Browsing by Author "Patita, Marta"
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- How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective studyPublication . Magro, Fernando; Estevinho, Maria Manuela; Catalano, Gaia; Patita, Marta; Arroja, Bruno; Lago, Paula; Rosa, Isadora; Sousa, Helena Tavares; Ministro, Paula; Mocanu, Irina; Vieira, Ana; Castela, Joana; Moleiro, Joana; Roseira, Joana; Cancela, Eugénia; Sousa, Paula; Portela, Francisco; Correia, Luís; Moreira, Paula; Santiago, Mafalda; Dias, Sandra; Afonso, Joana; Danese, Silvio; Peyrin‐Biroulet, Laurent; Dias, Cláudia CamilaBackgroundTimely stratification of Crohn's disease (CD) is essential for patients' management. The use of noninvasive accurate biomarkers is key to monitor treatment and to pursue mucosal healing, the ultimate treatment endpoint in CD. ObjectiveWe aimed to evaluate the performance of readily available biomarkers and develop risk matrices to predict CD progression. MethodsData from 289 CD patients receiving infliximab (IFX) maintenance therapy for 2 years was collected; those patients were included in DIRECT, a prospective multicenter observational study. Disease progression was evaluated using two composite outcomes incorporating clinical and drug-related factors, the first including IFX dose and/or frequency adjustments. Univariate and multivariable logistic regressions were used to calculate the odds ratios (OR) and to develop risk matrices. ResultsThe isolated presence of anemia at least once during follow-up was a significant predictor of disease progression (OR 2.436 and 3.396 [p <= 0.001] for composite outcomes 1 and 2, respectively) regardless of confounding factors. Isolated highly elevated C-reactive protein (CRP; >10.0 mg/L) and fecal calprotectin (FC; >500.0 mu g/g) in at least one visit were also significant predictors, while milder elevations (3.1-10.0 mg/L and 250.1-500.0 mu g/g) were only relevant when detected in at least two visits (consecutive or not). The combination of biomarkers in risk matrices had good ability to predict progression; patients simultaneously presenting anemia, highly elevated CRP and FC at least once had 42%-63% probability of achieving the composite outcomes. ConclusionThe combined evaluation of hemoglobin, CRP, and FC in at least one time point and their incorporation into risk matrices seems to be the optimal strategy for CD management, as data from additional visits did not meaningfully influence the predictions and may delay decision-making.
- Sexual quality of life in inflammatory bowel disease: A multicenter, national-level studyPublication . Roseira, Joana; Magro, Fernando; Fernandes, Samuel; Simoes, Carolina; Portela, Francisco; Vieira, Ana Isabel; Patita, Marta; Leal, Carina; Lago, Paula; Caldeira, Paulo; Gago, Tania; Currais, Pedro; Dias, Claudia Camila; Santiago, Mafalda; Dias, Sandra; Sousa, Helena TavaresBackground: The impact of inflammatory bowel disease (IBD) on sexual health is a leading concern among patients. Most studies focus on sexual dysfunction rather than patient-perceived sexual quality of life (SQoL). We aimed to assess SQoL in IBD patients compared with healthy controls. Methods: This is a multicenter, cross-sectional study of IBD patients (n = 575 with Crohn's disease and n = 294 with ulcerative colitis), compared with healthy controls (n = 398), that used an anonymous self-administered questionnaire. This multimodal questionnaire included sociodemographic data and 4 validated instruments: Short IBD Questionnaire, Social Desirability Scale, Sexual QoL Questionnaire-Male/Female, Nine-item Patient Health Questionnaire. Results: Inflammatory bowel disease patients reported lower SQoL (men: 77.29 vs 83.83; P < 0.001; women: 70.40 vs 81.63; P < 0.001) compared with controls. Among IBD patients, SQoL was positively correlated with health-related quality of life (HRQoL) and negatively correlated with depression symptoms. Perianal disease was associated with lower HRQoL and higher incidence of depression, but only impacted SQoL in men. In linear regression analysis for men, SQoL was associated with age, marital status, and depression (beta, -2.101; 95% confidence interval [CI], -2.505 to -1.696; P < 0.001). In women, SQoL was associated with depression (beta, -1.973; 95% CI, -2.313 to -1.632; P < 0.001) only. Conclusions: Patients with IBD had impaired SQoL compared with healthy controls. Age, widow status, and depression were independent predictors of SQoL in men with IBD, whereas in women depression was the only independent predictor. Emotional and self-esteem issues were the main concerns reported by IBD patients regarding sexual health.
- Soluble human Suppression of Tumorigenicity 2 is associated with endoscopic activity in patients with moderate-to-severe ulcerative colitis treated with golimumabPublication . Magro, Fernando; Lopes, Susana; Silva, Marco; Coelho, Rosa; Portela, Francisco; Branquinho, Diogo; Correia, Luís; Fernandes, Samuel; Cravo, Marília; Caldeira, Paulo; Sousa, Helena Tavares; Patita, Marta; Lago, Paula; Ramos, Jaime; Afonso, Joana; Redondo, Isabel; Machado, Patrícia; Philip, George; Lopes, Joanne; Carneiro, FátimaSuppressor of Tumorigenicity 2 (ST2) is an IL33 receptor detected in the mucosa and serum of ulcerative colitis (UC) patients. We evaluated soluble ST2 (sST2) as a surrogate biomarker of disease outcome and therapeutic response, in moderate-to-severe UC patients treated with golimumab.
- Thiopurines have no impact on outcomes of Crohn's disease patients beyond 12 months of maintenance treatment with infliximabPublication . Sousa, Paula; Patita, Marta; Arroja, Bruno; Lago, Paula; Rosa, Isadora; Sousa, Helena Tavares; Ministro, Paula; Mocanu, Irina; Vieira, Ana; Castela, Joana; Moleiro, Joana; Cancela, Eugenia; Roseira, Joana; Portela, Francisco; Correia, Luis; Santiago, Mafalda; Dias, Sandra; Alves, Catarina; Afonso, Joana; Dias, Claudia Camila; Magro, FernandoThe emergence of new treatments the inflammatory bowel diseases (IBD) raised questions regarding the role of older agents, namely thiopurines. Aims: To clarify the benefits of combination treatment with thiopurines on Crohn's disease (CD) patients in the maintenance phase of infliximab. Methods: In this analysis of the 2 -year prospective multicentric DIRECT study, patients were assessed in terms of clinical activity, faecal calprotectin (FC), C -reactive protein (CRP), and infliximab pharmacokinetics. A composite outcome based on clinical- and drug -related items was used to define treatment failure. Results: The study included 172 patients; of these, 35.5 % were treated with combination treatment. Overall, 18 % of patients achieved the composite outcome, without statistically significant differences between patients on monotherapy and on combination treatment (21.6% vs 11.5 %, p = 0.098). Median CRP, FC, and infliximab pharmacokinetic parameters were similar in both groups. However, in the sub -analysis by infliximab treatment duration, in patients treated for less than 12 months, the composite outcome was reached in fewer patients in the combination group than in the monotherapy group (7.1% vs 47.1 %, p = 0.021). Conclusion: In CD patients in maintenance treatment with infliximab, combination treatment does not seem to have benefits over infliximab monotherapy beyond 12 months of treatment duration.