02) were associated with a significantly higher risk for developing IF. Among the IF group, 53% had perioperative complications from intestinal resections contributing to long-term IF. Furthermore, these patients had more abdominal surgeries (P = 0.05) and stricturing disease was less common than in patients with primary active CD (P = 0.01). IF due to primary active CD was associated with penetrating behavior (P = 0.02) and early age at first surgery (P = 0.004). The need for intravenous nutrition as opposed to intravenous
fluids correlated inversely with small intestine Selumetinib research buy length (P < 0.001). CD resulting in IF relates to earlier age at diagnosis, family history of inflammatory bowel disease, stricturing disease, younger age at first surgery, and operative complications. These factors
deserve consideration when planning therapy for CD patients. “
“The treatment of hepatitis C virus (HCV) has undergone a dramatic evolution over the past 2 decades. Currently, the sustained virological response (SVR) rates with peginterferon (PEG-IFN)and ribavirin FDA approved Drug Library (RBV) are approximately 40% to 46% for genotype I and 80% to 82% for genotypes II and III.1–3 The most problematic side effect of RBV remains reversible hemolytic anemia, which significantly affects patients’ quality of life.4, 5 While the etiology of anemia is multifactorial, the RBV dose–dependent hemolytic anemia is due to RBV accumulation in erythrocytes, where it is phosphorylated; depleting adenosine triphosphate (ATP) reserves, which ultimately leads to senescence and erythrophagocytic removal.6 The addition of interferon also suppresses red blood cell (RBC) production, and the anemia seen with the combination of PEG-IFN and RBV therapy can lead to RBV dose reductions and a lower chance of SVR. DAA, direct-acting antiviral; ESA, erythropoietin-stimulating agent; HCV, hepatitis
C virus; IFN, interferon; IL-28, interleukin-28; ITPA, inosine triphosphatase; PEG-IFN, find more peginterferon; RBC, red blood cell; RBV, ribavirin; SVR, sustained virological response; TBV, taribavirin; ViSER, Viramidine Safety and Efficacy Versus Ribavirin. A common strategy for treating this anemia is the use of recombinant human erythropoietin-stimulating agents (ESAs). Although this therapy is effective at ameliorating RBV-induced anemia, it adds treatment costs and is associated with rare but life-threatening thromboembolic, cardiovascular, and hematologic events (red cell aplasia).7, 8 Studies have suggested that ESAs raise hemoglobin levels and improve the quality of life, but a significantly improved SVR rate in patients who receive ESAs has been difficult to demonstrate.9, 10 However, a recent study has also suggested that ESA administration in the setting of RBV-related anemia is associated with reduced dropout and higher SVR rates.11 Therapies that decrease the risk of RBV-induced anemia without compromising SVR rates or raising costs are desirable.