Y-ECCO
28April2022

Y-ECCO Literature Review: Patrick Dawson

Patrick Dawson

Intensive drug therapy versus standard drug therapy for symptomatic intestinal Crohn's disease strictures (STRIDENT): an open-label, single-centre, randomised controlled trial

Schulberg JD, Wright EK, Holt BA, et al.

Lancet Gastroenterol Hepatol. 2022;7:318–31. doi: 10.1016/S2468-1253(21)00393-9.


Patrick Dawson
© Patrick Dawson

Introduction

Crohn’s Disease (CD) is a chronic gastrointestinal inflammatory condition [1] that commonly causes strictures, with more than 50% of patients developing at least one stricture in the first decade after diagnosis [2]. Management options include biologics, endoscopic dilatation and surgery. Dilatation requires that the stricture be endoscopically accessible and medical therapy has limited benefit in fibrostenosing disease; therefore, surgery often remains the initial treatment of choice [3]. MRI and ultrasound can provide detailed assessment but cannot always definitively quantify active inflammation [4, 5].

This open label, randomised control trial was carried out at a specialist IBD unit in Australia with the aim of establishing whether medical therapy is an effective treatment of stricturing CD and, if so, whether intensive medical therapy is more effective than standard therapy. The primary end point was an improvement in the 14-day obstructive symptom score by one or more points compared to baseline at 12 months. Secondary outcomes included: improvement in the Crohn’s Disease Activity Index (CDAI), C-reactive protein (CRP), faecal calprotectin (FCP), stricture morphology on MRI, small bowel ultrasound (SBUS) or endoscopy, and correlation of serum adalimumab concentration with any improvement.

Posted in ECCO News, Y-ECCO Literature Reviews, Committee News, Y-ECCO, Volume 17, Issue 1

28April2022

Report on the 8th Y-ECCO Basic Science Workshop

Gianluca Pellino, Y-ECCO Member

Gianluca Pellino
© Gianluca Pellino

For another year, unexpectedly, the Y-ECCO Basic Science Workshop had to be an online-only event, as the uncertainties related to the status of the pandemic caused the ECCO Congress 2022 to be changed into a virtual event. However, the workshop participants showed clearly that this did not affect their enthusiasm.

Posted in ECCO News, Committee News, ECCO'22, Y-ECCO, Volume 17, Issue 1

28April2022

Y-ECCO Members’ Address

Charlotte Hedin, Y-ECCO Chair

Charlotte Hedin
© ECCO

Dear Y-ECCO Friends,

I hope you all enjoyed the ECCO Congress and got a lot out of sailing the seas of IBD! Although we were forced to hold the Congress digitally, there was a huge amount of great content – not least the contributions from Y-ECCO Members. Fourteen oral presentations were selected to be presented by Y-ECCO Members and a total of 20 Y-ECCO Members were awarded prizes. This demonstrates the great driving force of Y-ECCO within ECCO and paves the way for the next generation of IBD experts. Our annual Basic Science Workshop, which has been going since 2015, was again a great success. More information on what the 67 workshop participants were treated to can be read in the separate report by Y-ECCO Committee Member Gianluca Pellino.

Posted in ECCO News, Committee News, Y-ECCO, Volume 17, Issue 1

16December2021

Y-ECCO Interview Corner: Johan Burisch

Charlotte Hedin, Y-ECCO Member

Charlotte Hedin
© ECCO

Johan Burisch is a gastroenterologist in training who is currently working in Copenhagen, Denmark. His research focusses on IBD epidemiology. He works with both population-based cohorts of patients and the Danish national patient registries. Furthermore, he is involved in developing eHealth solutions for self-monitoring in IBD. He has authored over 100 peer-reviewed papers on IBD epidemiology as well as several book chapters. In 2019, he was awarded the UEG Rising Star award. He has been Y-ECCO Chair since 2020.

Posted in ECCO News, Committee News, Y-ECCO, Volume 16, Issue 4

16December2021

Y-ECCO Literature Review: Rawen Kader

Rawen Kader

Discontinuation of infliximab in patients with ulcerative colitis in remission (HAYABUSA): a multicentre, open-label, randomised controlled trial

Kobayashi T, Motoya S, Nakamura N, et al.

Lancet Gastroenterol Hepatol 2021;6:429–7. doi: 10.1016/S2468-1253(21)00062-5.


Rawen Kader
© Rawen Kader

Introduction

The anti-tumour necrosis factor monoclonal antibody infliximab is one of the most widely used therapies for corticosteroid-refractory Ulcerative Colitis (UC). Long-term use of infliximab is associated with an increased risk of adverse events such as malignancies and infections, which is particularly concerning for those on concurrent immunosuppressive medications such as corticosteroids, thiopurines or calcineurin inhibitors [1–3]. With the number of patients with UC on long-term infliximab therapy continuing to rise, an important clinical question to address is whether these patients remain in remission upon discontinuing infliximab. Prospective studies have evaluated discontinuation of infliximab in patients with Crohn’s Disease, with deep (i.e. clinical, biological and endoscopic) remission thought to have a lower risk of relapse, but the evidence for patients with UC is limited to retrospective studies [4–6]. The HAYABUSA study aimed to address this issue with a randomised controlled trial (RCT) to evaluate discontinuing infliximab in patients with UC in remission.

Posted in ECCO News, Y-ECCO Literature Reviews, Committee News, Y-ECCO, Volume 16, Issue 4

16December2021

Y-ECCO Literature Review: Aamir Saifuddin

Aamir Saifuddin

Tofacitinib as salvage therapy for 55 patients hospitalised with refractory severe ulcerative colitis: A GETAID cohort

Uzzan, M, Bresteau, C, Laharie, D, et al.

Aliment Pharmacol Ther. 2021;54:312– 9.


Aamir Saifuddin
© Aamir Saifuddin

Introduction

Approximately 25% of patients with Ulcerative Colitis (UC) require admission to hospital for acute severe (ASUC) or refractory disease, with one-third suffering from multiple episodes [1]. The mainstay of initial anti-inflammatory treatment remains corticosteroids, following the seminal report from Truelove and Witts in the BMJ in 1955 [2, 3]. Here, 210 patients were randomised to standard care with oral cortisone or placebo. Significant benefit was demonstrated in the cortisone group, particularly in those at index presentation and those who had mild UC. At follow-up to 2 years, 21.5% had undergone surgery.

It is interesting that acute colectomy rates remain approximately 20% despite improvements in overall care and infliximab or ciclosporin ‘rescue’ therapy [1, 3]. The CONSTRUCT trial, reported in 2016, demonstrated no significant difference in the frequency of colectomy between these rescue medications, with surgery required in roughly 40% of steroid-refractory patients within one year.

Posted in ECCO News, Y-ECCO Literature Reviews, Committee News, Y-ECCO, Volume 16, Issue 4

16December2021

Y-ECCO Members’ Address

Johan Burisch, Y-ECCO Chair

Johan Burisch
© ECCO

Dear Y-ECCO Friends,

The year is slowly coming to an end and we can start looking forward to 2022 and hopefully returning to our normal, pre-COVID existence. Next year’s ECCO Congress will be among the first major scientific meetings within our specialty to have physical attendance. I’m sure you are all looking forward to meeting colleagues and friends in real life as much as I am. Don’t forget to sign up for our Basic Science Workshop!

Posted in ECCO News, Committee News, Y-ECCO, Volume 16, Issue 4

17September2021

Y-ECCO Interview Corner: Maria Abreu

Charlotte Hedin, Y-ECCO Member

Charlotte Hedin
© ECCO

Maria T Abreu, MD, is the Martin Kalser Endowed Chair in Gastroenterology, a Professor of Medicine, a Professor of Microbiology and Immunology, and Director of the Crohn's and Colitis Center at the University of Miami.

She is Council Chair of the American Gastroenterological Association (AGA) Institute Council and has served as Chair of the AGA’s Underrepresented Minorities Committee. She has also been appointed as Chair of the International Organization for the Study of Inflammatory Bowel Disease (IOIBD).

She was interviewed via video link in March 2021.

Posted in ECCO News, Committee News, Y-ECCO, Volume 16, Issue 3

17September2021

Y-ECCO Literature Review: Omer F. Ahmad

Omer F. Ahmad

Central reading of ulcerative colitis clinical trial videos using neural networks

Gottlieb K, Requa J, Karnes W, et al.

Gastroenterology 2021;160:710–9.e2

Omer F. Ahmad
© Omer F. Ahmad

Introduction

Endoscopic grading of the severity of Ulcerative Colitis (UC) is a critical component of disease assessment and particularly important for guiding therapy. Despite the availability of numerous scoring systems, such as the Mayo Endoscopic Score (eMS) and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), widespread use in routine clinical practice is often limited, primarily due to inter-observer variability and lack of training for standardised use [1,2].

Posted in ECCO News, Y-ECCO Literature Reviews, Committee News, Y-ECCO, Volume 16, Issue 3

17September2021

Y-ECCO Literature Review: Jennifer Murray

Jennifer Murray

Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab

Kennedy NA, Goodhand JR, Bewshea C, et al., Contributors to the CLARITY IBD study

Gut 2021;70:865–875


Jennifer Murray
© Jennifer Murray

Introduction

Infection with the novel coronavirus SARS-CoV-2 leading to coronavirus disease-2019 (COVID-19) has a broad spectrum of clinical presentations and disease severity. A number of host and viral factors contribute to this heterogeneity in presentation and severity, including the host immune response [1]. Given that immune-mediated inflammatory diseases (IMIDs) including Inflammatory Bowel Disease (IBD), are characterised by immune dysregulation and use of biologic or immunosuppressive therapies, COVID-19 presents a particular challenge.

Posted in ECCO News, Y-ECCO Literature Reviews, Committee News, Y-ECCO, Volume 16, Issue 3