Julián Panés  ©  ECCO

Dear ECCO friends,

We are witnessing an exciting period in the development of new therapies for Inflammatory Bowel Diseases. New therapeutic targets, and new classes of drugs, are being integrated into our therapeutic armamentarium. However, when we consider the proportion of patients who respond to induction therapy and, among those, the fraction who achieve remission during maintenance, the percentage of initially treated patients in whom the disease is satisfactorily controlled over one year does not exceed 15%–30%.

The 13^th Congress of ECCO in Vienna is coming closer and so is the late registration deadline. Benefit from the late registration fee by registering up until January 31, 2018 (after this date the onsite registration fees will apply).

Laurent Peyrin-Biroulet © ECCO

I am happy to inform all ECCO members that the Governing Board started working while everybody was still on the plane! This year, we arrived on Friday afternoon and could already discuss numerous points. First, it was decided to continue increasing the amount of money for grants to foster exchange across ECCO centres and support innovative scientific projects. 

Dear friends and colleagues,

UR-CARE is online NOW!

This international database offered to you by ECCO’s research unit (IBDIM) has been designed for your patient records and your research studies.

Edouard Louis © ECCO

The BIOCYCLE project has now been ongoing for almost 2.5 years. This project, funded by the European Commission under the Horizon 2020 programme, aims at exploring different aspects of the question of treatment de-escalation in moderate-severe Crohn’s Disease, first requiring a combination therapy with anti-TNF and antimetabolites to control the disease. Once the disease has been stabilised, an unsolved question is to whether it is possible to de-escalate therapy. This question is important for several reasons including safety, tolerance, quality of life or costs to name the most prominent. 

Arie Levine © ECCO

Fecal microbial transplantation (FMT) is an exciting and evolving methodology to transform the microbiota in microbiota-related diseases. The rationale behind FMT is "transfer of a healthy microbiota" from a donor to a patient with IBD, leading to a change in recipient microbiota towards that of a healthy donor. However, current methods are simplistic. Random healthy donors do not necessarily have an appropriate microbiota, and transferred microbiota may not colonise the recipient’s gut. Diet can rapidly degrade certain taxa or increase others, such that if the recipient diet is not appropriate, donor microbiota expansion may not occur or functionality may be impaired.

Salome de Pinho © ECCO

Aims of the research

The current therapeutic strategies for Inflammatory Bowel Disease (IBD) are limited by effectiveness and/or toxicity, and the selection of patients for therapy remains a major challenge. These clinical concerns highlight the unmet need to identify key mechanisms (molecular markers) capable of being selectively targeted with new and optimised therapies. Glycosylation is a major post-translational mechanism characterised by the addition of carbohydrate structures (glycans) to essentially all cells [1]. Evidence in other immune-mediated disorders has shown that protein N-glycosylation, particularly branched N-glycans, regulates T cell immune response and controls the threshold of T cell activation [2].

Bram Verstockt © ECCO

Aims of the research

The introduction of new non-anti-TNF agents such as the anti-adhesion and anti-IL-12/IL-23 molecules will increase the therapeutic armamentarium for patients with IBD. It is nevertheless anticipated that clinical response and adverse events will vary significantly between individuals. Therefore, we need predictors of efficacy and safety so that we can select the right drug at the right time for the right patient. Targeted strategies in patients with poor prognostic factors and head-to-head trials are currently lacking.

September 15, 2017

The ECCO Workshop in Lithuania was organised in the quiet and beautiful city of Kaunas. Philip Hendy, from London, and Antonio López-Sanromán, from Madrid and an EduCom Officer, joined the local faculty (Limas Kupcinkas, Gediminas Giudelis and Laimas Jonaitis). 

September 28, 2017

The 53^rd ECCO Educational Workshop was held in Bucharest, Romania on September 28, 2017.  The faculty comprised Giovanni Maconi (Italy) and Marc Ferrante (Belgium), as well as Liana Simona Gheorghe, Alexandru Lupu, Roxana Zaharie and Dan Ionut Gheonea from Romania.

November 17, 2017

The 54^th ECCO regional workshop was held in Cardiff on November 17, and it was a pleasure to welcome ECCO to the capital city of Wales, to a day of sunshine. The meeting followed on from a highly successful one day IBD Clinical Research Group meeting organised by the British Society of Gastroenterology, also held in Cardiff on the preceding day.

December 8, 2017

The 55^th ECCO Educational workshop was held in Krakow, Poland on December 8, 2017. The faculty included Patrick Van Rheenen (The Netherlands), Gábor Veres (Hungary), and Maciej Dadalski, Jarosław Kierkuś, Edyta Zagorowicz, Małgorzata Sladek, Edyta Szymanska, and Piotr Socha from the Poland.

Marc Ferrante  ©  ECCO

Following the success of the previous workshops, the Clinical Research Committee (ClinCom) of ECCO will run a sixth workshop in 2018.

During past years, endpoints in clinical trials for patients with Inflammatory Bowel Disease (IBD) have evolved substantially. Initially we mainly aimed for clinical remission, but it has become obvious that this is certainly insufficient to alter the natural history of the disease.

Marieke Pierik  ©  ECCO

The Epidemiological Committee (EpiCom) of ECCO promotes epidemiological research within the field of Inflammatory Bowel Diseases (IBD) across Europe. Population-based cohort studies on disease course and prognosis are of great interest for IBD epidemiology since in these cohorts a sample or all of the cases in a defined population are selected for longitudinal assessment of exposure–outcome relationships. 

Christian Maaser  ©  ECCO

GuiCom, together with various ECCO Members, is constantly working to bring the ECCO Guidelines up to date, thereby helping IBD physicians to treat their patients. The most recent project, the Diagnostic IBD Guideline, will set out what to do for the following purposes: initial diagnosis, evaluation of treatment response, assessment of the asymptomatic patient, clarification of postoperative situations and investigation of suspected complications. In addition, one chapter will deal with the various scoring systems and another with the technical details of the different methods.

Palle Bager  ©  ECCO

The overarching aim of ECCO is to improve the care of patients with IBD in all its aspects through international guidelines for practice, education, research and collaboration in the area of IBD. For several years, ECCO has been exploring ways to increase nurse education opportunities throughout Europe. In addition to the three nursing Educational Activities that are offered at the ECCO Congress each year, ECCO will start a brand new IBD Nurse Education Programme in 2018. This programme is being developed collaboratively by N-ECCO and the ECCO Education Committee.

Paulo Kotze  ©  ECCO

Cancun, Mexico, August 2017

This S-ECCO session took place in the beautiful city of Cancun, on August 14, 2017, during the Mexican Congress of Colorectal Surgery. A significant part of the first day of the congress, within the main hall, was devoted to interesting medical and surgical IBD topics as part of the main core programme.

Paulo Kotze  ©  ECCO

Florianópolis, Brazil, October 2017

The 4th S-ECCO International IBD Workshop was held in Florianópolis, south of Brazil, on October 5–7, 2017. The meeting is already a tradition in the local IBD community, as this was the third local edition, organised by the Brazilian IBD Study Group (GEDIIB). Approximately 200 gastroenterologists and surgeons from Latin America attended the Workshop. 

Richard Russell  ©  ECCO

The revision of the Paediatric UC Guideline for children has been carried out jointly by the ESPGHAN Porto IBD group and ECCO. This revised guideline has updated the previous separate guidelines on Acute Severe UC and Ambulatory UC [1,2] and combined them into one document. The guideline was developed on the basis of an intensive literature search and careful evidence grading; the Oxford levels of evidence were used for the latter purpose after it became clear that the guideline was being developed too soon for the use of GRADE methodology. A summary of all the evidence assimilated during the guideline development will be published as supplementary tables so that others can benefit from the intensive search without having to redo the work.

Vincenzo Villanacci  ©  ECCO

The Inflammatory Bowel Diseases (IBD) Crohn’s Disease (CD) and Ulcerative Colitis (UC) are characterised by flares and remission, reflecting the pathological status of the inflamed intestinal tract. For decades, the treatment goal for IBD was the achievement of clinical response or remission. More recently, however, the normalisation of laboratory parameters and intestinal mucosa, termed mucosal healing (MH), has been considered a major target to prevent extra-intestinal complications and achieve sustained clinical remission. 

Miranda Lomer  ©  ECCO

At least a third of patients with inactive IBD have coexisting functional bowel symptoms (e.g.  abdominal pain, bloating, increased flatulence, diarrhoea and/or constipation) and these symptoms may be mistaken for active IBD. Patients may also experience increased anxiety/depression and reduced quality of life. Objective markers of disease activity (histological and inflammatory markers, e.g. faecal calprotectin, C-reactive protein), in conjunction with assessment of clinical symptoms, help to distinguish between functional bowel symptoms and active IBD. Identification of functional bowel symptoms in inactive IBD is important to avoid unnecessary and potentially harmful treatment strategies; on the other hand, active disease should be excluded before establishing that symptoms are functional in nature.

Isabelle Cleynen  ©  ECCO

Dear Y-ECCO Friends,

This will be the last time that I address you as Y-ECCO Chair. At the next ECCO Congress (2018, Vienna), I shall be stepping down and it is with great pleasure that I will then hand over the position of Chair to Nuha Yassin (UK), who has been serving on the Committee for three years. There will also be a new member joining the Committee, for which the selection process has been completed. We received seven excellent applications, and would like to encourage those who were not selected this time to re-apply in coming years.

Nuha Yassin  ©  ECCO

Dear Y-ECCO Friends,

We are revisiting the multidisciplinary IBD team. Today, I am delighted to be joined by Palle Bager, an IBD nurse specialist and the current N-ECCO Chair.

Please contact me for any interview suggestions for the Y-ECCO Interview Corner.

Nuha Yassin
Y-ECCO Interview Corner Coordinator

Dominik Bettenworth  © ECCO

Dear Y-ECCO Friends,

A warm welcome to the Y-ECCO Literature Review section, where you will find a summary and discussion of cutting-edge clinical trials as well as basic science studies in the field of IBD. 

If you are a Y-ECCO Member and you are looking for an opportunity to get actively involved in ECCO and gain some visibility, contribute your article to the Y-ECCO Literature Review corner, together with a short self-description and your picture.

Sandra Bohn Thomsen  © Sandra Bohn Thomsen

Evolution after anti-TNF discontinuation in patients with Inflammatory Bowel Disease: A multicentre long-term follow-up study

Casanova MJ, Chaparro M, García-Sánchez V, Nantes O, Leo E, Rojas-Feria M, et al.
Am J Gastroenterol. 2017;112:120–31

Kapil Sahnan  © Kapil Sahnan

Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: A randomised controlled, open-label, multicentre trial 

Ponsioen CY, de Groof EJ, Eshuis EJ, Gardenbroek TJ, Bossuyt PMM, Hart A, et al. 
Lancet Gastroenterol Hepatol. 2017;2:785–92. 

Bobby Zhao Sheng Lo © Bobby Zhao Sheng Lo

Prediction of complicated disease course for children newly diagnosed with Crohn’s disease: A multicentre inception cohort study

Kugathasan S, Denson LA, Walters TD, Kim MO, Marigorta UM, Schirmer M, et al.
Lancet. 2017;389:1710–8.

Croatia

Name of group: IBD Section, Croatian Society of Gastroenterology
Number of active members:  65
Number of meetings per year: 2-3
President: Željko Krznarić
Secretary: Brankica Mijandruŝić-Sinĉić
National Representatives: Zeljko Krznaric and Ante Tonkic
Joined ECCO in: 2001 (Boris Vucelic was one of the founders of ECCO) 
Incidence of IBD in the country (if available): 
     Primorsko-goranska County, Croatia, 2000–2004: UC 4.3/105, CD 7.0/105 
     Zagreb City and Zagreb Area, 2010: UC 3.3/105, CD 3.3/105

Greece

Name of group: Hellenic Group for the Study of Inflammatory Bowel Diseases (EOMIFNE)
Number of active members: 191
Number of meetings per year: one (1) annual congress
President: Prof. Ioannis Koutroubakis
Secretary: Dr. Nikos Viazis
National Representatives: Prof. Ioannis Koutroubakis and Prof. Georgios Bamias
Joined ECCO in:  2003
Incidence of IBD in the country (if available): 
The incidence of IBD has been estimated in older studies from Epirus and Crete regions.  For UC the incidence was 5.6/8.9 per 100.000 inhabitants and for Crohn’s disease 2.0/3.0 per 100.000 inhabitants, respectively, placing Greece in the group of countries with low to moderate incidence.  A recent ECCO-EpiCOM study including data from Ioannina showed incidence of UC (in the area of Ioannina for the years 2010/2011) 6.0/3.6 per 100.000 inhabitants and for CD 3.5/3.6 per 100.000 inhabitants.

Switzerland

Name of group: IBDnet (www.ibdnet.ch) The IBDnet is a Swiss interest group of medical doctors and scientists specialising in Inflammatory Bowel Disease. The aim is the promotion of research and communication on aetiology, diagnosis and therapy in order to improve patient outcomes.

Number of active members: Switzerland has roughly 475 gastroenterologists and hepatologists, 350 of whom are located in the German-speaking part of Switzerland and 125 in the French- and Italian-speaking parts. The IBDnet has 93 members, with a Steering Committee of 17 IBD specialists.

Number of meetings per year:

• Steering Committee Meetings: 4 per year, 1 General Assembly per year
• Educational Meetings: One or two major (2- or 3-day meetings, postgraduate course) and eight to ten minor ones (half-day meetings)
• Expert Meetings: The IBDnet organises one expert meeting per year to develop Swiss expert recommendations.
• Patient Relations: The IBDnet broadly supports patient events organised by the patient association SMCCV/ASMCC (four to six annually). Most speakers at these patient information events are IBDnet Steering Committee members. Furthermore, in collaboration with the patient association, IBDnet develops and releases patient information guidebooks.

President: Stephan Vavricka
Secretary: Pierre Michetti
National Representatives: Pierre Michetti and Frank Seibold
Joined ECCO in: Switzerland was among the founding countries of ECCO.
Incidence of IBD in the country (if available): IBD incidence is estimated to be 2 cases per 1,000 persons per year.