Browsing by Author "Travis, S.P.L."

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    Emerging IBD demographics, phenotype and treatment in South Asia, South-East Asia and Middle East: preliminary findings from the IBD-Emerging Nations' Consortium
    (Blackwell Scientific Publications, 2022) Banerjee, R.; Pal, P.; Hilmi, I.; Ghoshal, U.C.; Desai, D.C.; Rahman, M.M.; Dutta, U.; Mohiuddin, S.A.; Al Mohannadi, M.; Philip, M.; Ramesh, G.N.; Niriella, M.A.; de Silva, A.P.; de Silva, H.J.; Pisespongsa, P.; Limsrivilai, J.; Aniwan, S.; Nawarathne, M.; Fernandopulle, N.; Aye, T.T.; Ni, N.; Al Awadhi, S.; Joshi, N.; Ngoc, P.T.V.; Kieu, T.V.; Nguyen, A.D.; Abdullah, M.; Ali, E.; Zeid, A.; Sollano, J.D.; Saberi, B.; Omar, M.; Mohsin, M.N.; Aftab, H.; Wai, T.M.; Shastri, Y.M.; Chaudhuri, S.; Ahmed, F.; Bhatia, S.J.; Travis, S.P.L.
    Abstract Background and aims Inflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South East Asia and the Middle East, yet epidemiological data are scarce. Methods: We performed a cross-sectional study of IBD demographics, disease phenotype and treatment across 38 centers in 15 countries of South Asia, South-East Asia and Middle East. Intergroup comparisons included gross national income (GNI) per capita. Results: Among 10,400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD-Unclassified 227, 58% male). Peak age of onset was in the third decade, with a low proportion of elderly onset IBD (5% age >60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; IQR 5-30). Treatment of CD included mesalamine, steroids and immunomodulator (61%, 51% and 56% respectively), but a fifth received empirical anti-tubercular therapy. Treatment with biologics was uncommon (4% UC,13% CD) which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD)/100 patient/years. Conclusions: The IBD-ENC cohort provides insight into IBD in South-East Asia and the Middle East, but is not yet population-based. UC is twice as common as CD, familial disease uncommon and rates of surgery are low. Biologic use correlates with per capita GNI.
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    Optimum dose of olsalazine for maintaining remission in ulcerative colitis
    (British Medical Assosiation, 1994) Travis, S.P.L.; Tysk, C.; de Silva, H.J.; Sandberg-Gertzen, H.; Jewell, D.P.; Jarnerot, G.
    To evaluate the optimum dose of olsalazine for maintaining remission in ulcerative colitis, 198 patients in remission for more than three months were randomly assigned to receive 0.5 g, 1.0 g, or 2.0 g/day for 12 months. A dose-ranging effect was detected in the per protocol analysis, with remission rates of 60% (0.5 g), 70% (1.0 g), and 78% (2.0 g) (p = 0.03, trend in proportions). The higher dose was most effective in patients with proctitis (90% remission on 2 g/day, p = 0.03) or those in remission for less than 12 months before the trial (88% remission on 2 g/day, p = 0.0006). There was little dose-ranging effect in patients with extensive colitis or those in remission for more than 12 months. Diarrhoea necessitated treatment withdrawal in 12%. The optimal dose of olsalazine for maintaining remission in ulcerative colitis is 1 g/day. For patients with proctitis or recent relapse, 2 g/day may be preferable, although the dose seems to be less important in patients with more extensive disease or those in long term remission