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Browsing by Author "Marafini, Irene"

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  • Treatment options for refractory ulcerative colitis: Small molecules, big effects
    Publication . Marafini, Irene; Roseira, Joana; Duijvestein, Marjolijn
    Although the majority of patients with ulcerative colitis (UC) have a mild-to-moderate disease, approximately 10%–15% experience a severe disease course and require immunosuppressive therapies.1 A better understanding of the mechanisms sustaining the pathogenic process in inflammatory bowel diseases (IBD) has largely contributed to expand the therapeutic armamentarium for this group of patients. Alongside with conventional therapies, monoclonal antibodies against tumour necrosis factor-α, α4β7 integrin (vedolizumab), interleukin (IL)-12/IL-23 p40 subunit (ustekinumab), and small molecules inhibiting intracellular pathways downstream to cytokine receptors (tofacitinib, filogotinib and upadacitinib), have entered into the clinic for the treatment of UC.2 However, selecting the appropriate medical therapy for each patient at a given stage of the disease natural history is an increasingly complex task for clinicians, as no prediction for treatment effect can be made in the individual patient.
    2024-05-07Journal article Open access Show more
  • Vedolizumab and new‐onset spondyloarthritis: debunking the myth
    Publication . Roseira, Joana; Marafini, Irene; Noor, Nurulamin M.
    Despite an increased understanding of the etiopathogenesis of Inflammatory Bowel Disease (IBD), prevention or cure remains a distant aspiration and current treatment approaches often do not achieve long‐term disease remission. An additional complexity is that IBD can also be associated with a range of extra‐intestinal manifestations (EIMs). Among these EIMs, peripheral and axial rheumatological manifestations are perhaps the most prevalent, grouped under the term spondyloarthritis (SpA). The presentation of SpA can be before or after IBD diagnosis and presents several unique challenges. Notably, the presence of SpA can significantly impact on quality of life for patients and influence therapeutic decision‐making.
    2024-07-11Journal editorial Open access Show more