A5030564681- Inflammatory Bowel Disease
- Microscopic Colitis
- Immunodeficiency and Autoimmune Disorders
- COVID-19 Clinical Research Studies
- COVID-19 and healthcare impacts
- Eosinophilic Esophagitis
- Acute Lymphoblastic Leukemia research
- Biosimilars and Bioanalytical Methods
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Lymphocytic Leukemia Research
- Diverticular Disease and Complications
- Genomic variations and chromosomal abnormalities
- Genomics and Rare Diseases
- Pharmaceutical studies and practices
- Colorectal Cancer Screening and Detection
- Multiple Sclerosis Research Studies
- Peripheral Neuropathies and Disorders
- Adolescent and Pediatric Healthcare
- Autoimmune and Inflammatory Disorders Research
- SARS-CoV-2 and COVID-19 Research
- Pediatric Pain Management Techniques
- Systemic Lupus Erythematosus Research
- Genetic factors in colorectal cancer
- Pancreatitis Pathology and Treatment
- Helicobacter pylori-related gastroenterology studies
The University of Queensland
2023-2025
QIMR Berghofer Medical Research Institute
2023-2025
Royal Brisbane and Women's Hospital
2023-2025
Torbay and South Devon NHS Foundation Trust
2020-2023
Torbay Hospital
2022
University Gastroenterology
2016-2022
Royal Devon and Exeter Hospital
2018-2020
Royal Devon & Exeter NHS Foundation Trust
2016-2020
University of Exeter
2017-2020
PharmacoGenetics (China)
2020
Background & AimsAnti–tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce formation of anti-drug antibodies. The ability to identify patients at increased risk development antibodies would facilitate selection therapy and use preventative strategies.MethodsWe performed a genome-wide association study variants associated with time in discovery cohort 1240 biologic-naïve Crohn's disease...
IMPORTANCEUse of thiopurines may be limited by myelosuppression.TPMT pharmacogenetic testing identifies only 25% at-risk patients European ancestry.Among East Asian ancestry, NUDT15 variants are associated with thiopurine-induced myelosuppression (TIM).OBJECTIVE To identify genetic TIM among ancestry inflammatory bowel disease (IBD). DESIGN, SETTING, AND PARTICIPANTSCase-control study 491 affected and 679 thiopurine-tolerant unaffected who were recruited from 89 international sites between...
Summary Background Few studies have reported the systematic use of exclusive enteral nutrition in perioperative setting. Aim To test hypothesis that provides a safe and effective bridge to surgery reduces post‐operative complications, adult patients with Crohn's disease requiring urgent for stricturing or penetrating complications. Methods Patients treated prior were each matched two control behaviour, type surgery, age at diagnosis duration. Data on phenotype, nutritional status, operative...
Significance Pharmacogenetics is a prototype of genomics-guided precision medicine. While there rapid expansion novel pharmacogenetic variants discovered by genome sequencing, the lack variant interpretation in scalable fashion formidable barrier this field. NUDT15 polymorphism major genetic cause for hematopoietic toxicity during thiopurine therapy. Motivated need to understand effects clinical actions, we developed massively parallel assay preemptively characterize 91.8% all possible...
Age is a major prognostic factor for COVID-19 outcomes. The effect of inflammatory bowel disease [IBD] activity on unclear. We examined the relationship between IBD and severity according to age. included patients diagnosed with COVID-19, reported SECURE-IBD March 13, 2020 August 3, 2021. Clinical was measured by physician global assessment [PGA]. COVID-19-related outcomes were [1] intensive care unit [ICU] admission, ventilation or death, [2] hospitalization. Using generalized estimating...
The causes of microscopic colitis are currently poorly understood. Previous reports have found clinical associations with coeliac disease and genetic at the human leukocyte antigen [HLA] locus on ancestral 8.1 haplotype. We investigated pharmacological factors associated in UK Biobank.In total, 483 European Biobank participants were identified by ICD10 coding, a genome-wide association study was performed using BOLT-LMM, sensitivity analysis excluding potential confounders. HLA*IMP:02...
Abstract Background Perianal disease is an increasingly recognised complication of ulcerative colitis (UC) (1). Variant rs4151651 in complement factor B (CFB) associated with severe phenotype UC and, more recently, implicated the pathogenesis perianal Crohn’s (CD) (2, 3). In our previous work, we have shown minor allele frequency (MAF) for variant to be 0.03 non-IBD affected control patients, 0.05 patients mild UC, and 0.13 (3). Here, aim determine MAF disease. Methods Ulcerative were...
Abstract Background The prevalence of Inflammatory Bowel Disease (IBD) has increased worldwide with Australia and New Zealand amongst the highest rates. Older literature suggested that people IBD experienced higher mortality rates than general population1. Conversely, in other studies, patient survival been shown to be similar population2, 3. As these results are discrepant data possibly outdated, we explored comorbidities demography receiving care Australasian centres using Crohn’s Colitis...
Abstract Background Inflammatory bowel disease (IBD) is a global health issue with Australia (AUS) and New Zealand (NZ) having amongst the highest prevalence rates worldwide. Due to paucity of externally visible data on how care delivered within individual sites, little known about utilisation various inputs presence and/or magnitude any variation in this centres. We therefore examined use documented 11 Australasian IBD centres over 12-month period. Methods Crohn’s Colitis Care (CCCare)...
Abstract Background Inflammatory bowel disease (IBD) is a lifelong illness, increasing in prevalence, with Australia (AUS) and New Zealand (NZ) amongst the highest world. Long-term management poses significant economic burden on people IBD healthcare system. We aim to describe utilisation (HCU) across 18 sites using Crohn’s Colitis Care (CCCare) as their electronic record (EMR). Methods CCCare cloud based EMR used Australasia. Data feed into de-identified clinical quality registry (CQR),...
Acute severe ulcerative colitis (ASUC) is a life-threatening medical emergency affecting over 20% of patients with (UC). Up to 40% are refractory intravenous corticosteroids (IVCS) and require rescue therapy or immediate colectomy. The potent Janus kinase (JAK) inhibitors, upadacitinib tofacitinib, have proven efficacy in randomised control trial setting for moderate-to-severe UC, but not ASUC. We describe case series sequential JAK inhibitors following the failure dose-intensified...
Summary Background Primary care faecal calprotectin testing distinguishes inflammatory bowel disease ( IBD ) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded alarm symptoms. Aims We sought to evaluate the diagnostic accuracy of distinguish adults whom general practitioners GP s) suspected ; including reporting gastrointestinal hypothesised that would reduce secondary referrals and healthcare costs. Methods...
Summary Background Delay in the diagnosis of inflammatory bowel disease (IBD) is common and contemporary UK studies are lacking. Aim To determine factors associated with, consequences of, a prolonged time to IBD. Methods This quality improvement study included 304 adults with new IBD made between January 2014 December 2017 across 49 general practices (GP) gastroenterology secondary care services. Outcome measures were demographic, clinical laboratory delayed time, defined as greater than...
We sought to define temporal changes in prevalence of inflammatory bowel disease (IBD) East Devon, UK, order facilitate service planning over the next 5 years.Multiple primary and secondary care databases were used identify verify cases. Point incidence IBD reported April 2017 from 2008 2016, respectively. Future healthcare activity requirements estimated by linear regression.Prevalence ulcerative colitis (UC), Crohn's (CD) unclassified (IBDU) 479.72, 265.94 35.34 per 100 000 persons, In...
Summary Background Anti‐drug antibodies are associated with treatment failure to anti‐TNF agents in patients inflammatory bowel disease (IBD). Aim To assess whether immunogenicity a patient's first agent would be the second, irrespective of drug sequence Methods We conducted UK‐wide, multicentre, retrospective cohort study report rates and second therapies 1058 IBD who underwent therapeutic monitoring for both infliximab adalimumab. The primary outcome was agent, defined at any timepoint as...
Despite intravenous (IV) vedolizumab being established for treatment of inflammatory bowel disease (IBD), the novel subcutaneous (SC) route administration may provide numerous incentives to switch. However, large-scale real-world data regarding long-term safety and effectiveness this strategy are lacking.
Summary Background An episode of acute ulcerative colitis (UC) represents an important watershed moment in a patient's disease course. Aims To derive personalised algorithm for identifying patients at high risk corticosteroid non‐response from variables available hospital presentation using large prospectively collected UC patient database and machine learning‐based techniques. Methods We analysed data 682 consecutive presentations UC. used Akaike information criterion‐based elastic net...
Anti-TNF exposure has been linked to demyelination events. We sought describe the clinical features of events following anti-TNF treatment and test whether affected patients were genetically predisposed multiple sclerosis [MS].We conducted a case-control study exposure. compared genetic risk scores [GRS], calculated using carriage 43 susceptibility loci for MS, in 48 cases with 1219 exposed who did not develop demyelination.Overall, 39 [74%] female. The median age [range] at time was 41.5...
A substantial proportion of patients with inflammatory bowel disease (IBD) on intravenous infliximab require dose intensification. Accessing additional is labour-intensive and expensive, depending insurance pharmaceutical reimbursement. Observational data suggest that subcutaneous may offer a convenient safe alternative to maintain remission in requiring dose-intensified infliximab. prospective, controlled trial required confirm as effective infliximab, identify predictors flare establish...
Introduction Acute severe ulcerative colitis (ASUC) traditionally requires inpatient hospital management for intravenous therapies and/or colectomy. Ambulatory ASUC care has not yet been evaluated in large cohorts. Aims We used data from PROTECT, a UK multicentre observational COVID-19 inflammatory bowel disease study, to report the extent, safety and effectiveness of ambulatory pathways. Methods Adults (≥18 years old) meeting Truelove Witts criteria between 1 January 2019–1 June 2019 March...
Summary Background The COVID‐19 pandemic offered a unique opportunity to understand inflammatory bowel disease (IBD) management during unexpected disruption. This could help guide practice overall. Aims To compare prescribing behaviour for IBD flares and outcomes the early with pre‐pandemic findings Methods We performed an observational cohort study comprising patients who contacted teams symptomatic between March June 2020 in 60 National Health Service trusts United Kingdom. Data were...