Scientific corner

Sarcopenia and treatment failure in inflammatory bowel disease: a systematic review and meta-analysis

Yue Feng, Weihua Feng, Mei Xu, Chaoping Wu, Huanhuan Yang, Yu Wang, Huatian Gan, Rev Esp Enferm Dig 2023. doi:
10.17235/reed.2023.9808/2023.

Background: the association between sarcopenia and treatment outcomes in inflammatory bowel disease (IBD) is currently a subject of controversy.
Methods: a systematic search was performed of PubMed, Embase, Web of Science, and the Cochrane Library for studies published until April 2023. The quality assessment of each included study was performed using the Newcastle-Ottawa
Scale.
Results: seventeen studies were included with 2,895 IBD patients. Sarcopenia exhibited an increased risk of treatment failure (OR = 2.00, 95 % CI: 1.43-2.79) and notably increased the need for surgery (OR = 1.54, 95 % CI: 1.06-2.23) as opposed to a pharmacologic treatment plan change (OR = 1.19, 95 % CI: 0.71-2.01) among IBD patients. However, no significant association was found between sarcopenia and treatment failure in corticosteroid (OR = 1.21, 95 % CI: 0.55-2.64) or biologic agent (OR = 1.65, 95 % CI: 0.93-2.92) cohorts. Sarcopenia was also linked to elevated treatment failure risks in patients with Crohn’s disease (OR = 1.82, 95 % CI:1.15-2.90) and those diagnosed with ulcerative colitis (OR = 2.55, 95 % CI: 1.05-6.21), spanning both Asian (OR = 1.88, 95 % CI: 1.29-2.74) and non-Asian regions (OR = 2.17, 95 % CI: 1.48-3.18).
Conclusions: sarcopenia was considered as a novel marker for use in clinical practice to predict treatment failure, specifically, the need for surgery in IBD patients. This distinct cohort necessitates clinical attention and tailored care strategies.

Scientific corner

Use of granulocyte and monocyte adsorption apheresis in dermatology (Review)

Laura Gnesotto 1Guido Mioso 1Mauro Alaibac 1

Exp Ther Med 2022 Jun 24;24(2):536. doi: 10.3892/etm.2022.11463. eCollection 2022 Aug. DOI: 10.3892/etm.2022.11463

Adsorptive granulocyte and monocyte apheresis (GMA) is an extracorporeal treatment that selectively removes activated myeloid lineage leukocytes from peripheral blood. This technique consists of a column with cellulose acetate beads as absorptive leukocytapheresis carriers, and was initially used to treat ulcerative colitis. A literature search was conducted to extract recently published studies about the clinical efficacy of GMA in patients with different skin disorders, reporting information on demographics, clinical symptoms, treatment and clinical course. Dermatological diseases, in which GMA has been performed, include generalized pustular psoriasis, pyoderma gangrenosum, palmoplantar pustular psoriasis, Behcet’s disease, Sweet’s syndrome, adult-onset Still’s disease, impetigo herpetiformis, reactive arthritis, acne and hidradenitis suppurativa syndrome, cutaneous allergic vasculitis and systemic lupus erythematosus. In most patients, GMA was started after the failure of conventional therapeutic options and it was helpful in the majority of cases. Based on the information summarized, GMA could be considered a valid non-pharmacological treatment option for patients with several dermatological conditions, which are difficult to treat with other pharmacological preparations.

 PASH syndrome; cutaneous allergic vasculitis; granulocyte and monocyte apheresis; neutrophilic dermatoses; reactive arthritis; systemic lupus erythematosus.

https://pubmed.ncbi.nlm.nih.gov/35837066/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257973/

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