journal reading diagnosis and treatment colitis ulcerative
TRANSCRIPT
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
1/17
Journal Reading
Ulcerative Colitis
Diagnosis and TreatmentBy:Ayu Setyaningrum Iswandari Safitri
01.210.6100
SULTAN AGUNG ISLAMIC UNIVERSITY
SEMARANG
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
2/17
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
3/17
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
4/17
The greatest challenge
Symptom-
oriented
(step-up)
strategies
prevention-
oriented
(earlyintervention)
strategies
Molecular
diagnostics
Molecular diagnostics: antibody serology
Biomarkers
genotyping
Stratifying
patients with IBD
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
5/17
earlyintervention witheffective therapy
significantimprovement
mucosal healing
reduction in the progression of
disease
Biomarker(fecal
calprotectin)
correlate with endoscopicdisease severity in both
CD and UC
help
identify patients with active
disease
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
6/17
Treatment goals
minimize toxicity
induce remission as quickly as possible
maintain remission as long as possible
facilitate mucosal healing
improve quality of life
minimize cost
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
7/17
Treatment Options for UC
oral and rectal
5-aminosalicylic acid (5-ASA)agents
corticosteroids (IV [eg, hydrocortisone]
or
oral [eg, prednisone,methylprednisolone])
immuno-modulators (eg, azathioprine[AZA], 6-mercaptopurine [6-MP],
cyclosporine )
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
8/17
Cont
reduction of signs and symptoms
induction of clinical remission
and mucosal healing
elimination of corticosteroid use
infliximab adalimumab
anti-tumor necrosis factor(TNF) agents
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
9/17
Colitis arthritis sulfasalazine
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
10/17
5-ASA: First-Line Therapy
5-ASA
cytokine
5-lipoxygenasepathways of
arachidonic acidmetabolism
COX
transcriptionalactivity of nuclear
factor-kappa B
(NF-B)
Prostaglandin
Leukotrien
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
11/17
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
12/17
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
13/17
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
14/17
MESALAMINETHERAPYDURING
PREGNANCY
Acetyl-5-ASA clearly cross the placenta
all mesalamine therapies
Asacol/Asacol HD
Classification
B
Classification
C
fetal malformations
th i t i di t f A l t i
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
15/17
the inert ingredient of Asacolsenteric
coating, dibutyl phthalate (DBP)
maximum daily human intake
48 g
reproductive anomalies in male offspring
injury to androgenic-dependent development
higher doses
cryptorchidism hypospadias
atrophy or
agenesis of sexaccessoryorgans
reduced dailysperm production
permanentretention of
nipples
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
16/17
Cont
Exposure to DBP at dosesequivalent to 106 times
incidences of cleft palate
skeletal abnormalities
-
8/11/2019 Journal Reading Diagnosis and Treatment Colitis Ulcerative
17/17
Thank You!