Vedolizumab versus adalimumab for moderate-to-severe Ulcerative Colitis

Sands BE, Peyrin‑Biroulet L, Loftus E, Danese S, Colombel JF, Toruner M, Jonaitis L, Abhyankar B, Chen J, Rogers R, Lirio RA, Bornstein JD, Schreiber S, for the VARSITY Study Group

N Engl J Med 2019;381:1215–26. doi: 10.1056/NEJMoa1905725

Jonathan Blackwell © Jonathan Blackwell

Introduction

The management of Ulcerative Colitis (UC) increasingly involves the use of a biologic agent. Placebo-controlled trials have demonstrated the efficacy of both adalimumab, a tumour necrosis factor (TNF) inhibitor, and vedolizumab, an integrin inhibitor. However, variation in study design makes comparison between such trials difficult. This is particularly evident when comparing rates of clinical remission in the placebo groups of different trials. For example, in the ULTRA 2 trial, which established the superiority of adalimumab over placebo in moderate to severe UC, the 52-week clinical remission rate in the placebo group was just 8.5% compared to 15.9% in GEMINI 1, the placebo-controlled trial of vedolizumab [1,2]. In the absence of head-to-head trials between biologics there is a lack of data to inform clinicians of the best choice of agent. VARSITY is the first head-to-head trial to compare the efficacy and safety of vedolizumab and adalimumab in moderate to severely active UC.

Bram Verstockt © ECCO

Dear Y-ECCO Friends,

Bringing basic science from the bench to the bed, and back, can be challenging for both scientists and clinicians.  In order to encourage young scientists and clinicians to collaborate and to approach similar scientific questions from a different – but joint – perspective, the Y-ECCO Basic Science Workshop was founded years ago. Every year, the Y-ECCO Committee invites outstanding senior experts to give a state of the art overview on hot topics in the field. Furthermore, these top-notch speakers not only moderate the discussions following abstract presentations but also inspire and stimulate full-time researchers and young clinicians to do basic science at the start of their careers.

Roger Feakins © ECCO

The Histopathology Committee of ECCO (H-ECCO) is now more than 5 years old, having started as a new working group. It is an enthusiastic group that supports various activities and interacts well with other ECCO Committees. The most identifiable and consistent activity is the H-ECCO IBD Masterclass, a successful event attracting more than 70 delegates annually from Europe and further afield.

Yves Panis © ECCO

The 9^th S-ECCO Masterclass (held in collaboration with the European Association of Coloproctology, ESCP) was organised during the 15^th Congress of ECCO in Vienna. Thankfully, just before the coronavirus crisis!

As in previous years, it was a full-day masterclass, and once again it attracted a large number of participants, 149. This meant that in terms of attendance the S-ECCO Masterclass was second among all masterclasses and symposia, just after the N-ECCO Network Meeting.

Eytan Wine  © ECCO

D-ECCO, the Dietitians of ECCO, held its 5^th Workshop as part of the 15^th ECCO Congress in Vienna in February 2020. I will describe some of the highlights and main messages of the Workshop, which was attended by 104 registered delegates.

Ana Ibarra  © ECCO

On the evening of Wednesday, February 12, 16 nurses from 11 countries across Europe participated in our yearly N-ECCO National Representatives Meeting.

As the N-ECCO Committee Member responsible for the National Representatives, I welcomed the attendees, and this was followed by a short round of introductions. 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.

Susanna Jäghult  © ECCO

The 14^th N-ECCO Network Meeting was opened by Susanna Jäghult (Sweden), N-ECCO Chair. In total, 255 nurses from across the world attended the meeting.

The first session focussed on presentations regarding “The IBD Nurse Education Programme”, which was performed and completed in Italy during 2018–2019. Palle Bager (Denmark) and Karen Kemp (United Kingdom) reported on the development of the programme and how it was conducted in Italy. Then, Simona Radice and Gionata Fiorino, both from Italy, described the country perspective on the programme. This aroused great interest among the audience and the second cycle is now in the pipeline.

Miriam Ganon © ECCO

The 11^th N-ECCO School in Vienna was attended by 74 participants from 25 countries, including dietitians and IBD Nurses. The School covered various IBD topics of interest to both nurses and dietitians who work with IBD patients. The aim was to enhance participants’ basic knowledge in IBD, enabling them to provide better support to IBD patients throughout Europe and beyond. The N-ECCO School has also come to serve as a great networking opportunity, allowing nurses and dietitians to share their experiences.

Wladzia Czuber-Dochan © ECCO

The 6^th N-ECCO Research Forum was attended by 52 nurses active and/or interested in research. The Research Forum is arranged every second year and this year was opened by Wladzia Czuber-Dochan (United Kingdom), who also presented the winners of the N-ECCO Research Grant 2020: Simona Fourie (UK) and Katarina Pihl Lesnovska (Sweden).

Glen Doherty © ECCO

The revised pipeline for updating of ECCO Guidelines was recently established. This pipeline envisages updates to the two main guidelines on treatment of Crohn’s Disease and Ulcerative Colitis in adults every 3 years. Other ECCO Guidelines will be updated approximately every 5 years. Having just completed publication of the first ECCO Guideline on treatment of Crohn’s Disease in adults employing GRADE methodology, work is now underway on a similar update to the main ECCO UC Guideline. Similar to the 2019 Crohn’s Disease Guideline, the updated UC Guideline will employ GRADE methodology to address most of the key questions, covering both medical and surgical treatments.