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.

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.

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

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}

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.

During the 18^th ECCO Congress, Takeda collaborated with world-renowned experts to share practical tips for increasing treatment adherence, share key data, discuss new attitudes to treatment goals, and showcase real clinical experience. If you missed out on attending, then do not worry: you can read the highlights below and watch some of these sessions on-demand!