AIM Care for the inflammatory bowel disease (IBD) patients presents unique challenges as decisions regarding therapy must consider numerous distinct characteristics of each patient. The aim of the study was to recognize patients' characteristics as predictors of success in vedolizumab treatment. METHODS In a retrospective observational study, data regarding age, gender, body mass index (BMI), length of disease, previous exposure to anti-tumour necrosis factor (TNF), drugs, and smoking status were extracted from the routine clinical practice. Patients were assessed for clinical remission and steroid-free remission after the 26-week treatment with vedolizumab. RESULTS The study included 76 patients with UC and 63 with CD. A total of 63 (out of 76; 82.9%) (Cl: 72.5-90.6% ) of UC and 54 (out of 63; 85.7%) (Cl: 74.6-93.3%) CD patients achieved clinical remission in the 26-week vedolizumab treatment. Over five years, illness was noticed in 32 (53.1%) CD patients. Clinical remission was not achieved in six (out of 13; 46.1%) UC patients aged 40-49 years and six (out of nine; 66.6%) CD patients aged 30-49 years. Among CD patients, remission was achieved in 22 (85.7%) females and 23 (63.6%) males. Remission rates were generally higher in patients with a BMI of 18.6-25 and 25.1-30. Previous exposure to anti TNF drugs and smoking status did not influence treatment outcomes. CONCLUSION The efficacy of vedolizumab is a viable treatment option for both ulcerative colitis and Crohn's disease. The exploration of individual patient characteristics holds promise in predicting a treatment outcome.

Inflammatory bowel disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), necessitates effective management strategies. This study aims to evaluate the real-world efficacy of vedolizumab, a newer biological therapy, in treating IBD in Bosnia and Herzegovina. A retrospective observational study was conducted across six medical centers, involving 139 IBD patients, 76 with UC and 63 with CD. Patients were assessed for clinical remission and other outcomes at the 26-week mark post vedolizumab treatment initiation. At 26 weeks, clinical remission was achieved in 82.9% of UC patients and 85.7% of CD patients. Mucosal healing was observed in 38.1% of CD patients. The efficacy of vedolizumab did not significantly differ based on prior anti-tumor necrosis factor (anti-TNF) exposure. Notably, the clinical scoring tools for predicting vedolizumab response showed limited applicability in this cohort. Vedolizumab demonstrated high efficacy in treating both UC and CD in real-world settings in Bosnia and Herzegovina, underscoring its potential as a significant therapeutic option in IBD management.

Abstract Background To examine correlation between elevated levels of thyrotropin with the frequency of miscarriages. Methods A cross-sectional study was conducted on the 380 respondents and it investigated TSH (thyrotropin), thyroid peroxidase antibody(anti-TPO) and free thyroxine (FT4) in pregnant women who had a miscarriage (N = 179) and pregnant women with normal pregnancies (N = 201). Results The incidence of subclinical hypothyroidism in the miscarriages group was higher than in control group (61.4% vrs 15.79% (p < 0.001). In the miscarriages group with hypothyroidism (first trimester) mean value of TSH was significantly higher 4.31 ± 2.55 mIU/L compared to the control group 1.95 ± 0.86mIU/L (p < 0.001). Logistic multivariate regression revealed that TSH and body mass index (BMI) have a significant influence on the miscarriage; TSH level has a higher odds ratio (OR) 1.47 CI (95% 1.22–1.78) than BMI (OR) 1.14 CI (95% 1.06–1.23)) (p < 0.001). The combination of thyroid autoimmunity and TSH > 2.5mIU/L increase the risk of miscarriage (65.75%) compared to positive anti-TPO antibodies and TSH < 2.5mIU/L(14.15%)(p < 0.001). Conclusions Higher TSH levels correspond with obesity during early pregnancy and may be a sign of maternal thyroid dysfunction. Physiological thyroid function in the first trimester of pregnancy is important for perinatal outcome.