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  1. Article ; Online: Novel developments in IBD-related sclerosing cholangitis.

    Ponsioen, C Y

    Best practice & research. Clinical gastroenterology

    2011  Volume 25 Suppl 1, Page(s) S15–8

    Abstract: Primary sclerosing cholangitis is often regarded as an autoimmune disorder and occurs frequently in relation to inflammatory bowel disease. The ongoing fibro-obliterative process of the biliary tree ensues in liver failure or cholangiocarcinoma in 12-18 ... ...

    Abstract Primary sclerosing cholangitis is often regarded as an autoimmune disorder and occurs frequently in relation to inflammatory bowel disease. The ongoing fibro-obliterative process of the biliary tree ensues in liver failure or cholangiocarcinoma in 12-18 years. PSC patients with concurrent IBD are at increased risk of developing colorectal carcinoma. Ursodeoxycholic acid, which is widely prescribed in PSC, is despite intensive clinical research still not proven to halt disease progression. Nor-ursodeoxycholic acid seems promising in animal models of cholestasis. Novel compounds that are involved in the immunological axis between the gut and the liver await clinical testing in PSC.
    MeSH term(s) Animals ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized ; Cholagogues and Choleretics/therapeutic use ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/drug therapy ; Cholangitis, Sclerosing/immunology ; Disease Progression ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammatory Bowel Diseases/complications ; Natalizumab ; Ursodeoxycholic Acid/therapeutic use
    Chemical Substances Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Cholagogues and Choleretics ; Immunosuppressive Agents ; Natalizumab ; Ursodeoxycholic Acid (724L30Y2QR)
    Language English
    Publishing date 2011-04
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2048181-0
    ISSN 1532-1916 ; 1521-6918
    ISSN (online) 1532-1916
    ISSN 1521-6918
    DOI 10.1016/S1521-6918(11)70005-1
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  2. Article ; Online: Improving disease knowledge of primary sclerosing cholangitis patients and their relatives with a 3-dimensional education video.

    van Munster, K N / van Mil, J / Safer, R / Nieuwkerk, P T / Ponsioen, C Y

    Patient education and counseling

    2020  Volume 103, Issue 5, Page(s) 960–964

    Abstract: Objective: Primary sclerosing cholangitis is a severe liver disease. Liver transplantation is the only curative therapeutic option. The unpredictable disease course causes much uncertainty and anxiety among patients and relatives. Improved disease ... ...

    Abstract Objective: Primary sclerosing cholangitis is a severe liver disease. Liver transplantation is the only curative therapeutic option. The unpredictable disease course causes much uncertainty and anxiety among patients and relatives. Improved disease knowledge may result in better health outcomes. In PSC, there is lack of high quality patient education materials. The aim of this study was to evaluate the ability of a 3-dimensional education video to improve PSC knowledge in patients and relatives.
    Methods: A digital survey containing questions about PSC, anxiety and satisfaction was sent prior to, directly after, and one week after watching the video. Both European and American patients and relatives were included.
    Results: A total of 278 participants (224 patients and 54 relatives) were included. PSC knowledge score increased from 53 % to 74 % directly after and 70 % one week after the video. The STAI anxiety score decreased after the video (-0,8, p = 0,007). Younger age and lower baseline knowledge were independent predictors of knowledge improvement.
    Conclusion: Disease knowledge improved after watching the video and this was sustained one week later. Generally, patients were very enthusiastic about the video.
    Practice implications: 3D education videos can be useful to increase disease knowledge in a severe disease such as PSC.
    MeSH term(s) Adult ; Aged ; Cholangitis, Sclerosing/etiology ; Cholangitis, Sclerosing/psychology ; Cholangitis, Sclerosing/therapy ; Female ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Humans ; Male ; Middle Aged ; Patient Education as Topic/methods ; Patient Participation ; Prospective Studies ; Video Recording/methods
    Language English
    Publishing date 2020-01-10
    Publishing country Ireland
    Document type Evaluation Study ; Journal Article
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2020.01.005
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  3. Article ; Online: Comparison of proactive and conventional treatment of anastomotic leakage in rectal cancer surgery: a multicentre retrospective cohort series.

    Talboom, K / Greijdanus, N G / Brinkman, N / Blok, R D / Roodbeen, S X / Ponsioen, C Y / Tanis, P J / Bemelman, W A / Cunningham, C / de Lacy, F B / Hompes, Roel

    Techniques in coloproctology

    2023  Volume 27, Issue 11, Page(s) 1099–1108

    Abstract: Purpose: Comparative studies on efficacy of treatment strategies for anastomotic leakage (AL) after low anterior resection (LAR) are almost non-existent. This study aimed to compare different proactive and conservative treatment approaches for AL after ... ...

    Abstract Purpose: Comparative studies on efficacy of treatment strategies for anastomotic leakage (AL) after low anterior resection (LAR) are almost non-existent. This study aimed to compare different proactive and conservative treatment approaches for AL after LAR.
    Methods: This retrospective cohort study included all patients with AL after LAR in three university hospitals. Different treatment approaches were compared, including a pairwise comparison of conventional treatment and endoscopic vacuum-assisted surgical closure (EVASC). Primary outcomes were healed and functional anastomosis rates at end of follow-up.
    Results: Overall, 103 patients were included, of which 59 underwent conventional treatment and 23 EVASC. Median number of reinterventions was 1 after conventional treatment, compared to 7 after EVASC (p < 0.01). Median follow-up was 39 and 25 months, respectively. Healed anastomosis rate was 61% after conventional treatment, compared to 78% after EVASC (p = 0.139). Functional anastomosis rate was higher after EVASC, compared to conventional treatment (78% vs. 54%, p = 0.045). Early initiation of EVASC in the first week after primary surgery resulted in better functional anastomosis rate compared to later initiation (100% vs. 55%, p = 0.008).
    Conclusion: Proactive treatment of AL consisting of EVASC resulted in improved healed and functional anastomosis rates for AL after LAR for rectal cancer, compared to conventional treatment. If EVASC was initiated within the first week after index surgery, a 100% functional anastomosis rate was achievable.
    Language English
    Publishing date 2023-05-22
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-023-02808-z
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  4. Article ; Online: Highly selective diversion with proactive leakage management after low anterior resection for rectal cancer.

    Talboom, K / Vogel, I / Blok, R D / Roodbeen, S X / Ponsioen, C Y / Bemelman, W A / Hompes, R / Tanis, P J

    The British journal of surgery

    2021  Volume 108, Issue 6, Page(s) 609–612

    MeSH term(s) Anastomotic Leak/etiology ; Anastomotic Leak/therapy ; Colostomy/adverse effects ; Colostomy/methods ; Female ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/surgery ; Rectum/surgery ; Retrospective Studies ; Surgical Stomas/adverse effects
    Language English
    Publishing date 2021-04-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znab018
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  5. Article ; Online: A nationwide database study on colectomy and colorectal cancer in ulcerative colitis: what is the role of appendectomy?

    Stellingwerf, M E / Bemelman, W A / Löwenberg, M / Ponsioen, C Y / D'Haens, G R / van Dieren, S / Buskens, C J

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2020  Volume 23, Issue 1, Page(s) 64–73

    Abstract: Aim: Although has been suggested that an appendectomy has a positive effect on the disease course in patients with ulcerative colitis (UC), recent studies indicate a potential increase in risk of colectomy and colorectal cancer (CRC). This study aimed ... ...

    Abstract Aim: Although has been suggested that an appendectomy has a positive effect on the disease course in patients with ulcerative colitis (UC), recent studies indicate a potential increase in risk of colectomy and colorectal cancer (CRC). This study aimed to evaluate the rates of colectomy and CRC after appendectomy in UC patients using a nationwide prospective database [the Initiative on Crohn and Colitis Parelsnoer Institute - Inflammatory Bowel Disease (ICC PSI-IBD) database].
    Method: All UC patients were retrieved from the ICC PSI-IBD database between January 2007 and May 2018. Primary outcomes were colectomy and CRC. Outcomes were compared in patients with and without appendectomy, with a separate analysis for timing of appendectomy (before or after UC diagnosis).
    Results: A total of 826 UC patients (54.7% female; median age 46 years, range 18-89 years) were included. Sixty-three (7.6%) patients had previously undergone appendectomy: 24 (38.1%) before and 33 (52.4%) after their diagnosis of UC. In multivariate analysis, appendectomy after UC diagnosis was associated with a significantly lower colectomy rate compared with no appendectomy [hazard ratio (HR) 0.16, 95% C: 0.04-0.66, P = 0.011], and the same nonsignificant trend was seen in patients with an appendectomy before UC diagnosis (HR 0.35, 95% CI 0.08-1.41, P = 0.138). Appendectomy was associated with delayed colectomy, particularly when it was performed after diagnosis of UC (P = 0.009). No significant differences were found in the CRC rate between patients with and without appendectomy (1.6% vs 1.2%; P = 0.555).
    Conclusion: Appendectomy in established UC is associated with an 84% decreased risk of colectomy and a delay in surgery. Since the colon is in situ for longer, the risk of developing CRC remains, which underscores the importance of endoscopic surveillance programmes.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendectomy ; Colectomy ; Colitis, Ulcerative/epidemiology ; Colitis, Ulcerative/surgery ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/etiology ; Colorectal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Young Adult
    Language English
    Publishing date 2020-07-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15184
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  6. Article ; Conference proceedings: Endobiliary radiofrequency ablation for malignant biliary obstruction due to perhilar cholangiocarcinoma (RACCOON-p): a prospective pilot study

    Fritzsche, J. A. / Wielenga, M. C. / Van Delden, O. / Erdmann, J. I. / Klümpen, H. J. / van Wanrooij, L J / Fockens, P. / Ponsioen, C. Y. / Voermans, R. P.

    Endoscopy

    2023  Volume 55, Issue S 02

    Event/congress ESGE Days 2023, Dublin, Ireland, 2023-04-20
    Language English
    Publishing date 2023-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/s-0043-1765459
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  7. Article ; Online: Point-of-care Intestinal Ultrasound in IBD Patients: Disease Management and Diagnostic Yield in a Real-world Cohort and Proposal of a Point-of-care Algorithm.

    Bots, S / De Voogd, F / De Jong, M / Ligtvoet, V / Löwenberg, M / Duijvestein, M / Ponsioen, C Y / D'Haens, G / Gecse, K B

    Journal of Crohn's & colitis

    2021  Volume 16, Issue 4, Page(s) 606–615

    Abstract: Introduction: Intestinal ultrasound [IUS] is useful for assessment of inflammation, complications, and treatment follow-up in inflammatory bowel disease [IBD] patients. We aimed to study outcomes and impact on disease management for point-of-care [POC] ... ...

    Abstract Introduction: Intestinal ultrasound [IUS] is useful for assessment of inflammation, complications, and treatment follow-up in inflammatory bowel disease [IBD] patients. We aimed to study outcomes and impact on disease management for point-of-care [POC] IUS in IBD patients.
    Methods: Two patient cohorts undergoing POC IUS [January 2016-July 2018 and October 2019-December 2019] were included retrospectively. Disease management after IUS was analysed and IUS outcomes were compared with symptoms, biomarkers, and additional imaging within 8 weeks from IUS. To study differences in use of IUS over time, cohorts were compared.
    Results: In total, 345 examinations (280 in Crohn's disease [CD]/65 in ulcerative colitis [UC]) were performed. Present inflammation on IUS was comparable between symptomatic and asymptomatic CD [67.6% vs 60.5%; p = 0.291]. In 60%, IUS had impact on disease management with change in medication in 47.8%. Additional endoscopy/magnetic resonance imaging [MRI] was planned after 32.8% examinations, showing good correlation with IUS in 86.3% [ρ = 0.70, p <0.0001] and 80.0% [ρ = 0.75, p <0.0001] of cases, respectively. Faecal calprotectin was higher in active versus inactive disease on IUS [664 µg/g vs 79 µg/g; p <0.001]. Over the years, IUS was performed more frequently to monitor treatment response and the use of MRI was reduced within the cohort.
    Conclusions: POC IUS affects clinical decision making and could detect preclinical relapse in CD patients, with potential to reduce additional endoscopy or MRI. In addition, the paradigm expands towards monitoring treatment and close follow-up for IUS. Based on our results, we propose a POC IUS algorithm for follow-up of IBD patients.
    MeSH term(s) Algorithms ; Chronic Disease ; Colitis, Ulcerative/diagnostic imaging ; Colitis, Ulcerative/drug therapy ; Crohn Disease/complications ; Crohn Disease/diagnostic imaging ; Disease Management ; Feces ; Humans ; Inflammation/complications ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnostic imaging ; Point-of-Care Systems ; Retrospective Studies
    Language English
    Publishing date 2021-10-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjab175
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  8. Article ; Conference proceedings: High sensitivity of biliary brush cytology after optimization of protocol in patients with suspected perihilar or intrahepatic cholangiocarcinoma: a prospective cohort study with historical control

    Fritzsche, J. A. / Smit, E. / Van Delden, O. / Dijk, F. / Erdmann, J. I. / Fockens, P. / Sarasqueta, A. Farina / Kazemier, G. / Klümpen, H. J. / Meijer, S. L. / Ponsioen, C. Y. / Uyterlinde, A. M. / van Wanrooij, R.L J / Wielenga, M. C. / Zijlstra, I. A. / Verheij, J. / Voermans, R. P.

    Endoscopy

    2024  Volume 56, Issue S 02

    Event/congress ESGE Days 2024, Berlin, Germany, 2024-04-25
    Language English
    Publishing date 2024-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/s-0044-1782949
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  9. Article ; Online: Patterns of anti-TNF use and associated treatment outcomes in inflammatory bowel disease patients: results from an analysis of Dutch health insurance claims data.

    Bots, S J A / Hoekman, D R / Benninga, M A / Ponsioen, C Y / D'Haens, G R / Löwenberg, M

    The Netherlands journal of medicine

    2017  Volume 75, Issue 10, Page(s) 432–442

    Abstract: Introduction: Real-life patterns of anti-tumour necrosis factor (anti-TNF) use remain largely unknown. We aimed to investigate survival rates, clinical outcomes and costs of anti-TNF agents in a large population of patients with inflammatory bowel ... ...

    Abstract Introduction: Real-life patterns of anti-tumour necrosis factor (anti-TNF) use remain largely unknown. We aimed to investigate survival rates, clinical outcomes and costs of anti-TNF agents in a large population of patients with inflammatory bowel disease (IBD).
    Methods: Health insurance data from 22,082 IBD patients were provided by Achmea Healthcare. Time to anti-TNF discontinuation, treatment intensification, corticosteroid initiation and hospitalisation were analysed in patients starting on anti-TNF treatment from January 2008 until December 2014. Treatment regimens were analysed at different time points.
    Results: In this cohort, 855 and 1199 subjects started infliximab and adalimumab treatment, respectively. The median time to anti-TNF discontinuation was 600 days (IQR 156-1693). The proportion of subjects receiving intensified treatment increased over time (infliximab at 3 vs. 24 months: 22.2% vs. 33.6%, p = 0.01; adalimumab at 3 vs. 24 months: 10.5% vs. 19.3%, p < 0.001). Cessation of anti-TNF treatment was less common in Crohn's disease patients (HR 0.79, p = 0.001) and in patients receiving intensified treatment (HR 0.62, p = 0.001). Immunomodulator use was associated with a longer time to corticosteroid initiation (HR 0.80, p = 0.048), but not with longer drug survival (HR 0.99, p = 0.617). Hospitalisation was more common in Crohn's patients (HR 1.49, p = 0.011). Corticosteroid initiation was lower in Crohn's patients (HR 0.57, p < 0.001) and in patients using infliximab (HR 0.55, p < 0.001).
    Conclusions: Discontinuation of anti-TNF therapy occurred earlier than previously reported and was associated with a diagnosis of ulcerative colitis and non-intensified anti-TNF treatment. Immunomodulator use at the start of anti-TNF treatment was associated with a longer time to corticosteroid initiation, but not with longer drug survival.
    MeSH term(s) Adalimumab/economics ; Adalimumab/therapeutic use ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Cohort Studies ; Drug Costs ; Female ; Hospitalization/statistics & numerical data ; Humans ; Immunologic Factors/economics ; Immunologic Factors/therapeutic use ; Inflammatory Bowel Diseases/drug therapy ; Infliximab/economics ; Infliximab/therapeutic use ; Insurance, Health ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Netherlands ; Proportional Hazards Models ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Adrenal Cortex Hormones ; Immunologic Factors ; Tumor Necrosis Factor-alpha ; Infliximab (B72HH48FLU) ; Adalimumab (FYS6T7F842)
    Keywords covid19
    Language English
    Publishing date 2017-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 193149-0
    ISSN 1872-9061 ; 0300-2977
    ISSN (online) 1872-9061
    ISSN 0300-2977
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  10. Article ; Conference proceedings: Long-term efficacy of metal versus plastic stents in inoperable perihilar cholangiocarcinoma; a multicenter retrospective propensity score matched comparison

    Fritzsche, J. A. / de Jong, D. M. / Borremans, J. J. / Bruno, M. J. / Van Delden, O. / Erdmann, J. I. / Fockens, P. / De Gooyer, P. / Koerkamp, B. Groot / Klümpen, H. J. / Moelker, A. / Montazeri, N. S. / Nooijen, L. E. / Ponsioen, C. Y. / van Wanrooij, L J / Van Driel, L. M. / Voermans, R. P.

    Endoscopy

    2023  Volume 55, Issue S 02

    Event/congress ESGE Days 2023, Dublin, Ireland, 2023-04-20
    Language English
    Publishing date 2023-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/s-0043-1765476
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