ABSTRACT
The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
Subject(s)
Humans , Adalimumab , Asia , Asian People , Biological Factors , Biosimilar Pharmaceuticals , Colitis , Colitis, Ulcerative , Consensus , Cooperative Behavior , Crohn Disease , Gastroenterology , Hepatitis B , Immunologic Factors , Inflammatory Bowel Diseases , Infliximab , Pharmacogenetics , Philippines , Practice Guidelines as Topic , Tuberculosis , UlcerABSTRACT
BACKGROUND/AIMS: To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. METHODS: A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. RESULTS: Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77–3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). CONCLUSIONS: In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.
Subject(s)
Female , Humans , Case-Control Studies , Cohort Studies , Colitis, Ulcerative , Contraceptives, Oral , Crohn Disease , Inflammatory Bowel Diseases , Prospective Studies , Smoke , SmokingABSTRACT
Background Hp PUD is increasing. This study aimedto determine the trends of PUD andHp infection, and exposure to nonsteroid anti-infl ammatorydrugs and aspirin (NSAIDs/ASA), their association with upper gastrointestinal (UGI) bleeding, andcomparison to previous data.Methods Hp infection to previous data of 1992 to show their trends.Results Hp infection in each group was 38.18%, 42.86%, and 33.33%,respectively.Hp related ulcers had less UGI bleeding than NSAIDs/ASA related. When comparedto previous data, the proportion of DU had decreased, GU and combined ulcers had increased, andtheHp infection rate in all 3 groups had decreased.Conclusions Hp, non-NSAIDs/ASA related ulcers were diagnosed. NSAIDs/ASA related ulcers have morechances of bleeding.Chiang Mai Medical Journal 2010;49(2):41-48.While the prevalence of PUD and Hp was decreasing, more NSAIDs/ASA related andnon-A total of 98 cases were included; gastric ulcer (GU) in 55, duodenal ulcer (DU) in 28, and15 cases of combined ulcers. TheAll PUD patients with complete records of Hp status and NSAIDs/ASA exposure in 2008were included for analysis of prevalence and their association with UGI bleeding. We comparedpresent data of PUD andThe decline in global prevalence of Helicobacter pylori (Hp) and peptic ulcer disease(PUD) has been recognized, while the prevalence of non-