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. 

CALM Trial

Sasha Fehily  © ECCO

Introduction

There has been a recent shift in Crohn’s Disease (CD) management away from the conventional focus on short-term clinical outcomes and towards the maintenance of long-term remission.  In 2015 the International Organisation for the Study of Inflammatory Bowel Diseases released a consensus statement recommending a treat-to-target approach [1]. The STRIDE initiative recommended pursuing treatment escalation in order to achieve the treatment targets of clinical remission and mucosal healing, with adjunctive use of normal C-reactive protein (CRP) and faecal calprotectin (FC) levels. However, the authors noted that prospective studies would be needed to confirm that achievement of these targets would alter the natural history of disease and improve patients’ quality of life.

Dominik Bettenworth  © 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.

Charlotte Hedin © ECCO

Florian Rieder is currently an Associate Staff physician in the Department of Gastroenterology, Hepatology and Nutrition as well as an Investigator in the Department of Inflammation and Immunity at the Cleveland Clinic in the USA. His area of interest is pathogenesis of intestinal fibrosis and trial endpoint development for testing anti-fibrotics in stricturing IBD patients. He received his medical degree from the LMU Munich and has worked in Germany, Switzerland and South Africa as well as the USA. 

Nuha Yassin © ECCO

Dear Y-ECCO Friends,

I hope that this Members’ Address finds you all well and that you’re enjoying the beautiful autumn colours. Alas, this will be the last time that I address you as Y-ECCO Chair, as I will be stepping down from this position at the next ECCO Congress (2019, Copenhagen). It is with the greatest pleasure that I will then hand over the position of Chair to my colleague, Dominik Bettenworth (Münster, Germany), who has been an executive Y-ECCO Committee Member for the last 3 years. My colleague John Nik Ding will also be completing his 3-year Committee Membership and accompanying me down the path of the autumn leaves to regular ECCO Membership, thus making way for two new Y-ECCO Committee Members.