Crohn Disease: Bokemeyer B

Hoffmann JC, Preiss JC, Autschbach F, Buhr HJ, Häuser W, Herrlinger K, Höhne W, Koletzko S, Krieglstein CF, Kruis W, Matthes H, Moser G, Reinshagen M, Rogler G, Schreiber S, Schreyer AG, Sido B, Siegmund B, Stallmach A, Bokemeyer B, Stange EF, Zeitz M. · Medizinische Klinik I, St. Marienkrankenhaus, Ludwigshafen. · Z Gastroenterol. · Pubmed #18810679 No free full text.

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Hoffmann JC, Autschbach F, Bokemeyer B, Buhr HJ, Herrlinger K, Höhne W, Krieglstein C, Kruis W, Moser G, Preiss JC, Reinshagen M, Rogler G, Schreiber S, Schreyer AG, Siegmund B, Stallmach A, Stange EF, Zeitz M. · Medizinische Klinik I, St. Marienkrankenhaus Ludwigshafen. · Dtsch Med Wochenschr. · Pubmed #18788069 No free full text.

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Albert JG, Kotsch J, Köstler W, Behl S, Kaltz B, Bokemeyer B, Dollinger MM, Haerting J, Fleig WE. · Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität, Halle. · Z Gastroenterol. · Pubmed #18253897 No free full text.

Abstract: BACKGROUND: The course of Crohn's disease prior to the establishment of the diagnosis is widely unknown. Therefore, we instigated a survey amongst newly diagnosed patients. PATIENTS AND METHODS: Patients diagnosed with CD less than 12 months before enrollment were included. Data on demography, social status, time interval to diagnosis, symptoms, and health care service use were collected in a retrospective, web-based, census. Patients were contacted in cooperation with two organizations: a German patients' organization (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung e.V. [DCCV]) and a professional organization of German gastroenterologists (Berufsverband der Niedergelassenen Gastroenterologen Deutschlands e.V. [bng]). Study participation was anonymous by use of a transaction number. RESULTS: The median interval period between onset of first symptoms and diagnosis was 13 months. During this time, participants reported having five doctor consultations on average, with 44% of them having a mean of 1.5 hospitalizations. 65% were unfit for work with a 14 day median (2 to 480 days) due to their symptoms. A mean (+/-SD) of 8.6 (+/-7.1) diagnostic tests were performed before the diagnosis was established. Overall health state was judged as temporarily bad or very bad by 84% of the participants. Age at diagnosis, characteristic symptoms, and localization of the disease for the participants did not differ from previously reported international data. DISCUSSION: This web-based survey shows a substantial time interval of over one year until diagnosis of Crohn's disease amongst the study participants. This period is characterized by both psychological stress and impaired ability to work.

Bokemeyer B, Teml A, Roggel C, Hartmann P, Fischer C, Schaeffeler E, Schwab M. · Gastroenterology Practice Minden, Minden, Germany. · Aliment Pharmacol Ther. · Pubmed #17593067 No free full text.

Abstract: BACKGROUND: High frequency of incomplete or non-response to azathioprine (AZA) and/or mercaptopurine (MP) limit their use in Crohn's disease (CD). Non-adherence is considered to be of relevance for ineffectiveness. AIM: To assess adherence to thiopurines in CD out-patients treated in a single gastroenterology practice. METHODS: Patients were eligible for inclusion if they received AZA/MP for at least 3 months. After follow-up of 3 months, adherence to AZA/MP was assessed by quantitation of relevant thiopurine metabolite levels in red blood cells as well as by patients' self-report using standardized questionnaire. RESULTS: Sixty-five patients were prospectively included. Six patients (9.2%) had metabolite profiles indicative of non-adherence. Self-assessed questionnaire revealed non-adherence in four of 56 patients (7.1%). Therapeutic drug monitoring (TDM) and self-assessment as two independent methods had a concordance rate of 75%. Metabolite levels and self-assessed adherence were not significantly different between patients in remission compared with those with active disease. CONCLUSIONS: Out-patients with CD treated in a single gastroenterology practice had a satisfactory adherence (>90%) to thiopurine therapy. Different measures of adherence (TDM and self-report) applied to the same patient suggest comparable levels. TDM appears to be a reliable tool to assess adherence to thiopurines in clinical practice.

Kaltz B, Bokemeyer B, Hoffmann J, Porschen R, Rogler G, Schmiegel W. · Die Institutsangaben sind am Ende des Beitrags gelistet. · Z Gastroenterol. · Pubmed #17427117 No free full text.

Abstract: It has been assumed that cancer surveillance colonoscopy in patients with ulcerative colitis is not conducted according to the guidelines in Germany. An inquiry of the self-help organisation German Crohn's Disease/Ulcerative Colitis Association (DCCV) among organisation members belonging to colorectal cancer risk groups confirmed that the number of biopsies taken during colonoscopy is less than that proposed by the guidelines. Only with 9.2 % of the risk group did a guideline-conformal colonoscopy take place. In more than 50 % of the cases less than 10 biopsies were taken.

Herrlinger KR, Witthoeft T, Raedler A, Bokemeyer B, Krummenerl T, Schulzke JD, Boerner N, Kueppers B, Emmrich J, Mescheder A, Schwertschlag U, Shapiro M, Stange EF. · Robert-Bosch-Hospital, Stuttgart, Germany. · Am J Gastroenterol. · Pubmed #16635225 No free full text.

Abstract: BACKGROUND: Interleukin-11 has shown benefit in animal inflammatory bowel disease models. Recently, recombinant human interleukin-11 (rhIL-11) has been observed to induce remission in a subset of patients with mild to moderate Crohn's disease (CD). The present study compared the efficacy of rhIL-11 versus prednisolone in remission induction in CD. METHODS: Patients with active CD were randomly assigned to receive either subcutaneous rhIL-11 (1 mg once weekly) and prednisolone placebo tablets, or active prednisolone (60 mg/day) and rhIL-11 placebo, for 12 weeks. Prednisolone/placebo was tapered after week 1, and patients were assessed every second week. RESULTS: Fifty-one patients received medication: 13/27 (rhIL-11) and 17/24 (prednisolone) completed 12 weeks of treatment. Remission rates (intent to treat) for rhIL-11 versus prednisolone were 4% versus 46% at week 4 (p < 0.001) and 19% versus 50% at week 6 (p < 0.05). Response to treatment (deltaCDAI > 100) was seen in 19% (rhIL-11) versus 63% (prednisolone) after 4 weeks (p < 0.002) and 37% versus 63% after 6 weeks (p = 0.1). After 12 weeks of treatment, it was observed that 22% (rhIL-11) versus 21% (prednisolone) had remained in remission. Frequent side effects of rhIL-11 included fever (n = 3), rash (4), arthralgia/arthritis (3), nausea/vomiting (3), and headache (6). CONCLUSION: rhIL-11 is well tolerated but significantly inferior when compared to prednisolone in short-term remission induction in patients with active CD. In this patient cohort, both treatments appeared to be poor in maintaining remission over a period of 3 months.

Bokemeyer B. · Gastroenterologische Schwerpunktpraxis, Minden. · Z Gastroenterol. · Pubmed #11803494 No free full text.

Abstract: BACKGROUND AND OBJECTIVE: Elevated serum lipase and amylase are often observed in IBD patients (Crohn's disease and ulcerative colitis) without clinical symptoms of a pancreatitis. The intention of this prospective study is to evaluate the frequency of elevated serum lipase and amylase with these patients and to try to explain this phenomenon in consideration of the existing literature. PATIENTS AND METHODS: 136 IBD patients (MC: 66; CU: 70) participated in this prospective study which lasted 3 months. All patients with increased levels of serum lipase and amylase were prospectively followed-up for another 3 months. RESULTS: We found an asymptomatic elevation of serum lipase and amylase without symptoms of a pancreatitis in 14 % of the observed IBD patients. A significance between the elevation of lipase/amylase and the activity index (CDAI,CAI) or the CRP level could not be found. A significant increase of lipase/amylase (more than twice the normal standard) was shown more often in lipase (4.4 %) than in amylase levels (0.7 %). The possible reasons for an asymptomatic increase of lipase/amylase in IBD patients (e. g. latent extra-intestinal involvement of the pancreas in IBD with pancreatitis; extra-pancreatic release of lipase/amylase from the inflammatory bowel; intestinal reabsorption of released lipase/amylase in the inflammatory bowel) are discussed in this text. CONCLUSION: An asymptomatic elevation of lipase/amylase in IBD patients is not infrequent (14 %). The increase of lipase or amylase, without typical symptoms, makes a pancreatitis with a required therapy unlikely. A specific pancreatitis therapy is not necessary in these cases. The therapy should be guided by the requirements of the IBD therapy.

Bokemeyer B. · No affiliation provided · Z Gastroenterol. · Pubmed #13130334 No free full text.

This publication has no abstract.