<p><strong>Aim </strong>To evaluate the clinical impact of corticosteroids (CS) overuse in inflammatory bowel disease (IBD) patients. Excessive use of CS could delay more efficacious treatment and may indicate poor quality of care.<br /><strong>Method </strong>This is a two-phase study that used Steroid Assessment Tool (SAT) to measure corticosteroid exposure in IBD patients. In the first phase data from 211 consecutive ambulatory patients with IBD (91 with ulcerative colitis, 115 with Crohn's disease, and five with unclassified inflammatory bowel disease) were analyzed by SAT. In the second phase, one year after data entry, clinical outcome of patients with cortico-steroids overuse was analysed.<br /><strong>Results </strong>Of the 211 IBD patients, 132 (62%) were not on corticosteroids, 45 (22%) were cortico-steroid-dependent and 34 (16%) used corticosteroids appropriately, according to the European Crohn's and Colitis Organization guidelines. In the group of patients with ulcerative colitis, 57 (63%) were not on cortico-steroids, 18 (20%) were corticosteroid-dependent, and 16 (16%) used cortico-steroids appropriate-ly; in the group of patients with Crohn's disease 70 (61%), 27 (23%) and 18 (16%), respectively. Overall, 24 (out of 45; 53%) patients with IBD could avoid the overuse of cortico-steroids if they had a timely change of the treatment, surgery or entered a clinical trial.<br /><strong>Conclusion </strong>An excessive corticosteroid use can be recognized on time using the SAT. We have proven that excessive corticosteroid use could be avoided in almost half of cases and thus the overuse of CS may indicate poor quality of care in those patients.</p>

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.

Introduction: Thyroid dysfunction (TD) and diabetes mellitus (DM) are the two most common chronic endocrine disorders with variable prevalence among different populations. Both insulin and thyroid hormones are affected by autoimmune pathology and they do affect cellular metabolism, being a part of the metabolic syndrome. However, the correlations between T2DM and TD have not yet been sufficiently defined, followed by ambivalent results from previous studies.Objectives: The study was conducted to compare the metabolic parameters of patients with T2DM with and those without AITD so as to determine the existence of a correlation between these and hormonal parameters (TSH, FT4).Design and methods: This are documented observational case-control study that included 31 subjects with T2DM and AITD and 25 with T2DM without AITD. Sessions were conducted at the Clinic for Internal Medicine of the University Clinical Center in Tuzla. Individual metabolic parameters were analyzed, and in a broad evaluation, the values of hormonal and immune parameters were monitored and documented.Results: There were no differences in age, gender and BMI of the examined groups. There was a statistically significant difference between the values related to OS, SKT, DKT, PGN, 2h ppPG, and HbA1c. A statistically significant correlation was found between TSH and females, FT4 and BMI (rS = 0.375 pvalue = 0.045) as wellas a correlation between TSH and HbA1c (rS = 0.313 pvalue = 0.019) and TSH and 2x ppPG (rS = 0.281, pvalue = 0.036).Conclusion: The expression of metabolic control parameters is strongest in the group of patients with diabetes and AITD. Their identification as a risk factor and the detection of their subclinical signs are extremely important for the early implementation of preventive and therapeutic strategies, which could change the course of diabetic complications and significantly improve prognosis of diabetes.