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Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

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World Journal of Gastroenterology 2019年第38期25卷 5862-5882页

作者： rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery ramos Milene Fernandes Jose Jr rocha Marley r Feitosa Omar Feres Antonio S Scotton rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki rogerio S Hossne Mauro Bafutto roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes wilson r catapani Anderson A Faria Stella CS Souza rosana F Caratin Juliana T Senra Maria LA Ferrari Department of Surgery and Anatomy Ribeirao Preto Medical SchoolUniversity of Sao PauloRibeirao PretoSP 14049-900Brazil Hospital Universitario da Universidade Federal do Piaui TeresinaPI 64049-550Brazil Carolina D Gonclves Isabella M GuimaraesUniversidade Federal do Rio de JaneiroRio de JaneiroRJ 21941-913Brazil Universidade do Estado da Bahia -SalvadorBA 41150-000Brazil Department of Internal Medicine Botucatu Medical School at Sao Paulo State University(UNESP)BotucatuSP 18618-687Brazil Instituto Goiano de Gastroenterologia e Endoscopia Digestiva Ltda GoianiaGO 74535-170Brazil Kaiser Clinica Sao Jose do Rio PretoSP 15015-110Brazil Escola Paulista de Medicina Sao PauloSP 04023-900Brazil UNIFESP Disciplina de GastroenterologiaSao PauloSP 04040-002Brazil Faculdade de Medicina do ABC Santo AndreSP 09060-870Brazil Faculdade de Medicina UFMG Belo HorizonteMG30130-100Brazil Inflammatory Bowel Disease Center Federal University of Juiz de ForaJuiz de ForaMG 36036-247Brazil Takeda Pharmaceuticals Brazil Sao PauloSP 04709-011Brazil 不详 Hospital de Clinicas da Universidade Federal do Parana CuritibaPR 80060-900Brazil Hospital de Clinicas de Porto Alegre Porto Alegre-RS 90035-007Brazil Universidade Federal do Piaui TeresinaPI 64073-500Brazil Hospital de Clínicas da Universidade Federal do Parana CuritibaPR 80060-900Brazil CTI Clinical Trial&Consulting Services Lisbon 1070-274Portugal CMIP Centro Mineiro de Pesquisa Juiz de ForaMG 36010-570Brazil Hospital Nossa Senhora das Gracas CuritibaPR 80810-040Brazil

BACKGrOUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general *** about disease control,patient-reported outcomes(PrOs),treatment patterns and use of healthcare resources is relevant to optimizing IBD *** To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in *** A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,*** PrO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI *** about healthcare resources and treatment during the previous 3 years was collected from medical ***-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PrOs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).rESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at *** in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/*** to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(Prk productivity impairment was 20%and 5%for CD and UC patients,re

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Quality of life Healthcare resources

real-world treatment patterns and disease control over one year in patients with inflammatory bowel disease in Brazil

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World Journal of Gastroenterology 2021年第23期27卷 3396-3412页

作者： Ligia Yukie Sassaki Sender J Miszputen roberto Luiz Kaiser Junior wilson r catapani Mauro Bafutto António S Scotton Cyrla Zaltman Julio Pinheiro Baima Hagata S ramos Mikaell Alexandre Gouvea Faria Carolina D Gonçalves Isabella Miranda Guimaraes Cristina Flores Heda M B S Amarante rodrigo Bremer Nones JoséMiguel Luz Parente Murilo Moura Lima Júlio Maria Chebli Maria de Lourdes Abreu Ferrari Julia F Campos Maria G P Sanna Odery ramos rogério Serafim Parra Jose J r da rocha Omar Feres Marley r Feitosa rosana Fusaro Caratin Juliana Tosta Senra Genoile Oliveira Santana Department of Internal Medicine Botucatu Medical School at Sao Paulo State University(UNESP)Botucatu 18618-687São PauloBrazil Department of Gastroenterology Escola Paulista de MedicinaSao PauloSão Paulo 18618-687São PauloBrazil Department of Proctology Kaiser Day HospitalSão Jose do Rio Preto 15015-110São PauloBrazil Department of Gastroenterology Faculdade de Medicina do ABCSanto Andre 09060-870São PauloBrazil Department of Gastroenterology Faculdade de MedicinaGoiania 74535-170GoiásBrazil Department of Gastroenterology CMIP Centro Mineiro de PesquisaJuiz de Fora 36010-570Minas GeraisBrazil Department of Internal Medicine Federal University of Rio de JaneiroRio de Janeiro 21941-913Rio de JaneiroBrazil Department of Gastroenterology Escola Paulista de MedicinaSão Paulo 04023-900São PauloBrazil Hospital de Clínicas de Porto Alegre Hospital de Clínicas de Porto AlegrePorto Alegre 90035-903Rio Grande do SulBrazil Hospital de Clinicas da Universidade Federal do Paraná Hospital de Clinicas da Universidade Federal do ParanáCuritiba ParanáParanáBrazil Gastroenterology Department Hospital Nossa Senhora das GraçasCuritiba 80810-040ParanáBrazil Department of General Medicine Universidade Federal do PiauíTeresina 64049-550PiauíBrazil Gastroenterology Hospital Universitario da Universidade Federal do PiauiTeresina 64049-550PiauíBrazil Department of Medicine University Hospital of Federal University of Juiz de ForaJuiz de ForaJuiz de Fora 36036-247Minas GeraisBrazil Department of Clinical Medicine Universidade Federal de Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Hospital de Clinicas da Universidade Federal do Paraná Hospital de Clinicas da Universidade Federal do ParanáCuritiba 80060-900ParanáBrazil Department of Surgery and Anatomy Ribeirao Preto Medical SchoolUniversity of Sao PauloRibeirão Preto 14048-900São PauloBrazil Scientific Affairs Takeda Pharmaceuticals BrazilSao Paulo 04709-011Brazil Clinical research Takeda PharmaceuticalsSão Paulo 04709-011Sã

BACKGrOUND Crohn’s disease(CD)and ulcerative colitis(UC)are inflammatory bowel diseases(IBDs)with a remission-relapsing presentation and symptomatic exacerbations that have detrimental impacts on patient quality of life and are associated with a high cost burden,especially in patients with moderate-to-severe *** real-world Data of Moderate-to-Severe Inflammatory Bowel Disease in Brazil(rISE Br)study was a noninterventional study designed to evaluate disease control,treatment patterns,disease burden and health-related quality of life in patients with moderate-to-severe active *** report findings from the prospective follow-up phase of the rISE Br study in patients with active UC or *** To describe the 12-mo disease evolution and treatment patterns among patients with active moderate-to-severe IBD in *** This was a prospective,noninterventional study of adult patients with active Crohn’s disease(CD:Harvey-Bradshaw Index≥8,CD Activity Index≥220),inadequate CD control(i.e.,calprotectin>200μg/g or colonoscopy previous results),or active ulcerative colitis(UC:Partial Mayo score≥5).Enrollment occurred in 14 centers from October 2016 to February *** proportion of active IBD patients after 9-12 mo of follow-up,Kaplan-Meier estimates of the time to mild or no activity and a summary of treatment initiation,discontinuation and dose changes were *** The study included 118 CD and 36 UC patients,with mean±SD ages of 43.3±12.6 and 44.9±16.5 years,*** most frequent drug classes at index were biologics for CD(62.7%)and 5-aminosalicylate derivates for UC patients(91.7%).During follow-up,65.3%of CD and 86.1%of UC patients initiated a new treatment at least ***/dose changes occurred in 68.1%of CD patients[median 2.0(IQr:2-5)]and 94.3%of UC patients[median 4.0(IQr:3-7)].On average,CD and UC patients had 4.4±2.6 and 5.0±3.3 outpatient visits,*** median time to first mild or no activity was 319(IQr:239-3

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel diseases Prospective study

real-world disease activity and sociodemographic,clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil

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World Journal of Gastroenterology 2021年第2期27卷 208-223页

作者： Cyrla Zaltman rogério Serafim Parra Ligia Yukie Sassaki Genoile Oliveira Santana Maria de Lourdes Abreu Ferrari Sender J Miszputen Heda M B S Amarante roberto Luiz Kaiser Junior Cristina Flores wilson r catapani JoséMiguel Luz Parente Mauro Bafutto Odery ramos Carolina D Gonçalves Isabella Miranda Guimaraes Jose J r da rocha Marley r Feitosa Omar Feres rogerio Saad-Hossne Francisco Guilherme Cancela Penna Pedro Ferrari Sales Cunha Tarcia NF Gomes rodrigo Bremer Nones Mikaell Alexandre Gouvea Faria Mírian Perpétua Palha Dias Parente António S Scotton rosana Fusaro Caratin Juliana Senra Júlio Maria Chebli Department of Internal Medicine Federal University of Rio de JaneiroRio de Janeiro 21941-913Brazil Department of Surgery and Anatomy Ribeirão Preto Medical SchoolUniversity of São PauloRibeirao Preto 14049-900São PauloBrazil Department of Internal Medicine São Paulo State University(UNESP)Medical SchoolBotucatu 18618-687São PauloBrazil IBD Unit Federal University of BahiaSalvador 41150-000BahiaBrazil Department of Clinical Medicine Medical SchoolUniversidade Federal de Minas GeraisBelo Horizonte 30130-100Minas GeraisBrazil Department of Gastroenterology Escola Paulista de MedicinaSão Paulo 04023-900Brazil Hospital de Clinicas Universidade Federal do ParanaCuritiba 80060-900ParanaBrazil Department of Proctology Beneficencia Portuguesa Hospital/Kaiser Day HospitalSao Jose do Rio Preto 15015110São PauloBrazil Department of Gastroenterology and Hepatology Sciences Hospital de ClínicasUniversidade Federal do Rio Grande do SulPorto Alegre 90560002Rio Grande do SulBrazil Department of Gastroenterology Faculdade de Medicina do ABCSanto Andre 09060-870São PauloBrazil Department of General Medicine Gastroenterology UnitUniversity HospitalFederal University of PiauiTeresina 64049-550PiauíBrazil Department of Gastroenterology Faculdade de MedicinaUniversidade Federal de GoiásGoiania 74535-170GoiasBrazil Department of Surgery Botucatu Medical School at São Paulo State University(UNESP)Botucatu 18618687São PauloBrazil Department of Gastroenterology UNIFESPSão Paulo 04040-002Brazil IBD unit Gastroenterology DepartmentHospital Nossa Senhora das GraçasCuritiba 80810-040ParanaBrazil Department of Proctology Kaiser Hospital DiaSao Jose do Rio Preto 15015-110São PauloBrazil Health Sciences Center Epidemiology UnitState University of PiauiTeresina 64001-280PiauíBrazil Department of Gastroenterology CMIP Centro Mineiro de PesquisaJuiz de Fora 36010-570Minas GeraisBrazil Scientific Affairs Takeda Pharmaceuticals BrazilSão Paulo 04709-011Brazil Clinical research Takeda Pharma

BACKGrOUND Understanding the treatment landscape of inflammatory bowel diseases(IBD)is essential for improving disease management and patient *** is the largest Latin American country,and it presents socioeconomic and health care differences across its geographical *** country has the highest increase in IBD incidence and prevalence in Latin America,but information about the clinical and treatment characteristics of IBD is *** To describe the sociodemographic,clinical,and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast,South and Northeast/Midwest *** Multicenter,cross-sectional study with a 3-year retrospective chart review *** with moderate-to-severe Crohn’s disease(CD)or ulcerative colitis(UC)were consecutively enrolled between October 2016 and February *** CD at enrollment was defined as a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or a calprotectin level>200μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year;active UC was defined as a partial Mayo score≥*** statistics were used to analyze all *** In a total of 407 included patients,CD was more frequent than UC,both overall(264 CD/143 UC patients)and by region(CD:UC ratios of 2.1 in the Southeast,1.6 in the South and 1.2 in the Northeast/Midwest).The majority of patients were female(54.2%of CD;56.6%of UC),and the mean ages were 45.9±13.8 years(CD)and 42.9±13.0 years(UC).The median disease duration was 10.0(range:0.5-45)years for both IBD *** enrollment,44.7%[95%confidence interval(CI):38.7-50.7]of CD patients and 25.2%(95%CI:18.1-32.3)of UC patients presented with active *** than 95%of IBD patients were receiving treatment at enrollment;CD patients were commonly treated with biologics(71.6%)and immunosuppressors(67.4%),and UC patients were commonly treated with mesalazine[5-Aminosalicylic acid(5-ASA)]derivates(69.9%)and

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Disease activity Epidemiology Treatment

Detection of anti-Helicobacter pyloriantibodies in serum and duodenal fluid in peptic gastroduodenal disease

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World Journal of Gastroenterology 2004年第20期10卷 2997-3000页

作者： Angelo Locateili wilson roberto catapani Claudio rufino Gomes Junior Claudilene Battistin Paula Silva Jaques Waisberg Department of Surgery ABC Faculty of MedicineAvenida Principe de Gales 821Santo AndreSao Paulo09060-650Brazil

AIM:To study the diagnosis of Helicobacter pylori(H pylori) infection through the determination of serum levels of anti- H pylori IgG and IgA antibodies,and the levels of anti-H pylori IgA antibodies in duodenal fluid. METHODS:Data were collected from 93 patients submitted to upper digestive endoscopy due to dyspeptic symptoms. The patients were either negative(group A)or positive (group B)to H pylori by means of both histological detection and urease *** endoscopy,peripheral blood was collected for the investigation of anti-H pylori IgG and IgA *** perform the urease test,biopsies were obtained from the gastric *** the histological evaluation,biopsies were collected from the gastric antrum (greater and lesser curvatures)and the gastric body. Following this,duodenal fluid was collected from the first and second portions of the *** the serological assaying of anti-Hpylori IgG and IgA,and anti-Hpylori IgA in duodenal fluids,the ELISA method was utilized. rESULTS:The concentration of serum IgG showed sensitivity of 64.0%,specificity of 83.7%,positive predictive value of 82.0%,negative predictive value of 66.6% and accuracy of 73.1% for the diagnosis of H pylori *** the same purpose,serum IgA showed sensitivity of 72.0%, specificity of 65.9%,positive predictive value of 72.0%, negative predictive value of 67.4% and accuracy of 69.8%. If the serological tests were considered together,*** both were positive or negative,the accuracy was 80.0%, sensitivity was 86.6%,specificity was 74.2%,positive predictive value was 74.2% and negative predictive value was 86.6%.When values obtained in the test for detecting IgA in the duodenal fluid were analyzed,no significant difference(P=0.43)was observed between the values obtained from patients with or without H pylori infection. CONCLUSION:The results of serum IgG and IgA tests for H pylori detection when used simultaneously,are more efficient in accuracy,sensitivity and negative pred

关键词： Adolescent Adult Aged Antibodies, Bacterial Duodenum Endoscopy, Gastrointestinal Enzyme-Linked Immunosorbent Assay Female Gastric Mucosa Helicobacter Infections Helicobacter pylori purification Humans Immunoglobulin A Immunoglobulin G Male Middle Aged Peptic Ulcer Sensitivity and Specificity Serologic Tests