Decreased risk of treatment failure with vedolizumab and thiopurines combined compared with vedolizumab monotherapy in Crohn’s disease

Julien Kirchgesner, Rishi J. Desai, Maria C. Schneeweiss, Laurent Beaugerie, Sebastian Schneeweiss, Seoyoung C Kim

Gut 2022 Apr 6; doi: 10.1136/gutjnl-2022-327002. Online ahead of print

Charles Miller © Charles Miller

Introduction

Vedolizumab (VDZ) was the first biologic to be approved for Ulcerative Colitis (UC) and Crohn’s Disease (CD) after the age of anti-tumour necrosis factor antagonists (anti-TNF). The role of thiopurines in combination with anti-TNFs in the management of IBD is well recognised. However, the role for combination of VDZ with thiopurines is uncertain [1, 2]. This study aimed to investigate the comparative effectiveness of VDZ in combination with a thiopurine versus VDZ monotherapy in the management of both UC and CD.

Charlotte Hedin © ECCO

Dear Y-ECCO Friends,

We are living through challenging times; the pandemic is evolving but is not yet over and conflict in Europe occupies all our minds. Many training programmes and research projects have had to be delayed or adapted over the last two years, but now that restrictions are less onerous much of our clinical and research work is back on track. I therefore hope that you all got your abstracts in to the UEG before the deadline at the end of April. Bear in mind also that the ECCO'23 abstract submission is open. We are looking forward to reading your contributions and selecting the best abstracts for the Y-ECCO Awards and the Basic Science Workshop.

The H-ECCO Committee is saying goodbye to Monika Tripathi and would like to thank her for all her work on behalf of the Committee in recent years.

At the same time, as chairman of the Committee, I am very happy to welcome our new member, Aart Mookhoek. Aart currently works as a pathologist at the Institute of Pathology, University of Bern, Switzerland. He is, however, Dutch originally, and developed his passion for gastrointestinal pathology during a residency and subsequent fellowship at the University of Amsterdam, the Netherlands. Aart and I trained together on histological scoring systems for disease activity in Ulcerative Colitis and Crohn’s Disease, and we participated in a research project on this topic.

As the new chair of the P-ECCO Committee, it is my pleasure to introduce two newly elected members of the Committee: Richard Hansen and Dror Shouval, two wonderful paediatric gastroenterologists from Scotland and Israel, respectively. Both are very active in the paediatric IBD field and they bring a wealth of expertise and energy to our group.

Pär Myrelid © ECCO

By now we are all hoping that the cases of COVID-19 that we still see represent the beginning of the end of the pandemic. For more than two years, the health care system has been overloaded globally and the whole world has been suffering. Initially we struggled with severely ill COVID-19 patients filling up ICU wards at more or less every hospital, and in addition theatre staff were often asked to help out with COVID-19 patients rather than assisting in theatres. At some hospitals the theatres were turned into extra ICU wards. This was made easier by the fact that during the early days of the pandemic the normal emergency cases seemed to have disappeared. Just like prior to a tsunami, where the water withdraws before the giant wave hits, the emergency rooms were left empty for some days or even weeks. A deceptive calmness soon gave way to chaos.

Eytan Wine © ECCO

Many IBD specialists take pride in their multidisciplinary team (MDT), which is of huge benefit and should be considered a necessity for this complex group of conditions. When I joined the Dietitians of ECCO (D-ECCO) Committee 3 years ago, I came with a clear appreciation of the specific role of dietitians in IBD MDTs, but I continue to learn and be amazed by how much more can and should be achieved through the contribution of IBD-focused dietitians. As a paediatric IBD specialist, I have had the privilege and pleasure of working with dietitians in our team for many years, mostly in the context of nutritional assessment and follow-up, as well as nutritional therapy. As nutritional therapy has been established as a first-line therapy for paediatric Crohn’s Disease for many years [1], it is likely that we paediatricians may have a head start in involving dietitians. While many adult centres have built excellent units [2], the specific roles of dietitians are not always appreciated [3].

We are delighted to announce that this year we will run the 2nd cycle of the IBD Nurse Education Programme. The programme will take place in Hungary, and we are currently at the exciting stage of recruiting and selecting nurses to the programme. The primary aim of the programme is to increase the skills, knowledge and competences of nurses who are new to IBD and to help them in their role of delivering high-quality care to patients.  

The ECCO Guidelines Committee (GuiCom) is welcoming two new committee members. Both are already well known in the ECCO Family. Michel Adamina was the former chair of S-ECCO and Javier Gisbert was ClinCom member in the past.  

Young GEDII © GEDII

The 68^th ECCO Educational Workshop took place at the Hotel Cascais Miragem on April 6, 2022, in Cascais, Portugal. This event - the first ECCO live meeting since the COVID 19 pandamic - brought together more than 120 participants and was the perfect launch to GEDII’s Annual Meeting, which began on the following day. The workshop featured interactive discussion on various clinical scenarios and hot topics in IBD.

The primary goal of the Educational Workshops organised by the ECCO Education Committee is to harmonise IBD practices within ECCO Country Members by presenting the practical use of the ECCO Guidelines on Crohn's Disease and Ulcerative Colitis.