Inflammatory Bowel Disease

Questions discussed in this category

What diet do you recommend for patients with inflammatory bowel disease?

1 Answer available

What is your approach to choosing a particular advanced therapy based on patient or disease factors when initiating treatment for moderate-severe IBD?

1 Answer available

How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?

7 Answers available

Do you feel comfortable using Jak inhibitors in patients with a strong family history of CAD, but no other risk factors?

How do you counsel patients in this scenario?

1 Answer available

How would you manage a patient with highly active ankylosing spondylitis, iritis and Crohn’s, controlled with weekly adalimumab with co-morbid IgG4RD and intolerance of azathioprine due to elevated LFTs?

IgG4 manifestations include autoimmune pancreatitis and periaortic soft tissue mass.

2 Answers available

In patients with active IBD and rectal cancer, do you take any precautions before starting TNT?

Would you wait until bowel symptoms are controlled or ever pursue diversion before starting treatment?

2 Answers available

Do you have concerns with the use of oral contraceptives in patients on JAK inhibitors given the black box warning for thromboembolic events?

How has this impacted your counseling and management?

2 Answers available

Do you consider anti-viral prophylaxis in patients taking JAK inhibitors who have recurrent uncomplicated Zoster infection, but would prefer not changing therapy?

2 Answers available

How would you approach additional workup and management of a patient with active Crohn’s disease, who has multiple lung and brain nodules, with lung pathology demonstrating necrotizing granulomatous inflammation and brain biopsy with granulomatous inflammation and medium-large vessel vasculitis?

The patient is on mesalamine for Crohn’s and CellCept and HCQ for skin manifestations (currently on hold during workup). The infectious workup i...

1 Answer available

Do you have a preference between Quantiferon Gold and T-spot TB for screening in patients starting immunosuppressive agents?

1 Answer available

Do you stop TNF inhibitors during the third trimester of pregnancy?

2 Answers available

Which biologics are you comfortable combining with vedolizumab for spondyloarthritis or psoriatic arthritis patients in the setting of well-controlled inflammatory bowel disease?

2 Answers available

What is your approach to continuing or altering therapy when inheriting a patient with combined biologic immunosuppression that is in excess of guidelines?

How do you approach de-escalation or justify therapy maintenance? Do you have tiers of medications that you attempt to de-escalate first? In one parti...

1 Answer available

Would you be comfortable using a JAK inhibitor in a patient with baseline thrombocytosis?

Would the etiology of the thrombocytosis play a role in your decision-making?

1 Answer available

How do you counsel patients about the malignancy risk associated with azathioprine?

1 Answer available

How do you approach the continued use of TNF inhibitors in a patient with inflammatory arthritis who develops a positive dsDNA without clinical evidence of drug-induced lupus?

2 Answers available

Is there a role for regular hepatitis and TB screening in patients on chronic immunosuppressive therapy in the absence of new risk factors or exposures?

1 Answer available

How would you treat a patient with metastatic renal cell cancer with Crohn's disease after failing available tyrosine kinase inhibitor therapies?

Is Crohn's diagnosis an absolute contraindication for immunotherapy?

3 Answers available

How would you approach new-onset large vessel vasculitis in a young patient with Crohn's disease?

3 Answers available

Is prophylactic anticoagulation indicated in patients with frequent ulcerative colitis flares?

If so, what agent(s) do you prefer?

1 Answer available

How do you approach screening for inflammatory bowel disease prior to starting IL-17 inhibitors?

1 Answer available

Do you recommend checking anti-drug antibodies for patients on TNF inhibitors?

If so, how would positive levels guide your management?

3 Answers available

Would you use an IL-17 inhibitor for a psoriatic arthritis patient with inactive inflammatory bowel disease?

1 Answer available

Would you hold all immunosuppressive medications for the first month of LTBI treatment, or just biologics?

1 Answer available

Do you avoid any specific biologic therapies in HIV positive patients?

1 Answer available

How do you counsel patients who ask if there are any dietary modifications they can make to help control their autoimmune disease?

This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet

1 Answer available

Is it okay to use COX-2 selective NSAIDs in patients with IBD-associated arthritis when the IBD is in remission?

1 Answer available

Would you re-challenge patients who have had a TNF-associated paradoxical adverse event (such as inflammatory bowel disease) with a different TNF inhibitor?

1 Answer available

What do you try in patients with IBD-related spondyloarthritis with predominantly axial symptoms who are refractory to TNF inhibitors?

1 Answer available

Is it necessary to hold immunotherapy during a 4-6wk steroid taper after resolution of immunotherapy related toxicity?

Would you ever considering re-starting immunotherapy before completing the taper? According to the new guildelines on managing immunotherapy related ...

1 Answer available

Papers discussed in this category

Annals of the rheumatic diseases, 2017-08

Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study.

Lancet (London, England), 2018-12-01

Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomised, placebo-controlled, phase 2 trial.

Arthritis Rheumatol, 2019 Oct

2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.

Lancet, 2019 Nov 12

Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis (SELECT-AXIS 1): a multicentre, randomised, double-blind, placebo-controlled, phase 2/3 trial.

Cochrane Database Syst Rev, 2014 Oct 23

Tolerability of selective cyclooxygenase 2 inhibitors used for the treatment of rheumatological manifestations of inflammatory bowel disease.

Journal of psoriasis and psoriatic arthritis, 2019-04

TNF Inhibitor-Induced Psoriasis: Proposed Algorithm for Treatment and Management.

Arthritis care & research, 2017-03

Rates of Serious Infections in HIV-Infected Patients Receiving Tumor Necrosis Factor Inhibitor Therapy for Concomitant Autoimmune Diseases.

Clin Exp Dermatol, 2018 May 24

Treatment of psoriasis with ustekinumab in a patient with HIV-related Kaposi sarcoma.

Gut, 1999-04

Linkage of Crohn's disease to the major histocompatibility complex region is detected by multiple non-parametric analyses.

Gut, 2012-12

Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn's disease: unexpected results of a randomised, double-blind placebo-controlled trial.

Annals of the rheumatic diseases, 2019-04

Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials.

Ann Rheum Dis, 2014 Mar 21

The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study.

Seminars in arthritis and rheumatism, 2016-02

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature.

Bull Soc Ophtalmol Fr,

[Uveal effusion syndrome secondary to orbital cellulitis].

Am J Hum Genet, 2021 Jan 7

Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study.

The New England journal of medicine, 2013-08-22

Vedolizumab as induction and maintenance therapy for Crohn's disease.

JAMA oncology, 2016-02

Ipilimumab Therapy in Patients With Advanced Melanoma and Preexisting Autoimmune Disorders.

Annals of oncology : official journal of the European Society for Medical Oncology, 2017-02-01

Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab.

Ann Oncol,

Inflammatory gastrointestinal diseases associated with PD-1 blockade antibodies.

Immunology,

Integrin signalling and function in immune cells.

J Immunother Cancer, 2019 Jan 06

Complete response of metastatic melanoma in a patient with Crohn's disease simultaneously receiving anti-α4β7 and anti-PD1 antibodies.

Autoimmun Rev, 2012 Nov 30

Immunogenicity and autoimmunity during anti-TNF therapy.

Arthritis & rheumatology (Hoboken, N.J.), 2017-10

The Safety and Immunogenicity of Live Zoster Vaccination in Patients With Rheumatoid Arthritis Before Starting Tofacitinib: A Randomized Phase II Trial.

Lancet Gastroenterol Hepatol, 2023 Feb 01

Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): a randomised, double-blind, controlled, phase 2, proof-of-concept trial.

Dig Liver Dis, 2022 Aug 16

Efficacy and safety of combination targeted therapies in immune-mediated inflammatory disease: the COMBIO study.

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