Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.
Asian Continental Ancestry Group ; Colectomy ; Colitis, Ulcerative ; Colorectal Neoplasms ; Consensus ; Crohn Disease ; Disease Management* ; Disease Progression ; Early Intervention (Education) ; Epidemiology ; Expert Testimony ; Gastrointestinal Tract ; Hospitalization ; Humans ; Inflammatory Bowel Diseases* ; Japan* ; Prevalence ; Prognosis

Although programmed cell death-ligand 1 (PD-L1) is a prognostic biomarker for nivolumab therapy, it is not very reliable due to its low accuracy. The pharmacological effect of nivolumab involves the cancer immunity cycle, a process that involves T cells, which are strongly associated with nutrition. In this study, we retrospectively investigated whether two measures of nutrition, namely, the Glasgow Prognostic Score (GPS) and the Prognostic Nutritional Index (PNI), could predict response to nivolumab as evaluated in terms of survival time. The subjects were 37 patients treated with nivolumab in the Department of Respiratory Medicine at our hospital between January 2017 and December 2018. Patients were classified into 2 PNI risk groups (low and high risk) and 3 GPS groups (0, 1, and 2), with lower GPS indicating better nutrition. Kaplan-Meier analysis was used to compare differences between the PNI groups and between each possible pairing of GPS groups. Survival time was significantly longer for the low-risk PNI group compared with the high-risk PNI group and for a GPS score of 0 versus 2 and 1 versus 2, but there was no significant difference for a GPS score of 0 versus 1. These results show that GPS and PNI may be potential predictors of response to nivolumab in non-small cell lung cancer.