Y-ECCO
15December2020

Y-ECCO Interview Corner: Hemel M

Charlotte Hedin, Y-ECCO Member

Charlotte Hedin
© ECCO

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.

Posted in ECCO News, Committee News, Volume 15, Issue 4, Y-ECCO

15December2020

Y-ECCO Literature Review: Polychronis Pavlidis

Polychronis Pavlidis

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].

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 4, Y-ECCO

15December2020

Y-ECCO Literature Review: Jonathan Digby-Bell

Jonathan Digby-Bell

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.


Jonathan Digby-Bell
© Jonathan Digby-Bell 

Introduction

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 [35].

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 4, Y-ECCO

15December2020

Y-ECCO Literature Review: Toer Stevens

Toer Stevens

Development and validation of a deep neural network for accurate evaluation of endoscopic images from patients with ulcerative colitis

Takenaka K, Ohtsuka K, Fujii T, et al.

Gastroenterology. 2020;158: 2150–7.


Toer Stevens
© Toer Stevens

Introduction

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]. 

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 4, Y-ECCO

15December2020

Y-ECCO Members’ Address

Johan Burisch, Y-ECCO Chair

Johan Burisch
© ECCO

Dear Y-ECCO Friends,

I hope you had a nice UEG Week Virtual earlier in October. My experience with the many virtual symposia over recent months has been mixed, but I think that the virtual UEG Week worked very well, with great interactions from viewers and excellent lectures. Hopefully, we’ll be able to attend the ECCO Congress next year in person – I’m sure that you miss interacting with friends and colleagues as much as I do. But the experience at UEG Week makes me optimistic that this format can also work well.

Posted in ECCO News, Committee News, Volume 15, Issue 4, Y-ECCO

30September2020

Y-ECCO/ClinCom call for Y-ECCO Small Research Survey Proposals

At the 15th Congress of ECCO in Vienna, the Young ECCO Committee (Y-ECCO) and the Clinical Research Committee of ECCO (ClinCom) jointly conducted a survey of attendees entitled “Decision-making in IBD dysplasia management”. The results are currently being prepared for publication. This project followed on from other successful surveys which led to submission of abstracts at the ECCO Congress and publication of full manuscripts in scientific journals.

Posted in ECCO News, ClinCom, ECCO'21, Volume 15, Issue 3, Y-ECCO

30September2020

Y-ECCO Interview Corner: Britta Siegmund

Charlotte Hedin, Y-ECCO Member

Charlotte Hedin
© ECCO

Britta Siegmund is Medical Director of the Medical Department, Division of Gastroenterology, Infectiology and Rheumatology, Charité – Universitätsmedizin Berlin and holds many other important national and international roles within the scientific and medical communities. She has an extensive publication record in the mucosal immunology of IBD. She is also President-Elect of ECCO.

Posted in ECCO News, Committee News, Volume 15, Issue 3, Y-ECCO

30September2020

Y-ECCO Literature Review: Radha Gadhok

Radha Gadhok

Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: retrospective long-term follow-up of the LIR!C trial  

Stevens TW, Haasnoot ML, D’Haens GR, Buskens CJ, De Groof EJ, Eshuis EJ, Gardenbroek TJ, Mol B, Stokkers PCF, Bemelman WA, Ponsioen CY on behalf of the LIR!C study group

Lancet Gastroenterol Hepatol 2020 Jun 30;S2468-1253(20)30117-5. doi: 10.1016/S2468-1253(20)30117-5. Online ahead of print.


Radha Gadhok
© Radha Gadhok

Introduction

The positioning of medical therapies in the management of Crohn’s Disease (CD) continues to be debated [1] whilst surgery is reserved for cases with disease complications or failure of medical therapy.  The LIR!C trial [2] provided evidence for  surgical resection as an alternative to infliximab (IFX) in the management of localised terminal ileitis, a common presentation of CD [3].

Briefly, the LIR!C trial reported quality of life scores (IBDQ) among 143 adult patients with terminal ileitis (<40 cm) who underwent randomisation to IFX induction/maintenance or ileocaecal resection. Patients were recruited from 29 secondary and tertiary Dutch and British centres. Exclusion criteria included non-inflammatory disease, prestenotic dilatation, abscess and previous surgery. Inclusion criteria included failing at least three months of conventional therapy [immunomodulator (IM) and/or corticosteroid (CS)] [2]

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 3, Y-ECCO

30September2020

Y-ECCO Literature Review: Rebecca Reynolds

Rebecca Reynolds

No benefit of continuing vs stopping 5-aminosalicylates in patients with ulcerative colitis escalated to anti-metabolite therapy

Singh S, Kim J, Zhu W, Dulai P, Sandborn WJ, Jairath V

Aliment Pharmacol Ther. 2020;52:481–91.


Rebecca Reynolds
© Rebecca Reynolds 

Introduction

First introduced by Svartz in 1942, 5-aminosalicylates (5-ASAs) are a well-established and effective first-line therapy for the induction and maintenance of remission in patients with mild-to-moderate Ulcerative Colitis (UC). They remain the most frequently prescribed medication for UC and are known to be effective and well tolerated [1]. Between 87% and 98% of UC patients receive 5-ASA treatment within the first year of diagnosis and 60%–87% continue on this treatment at ten years [2, 3].

Escalation to anti-metabolites (thiopurines or methotrexate) and/or biologic or small molecule therapy is often required for UC patients with a more aggressive disease course. Whilst it is now accepted that discontinuing 5-ASA therapy when escalating to a biologic is not associated with adverse outcomes, less is known about the therapeutic benefit of continuation of 5-ASAs with an antimetabolite [2, 4].

Singh et al conducted a retrospective cohort study to evaluate the pattern of 5-ASA use in patients with UC following escalation to an antimetabolite. The study evaluated patients escalated to antimetabolite therapy (stopping 5-ASA vs short-term 5-ASA use for <6 months vs persistent 5-ASA use for >6 months) and compared the risk of clinically important complications based on the pattern of 5-ASA use in these patients. They hypothesised that continuing 5-ASA therapy would not be more beneficial than stopping it.

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 3, Y-ECCO

30September2020

Y-ECCO Literature Review: Susanna Meade

Susanna Meade

Prominence of ileal mucosa-associated microbiota to predict postoperative endoscopic recurrence in Crohn’s disease

Sokol H, Brot L, Stefanescu C, et al.

Gut 2020;69:462–472.


Susanna Meade
© Susanna Meade

Introduction

The aetiopathogenesis of CD is multifactorial but includes the interaction between the microbiome and the host’s immune response. Up to 80% of patients with Crohn’s Disease (CD) require surgery during their lifetime and many factors are associated with postoperative recurrence (POR). Differential abundance of bacterial species is seen in patients with IBD compared with healthy individuals and several studies have suggested an association between microbiota composition and CD recurrence [1–3]. Altered mucosal gene expression and abundance of specific microbiota are associated with, and specific to, ileal CD [4].

Posted in ECCO News, Committee News, Y-ECCO Literature Reviews, Volume 15, Issue 3, Y-ECCO

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