This March, the highly anticipated Pfizer symposia at ECCO 2023 delivered interesting, engaging, and thought-provoking updates for the treatment of patients with Ulcerative Colitis (UC).

The first of the two symposia took place on Thursday 2 March, as we asked delegates to join us at the crossroads in UC patient care. The ‘Choose your own path: UC patients at the crossroads’ symposium provided an engaging and interactive experience, led by distinguished faculty members Dr Peter Irving, Dr Joana Torres, Dr Maria T Abreu, and Dr Iris Dotan. Delegates entered the symposium hall to a rocking soundtrack from The Clash, Fleetwood Mac, Blondie, and Queen: a nod to the music stars’ top hits in each of the symposium presentation titles set the tone, looking to an upbeat future for patients with UC.

Introduction to Diets in the Management of IBD

Prof. Franck Carbonnel
Professor of Gastroenterology, University Paris Sud, France
Head, Gastroenterology Department, University Hospital of Kremlin Bicetre, Paris, France

In recent years, studies have shown the associations between food and the risks of developing Inflammatory Bowel Disease (IBD).

An early study showed a significant link between the consumption of red meat and the likelihood of developing Ulcerative Colitis (UC). Subsequent studies deepened our knowledge, pointing to associations between UC and a high consumption of omega-6, and low consumption of omega-3, fiber (fruit and vegetables), zinc and potassium.^{1,2,3,4,5,6,7,8,9}

Other studies have shown a decreased risk of Crohn’s Disease (CD) in people who consume a larger proportion of unprocessed or minimally processed food, and an association between proinflammatory diets, ultra-processed foods, non-Mediterranean diet and CD.^{1-8,10,11,12,13,14}

Ignacio Catalán-Serra © I. Catalán-Serra

Dear ECCO friends,

Welcome to this wide-range conversation with the National Representatives of Israel at ECCO Bella Ungar and Ayal Hirsch, where we got to know more about IBD care in Israel and we discussed some hot areas of interest like: diet in IBD, new technologies and the need for multidisciplinary care and much more!

Hope you enjoy it!

Ignacio Catalán-Serra
ECCO News Associate Editor

Dear ECCO friends and family,

Please join us for the 3^rd episode of our podcast series Meet the JCC Authors!

It is my pleasure to introduce Mads Damsgaard Wewer from the University of Copenhagen, Denmark. He talks about the recently in JCC published paper: Disease Activity Patterns of Inflammatory Bowel Disease—A Danish Nationwide Cohort Study 1995–2018. We hope you enjoy getting to know Mads and learn more about his journal article.

Enjoy and do not forget to spread the word about our new podcast to your friends and colleagues!

Best Wishes,

Nuha Yassin

Consultant Colorectal Surgeon

ECCO News Associate Editor

Robin Dart © ECCO

The return of a physical ECCO Congress finally gave me the chance to interview people in person for ECCO News. So, after an early morning start, the outgoing Chair of Y-ECCO, Charlotte Hedin, and I sat down to talk about what led her into gastroenterology, the impact of moving country mid-career and the Y-ECCO Communication Toolbox, which has recently been made available on the ECCO e-Learning Platform.

Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): A randomised, double-blind, controlled, phase 2, proof-of-concept trial

Feagan BG, Sands BE, Sandborn WJ, et al.

Lancet Gastroenterol Hepatol 2023;8:307–20.

Introduction

Despite a growing armamentarium of advanced therapies for Ulcerative Colitis (UC), fewer than 40% of patients maintain clinical remission at 12 months [1]. Combination therapy utilising dual biologic or small molecule agents can be considered in highly selected, medically refractory cases; however, robust data to support dual therapy in routine clinical practice are still lacking [2]. Inhibitors of TNF-α and IL-23 have demonstrated efficacy in the treatment of UC [3,4]. Data emerging from animal studies have suggested that their use in combination reduces colitis synergistically and may be more efficacious than treatment with either monotherapy [5].

This randomised double-blinded controlled phase 2 trial, named the VEGA trial, was conducted across 54 sites internationally and aimed to determine the efficacy and safety of combination therapy with guselkumab (GUS), an IL-23 p19 antagonist, plus golimumab (GOL), a TNF-α inhibitor, compared with either monotherapy in UC.

Point-of-care intestinal ultrasound in IBD patients: Disease management and diagnostic yield in a real-world cohort and proposal of a point-of-care algorithm

Bots S, De Voogd F, De Jong M, et al.

J Crohns Colitis 2022;16:606–615.

Introduction

Intestinal ultrasound (IUS) is an inexpensive, non-invasive, safe and repeatable, dynamic cross-sectional imaging technique for IBD. It has been demonstrated to be accurate and reliable both for initial diagnosis of IBD and for follow-up monitoring [1]. Huge advantages of IUS are that it does not need any prior preparation of the patient and provides a real-time result. IUS can be performed in various hospital settings, which makes it the only point-of-care (POC) imaging technique available today [2].

The impact of POC IUS on daily decision making and the evolution in its use over the years were evaluated in this retrospective study, which included two consecutive cohorts of IBD patients in a real-world outpatient setting. The first cohort of patients, included between January 2016 and July 2018, was compared with a second cohort collected between October 2019 and December 2019.

Withdrawal of infliximab or concomitant immunosuppressant therapy in patients with Crohn’s disease on combination therapy (SPARE): a multicentre, open-label, randomised controlled trial

Louis E, Resche-Rigon M, Laharie D, et al; GETAID and the SPARE-Biocycle research group

Lancet Gastroenterol Hepatol 2023;8:215–27.

Introduction

Therapeutic strategies for Crohn’s Disease have evolved over the past decade, with mounting evidence that achieving deep remission (defined as clinical, biochemical and endoscopic remission) is associated with better long-term outcomes [1, 2]. Combination therapy with infliximab and azathioprine has been shown to be superior to either infliximab or azathioprine monotherapy in achieving clinical remission and endoscopic healing in azathioprine-naive patients, thus supporting the paradigm of early disease management and the use of treatment combinations to increase treatment success [3]. Concerns regarding the implications of long-term combination therapy, such as infections and lymphoproliferative disorders, have provided the rationale for a formal clinical trial of treatment de-escalation.

The aim of this trial was to compare the relapse rate and the time spent in remission over 2 years between patients continuing combination therapy and those stopping infliximab or immunosuppressant therapy.

After two consecutive virtual events, the Y-ECCO Basic Science Workshop was back with a face-to-face meeting, reaching its 9^th edition on March 1, 2023, in Copenhagen.

This Workshop aims to involve young fellows in a fully comprehensive manner, giving them the opportunity to present relevant data that were submitted for the scientific programme and discuss their views with successful key opinion leaders in the field of Inflammatory Bowel Diseases (IBD), with special focus on basic and translational research. All sessions open with a hot topic presented by an invited senior specialist, followed by excellent presentations by selected young researchers. The secret of the constant success of this initiative is the friendly atmosphere, which allows participating Y-ECCO Members to increase their knowledge while also preparing for more challenging stages.

Dear Y-ECCO Friends,

I do hope you all enjoyed the ECCO Congress in Copenhagen and made the most of the opportunity to “get physical” again for the first time in too long! I’m sure many will agree that, although virtual conferencing has its positives, much of what makes ECCO such a special organisation to be part of can only be fully realised in person. The fact that this year’s meeting was the first in-person ECCO Congress since before the pandemic only added to the sense of excitement, and the meeting’s content did not disappoint. As is often the case, contributions from Y-ECCO Members made up a sizeable proportion of the original research presented: 58 oral presentations were selected to be presented by Y-ECCO Members and a total of ten Y-ECCO Members were awarded prizes. This again underscores the essential role played by Y-ECCO within ECCO, as a new generation of IBD experts are ushered in.