Infliximab in Paediatric Crohn’s Disease; in whom to start (ImProve)

Lissy de Ridder © Lissy de Ridder

Aim of Research

Crohn’s Disease (CD) is a heterogeneous chronic immune-mediated inflammatory disease. To improve management, precision medicine is urgently needed to target the underlying pathogenic immune response that is driving disease. There is a key unmet need to identify biomarkers that will predict the need for, and the response to, anti-tumor necrosis factor (TNF) treatment, including in paediatric CD. This constitutes the aim of the present project. The use of such predictive biomarkers will help to avoid delay in effective treatment, complications due to ongoing inflammation and exposure of non-responders to anti-TNF. We hypothesise that genetic expression profiling, in combination with thorough patient characterisation, will lead to such biomarkers and thereby improve targeted anti-TNF use in paediatric CD.

Nuha Yassin © ECCO

Dear IBD Friends,

Warm greetings to you all at the start of the festive season. As we prepare to welcome the New Year, we are also preparing to welcome you back to our IBD and ECCO hub in the beautiful city of Vienna. Our introduction to ECCO'20 starts slightly differently this time, with a short prelude about IBD standards.

Willem Bemelman © ECCO

On October 19, 2019, ECCO held its 1^st Council of National Representatives Meeting adjacent to UEGW Barcelona. The following countries were represented at the meeting: Cyprus, Denmark, Finland, France, Israel, Spain, Italy, Belgium, Bulgaria, Croatia, Estonia, Germany, Greece, Iceland, Latvia, Lithuania, Norway, Poland, Portugal, Romania, Slovenia, the Netherlands, Austria, United Kingdom, Serbia and Sweden.

Topics presented by ECCO Governing Board Officers included the review of relevant results from the Strategic Survey, which had been sent to all ECCO Members at the beginning of the year and to all participants prior to the ECCO 1^st Council of National Representatives Meeting. The purpose of the meeting was to deliver information in regard to ECCO Activities and to obtain feedback from the various representatives.

Silvio Danese © ECCO

Dear ECCO Friends,

Our annual meeting is just around the corner!

ECCO 2020 in Vienna offers physicians, researchers, nurses and dietitians the opportunity to come together and reflect on our current landscapes in order to align our activities. The meeting will feature plenary sessions, poster sessions and collateral initiatives that merge evidence and experience to empower participants by equipping them with the knowledge and skills needed to provide the best outcomes for patients.

With this purpose in mind, ClinCom is organising several sessions during the upcoming ECCO Congress in Vienna, targeting clinicians, nurses and industry. The 5th Basic ECCO:EduCational COurse for Industry will aim to provide a state of the art introduction to IBD for both corporate and non-corporate members and the 7th ClinCom Workshop will focus on two hot topics in the world of IBD clinical trials.

Eveline Hoefkens © Eveline Hoefkens

Belgium

N-ECCO National Representative:
Eveline Hoefkens
Job Title: IBD Nurse

What influenced your decision to apply for the role of N-ECCO National Representative for your country?

By being a national representative, you are actively involved in N-ECCO meetings. The yearly national representatives meeting at the ECCO congress is the ideal place to expand your network. You interact with IBD nurses from other countries and share experiences. It is a great opportunity to create an international network. 

Nensi Lusičić  © Nensi Lusičić

Vesna Oroz © Vesna Oroz

Croatia

N-ECCO National Representative:
Nensi Lusičić
Job Title: IBD Nurse

What influenced your decision to apply for the role of N-ECCO National Representative for your country?
Opportunity to become more involved in IBD.

Tariq Ahmad  © Tariq Ahmad

Ian Arnott © Ian Arnott

United Kingdom

Name of group: The IBD section of the British Society of Gastroenterology (BSG).
Number of active members: Approx. The IBD section is the largest section of the BSG and has 997 members including physicians, surgeons, pathologists, radiologists, scientists, nurses, dietitians, and others interested in IBD. The IBD section committee includes nurse, trainee and patient group membership.
Number of meetings per year: The BSG holds an annual national meeting in June with two or three IBD symposia. In addition, the BSG supports or endorses numerous regional gut clubs and network meetings across the UK each year. Many of these are focused on IBD. The IBD section includes the IBD clinical research group which leads research activity across the UK.
This group holds an annual meeting every November to which all investigators are invited. In 2018, 120 delegates attended, including physicians, research nurses and research co-ordinators. 
President and Secretary: BSG president – Cathryn Edwards BSG secretary - Adrian Stanley Chairman, IBD section of the BSG – Ian Arnott Chairman of IBD clinical research group – Charlie Lees
National Representatives: Tariq Ahmad, Exeter and Ian Arnott, Edinburgh. Lynn Gray, Wirral University Hospital and Catherine Stansfield, Salford Royal are the UK representatives of N-ECCO. 
Joined ECCO in: 2003
Incidence of IBD in the country: Recent data from Scotland reveal incidence rates for UC, CD and IBDU of 19.8, 13.6 and 5.4 per 100,000 respectively (Jones GR Gut 2019)

Denmark

Name of group: There is an interest group for IBD, but gastroenterologists with an interest in IBD are organised in “Dansk Selskab for Gastroenterologi og Hepatologi” (DSGH), which is our national society of gastroenterology and hepatology.
Number of active members: Approx. 750 members of DSGH
Number of meetings per year: There is one annual meeting lasting 2 days. In addition, a number of minor meetings are held throughout the year, one or two of which have an IBD focus. 
President and Secretary: President: Ebbe Langholz, Department of Gastroenterology, Herlev-Gentofte University Hospital Secretary: Annette Dam Fialla, Department of Gastroenterology, Odense University Hospital
National Representatives: Jørn Brynskov, Department of Gastroenterology, Herlev-Gentofte University Hospital Signe Wildt, Department of Gastroenterology, Køge University Hospital
Joined ECCO in: Denmark has been a member of ECCO since 2004
Incidence of IBD in the country: Crohn´s disease:10/100,000    Ulcerative colitis: 15/100,000

Karin A. Wasmann  © Karin A. Wasmann

Karin A. Wasmann¹, IBD study group Amsterdam UMC, location AMC²

While striving to meet the quality standards for oncological care, hospitals prioritise oncological procedures more frequently, resulting in longer waiting times for surgery for benign diseases such as Inflammatory Bowel Disease (IBD). Currently in the Netherlands, oncological treatment should be started within six weeks after diagnosis and this is reinforced by the Dutch Health Care Inspectorate, insurance companies and patient organisations [1]. The situation in other European countries is similar. Additionally, since the introduction of national bowel cancer screening programmes, the demand for oncological surgical resections has risen worldwide [2–5]. The subsequent longer waiting time for benign diseases is not only inconvenient for patients, but in the case of IBD may lead to severe complications.

Charlotte Hedin © ECCO

Professor Fiona Powrie is the Director of the Kennedy Institute of Rheumatology at the University of Oxford. Her work has been seminal in defining the mechanisms that govern and regulate immune responses in the gut. Her research has revealed the pivotal role of regulatory T cells, interleukin-10, interleukin-23 and transforming growth factor-β (TGF-β) in intestinal inflammation.