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combination therapy for inflammatory bowel disease

World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第2期8卷 103-113页

作者： Keith S Sultan joshua.c berkowitz Sundas Khan Department of Medicine Division of Gastro- enterologyHofstra Northwell School of Medicine Department of Medicine Hofstra Northwell School of Medicine

Biologic therapies such as infliximab and adalimumab have become mainstays of treatment for inflammatory bowel disease. Early studies suggested that combination therapy(cT) with infliximab and an immunomodulator drug such as azathioprine may help optimize biologic pharmacokinetics, minimize immunogenicity, and improve outcomes. The landmark SONIc trial in crohn's disease and the Uc SUccESS trial in ulcerative colitis demonstrated cT with infliximab and azathioprine to be superior to monotherapy with either agent alone at inducing clinical remission in treatment na?ve patients with moderate to severe disease. However, many unanswered questions linger. The role of cT in non-naive patients as well as the optimal duration of cT remains unknown. The effectiveness of cT with alternate biologics and/or alternate immunomodulators is not as clear, and it is unknown whether SONIc's conclusions can be extrapolated beyond infliximab and azathioprine. Also looming are the risks of cT including opportunistic infection and malignancy; specifically, lymphoma. This review lays out the evidence as it pertains to the risks and benefits of cT as well as the areas that require further research. With this information in hand, the practitioner may develop a treatment strategy that best suits each individual patient.

关键词： crohn’s disease Adalimumab Vedolizumab Ulcerative colitis Infliximab Inflammatory bowel disease Methotrexate Azathioprine

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Declining use of combination infliximab and immunomodulator for inflammatory bowel disease in the community setting

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2018年第1期9卷 8-13页

作者： joshua.c berkowitz Joanna Stein-Fishbein Sundas Khan Richard Furie Keith S Sultan Department of Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Feinstein Institute for Medical Research Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Department of Medicine Division of Rheumatology Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Department of Medicine Division of Gastroenterology Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

AIM To describe trends of combination therapy (cT) of infliximab (IFX) and immunomodulator (IMM) for inflammatory bowel disease(IBD) in the community setting. METHODS A retrospective study was conducted of all IBD patients referred for IFX infusion to our community infusion center between 04/01/01 and 12/31/14. cT was defined as use of IFX with either azathioprine, 6-mercaptopurine, or methotrexate. We analyzed trends of cT usage overall, for crohn's disease (cD) and ulcerative colitis (Uc), and for the subgroups of induction patients. We also analyzed the trends of cT use in these groups over the study period, and compared the rates of cT use prior to and after publication of the landmark SONIc *** Of 258 IBD patients identified during the 12 year study period, 60 (23.3%) received cT, including 35 of 133(26.3%) induction patients. Based on the cochranArmitage trend test, we observed decreasing cT use for IBD patients overall(P ction patients,(P = 0.0024). Of 154 cD patients, 37(24.68%) had cT, including 20 of 77 (26%) induction *** cochran Armitage test showed a trend towards decreasing cT use for cD overall(P cD induction,(P = 0.0024). Overall, 43.8% of cD patients received cT pre-SONIc vs 7.4% post-SONIc (P cD induction, 40.0% received cT preSONIc vs 10.8% post-SONIc(P = 0.0035). Among the 93 patients with Uc, 19 (20.4%) received cT. Of 50 induction patients, 14 (28.0%) received cT. The trend test of the 49 patients with a known year of induction again failed to demonstrate any significant trends in the use of cT(P = 0.6). cONcLUSION We observed a trend away from cT use in IBD. A disconnect appears to exist between expert opinion and evidence favoring cT with IFX and IMM, and evolving community practice.

关键词： crohn’s disease Ulcerative colitis Infliximab Azathioprine Inflammatory bowel disease

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Etiology and long-term outcome of extrahepatic portal vein obstruction in children

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World Journal of Gastroenterology 2010年第39期16卷 4968-4972页

作者： Batia Weiss Eyal Shteyer Asaf Vivante Drora berkowitz Shimon Reif Zvi Weizman Yoram Bujanover Rivka Shapiro Division of Pediatric Gastroenterology Hepatology and NutritionEdmond and Lily Safra Children's Hospital Sackler Faculty of Medicine Tel-Aviv University Division of Pediatric Gastroenterology Hepatology and NutritionHadassah Medical CenterThe Hebrew University School of Medicine Division of Pediatric Gastroenterology Hepatology and NutritionMeyer Children's HospitalRambam Medical Center Rappaport School of Medicine TechnionIsrael Institute of Technology Division of Pediatric Gastroenterology Hepatology and NutritionDana Children's HospitalSouraski Medical Center Division of Pediatric Gastroenterology Hepatology and NutritionSoroka Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev Department of Pediatric Gastroenterology and Nutrition Division of Pediatric TransplantationSchneider Children's Hospital

AIM:To study the management and outcome of children with extrahepatic portal vein obstruction(EHPVO) in a whole country ***:A nationwide multicenter retrospective case series of children with EHPVO was *** on demographics,radiographic studies,laboratory workup,endoscopic and surgical procedures,growth and development,were extracted from the patients' *** of clinical presentation,etiology of EHPVO,management and outcome were ***:Thirty patients,13 males and 17 females,19(63.3%) Israeli and 11(36.7%) Palestinians,were included in the *** at presentation was 4.8± 4.6 years,and mean follow-up was 4.9±4.3 *** anomalies were found in 4 *** incidence of EHPVO in Israeli children aged 0-14 years was 0.72/*** factors for EHPVO were detected in 13(43.3%)patients,including 9 patients(30%) with perinatal risk factors,and 4 patients(13.3%) with prothrombotic states:two had low levels of protein S and c,one had lupus anticoagulant,and one was homozygous for methyltetrahydrofolate reductase *** 56.6% of patients,no predisposing factors were *** most common presenting symptoms were an incidental finding of splenomegaly(43.3%),and upper gastrointestinal bleeding(40%).No differences were found between Israeli and Palestinian children with regard to age at presentation,etiology and clinical *** occurred in 18 patients(60%),at a median age of 3 *** or esophageal banding was performed in 20 *** sclerotherapy complications were *** shunts were performed in 11 patients(36.6%),at a median age of 11(range 3-17)years:splenorenal in 9,mesocaval in 1,and a meso-Rex shunt in 1 *** patient underwent splenectomy due to severe *** were followed up for a median of 3(range 0.5-15)*** patient died aged 3 years due to mucopolysaccharidase deficiency type Ⅲ.None of the patients died due to gastrointestin

关键词： children Extrahepatic Obstruction Outcome Portal Vein

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社会心理学

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1988年

作者：伯克威茨(berkowitz.L.)

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前列腺癌:利用MR扩散加权成像和动态增强MRI定量评估雄激素阻断治疗疗效

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国际医学放射学杂志 2015年第6期 597-598页

作者： A.M.Htker Y.Mazaheri J.Zheng c.S.Moskowitz J.berkowitz J.E.Lantos 陈丽华 Department of Radiology Memorial Sloan-Kettering Cancer Center

摘要目的研究前列腺癌雄激素阻断治疗(ADT)后MRI参数上的改变,以及与治疗后反应间的相关性。方法经病理证实为前列腺癌的30例男性病人纳入本研究,且均于ADT

关键词：前列腺癌雄激素性甾体 MR 动态增强阻断治疗 MRI

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经医疗保健代理人调查耶和华见证人会孕妇对应用血制品的反应

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世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 48-48页

作者： Gyamfi c. berkowitz R.L. 杨晓梅 Division of Maternal-Fetal Medicine Dept. Obstet. Gynecol./Repro. Sci. Mount Sinai Medical Center 5 East 98th St reet New York NY 10029 United States Dr.

OBJEcTIVE: To review the treatment options presented on die New York State H ea lth care Prosy for Jehovah’s Witnesses, which is signed by pregnant women when they present for care. METHODS: chart reviews were performed for all women who p resented to labor and delivery at our institution from 1997 to 2002 and identifi ed themselves as Jehovah’s Witnesses. A patient was included in the study if a completed health care proxy was available in her chart Data were derived from th e health care prosy and from the Mount Sinai School of Medicine’s Blood Product checklist for Jehovah’s Witness Patients. Variables of interest included age, race, parity, and antenatal and perinatal complications. RESULTS: A total of 61 patients were identified. Of these, 39.3%agreed to accept a variety of donated blood products, 9.8%would accept donated packed red blood cells, and 50.1%woul d accept neither from a homologous donor. With respect to nonstored autologous b lood, 55%of respondents would accept either intraoperative normovolemic hemodil ution or transfusion of their own blood obtained by a cell salvage system. No si gnificant differences in responses were noted for any of the above-mentioned va riables. cONcLUSION: This review refutes the commonly held belief that all Jehov ah’s Witnesses refuse to accept blood or any of its products. In this populatio n of pregnant women, the majority were willing to accept some form of blood or b lood products. This information can be used to help health care providers counse l a patient when she is initially faced with considering these issues and may he lp to remove the stigma of accepting one of the options.

关键词：医疗保健血制品自体血浓缩红细胞图表分析围生期出生前蒙特纽约州无显著性差异

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