On Sunday October 11, 2020, all participants of the ECCO Guidelines on Prevention and Management of Infection met with the aim of reaching a consensus on each statement of the guideline. This guideline provides evidence-based insights into the prevention, diagnosis and management of infection in Inflammatory Bowel Disease. The project is led by Torsten Kucharzik and Stephan Vavricka, with 25 authors from 15 different countries. This is ECCO’s third guideline on infection in IBD; the first guideline on opportunistic infection was published in 2009, and updated in 2014.
“I’m not a fellow anymore but I would love to have the opportunity to be part of such a course!” This is a quote from a colleague who works in a private practice that I heard on the bus on the way back to Copenhagen airport after ECCO 2019. Thanks to this remark we embarked on this endeavour to hold the 1st ECCO Postgraduate Course in IBD.
Digital health is a broad concept encompassing categories such as mobile health (mHealth), health information technology (HIT), wearable devices, telehealth and telemedicine, with several aims, one of which is to foster the development of personalised medicine [1, 2].
Digital care meets the same requirements as in-person medicine (regarding ethics, patient consent, authentication of health professionals, report of consultation in the patient's file). Pre-COVID-19 this model of care was successfully used to monitor patients with a variety of chronic illnesses, and it gained traction after the emergence of COVID-19 because of the emerging need to apply alternative ways of delivering healthcare without human contact.
During the upcoming ECCO Virtual Congress, ClinCom is organising the 4th School for Clinical Trialists. One of ClinCom’s aims is to increase the quality of clinical trials in IBD and to provide new insights into the fast-moving field of clinical trial development. Randomised clinical trials (RCTs) are still the gold standard for the development and registration of new treatment options.
ECCO has established Fellowships, Grants and Travel Awards to encourage and support young physicians in their careers and to promote innovative scientific research in IBD.
It gives me great pleasure to introduce you to ECCO’s new Treasurer, Professor Janneke van der Woude. Janneke is a Consultant Gastroenterologist at the Erasmus University Medical Centre in Rotterdam. She is the clinical lead for the IBD unit and has published widely in the field. As a very active ECCO Committee and Executive Board Member since its infancy, we are really excited to get to know Prof Van Der Woude more.
The interview will comprise of a personal introduction, insights into Janneke’s professional life, her ECCO journey, some hot topic discussions and what’s in store for the future. We hope you enjoy listening to this interview by clicking on the audio link below:
Hemel is currently working as a dentist in London. He was diagnosed with Crohn’s Disease and within a year of getting his diagnosis he was invited to participate in a trial of an anti-TNF drug. Here he gives his view of his experience of being in a clinical trial.
Serum biomarkers identify patients who will develop inflammatory bowel diseases up to 5 years before diagnosis
Torres J, Petralia F, Sato T, et al.
Gastroenterology 2020;159:96–104.
Introduction
Inflammatory Bowel Disease is a chronic relapsing-remitting, immune-mediated condition with increasing prevalence globally [1]. Despite novel agents targeting different disease pathways, the likelihood of achieving sustained clinical remission and mucosal healing remains low [2]. One of the potential reasons may be that patients seek help and clinicians treat IBD once the disease is in its clinical phase. A sub-clinical phase of variable length may precede the symptoms that lead to a diagnosis and perhaps contribute to tissue damage which, once established, is difficult to reverse with currently available medical treatments.
In this study, Torres and colleagues set out to test the hypothesis that a pre-clinical phase of IBD may well be present and could be identified by proteomic markers [3].
Expression levels of 4 genes in colon tissue might be used to predict which patients will enter endoscopic remission after vedolizumab therapy for Inflammatory Bowel Diseases
Verstockt B, Verstockt S, Veny M, et al.
Clinical Gastroenterology and Hepatology. 2020;18:1142–51.
In the past few years the armamentarium of drugs used to treat Inflammatory Bowel Disease (IBD) has accelerated, with the emergence of new therapies targeting differing immune pathways (ustekinumab and tofacitinib) and lymphocyte trafficking (vedolizumab). Furthermore, a number of promising new drugs are on the horizon (JAK-1 inhibitors, IL23p19 antibodies and S1P inhibitors) [1, 2]. However, as the choice of drugs expands, so the uncertainty over which drug should be selected by the clinician also increases. Drug selection may be determined by a number of factors such as cost, mechanism of delivery (e.g. oral, intravenous or subcutaneous), presence of co-morbidities (such as malignancy or multiple sclerosis) and presence of extraintestinal manifestations. However, no drug is effective in all patients, with between 10% and 40% of patients suffering from primary and secondary loss of response [3–5].
Nowadays, IBD treatment not only targets symptomatic disease control but also aims to heal the intestinal mucosa [1] In Ulcerative Colitis (UC) there is mounting evidence that histological healing of the intestinal mucosa is associated with incremental benefit compared to endoscopic healing alone [2–8]. In a very recent meta-analysis of ten studies including 757 UC patients with complete endoscopic remission (Mayo Score 0 or equivalent) and with a minimum follow-up of >12 months, patients with histological remission had a 63% lower risk of clinical relapse (RR 0.37, 95% CI 0.24–0.56) than patients with ongoing microscopic inflammation [9].
Hannah Gordon 
Henit Yanai
Sophie Restellini
Sebastian Zeissig 
Nuha Yassin
Charlotte Hedin 
