I hope all of you were able to enjoy the short Easter break with your families and loved ones.
I also hope that you enjoyed the exciting scientific and educational programmes at the ECCO’22 Congress back in February. In case you missed or would like to re-watch some of the content, you can find all the recordings on our e-Library. Please note that access to this service and all of our wonderful content requires an up-to-date ECCO Membership.
A total of ten abstracts focusing on IBD genetics were accepted for presentation at the 17th Congress of ECCO. Four abstracts were presented in the scientific programme (OP) and two in digital oral presentation (DOP) sessions. The remaining four abstracts were presented as posters (eP). I describe here the most interesting findings from different domains of genetics in IBD.
A total of 72 abstracts focusing on IBD epidemiology were accepted for presentation at the 17th Congress of ECCO. Among the best abstracts, seven were presented in digital oral presentation (DOP) sessions. The remaining 65 abstracts were presented as posters. Below, I summarise the most interesting studies, covering various fields in the epidemiology of IBD.
Academia can generate high-quality paediatric data during off-label use of drugs: the example of the prospective multicentre VEDOKIDS study
Remarkably, of the numerous biologics approved in adults with IBD, only infliximab and adalimumab have been approved in children. The long delay between approval of new drugs in adults versus children leads to their extensive off-label use, in the absence of appropriate dosing and safety data. Prospective paediatric data regarding vedolizumab are limited to a small phase 2 study (n=88; HUBBLE trial) focusing on pharmacokinetics. A paediatric phase 3 trial is underway but its completion is long overdue, also since vedolizumab is easily accessible in most countries without the constraints of study protocols. With that challenge in mind, once vedolizumab received approval in adults we initiated a prospective cohort study to explore the effectiveness, dosing and safety of vedolizumab in children. The VEDOKIDS study was sponsored by ECCO, The Paediatric Porto group of ESPGHAN and Takeda. Explicit demographic, clinical and safety data were prospectively recorded, and serum was collected for drug levels and stool for faecal calprotectin.
A treat-to-target strategy and tight disease control may improve outcome in Crohn’s Disease (CD). However, this approach may necessitate long-term use of biological agents and immunosuppression. Combination therapy with anti-TNF and antimetabolite agents is now well established in this context. These drugs may be associated with long-term risks and elevated costs. It is important to establish whether treatment de-escalation, once deep remission has been achieved, is feasible and whether this strategy may improve safety profile and costs without jeopardising disease control.
The efficacy profile of IBD drugs is rapidly characterised by pivotal randomised controlled trials, but the safety profile of both old and new IBD drugs can only be established after years or decades of post-approval use. This is particularly true for relatively rare events, such as immunosuppression-related cancers. Clinical trials, meta-analyses and safety-dedicated registries are in general underpowered to evaluate the impact of IBD therapies on the risk of development of particular cancers. Data on clinical activity and phenotype of IBD are missing from nationwide administrative health databases, making it impossible to distinguish between the respective effects of IBD drugs and IBD activity on the risk of outcomes of particular interest, such as lymphomas.
It is with great pleasure and excitement that we announce the brand new ECCO Young Researcher Award 2022. This new ECCO Prize will be awarded to outstanding young researchers in recognition of their excellent contributions to basic and clinical science in the field of IBD. With this prize, ECCO strives to further support the visibility of exceptional young talents in IBD, acknowledge their achievements in the field and facilitate their ongoing and future research.
Paulo Kotze is Adjunct Senior Professor of Surgery at the Colorectal Surgery Unit at Cajuru University Hospital in Curitiba, Brazil. Working as a colorectal surgeon, he manages IBD with both the scalpel and medical therapies. He has been a key figure in ECCO for many years, having been a committee member of both S-ECCO and, more recently, EduCom. In the absence of the ECCO Congress, I spoke with him over Zoom about global ECCO, being an iconoclastic surgeon and his past as a bassist in the Brazilian punk band the Pinheads.
The influence of proton pump inhibitor therapy on the outcome of infliximab therapy in inflammatory bowel disease: a patient-level meta-analysis of randomized controlled studies
The management of Inflammatory Bowel Disease (IBD) has evolved significantly over the last two decades [1, 2], as the development of biologic therapy has increased dramatically the rates of induction and prolonged maintenance of remission in patients with IBD. Infliximab (an anti-tumour necrosis factor) was the first biologic therapy to be approved for the treatment of IBD [3] and remains the biologic therapy with which clinicians have the most clinical experience [4].
Due to comorbidities, patients are frequently on other medications in addition to infliximab. How these other concomitant medications influence the response to infliximab therapy is largely unexplored.
Proton pump inhibitors (PPIs) are the first-line treatment for many digestive disorders such as gastro-oesophageal reflux disease (GORD), peptic ulcers, eosinophilic oesophagitis and dyspepsia [5]. PPIs are one of the most used family of medications in the United States, with more than 50 million prescriptions filled every year [6].
A few retrospective trials have attempted to investigate the impact of concomitant PPI therapy on response to infliximab in patients with IBD; however, these studies have suffered from the presence of many confounders, such as the lack of data on smoking status or the increased risk for gastroenteritis and C. difficile infection amongst patients treated with PPIs.
To increase the power to detect differential effects of PPI treatment on patients treated with infliximab in randomised trials and to allow adjustment for confounding factors, the investigators performed a patient-level meta-analysis of IBD randomised controlled clinical trials from the Yale Open Data Access (YODA) Framework.
Pascal Juillerat 
Sebastian Zeissig
Robin Dart