A total of 76 abstracts focussing on IBD epidemiology were accepted for presentation at the 16^th Congress of ECCO. Among the ten best abstracts, one was presented in the scientific programme and nine in digital oral presentation (DOP) sessions. The remaining 66 abstracts were presented as posters.

Take your study to the next level with the IBD National Study Group Meeting at the ECCO Congress

Uri Kopylov  © ECCO

One of the missions of the Clinical Research Committee of ECCO (ClinCom) is to facilitate innovative clinical research in the area of Inflammatory Bowel Diseases (IBD).

To promote international scientific collaboration among researchers from different European countries, ClinCom established the IBD National Study Group Meeting, which takes place at the annual ECCO Congress. With this great platform, ClinCom enables investigators to have their studies challenged and promoted at the same time. Before the meeting, investigators are invited to provide a study synopsis for their project, including background, design, objectives, outcome parameters, major inclusion and exclusion criteria, statistics and co-variates. Submitted projects are then reviewed by ClinCom and, if found feasible, discussed during the IBD National Study Group Meeting at the ECCO Congress.

Nicolas Pierre © Nicolas Pierre

Blood proteins related to immunoregulation or cellular junctions reveal distinct biological profiles associated with the risk of short-term versus mid/long-term relapse in Crohn’s Disease patients stopping infliximab

In Crohn’s Disease (CD), anti-tumour necrosis factor α (TNFα) therapy can induce mucosal healing and stable remission. When this objective is achieved, treatment de-escalation may be considered for safety, economic and patient preference purposes. Indeed, chronic exposure to anti-TNFα has been linked to serious complications (e.g. lymphoma, infections, melanoma and non-melanoma skin cancers) [1–4], and this treatment is a burden for the healthcare system [5]. On the other hand, around 50% of CD patients relapse 1–2 years after stopping anti-TNFα [6]. Thus, this strategy cannot be proposed to every patient in remission; rather, decisions should be made on an individualised basis [6].

The 5^th Advanced ECCO: EduCational COurse for Industry, organised by the Clinical Research Committee of ECCO (ClinCom), was one of the highlights of the educational programme during the ECCO’21 Congress and was held virtually, with live presentations and discussions. The course was aimed at our industry partners and had the broad goal of discussing the areas of IBD research of key importance in the immediate future. 

Laurent Beaugerie © ECCO

This year’s 4^th School for Clinical Trialists, organised by the ECCO Clinical Research Committee (ClinCom), offered an excellent opportunity to review all the key points of the balance between expected efficacy and potential risks of IBD drugs, in the contexts of both clinical trials and routine care.

JAK-STAT-driven immunometabolism as a novel principle in the pathophysiology of Ulcerative Colitis

Janus kinase (JAK) inhibition is a novel therapeutic approach in the management of Ulcerative Colitis (UC). However, the role of JAK inhibition with respect to cell-specific immunometabolic properties is not known.

The overall aim of this multi-year research proposal is to generate deeper understanding of the interplay of JAK inhibition and immunometabolic properties in the intestinal mucosa at a cellular level and thereby to open up new avenues in biomarker development and novel targeted interventions in UC. This aim is being pursued by (i) identifying immunometabolomic signatures of JAK inhibition in UC patients using multi-omics analysis of longitudinal therapy response cohorts and (ii) modelling the impact of two metabolic principles, namely amino acide (e.g. tryptophan) and short-chain fatty acids (e.g. butyrate), on the efficacy of JAK inhibition in ex vivo organisms.

Yves Panis © ECCO

Precision medicine in IBD 

The ninth edition of the SciCom Workshop, held during the 16^th Congress of ECCO, was dedicated to recent advances in "Precision medicine in IBD", covering different aspects from disease prevention to prediction of disease course and therapeutic responses and potential strategies for disease cure.

Charlotte Hedin © ECCO

Dr. Rupa Banerjee is a senior consultant gastroenterologist in the Department of Gastroenterology and Director of the Inflammatory Bowel Diseases (IBD) Centre at the Asian Institute of Gastroenterology, Hyderabad, India. She is also Director of IBD Research with the Asian Healthcare Foundation, Hyderabad. 

Dr. Rupa established the first dedicated IBD centre of excellence in India in 2004. She has designed and maintains a 6500-patient database and biorepository for the centre detailing the demographics, type and course of disease and response to treatment in the Indian subpopulation.

Her primary focus has been optimal and affordable multidisciplinary care of IBD. The outpatient clinics run from early morning to late evening, and many of the patients are from middle- or low-income strata. The centre has adopted a large cluster of villages for screening for IBD, including blood and endoscopic evaluations free of cost to enable early diagnosis and with house-to-house surveys on the incidence and prevalence of IBD in the region.

Dr. Rupa is actively involved in research on IBD in the Asian region, focussing on the epidemiology, microbiota and genetic profile of this population for the purposes of optimisation and individualisation of the management of IBD. 

Dr. Rupa has initiated the IBD-ENC (IBD – Emerging Nations Consortium), comprising more than 20 countries in South Asia, Middle East and Africa, to promote collaborative work on IBD in these parts of the world. She has been the key person in the design of the interactive web platform for the IBD-ENC (www.ibdenc.org), which presents IBD news and the latest publications, discusses challenging cases and offers members the unique opportunity to create their own patient IBD registry.

Dr. Rupa has received support from the Helmsley Charitable Trust, USA for the Rural programme for early diagnosis of Crohn’s Disease.

DEEP REMISSION AT 1 YEAR PREVENTS PROGRESSION OF EARLY CROHN’S DISEASE

Ungaro RC, Yzet C, Bossuyt P, et al.

Gastroenterology 2020;159:139–47.

Omer Serhan Omer © Omer Serhan Omer

Introduction

Despite recent advances in medical therapy, patients with Crohn’s Disease may still suffer disease progression requiring surgery and hospitalisation. It is increasingly recognised that early effective therapy is associated with improved patient outcomes and there is growing emphasis on early intervention, treat to target and tight control (TC) approaches [1]. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) programme highlighted the importance of targetting deep remission, defined as resolution of symptoms and objective resolution of inflammation on endoscopy [2]. The Effect of Tight Control Management on CD (CALM) study recently demonstrated that a TC approach in which therapy is escalated based on objective markers of inflammation [faecal calprotectin and C-reactive protein (CRP)], in addition to symptoms, is an effective strategy to achieve endoscopic and deep remission [3]. 

DRUG SURVIVAL OF ANTI-TNF AGENTS COMPARED WITH VEDOLIZUMAB AS A SECOND-LINE BIOLOGICAL TREATMENT IN INFLAMMATORY BOWEL DISEASE: RESULTS FROM NATIONWIDE SWEDISH REGISTERS

Sara Rundquist, Michael C Sachs, Carl Eriksson, Ola Olén, Scott Montgomery, Jonas Halfvarson, SWIBREG Study Group

Aliment Pharmacol Ther 2021;53:471–83. doi: 10.1111/apt.16193.

Samuel Lim © Samuel Lim

Introduction

The advent of monoclonal antibody therapy has propelled the management of Inflammatory Bowel Disease firmly into the biologic era, with numerous biologic therapies now licensed or in various stages of development.

Anti-tumour necrosis factor (TNF) agents such as infliximab [1, 2], adalimumab [3, 4] and golimumab [5] were the first biologics to be developed and have the greatest body of evidence for their effectiveness and safety in the treatment of Crohn’s Disease (CD) and Ulcerative Colitis (UC). The arrival of biosimilars has brought down costs and made treatment with anti-TNF more widespread, such that they are the most important first-line treatment option for moderate to severe IBD.