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e162
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
P.07.12
BETA-GLUCAN, INOSITOL AND DIGESTIVE ENZYMES IN PATIENTS
WITH INFLAMMATORY BOWEL DISEASE ASSOCIATED WITH
IRRITABLE BOWEL SYNDROME
Spagnuolo R.*, Ruggiero G., Cosco C., Cosco V., Garieri P., Gidaro A.,
Doldo P.
Università “Magna Graecia”, Catanzaro, Italy
Background and aim:
Symptoms compatible with irritable bowel
syndrome (IBS) are frequently present in patients with inflammatory
bowel disease (IBD). A recent meta-analysis of patients with
inflammatory bowel disease (IBD) demonstrated that 25–46%
of those in clinical remission have symptoms compatible with a
diagnosis of IBS. To evaluate the effectiveness of the administration
of a mixture of beta-glucan, inositol and digestive enzymes in
improving GI symptoms in IBD patients on clinical remission.
Material and methods:
The study was conducted in the
Gastroenterology Unit of the University of Catanzaro. Were enrolled
patients with a diagnosis of IBD performed by clinical, endoscopic,
histological and radiological criteria. Patients were affected by IBD
(CD, RCU) in clinical and endoscopic remission defined by Harvey
Bradshaw score <5 for CD and Mayo Score <2 for UC, in treatment
only with systemical and topical mesalazine. All patients fulfilling
the Rome III citeria for the diagnosis of IBS. Were excluded from
the study patients with IBD: UC and CD without strictures, who
did not report symptoms of IBS and in treatment by steroids,
immunosuppressants and biological agents. The subjects included
in the study were randomized to receive Biointol® (one tablet after
lunch and after dinner) for four consecutive weeks (Group A), or
any therapy (group B). Severity of symptoms at the entry and after
four week was evaluated by means of 10 cm Visual Analogical Scales
(VAS) in either group.
Results:
Were analyzed one hundred patients with IBD. Of these,
sixty-two (62%) were in clinical remission: 33 were male (53%),
median age of 51 years. 29 (46%) were affected by CD and 33 (53%)
by UC. 14 (22%) were smokers. All patients completed the study to
four weeks. At enrollment there were no significant differences
between the two treatment groups. After four weeks of treatment,
in the group A there was a statistically significant reduction
compared to the group B in abdominal pain (mean VAS score 2 ± 2
VS 4 ± 3 p <0.001) in bloating (mean VAS score 4 ± 3 VS 1 ± 1 p
<0.001) and flatulence (mean VAS score 4 ± 3 VS 7 ± 1 p 0.006).
Conclusions:
Few studies have been conducted previously to
identify the association between IBS and IBD. For the first time,
in this work, was evaluated the effect of the administration of a
mixture of beta-glucan, inositol and digestive enzymes. These
findings could pave the way to better characterize the pathogenesis
of IBS and IBD. Further studies are needed to clarify the effectiveness
of this evidence
P.07.13
FOUR-YEAR EFFICACY AND SAFETY OF AZATHIOPRINE
TREATMENT IN THE MAINTAINANCE OF STEROID-FREE
REMISSION IN INFLAMMATORY BOWEL DISEASE PATIENTS
Cassieri C.*
1
, Pica R.
3
, Avallone E.V.
1
, Brandimarte G.
2
, Zippi M.
3
,
Crispino P.
1
, De Nitto D.
3
, Corrado C.
1
, Vernia P.
1
, Paoluzi P.
1
,
Corazziari E.S.
1
1
Internal Medicine and Medical Specialties, “Sapienza” University of
Rome, Rome, Italy,
2
Internal Medicine, “Cristo Re” Hospital, Rome,
Rome, Italy,
3
Unit of Gastronterology and Digestive Endoscopy, Sandro
Pertini Hospital, Rome, Italy., Rome, Italy
Background and aim:
Azathioprine (AZA) and thiopurine are widely
used for induction and maintenance of remission in patients steroid-
dependent with inflammatory bowel disease (IBD). The treatment
must be withdrawn in 5-30% of patients due to the occurrence
of adverse events. Aim of this study has been to investigate its
efficacy and safety in maintaining steroid-free remission in steroid
dependent IBD patients four year after the institution of treatment.
Material and methods:
Data from consecutive IBD outpatients
referred in our Institution, between 1985-2013, were reviewed and
all patients treated with AZA were included in this retrospective
study. AZA was administered at the recommended dose of 2–2.5 mg/
kg. Blood chemistry was analysed before administration of the drug,
every 10-15 days for the first 3 months and then every 1-2 months
following the institution of treatment.
Results:
Out of 2556 consecutive IBD outpatients visited in the index
period, AZAwas prescribed to 376 patients, 198 (52.7%) were affected
by Crohn’s disease (CD) and 178 (47.3%) by ulcerative colitis (UC).
One hundred and four patients with a follow-up <48 months were
excluded from the study. Two hundred and seventy-two patients
were evaluated, 146 (53.7%) with CD and 126 (46.3%) with UC. One
hundred and forty-nine (54.8%) were male and 123 (45.2%) female
(average age of 33.56 ± 14.34 SD years, range 14-74 y.). Four year
after the institution of treatment, 149 (54.8%) patients still were in
steroid-free remission (89 CD vs 60 UC, 61% and 47.6%, respectively,
p=0.0288), 71 (26.1%) had a relapse requiring retreatment with
steroids (42 UC vs 29 CD, 33.4% and 19.8%, respectively, p=0.0130),
52 (19.1%) discontinued the treatment due to side effects (28 CD vs
24 UC, 19.2% and 19%, respectively). Loss of response from 1st to 4rd
year of follow-up was low, about 15%.
Conclusions:
Four year after the onset of treatment 55% of patients
did not require further steroid courses. After the first year loss of
response was low in three subsequent years. In the present series
the maintenance of steroid-free remission was significantly higher
in CD than in UC patients. The occurrence of side effects leading to
the withdrawal of AZA treatment has been low.
P.07.14
BIOLOGICAL THERAPY IS ABLE TO MODIFY THE DISEASE
PROGRESSION OF CROHN’S DISEASE PREVENTING ITS LONG-
TERM ASSOCIATED DISABILITY – A STUDY PERFORMED USING
THE LéMANN SCORE
Bodini G.*
1
, Giannini E.
1
, Savarino V.
1
, De Maria C.
1
, Baldissarro I.
1
,
Savarino E.
2
1
IRCCS San Martino, Genoa, Italy,
2
2 Gastroenterology Unit,
Department of Surgery, Oncology and Gastroenterology, Padua, Italy