Optimised infliximab monotherapy is as effective as optimised combination therapy, but is associated with higher drug consumption in Inflammatory Bowel Disease

Drobne D, Kurent T, Golob S, Švegl P, Rajar P, Hanžel J, Koželj M, Novak G, Smrekar N, Ferkolj I, Štabuc B

Aliment Pharmacol Ther. 2019;49:880–9

Aravind Gokul Tamilarasan  © Aravind Gokul Tamilarasan

Introduction

Since the publication of the landmark SONIC trial in 2010 [1], the use of combination biologic–immunomodulator therapy has been considered best standard practice for patients with Inflammatory Bowel Disease (IBD) who have failed topical therapies or immunomodulators (thiopurines or methotrexate). More recently, real-world data from the PANTS (Personalised anti-TNF therapy in Crohn’s Disease) study demonstrated the benefit of combination therapy (particularly for infliximab) in the form of higher week 54 remission rates and prevention of immunogenicity [2]. Notably, the week 54 remission rates were independent of infliximab trough levels or immunogenicity status, suggesting additional benefits apart from improving the pharmacokinetics of infliximab. This study aimed to provide further real-world data on the effect of combination therapy on clinical and pharmacokinetic outcomes.

Risankizumab in patients with moderate to severe Crohn's Disease: An open-label extension study

Feagan BG, Panés J, Ferrante M, Kaser A, D'Haens GR, Sandborn WJ, Louis E, Neurath MF, Franchimont D, Dewit O, Seidler U, Kim KJ, Selinger C, Padula SJ, Herichova I, Robinson AM, Wallace K, Zhao J, Minocha M, Othman AA, Soaita A, Visvanathan S, Hall DB, Böcher WO

Lancet Gastroenterol Hepatol. 2018;3:671–80. DOI: https://doi.org/10.1016/S2468-1253(18)30233-4   

James Gauci  © James Gauci

Introduction

Management of Crohn’s Disease involves the suppression of inflammation through administration of immunosuppressive drugs. While conventional therapies such as corticosteroids and thiopurines exert a broad effect on the immune system, the advent of biological agents has allowed for selective targeting of cytokines and integrins.

Unfortunately, a third of patients treated with tumour necrosis factor (TNF) antagonists demonstrate a primary non-response, with another third developing either secondary failure or intolerance. These patients will then have a lower chance of responding to treatment with other TNF antagonists or with the integrin antagonist vedolizumab.

Serum Concentration of 7α-hydroxy-4-cholesten-3-one Are Associated With Bile Acid Diarrhea in Patients With Crohn's Disease

Battat R, Duijvestein M, Vande Casteele N, Singh S, Dulai PS, Valasek MA, Mimms L, McFarland L, Hester KD, Renshaw M, Jain A, Sandborn WJ, Boland BS

Clin Gastroenterol Hepatol. 2018 Nov 15. doi:10.1016/j.cgh.2018.11.012    

Ivan Lyutakov  © Ivan Lyutakov

Introduction

Inflammatory Bowel Disease (IBD) comprises a heterogeneous group of chronic inflammatory disorders with two main conditions, Crohn’s Disease (CD) and Ulcerative Colitis (UC) [1]. Bile acid malabsorption (BAM) and bile acid diarrhoea (BAD) have been recognised to be a common cause of chronic diarrhoea, and this recognition has led to the initiation of a search for new screening tests (biomarkers). BAM is one of the mechanisms leading to microscopic colitis, a key factor in the pathogenesis of irritable bowel syndrome-diarrhoea, and molecular mechanisms of BAM are found in IBD patients with or without involvement of the terminal ileum. BAM/BAD is more frequently found in CD than in UC, and the obvious aetiology for BAM in CD is either ileal resection or ileal disease [2]. The pathophysiology of diarrhoea in CD is multifactorial but there are two key factors, colonic water and electrolyte absorption, which can be impaired directly by colonic inflammation or indirectly by increased concentrations of bile acids having secretory effects, referred to as BAD [3].

Mark Samaan  © ECCO

Dear Y-ECCO Friends,

A warm welcome to the Y-ECCO Literature Review section, where you will find a summary and discussion of cutting-edge clinical trials as well as basic science studies in the field of IBD. 

If you are a Y-ECCO Member and you are looking for an opportunity to get actively involved in ECCO and gain some visibility, contribute your article to the Y-ECCO Literature Review corner, together with a short self-description and your picture.

Johan Burisch © ECCO

Every two years, Y-ECCO arranges a workshop addressing topics about career and skill development for young researchers and physicians. We thereby aim to address important topics that are not fully covered during the rest of the ECCO Congress. This year the workshop took place for the 11^th time, with the overall topic being modern career-enhancing skills. 

Nuha Yassin © ECCO

Dear Y-ECCO Friends,

We hope you are all well and that you enjoyed the ECCO Congress. We certainly did, and we were very pleased to meet many new members at the Y-ECCO Basic Science Workshop as well as to catch up with familiar faces. This year our workshop was over-subscribed, and the room was jam-packed. Our participants consisted of a mixture of basic scientists, clinicians, clinician scientists, nurses, trainees and senior members. We are delighted that our Basic Science Workshop appeals to everyone and caters for many needs. 

Dominik Bettenworth © ECCO

Dear Y-ECCO Friends,

It is a great pleasure for me to write my first Members’ Address. A few weeks ago, the 14^th Congress of ECCO took place and was fully packed with world-class, international presentations on basic science research and clinical studies that had the common goal of improving the care of our IBD patients. My personal highlight of the Congress was, however, to take over as Y-ECCO Chair from Nuha Yassin. Many of you will know Nuha from personal meetings at the Y-ECCO Workshops, Consensus Guidelines meetings or the ECCO Interaction: Hearts and Minds at the Annual Congress of ECCO. Personally, over the past three years I have got to know Nuha as an inspiring person with a very clear vision of the various Y-ECCO projects that she has been able to put into practice as a highly talented networker, while always adding the perspective of an experienced surgeon. 

David Wilson © ECCO

The mission of the Paediatric Committee of ECCO is improving knowledge on paediatric-specific IBD issues as well as supporting and facilitating research into paediatric IBD. During the ECCO Congress in Copenhagen, P-ECCO said goodbye to Patrick van Rheenen and Jaroslaw Kierkus. We greatly thanked them for all their contributions to P-ECCO and welcomed two new members: Johan van Limbergen and Amit Assa. 

Yves Panis © ECCO

The 8^th S-ECCO IBD Masterclass (held in collaboration with the European Association of Coloproctology, ESCP) was organised to take place during the 14^th Congress of ECCO in Copenhagen. As in previous years, it was a full-day masterclass, and this year it attracted 183 participants.

Dearbháile O’Hanlon  © ECCO

As a new member of the D-ECCO Committee it is a pleasure to review the 4th D-ECCO Workshop at the 14th Congress of ECCO. This year we had an excellent attendance of 140 attendees from across the multidisciplinary areas, including dietitians, nurses, physicians and clinical researchers.

The programme was divided into three sessions.