palermo, Andrea / Zilli, Alessandra / Invernizzi, Pietro / Danese, Silvio

Inflammatory bowel diseases

2022 Volume 29, Issue 9, Page(s) 1477–1487

Abstract: Advanced therapies (biologic agents and small molecules) for inflammatory bowel diseases (IBD) have radically changed the management of these diseases during the last decade. Data about these drugs in patients with hepatic disorders derive mainly from ... ...

Abstract	Advanced therapies (biologic agents and small molecules) for inflammatory bowel diseases (IBD) have radically changed the management of these diseases during the last decade. Data about these drugs in patients with hepatic disorders derive mainly from real-life studies, as these conditions often represent an exclusion criterion from pivotal drug developmental trials. However, IBD patients sometimes have concomitant liver diseases. Nonalcoholic fatty liver disease is the most prevalent hepatic comorbidity, whereas viral hepatitis, primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, and hepatic vascular disorders are less frequent. This review aimed at describing the real-life data about the use of advanced therapies for IBD in patients with concomitant hepatobiliary disorders. Hepatitis B virus and hepatitis C virus infections do not represent an absolute contraindication for novel IBD therapeutic agents. Data from the literature suggest a safe hepatobiliary profile of biologic agents and small molecules in the case of nonalcoholic fatty liver disease, autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis, and portal vein thrombosis. Consequently, although the liver disease does not affect a different therapeutic approach in patients with concomitant IBD and liver disease, a close risk/benefit analysis for each drug should be performed in these patients, especially in cirrhotic patients and in the postliver transplant setting.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/drug therapy ; Non-alcoholic Fatty Liver Disease/epidemiology ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/drug therapy ; Hepatitis, Autoimmune/complications ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/drug therapy ; Comorbidity ; Biological Factors/therapeutic use
Chemical Substances	Biological Factors
Language	English
Publishing date	2022-08-29
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izac189
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Article ; Online: Impact of COVID-19 on inflammatory bowel disease practice and perspectives for the future.

Viganò, Chiara / Mulinacci, Giacomo / Palermo, Andrea / Barisani, Donatella / Pirola, Lorena / Fichera, Maria / Invernizzi, Pietro / Massironi, Sara

World journal of gastroenterology

2021 Volume 27, Issue 33, Page(s) 5520–5535

Abstract: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); since its first description in December 2019, it has rapidly spread to a global pandemic. Specific ... ...

Abstract	Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); since its first description in December 2019, it has rapidly spread to a global pandemic. Specific concerns have been raised concerning patients with inflammatory bowel diseases (IBD), which are chronic autoimmune inflammatory disorders of the gut that frequently require immunosuppressive and biological therapies to control their activity. Accumulating evidence has so far demonstrated that patients with IBD are not at increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection. As for the general population, the identified risk factors for severe COVID-19 course among IBD patients have been established to be advanced age and the presence of comorbidities. Treatment with high-dose corticosteroids has also been associated with an increased risk of death in IBD patients with COVID-19. Information on COVID-19 is constantly evolving, with data growing at a rapid pace. This will guarantee better knowledge and stronger evidence to help physicians in the choice of the best therapeutic approach for each patient, concurrently controlling for the risk of IBD disease under treatment and the risk of COVID-19 adverse outcomes and balancing the two. Moreover, the impact of the enormous number of severe respiratory patients on healthcare systems and facilities has led to an unprecedented redeployment of healthcare resources, significantly impacting the care of patients with chronic diseases. In this newly changed environment, the primary aim is to avoid harm whilst still providing adequate management. Telemedicine has been applied and is strongly encouraged for patients without the necessity of infusion therapy and whose conditions are stable. The severe acute respiratory syndrome coronavirus 2 pandemic has already revolutionized the management of patients with chronic immune-mediated diseases such as IBD. Direct and indirect effects of the COVID-19 pandemic will be present for some time. This is the reason why continuous research, rapid solutions and constantly updated guidelines are of utmost importance. The aim of the present review is, therefore, to point out what has been learned so far as well as to pinpoint the unanswered questions and perspectives for the future.
MeSH term(s)	COVID-19 ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Inflammatory Bowel Diseases/epidemiology ; Pandemics ; SARS-CoV-2 ; Telemedicine
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v27.i33.5520
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Article: Acute mesenteric ischemia and small bowel imaging findings in COVID-19: A comprehensive review of the literature.

Pirola, Lorena / Palermo, Andrea / Mulinacci, Giacomo / Ratti, Laura / Fichera, Maria / Invernizzi, Pietro / Viganò, Chiara / Massironi, Sara

World journal of gastrointestinal surgery

2021 Volume 13, Issue 7, Page(s) 702–716

Abstract: Background: Coronavirus disease 2019 (COVID-19), an infectious condition caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide since its first description in Wuhan in December 2019. Even though respiratory ... ...

Abstract	Background: Coronavirus disease 2019 (COVID-19), an infectious condition caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide since its first description in Wuhan in December 2019. Even though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality, extrapulmonary involvement has progressively gained relevance. In particular, gastrointestinal (GI) signs and symptoms, reported in up to two-thirds of patients with COVID-19, might represent the first and, in some cases, the only disease presentation. Their presence has been associated in some studies with an increased risk of a severe disease course. Proposed pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells Aim: To discuss small bowel radiological manifestations of SARS-CoV-2 infection in abdominal imaging studies. Methods: Bibliographical searches were performed in PubMed, using the following keywords: "COVID-19" AND "imaging" AND "gastrointestinal" OR "abdominal" OR "small bowel". Results: Of 62 patients with described radiologic small bowel alterations, mesenteric ischemia was diagnosed in 31 cases (50%), small bowel wall thickening in 10 cases (16%), pneumatosis in nine cases (15%), intussusception in eight cases (13%), pneumoperitoneum in two cases (3%) and paralytic ileus in two cases (3%). We also reported mesenteric adipose tissue hypertrophy and lymph nodes enlargement in a young woman. Conclusion: So far it is difficult to establish whether these manifestations are the direct consequence of SARS-CoV-2 infection or collateral findings in infected patients, but their recognition would be pivotal to set a closer follow-up and to reduce missed diagnoses.
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v13.i7.702
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Article ; Online: Prevalence of Disease-Related Malnutrition and Micronutrients Deficit in Patients with Inflammatory Bowel Disease: A Multicentric Cross-Sectional Study by the GSMII (Inflammatory Bowel Disease Study Group).

Viganò, Chiara / Palermo, Andrea / Mulinacci, Giacomo / Pirola, Lorena / Losco, Alessandra / Meucci, Gianmichele / Saibeni, Simone / Pastorelli, Luca / Amato, Arnaldo / Gatti, Mario / Cortelezzi, Claudio / Di Sabatino, Antonio / Morganti, Daniela / Boni, Francesca / Grasso, Gianalberto / Casella, Giovanni / Casini, Valentina / Caprioli, Flavio Andrea / Vecchi, Maurizio /

Bezzio, Cristina / Bergna, Irene / Radaelli, Franco / Mengoli, Caterina / Massironi, Sara

Inflammatory bowel diseases

2023

Abstract: Background and aims: Inflammatory bowel disease (IBD) patients might experience disease-related malnutrition (DRM), but prevalence and risk factors are not well defined. The primary aim of the study was to define the prevalence of DRM and micronutrient ... ...

Abstract	Background and aims: Inflammatory bowel disease (IBD) patients might experience disease-related malnutrition (DRM), but prevalence and risk factors are not well defined. The primary aim of the study was to define the prevalence of DRM and micronutrient deficiency in IBD patients; the secondary aim was to assess variables related to DRM. Materials and methods: A multicenter, cross-sectional study was performed including consecutive adult IBD patients during a period of 2 weeks. Nutritional status was assessed with the body mass index (BMI) and the Malnutrition Universal Screening Tool. DRM was defined according to European Society for Clinical Nutrition and Metabolism guidelines. Results: Among the 295 enrolled patients, the prevalence of DRM was 23%, with no statistical difference between Crohn's disease and ulcerative colitis. Compared with well-nourished patients, patients with DRM showed higher rate of hospitalization in the previous month, were more often receiving systemic steroids, and had lower hemoglobin, albumin, and prealbumin levels and higher median C-reactive protein levels. At univariate logistic regression, current hospitalization, hospitalization in the previous month, low serum albumin, low BMI, high C-reactive protein, high Crohn's Disease Activity Index, and female sex were variables related to DRM. At the multivariate logistic regression, low BMI, current hospitalization and hospitalization in the previous month were significantly associated with DRM. In 23% of IBD patients, a deficiency of at least 1 micronutrient was observed, with no difference between ulcerative colitis and Crohn's disease. Conclusions: DRM and microelements malnutrition are frequent conditions in the IBD population. DRM seems to be associated with disease activity and hospitalization.
Language	English
Publishing date	2023-08-03
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/izad146
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Article ; Online: COVID-19 in Patients With Inflammatory Bowel Disease: A Single-center Observational Study in Northern Italy.

Viganò, Chiara / Massironi, Sara / Pirola, Lorena / Cristoferi, Laura / Fichera, Maria / Bravo, Marianna / Mauri, Martina / Redaelli, Alessandro Ettore / Dinelli, Marco Emilio / Invernizzi, Pietro

Inflammatory bowel diseases

2020 Volume 26, Issue 11, Page(s) e138–e139

MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Clinical Laboratory Techniques/statistics & numerical data ; Contact Tracing/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammatory Bowel Diseases/classification ; Inflammatory Bowel Diseases/epidemiology ; Inflammatory Bowel Diseases/therapy ; Italy/epidemiology ; Male ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Prevalence ; Risk Adjustment/methods ; Risk Factors ; SARS-CoV-2 ; Symptom Assessment/methods
Chemical Substances	Immunosuppressive Agents
Keywords	covid19
Language	English
Publishing date	2020-09-19
Publishing country	England
Document type	Letter ; Observational Study
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izaa244
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Article ; Online: Safety and clinical efficacy of the double switch from originator infliximab to biosimilars CT-P13 and SB2 in patients with inflammatory bowel diseases (SCESICS): A multicenter cohort study.

Clinical and translational science

2021 Volume 15, Issue 1, Page(s) 172–181

Abstract: Data regarding double switching from originator infliximab (IFX) to IFX biosimilars in inflammatory bowel diseases (IBDs) are lacking. The purpose of this study was to evaluate the safety and efficacy of switching from originator IFX to CT-P13 and ... ...

Abstract	Data regarding double switching from originator infliximab (IFX) to IFX biosimilars in inflammatory bowel diseases (IBDs) are lacking. The purpose of this study was to evaluate the safety and efficacy of switching from originator IFX to CT-P13 and subsequently to SB2 (double switch) in patients with IBD. Patients undergoing IFX-double switch in eight Centers in Lombardy (Italy) from November 2018 to May 2019 were retrospectively analyzed. The IFX discontinuation rate, incidence and type of adverse events (AEs), and clinical remission rate were recorded. A comparison with a control group of patients with IBD single-switched from originator IFX to CT-P13 was performed, before and after an inverse probability of treatment weighting (IPTW)-based propensity score analysis. Fifty-two double-switched patients with IBD were enrolled. The 24- and 52-week proportions of patients continuing on IFX therapy following the second switch (CTP13 → SB2) were 98% (95% confidence interval [CI] 94%-100%) and 90% (95% CI 81%-99%), respectively. Four patients experienced a total of five AEs, all graded 1-3 according to Common Terminology Criteria for Adverse Events (CTCAE). No infusion reactions were observed. The 24-week and follow-up end clinical remission rates following the second switch were 94% and 88%, respectively. No differences were observed in the safety and efficacy outcomes by comparing the double-switch group with a single-switch group of 66 patients with IBD; all these results were confirmed by IPTW-adjusted analysis. The study suggests both the safety and efficacy of the double switch from originator IFX to CT-P13 and SB2 in patients with IBD is maintained. This strategy may be associated with potential cost implications.
MeSH term(s)	Adolescent ; Adult ; Antibodies, Monoclonal/pharmacology ; Antibodies, Monoclonal/therapeutic use ; Biosimilar Pharmaceuticals/pharmacology ; Biosimilar Pharmaceuticals/therapeutic use ; Cohort Studies ; Drug Substitution ; Female ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Infliximab/pharmacology ; Infliximab/therapeutic use ; Male ; Treatment Outcome ; Young Adult
Chemical Substances	Antibodies, Monoclonal ; Biosimilar Pharmaceuticals ; CT-P13 ; SB2 infliximab ; Infliximab (B72HH48FLU)
Language	English
Publishing date	2021-09-15
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/cts.13131
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Article: COVID-19 in Patients With Inflammatory Bowel Disease: A Single-center Observational Study in Northern Italy

Viganò, Chiara / Massironi, Sara / Pirola, Lorena / Cristoferi, Laura / Fichera, Maria / Bravo, Marianna / Mauri, Martina / Redaelli, Alessandro Ettore / Dinelli, Marco Emilio / Invernizzi, Pietro

Inflamm Bowel Dis

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #780401
Database	COVID19

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