Intensive drug therapy versus standard drug therapy for symptomatic intestinal Crohn's disease strictures (STRIDENT): an open-label, single-centre, randomised controlled trial

Schulberg JD, Wright EK, Holt BA, et al.

Lancet Gastroenterol Hepatol. 2022;7:318–31. doi: 10.1016/S2468-1253(21)00393-9.

Patrick Dawson © Patrick Dawson

Introduction

Crohn’s Disease (CD) is a chronic gastrointestinal inflammatory condition [1] that commonly causes strictures, with more than 50% of patients developing at least one stricture in the first decade after diagnosis [2]. Management options include biologics, endoscopic dilatation and surgery. Dilatation requires that the stricture be endoscopically accessible and medical therapy has limited benefit in fibrostenosing disease; therefore, surgery often remains the initial treatment of choice [3]. MRI and ultrasound can provide detailed assessment but cannot always definitively quantify active inflammation [4, 5].

This open label, randomised control trial was carried out at a specialist IBD unit in Australia with the aim of establishing whether medical therapy is an effective treatment of stricturing CD and, if so, whether intensive medical therapy is more effective than standard therapy. The primary end point was an improvement in the 14-day obstructive symptom score by one or more points compared to baseline at 12 months. Secondary outcomes included: improvement in the Crohn’s Disease Activity Index (CDAI), C-reactive protein (CRP), faecal calprotectin (FCP), stricture morphology on MRI, small bowel ultrasound (SBUS) or endoscopy, and correlation of serum adalimumab concentration with any improvement.

Gianluca Pellino © Gianluca Pellino

For another year, unexpectedly, the Y-ECCO Basic Science Workshop had to be an online-only event, as the uncertainties related to the status of the pandemic caused the ECCO Congress 2022 to be changed into a virtual event. However, the workshop participants showed clearly that this did not affect their enthusiasm.

Charlotte Hedin © ECCO

Dear Y-ECCO Friends,

I hope you all enjoyed the ECCO Congress and got a lot out of sailing the seas of IBD! Although we were forced to hold the Congress digitally, there was a huge amount of great content – not least the contributions from Y-ECCO Members. Fourteen oral presentations were selected to be presented by Y-ECCO Members and a total of 20 Y-ECCO Members were awarded prizes. This demonstrates the great driving force of Y-ECCO within ECCO and paves the way for the next generation of IBD experts. Our annual Basic Science Workshop, which has been going since 2015, was again a great success. More information on what the 67 workshop participants were treated to can be read in the separate report by Y-ECCO Committee Member Gianluca Pellino.

Gert De Hertogh © ECCO

Contrary to everyone’s ardent expectations and hopes, this year’s ECCO Congress was once again held virtually. While the experiences from 2021 had taught the H-ECCO Committee how to prepare for this and what to expect, we were so happy to be supported again by an excellent ECCO Office team.

Christianne Buskens © ECCO

In contrast to what we had hoped, the 11^th S-ECCO Masterclass was again a virtual event due to the ongoing COVID-19 pandemic. However, as everyone has slowly got used to online conferences, it almost felt intimate to meet like this once more.

Lihi Godny  © ECCO

As a part of the 17th ECCO Congress, the 7th D-ECCO (Dietitians of ECCO) Workshop was conducted virtually and included three sessions: (1) Science, moving from a causality in IBD; (2) Practicalities and pitfalls of dietary therapy in IBD; (3) MDT: More than just the MD? Case presentations and panel discussion.

Ana Ibarra  © ECCO

On the evening of Wednesday, February 16, nurses from several countries across Europe participated in our yearly N-ECCO National Representatives Meeting.

As N-ECCO Committee Member responsible for the National Representatives, I welcomed the attendees. An exchange of nurses every 2–3 years is greatly encouraged by N-ECCO, but many countries nevertheless retain the same National Representatives for more than 3 years. New people tend to mean new ideas, although some countries have different service setups and getting new representatives is sometimes difficult.

The N-ECCO Research Forum takes place every other year and this year’s programme was designed to help nurses and other health-aligned professionals to better understand the different aspects of the research process.

Wladyslawa Czuber-Dochan opened the meeting and announced that the winner of the N-ECCO Research Grant for 2022 was Rosanna Comoretto from Torino, Italy.

Miriam Ganon © ECCO

The N-ECCO School ran for the first time in 2010. The aim of the School is to enhance the knowledge and expertise of nurses and dietitians who are new to IBD, enabling them to provide better quality care to IBD patients throughout Europe and beyond. In addition, the N-ECCO School has become a great networking opportunity for both nurses and dietitians, allowing them to share their experiences and plans for furthering their careers and demonstrating the importance of the MDT approach to IBD care.

Wladzia Czuber-Dochan © ECCO

The N-ECCO Chair, Susanna Jäghult, opened the 16^th N-ECCO Network Meeting by welcoming 171 nurses from around the world. This was the second virtual Congress due to the COVID-19 pandemic.