Takayuki Yamamoto

• MD, PhD, FACG
• Head of Department at Yokkaichi Hazu Medical Center

Background We present the final analysis of a tofacitinib post-marketing surveillance (PMS) study in Japanese patients with ulcerative colitis (UC). Methods Safety/effectiveness data were evaluated (through Sept/30/2022). All patients with UC in Japan receiving tofacitinib were registered (60-week observation period). Adverse events (AEs) were rec...

Aim Ulcerative colitis (UC) is a known contributor to the development of colitis‐associated cancer (CAC), although the exact mechanism remains to be elucidated. CAC typically presents as a flat type macroscopically and manifests histologically as mucinous carcinoma and signet ring cell carcinoma. While the relationship between disease duration and...

Background and Aim Colitis‐associated intestinal cancer (CAC) can develop in patients with inflammatory bowel disease; however, the malignant grade of CAC may differ from that of sporadic colorectal cancer (CRC). Therefore, we compared histological findings distinct from cancer stage between CAC and sporadic CRC to evaluate the features of CAC. Me...

Background Tofacitinib is an oral Janus kinase inhibitor for the treatment of ulcerative colitis (UC). We present the final analysis of a 60-week post-marketing surveillance (PMS) study of tofacitinib in patients (pts) with UC in Japan. Methods A final analysis of safety and effectiveness data from a PMS study was conducted (final data as of 30 Se...

Background Fistulising perianal diseases (FPD) are common in patients with Crohn's disease (CD) in Asia, but the treatment pattern and the proportion of patients who develop new FPD after diagnosis are not clear. An interim analysis of a large registry study was performed to evaluate the difference in prognosis between patients with and without FPD...

Introduction Ulcerative colitis (UC) is an inflammatory bowel disease of unknown aetiology. Long-standing chronic inflammation leads to the development of dysplasia and, ultimately, colitis-associated colorectal cancer (CAC)¹. There is little difference between sporadic colorectal cancer (SCRC) and CAC with regards to prognosis, despite many clinic...

Background: The YOu and Ulcerative colitis: Registry and Social network (YOURS) is a large-scale, multicenter, patient-focused registry investigating the effects of lifestyle, psychological factors, and clinical practice patterns on patient-reported outcomes in patients with ulcerative colitis in Japan. In this initial cross-sectional baseline ana...

Introduction: This ongoing post-marketing surveillance monitors the long-term safety and effectiveness of vedolizumab in routine clinical practice in patients with moderate-to-severe ulcerative colitis (UC) in Japan. This interim analysis assessed induction-phase data, covering the initial three doses of vedolizumab. Methods: Patients were enrol...

Objectives: Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD...

Background and aims: Perianal lesion is a refractory phenotype of Crohn's disease (CD) with significantly diminished quality of life. We evaluated the clinical characteristics of perianal lesions in newly diagnosed CD patients and the impact of perianal lesions on the quality of life in Japanese patients with CD. Methods: Patients newly diagnose...

Background Biologics are commonly used for the treatment of Crohn’s disase (CD); however, the proportion of biologics used and their initiation time from diagnosis differs widely between different regions. There is limited information about the patient characteristics and the treatment persistence of each initial biologics, and the treatment persis...

Introduction: The aim of this study was to evaluate the effect of biologics on the risk of advanced-stage inflammatory bowel disease (IBD)-associated intestinal cancer from a nationwide multicenter data set. Methods: The medical records of patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed with IBD-associated intestinal neo...

Background Patients with longstanding inflammatory bowel disease are at high risk of developing intestinal cancers. In this study, we aimed to elucidate the differences between intestinal cancers associated with ulcerative colitis and Crohn’s disease.Methods Intestinal cancers in ulcerative colitis and Crohn’s disease patients treated between 1983...

Background: The Inception Cohort Registry Study of Patients with Crohn's Disease aimed to clarify clinical characteristics and disease course of newly diagnosed Crohn's disease patients in Japan throughout a 4-year period. Results from an interim analysis of the largest nation-wide registry study that covers approximately 1% of Crohn's disease pat...

Background Endpoints to determine the efficacy and safety of medical therapies for Crohn’s disease (CD) and ulcerative colitis (UC) are evolving. Given the heterogeneity in current outcome measures, harmonizing endpoints in a core outcome set (COS) for randomized controlled trials (RCTs) is a priority for drug development in inflammatory bowel dise...

Environmental and lifestyle factors play an important role in the natural history of Crohn's disease and ulcerative colitis. A group of international experts from the International Organization for the Study of Inflammatory Bowel Diseases voted on a series of consensus statements to inform the management of inflammatory bowel disease (IBD). The rec...

Background AJM300 is an oral, small-molecule α4-integrin antagonist. We assessed the efficacy and safety of AJM300 in patients with moderately active ulcerative colitis. Methods This multicentre, randomised, double-blind, placebo-controlled, phase 3 study consisted of two phases: a treatment phase and an open-label re-treatment phase. The study wa...

Among various perovskite proton conducting oxides, Y-doped BaZrO3 perovskite is a promising material for electrochemical hydrogen devices due to its good chemical stability and higher proton conductivity at higher operating temperatures like 500-800 °C. For the practical application of the functional BaZrO3 proton conductors in electrochemical hydr...

Original Paper Title: Isotopic effect of proton conductivity in barium zirconates for various hydrogen-containing atmospheres

Complex perianal Crohn's disease (CD) remains a challenging problem. Fecal stream is thought to be a trigger of disease progression in patients with CD. In patients with refractory perianal CD, diversion of fecal stream is sometimes required to alleviate clinical symptoms when medical and local surgical management are unsuccessful. Several studies...

BaZrO3-based materials doped with a trivalent cation have excellent chemical stability and relatively high proton conductivity which makes them potential proton conducting oxide materials for various electrochemical device applications such as hydrogen processing, high-temperature electrolysis, and solid electrolyte in fuel cells. However, BaZrO3 s...

Background Information on patient demographics and disease characteristics at the time of Crohn’s disease (CD) diagnosis is considered to be an important aspect in the treatment and management of CD. However, reports on phenotypes, disease course, and treatment impact in newly diagnosed CD patients are limited. An interim analysis of a large regist...

Background We aimed to investigate the presence and severity of coronary microvascular dysfunction (CMD) in inflammatory bowel disease (IBD) including Crohn disease and ulcerative colitis and to elucidate the influence of surgical resection of the diseased intestines on CMD by assessing coronary flow velocity reserve (CFVR) using transthoracic Dopp...

Background Anti-tumour necrosis factor (TNF) agents are the mainstay of long-term treatment for refractory ulcerative colitis. However, long-term use of anti-TNF therapy might lead to an increased risk of malignancy or infection. To date, no randomised controlled trial has evaluated whether anti-TNF agents can be safely discontinued in patients wit...

Background: Anorectal stricturing is a particularly morbid manifestation of Crohn's disease resulting in a diminished quality of life related to pain, incontinence, and recurrent operative interventions. Objective: To determine the role of medical therapy, endoscopic dilation, and surgical intervention for the treatment of isolated anorectal str...

Background Adrenomedullin (AM) is a bioactive peptide having many pleiotropic effects, including mucosal healing and immunomodulation. AM has shown beneficial effects in rodent models and in preliminary study for patients with ulcerative colitis (UC). We performed a clinical trial to investigate the efficacy and safety of AM in patients with UC. M...

Introduction: The ileocecal region is most commonly involved in patients with Crohn's disease (CD). Area covered: In the management of ileocecal CD, this review discusses the underlying clinical issues with perioperative management and surgical intervention. Expert commentary: Despite advances in medical treatments, surgery is required in a propor...

Despite significant advances in medical therapy in the management of Crohn’s disease (CD), surgery is still required in a significant proportion of patients and constitutes an important tool in treatment algorithms. Recently, more options of biological agents have been made available, and most patients with CD undergoing surgical procedures have be...

Despite significant advances in new drugs and therapeutic strategies, surgery is still needed in a significant proportion of Crohn's disease (CD) patients. As no medical or surgical cure exists, recurrence after surgical resections is a common scenario in clinical practice. Endoscopic recurrence precedes clinical and surgical recurrences. Thus, the...

Duodenal Crohn's disease (CD) is an uncommon condition, and the treatment options include medications, endoscopic dilation or surgical intervention. The most common indication for surgery is presence of progressive obstructive symptoms despite medical therapy or endoscopic dilatation. Surgical options for duodenal CD include bypass, resection or st...

Thank you for providing us with the opportunity to reply to the comments by Lee and Brown. The impact of preoperative optimization with enteral nutrition (EN) on the incidence rate of complications after surgery in Crohn’s disease (CD) remains to be fully validated. We undertook a case‐matched study to assess the relevance of nutritional optimizati...

Introduction: In recent decades, biologics have resulted in significantly improvement medical management of ulcerative colitis (UC). Rates of surgery for UC are declining. However, there is still a controversial question of the relation of biologics to postoperative adverse outcomes and the most appropriate timing for operative intervention. Areas...

Background Anti-tumour necrosis factor (TNF)-α agents are the mainstay of the long-term treatments for refractory ulcerative colitis (UC). However, there is no prospective randomised controlled trial evaluating if anti-TNF-α agents can be discontinued in UC patients in remission. Methods Patients with UC maintained in clinical remission with infli...

LINKED CONTENT This article is linked to Kayal et al and Kayal and Ungaro papers. To view these articles, visit https://doi.org/10.1111/apt.15505 and https://doi.org/10.1111/apt.15582.

Background: Apheresis therapy involves the selective removal of leukocytes and is used to induce remission in ulcerative colitis (UC) patients. The aim of this study was to demonstrate the efficacy and safety of apheresis therapy for maintaining UC remission. Methods: We conducted a multicenter, prospective, randomised-control trial of patients...

Two rare cases of ulcerative colitis (UC)-like gastroduodenitis that developed after total proctocolectomy are reported. Two women (Case 1 : 22-year-old and Case 2 : 29-year-old) had a 5-year and a 7-year history of left-sided UC, respectively. Both patients underwent total proctocolectomy with stapled ileal pouch anal anastomosis and covering ileo...

Aim: Currently, the notion that preoperative optimization with enteral nutrition (EN) reduces the incidence of complication after surgery in Crohn's disease (CD) patients is being debated. This case-matched study was to evaluate the impact of preoperative EN on surgical outcomes in patients with CD. Method: Twenty-four patients received EN thera...

Background: The available information on granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease (IBD) under special situations remains unclear. We conducted a retrospective, multicentre cohort study to evaluate the safety and effectiveness of GMA in patients with IBD under special situations. Methods: Thi...

LINKED CONTENT This article is linked to Lin et al papers. To view these articles, visit https://doi.org/10.1111/apt.15184 and https://doi.org/10.1111/apt.15487.

Background Inflammatory bowel disease (IBD) is a complex multisystem disease characterized by chronic inflammation, which can lead to coronary microvascular dysfunction (CMD). Purpose We aimed to investigate the presence and the severity of CMD in Crohn's disease (CD) and ulcerative colitis (UC) by assessing coronary flow reserve (CFR) using trans...

Background We recently reported the efficacy of indigo naturalis (IN) in patients with active ulcerative colitis (UC) in a randomized controlled trial (INDIGO study). However, few studies have been conducted to investigate whether IN is effective even in treatment-refractory cases, such as in those with steroid dependency and anti-TNF refractorines...

Perianal fistulizing Crohn’s disease (PFCD) is associated with significant morbidity and might negatively impact the quality of life of CD patients. In the last two decades, the management of PFCD has evolved in terms of the multidisciplinary approach involving gastroenterologists and colorectal surgeons. However, the highest fistula healing rates,...

Purpose We evaluated the recent incidence of surgery and the changing surgery trends for ulcerative colitis (UC) in Japan due to the increasing use of anti-tumor necrosis factor (TNF) agents. Methods A questionnaire survey was performed to assess the number of surgeries, surgical indications, surgical timing, and immunosuppressive treatments befor...

Patients who are affected by isolated Crohn’s disease of the rectum or rectosigmoid region and do not respond well to medical therapy including biologic agents or immunosuppressants may require surgical intervention. Nonetheless, there have been few reports about the surgical treatment for isolated proctitis/proctosigmoiditis likely because Crohn’s...

Objectives: A case-control study was undertaken to assess the impact of preoperative nutrition on surgical outcomes in patients with inflammatory bowel disease with vs without preoperative biologic therapy. Methods: Seventy patients who had received biologic therapy within 8 weeks before undergoing resection for active ulcerative colitis (n = 34...

BACKGROUND: Biological therapy with anti-tumour necrosis factor (TNF)-α agents revolutionised the treatment of inflammatory bowel disease over the last decades. However, there may be an increased risk of postoperative complications in Crohn's disease (CD) patients treated with anti-TNF-α agents prior to abdominal surgery. OBJECTIVE: To evaluate...

Crohn's disease (CD) is an immune mediated condition characterized by transmural inflammation of the gut tissue, associated with progressive bowel damage often leading to surgical intervention. As operative resection of the damaged segment is not curative, a majority of patients undergoing intestinal resections for complicated CD present with disea...

Background Adsorptive granulomonocytapheresis (GMA) with the Adacolumn is a novel non-pharmacologic strategy for treating patients with ulcerative colitis (UC). Multiple studies in Japan and Europe found that GMA was safe and therapeutically effective in patients with active UC. However, endoscopic efficacy and factors affecting the endoscopic effi...

Background The value of faecal biomarkers for evaluating small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was designed to assess the relationship between computed tomography enterography (CTE) findings and levels of faecal biomarkers in patients with small bowel Crohn’s disease. Method...

Background Adsorptive granulomonocytapheresis (GMA) with the Adacolumn has been introduced as a non-pharmacologic treatment for ulcerative colitis (UC). A subset of patients who might or might not respond to GMA has not been fully identified. In clinical practice setting, it is important to know which patients are most likely to respond to GMA to a...

Background Previous studies have reported that Granulomonocytapheresis (GMA) was effective in patients with mild-to-moderately active ulcerative colitis (UC) and had a favourable safety profile. Currently, GMA is widely used in Japan and is available in the European Union countries. Calprotectin is a calcium-binding protein, which can be measured i...

en Linked Content This article is linked to Auzolle et al paper. To view this article visit https://doi.org/10.1111/apt.14944.

This Article was originally published under Nature Research’s License to Publish, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the Article have been modified accordingly.

A multicenter retrospective study aiming to identify patients who respond well to adsorptive granulomonocytapheresis in moderately to severely active ulcerative colitis

Background: Calprotectin is a stable neutrophil protein, which can be measured in faecal samples. The faecal level of calprotectin increases during disease activity in ulcerative colitis (UC). Nonetheless, the relevance of faecal calprotectin (FC) measurement during granulomonocytapheresis (GMA) for UC has not yet been fully evaluated. This prospec...

Introduction: Fistula-associated anal carcinoma in patients with Crohn’s disease (CD) is a rare condition. More recently, this entity has been increasingly reported likely due to increased recognition and the incidence may be greater than once appreciated. There remains a paucity of data regarding the incidence, diagnosis, treatment and outcome of...

Background Anastomotic recurrence is frequent in patients with Crohn’s disease (CD) following ileocecal resection. The degree of endoscopic recurrence, quantified by the Rutgeerts score (RS), correlates with risk of clinical and surgical recurrence. Several studies demonstrate the accuracy of fecal calprotectin (FC) for detection of endoscopic recu...

Objectives: Adsorptive granulomonocytapheresis (GMA) with the Adacolumn has been introduced as a non-pharmacologic treatment for ulcerative colitis (UC). However, a subset of patients who might respond well to GMA needs to be targeted. This study was conducted at three IBD centers to determine factors affecting the efficacy of GMA in patients with...

Background There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn's disease (CD). Aim To compare complication rates after elective abdominal operations in CD patients with different durations of disease. Methods Retrospective observational study with CD patients who submitted to elective...

Orally administered Qing-dai, called indigo naturalis in Latin, is reportedly useful for the treatment of ulcerative colitis. We herein describe two patients with ulcerative colitis who developed colitis with wall thickening and edematous changes during oral administration of the powdered form of Qing-dai. In Case 1, a 35-year-old man developed col...

Objectives: Achieving endoscopic remission or decreasing the level of fecal biomarkers as an ideal therapeutic goal in ulcerative colitis has not been determined. This prospective study was to compare the clinical relevance of endoscopic score with fecal biomarkers for predicting relapse after clinical remission and mucosal healing (MH). Methods...

Background Achieving endoscopic remission or decreasing the level of faecal biomarkers as an ideal therapeutic goal in ulcerative colitis has not been determined. This prospective study was to compare the clinical relevance of endoscopic score with faecal biomarkers for predicting relapse after clinical remission and mucosal healing (MH). Methods...

Background The value of faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was to evaluate the utility of faecal biomarkers for detecting small intestinal inflammation. Methods One hundred twenty-two consecutive patients with a diagnosis of CD in the small...

Background Since 2010, treatment with tacrolimus or biologics has been introduced for refractory ulcerative colitis (UC) in our IBD centre. This retrospective study was to investigate the impacts of these agents on surgery avoidance effects and postoperative complication rates. Methods Fifty hospitalised patients with severely active UC (UC-DAI sc...

Perianal fistulae in patients with Crohn’s disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal...

Background & aims: Indigo naturalis (IN) is a traditional Chinese medicine that contains ligands for the aryl hydrocarbon receptor and promotes regeneration of the mucosa, by inducing production of interleukin 22. IN might induce mucosal healing in patients with ulcerative colitis (UC). We performed a randomized controlled trial to investigate the...

Despite advances in medical therapy, many patients with Crohn's disease (CD) require surgical intervention. Conservative treatment strategies including limited bowel resection and strictureplasty have been widely employed in the surgical management of CD. Laparoscopic surgery offers multiple advantages for patients, including faster postoperative r...

Background: data are scarce regarding the effect of preoperative Adalimumab (ADA) in postoperative complications in Crohn's disease (CD) patients. Aim: to compare the rates of postoperative complications after intestinal resections in CD, with and without previous exposure to ADA. Method: case-matched retrospective observational study of patie...

Background: This narrative review was to determine which medication, tacrolimus (TAC) or infliximab (IFX), is safer and more effective in the management of active UC. Our literature search identified 5 studies directly comparing the outcomes of TAC versus IFX for active UC. A review of the 5 studies was undertaken. Summary: The incidence of seri...

Background The value of faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was to evaluate the utility of faecal biomarkers for detecting small intestinal inflammation. Methods A total of 122 consecutive patients with a diagnosis of CD in the small intesti...

Introduction: Ileocolonoscopy is the gold standard for the diagnosis and assessment of postoperative recurrence in Crohn’s disease (CD). Nevertheless, endoscopy is time-consuming and invasive. A minimally invasive and simple screening test would improve patient adherence to examination and provide greater clinical benefit. A number of fecal biomark...

Introduction: Patients with inflammatory bowel diseases (IBD) require life-long medications, which even if effective have the potential to cause adverse effects as additional morbidity factors. In pediatric patients, drug therapy has more serious limitations, including impaired physical and mental development. A non-drug therapeutic option is belie...

Abstract Background Efficacy of maintenance therapy in ulcerative colitis (UC) in the remission stage has been reported to depend on release profile or dosing regimen of oral 5-aminosalicylic acid (5-ASA) products used. Aim of this study is to investigate real life results in using oral 5-ASA products for maintaining mild to moderate UC patients in...

It is now widely acknowledged that the intestinal bacterial flora together with genetic predisposing factors significantly contribute to the immunopathogenesis of inflammatory bowel disease (IBD) as reflected by mucosal immune dysregulation. Recently, there has been an increased interest in nutraceutical therapies, including probiotics, prebiotics...

Background: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergen...

en Linked Content This article is linked to Fumery and Dulai et al paper. To view this article visit https://doi.org/10.1111/apt.13886.

Background Granulocyte and monocyte apheresis (GMA) has shown therapeutic efficacy in active ulcerative colitis (UC). We thought that in patients with pouchitis after proctocolectomy for UC, GMA might produce immunological effects in the intestinal mucosa, and improve clinical symptoms. This prospective study was to evaluate the efficacy of GMA for...

Background: Granulocyte and monocyte apheresis (GMA) has shown therapeutic efficacy in patients with active ulcerative colitis (UC). We thought that in patients with pouchitis, GMA should produce immunoregulatory effects in the intestinal mucosa, and improve clinical symptoms. With this in mind, we undertook a prospective study to evaluate the effi...

Background: The paradigm for treatment for inflammatory bowel disease (IBD) is shifting from resolving symptoms toward objective measures such as mucosal healing (MH). Several studies suggest that MH is associated with an increased rate of long-term clinical remission and a decreased rate of surgery. However, few studies investigated the impacts of...

It was with great interest that we read the manuscript entitled ‘Postoperative Outcomes in Vedolizumab-treated Patients Undergoing Abdominal Operations for Inflammatory Bowel Diseases’, recently published in this journal, by Lightner et al .1 In this retrospective study, 94 patients with previous exposure to vedolizumab [VEDO] within 12 weeks befor...

Aim: Early endoscopic recurrence is frequently observed in patients following resection for Crohn's disease (CD). However, factors affecting the incidence of an early postoperative endoscopic recurrence (EPER) have not been fully determined. The aim of this study was to evaluate risk factors for EPER after ileocolonic resection for CD. Method: T...

Background: It is recommended that ileocolonoscopy is performed within 1 year after resection for Crohn's disease (CD). Nevertheless, optimal monitoring strategies for recurrence after the ileocolonoscopy remain to be elucidated. This prospective study was to evaluate the value of serial monitoring of faecal calprotectin (FC) after ileocolonoscopy...