GASTROENTEROLOGY ARTICLE OF THE WEEK
May 5, 2011
D’Haens GR, Panaccione R, Higgins PD, et al. The London position statement of the WCG on Biological therapy for IBD: When to start, when to stop, which drug to use and how to predict response? Am J Gastroenterol 2011;106:199-212.
1. Which of the following characteristics predict a disabling course of CD?
a. Onset after age 65
b. Stricturing disease
c. Perianal disease
d. Small bowel-only involvement
e. Need for one or more steroid courses
2. After shingles vaccine, a patient should wait how long to start biologics
a. no need to wait
b. 4 weeks
c. 6 weeks
d. 3 months
e. 6 months
True or False
3. Biologics are more effective in patients with short duration of disease
4. Most patients with Crohn’s disease need biologic therapy or prolonged or repeated courses of steroids
5. Patients with primary non-response to an anti-TNF agent are not likely to respond to another anti-TNF agent, and should be treated with alternate therapies
6. Natalizumab can be used to achieve remission, but should not be used after that to maintain remission
7. There is no controlled data available to assess the efficacy of certoluzimab or natalizumab for fistula closure
8. Failure of response to high dose steroids in a patient with stenotic ileal disease is an indication to start biologic therapy
9. Ciprofloxacin combined with biologic therapy may improve results of therapy for complex perianal fistulizing disease
10. Infliximab is superior to cyclosporine for the treatment of acute severe UC not responsive to corticosteroids
11. Most patients who start biologic therapy should continue therapy indefinitely if a response is achieved