Randomised clinical trial: exclusive enteral nutrition versus standard of care for acute severe ulcerative colitis

Sahu P, Kedia S, Vuyyuru SK et al.

Aliment Pharmacol Ther. 2021;53:568–76.

Homira Ayubi © Homira Ayubi

Introduction

Acute Severe Ulcerative Colitis (ASUC) is a medical emergency which affects about 25% of UC patients at least once in their lifetime [1]. Corticosteroids are the mainstay of treatment for ASUC; however, 30%–40% of patients do not respond and eventually need medical rescue therapy or surgery [2].Medical rescue therapy (in the form of ciclosporin or infliximab) can be costly and its use can be limited by side effects. Therefore, there is a need for safe and low-cost therapy which can augment the effect of corticosteroids to induce and maintain remission.

Bram Verstockt © ECCO

Dear Y-ECCO Friends,

Due to the pandemic, we unfortunately were unable to meet and interact physically in the usual way during our most recent Y-ECCO Basic Science Workshop. However, this is exactly what Y-ECCO is about: connecting people, colleagues and friends, clinicians and scientists in order to bring basic science from the bench to the bed, and back. Every year, the Y-ECCO Committee invites outstanding senior experts to give a state-of-the-art overview on hot topics in the IBD field. Furthermore, these top-notch speakers not only moderate the discussions that follow abstract presentations but also inspire and stimulate young researchers and clinician-scientists at the start of their careers. Although this year’s workshop was virtual, we succeeded in continuing our interactive format, with excellent talks and many questions via the virtual platform chat.

Johan Burisch © ECCO

Dear Y-ECCO Friends,

Did you enjoy the virtual ECCO Congress?

I personally found it very well organised and without major technical problems. And the programme was once again fantastic! As always, it was great to witness the many dedicated and brilliant researchers/physicians who work towards improving the care of IBD patients. But let’s hope that this is the last time that we cannot meet in person.

The call for research proposals returns with opportunities for Y-ECCO Members to propose and perform a brief, focused research project with ClinCom/Y-ECCO guidance and ECCO support.

Based on the successes of the surveys jointly conducted by the Young ECCO Committee (Y-ECCO) and the Clinical Research Committee of ECCO (ClinCom) at the ECCO Congresses in the past, we are asking Y-ECCO Members to propose a new survey study.

Charlotte Hedin © ECCO

Dr. Rupa Banerjee is a senior consultant gastroenterologist in the Department of Gastroenterology and Director of the Inflammatory Bowel Diseases (IBD) Centre at the Asian Institute of Gastroenterology, Hyderabad, India. She is also Director of IBD Research with the Asian Healthcare Foundation, Hyderabad. 

Dr. Rupa established the first dedicated IBD centre of excellence in India in 2004. She has designed and maintains a 6500-patient database and biorepository for the centre detailing the demographics, type and course of disease and response to treatment in the Indian subpopulation.

Her primary focus has been optimal and affordable multidisciplinary care of IBD. The outpatient clinics run from early morning to late evening, and many of the patients are from middle- or low-income strata. The centre has adopted a large cluster of villages for screening for IBD, including blood and endoscopic evaluations free of cost to enable early diagnosis and with house-to-house surveys on the incidence and prevalence of IBD in the region.

Dr. Rupa is actively involved in research on IBD in the Asian region, focussing on the epidemiology, microbiota and genetic profile of this population for the purposes of optimisation and individualisation of the management of IBD. 

Dr. Rupa has initiated the IBD-ENC (IBD – Emerging Nations Consortium), comprising more than 20 countries in South Asia, Middle East and Africa, to promote collaborative work on IBD in these parts of the world. She has been the key person in the design of the interactive web platform for the IBD-ENC (www.ibdenc.org), which presents IBD news and the latest publications, discusses challenging cases and offers members the unique opportunity to create their own patient IBD registry.

Dr. Rupa has received support from the Helmsley Charitable Trust, USA for the Rural programme for early diagnosis of Crohn’s Disease.

DEEP REMISSION AT 1 YEAR PREVENTS PROGRESSION OF EARLY CROHN’S DISEASE

Ungaro RC, Yzet C, Bossuyt P, et al.

Gastroenterology 2020;159:139–47.

Omer Serhan Omer © Omer Serhan Omer

Introduction

Despite recent advances in medical therapy, patients with Crohn’s Disease may still suffer disease progression requiring surgery and hospitalisation. It is increasingly recognised that early effective therapy is associated with improved patient outcomes and there is growing emphasis on early intervention, treat to target and tight control (TC) approaches [1]. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) programme highlighted the importance of targetting deep remission, defined as resolution of symptoms and objective resolution of inflammation on endoscopy [2]. The Effect of Tight Control Management on CD (CALM) study recently demonstrated that a TC approach in which therapy is escalated based on objective markers of inflammation [faecal calprotectin and C-reactive protein (CRP)], in addition to symptoms, is an effective strategy to achieve endoscopic and deep remission [3]. 

DRUG SURVIVAL OF ANTI-TNF AGENTS COMPARED WITH VEDOLIZUMAB AS A SECOND-LINE BIOLOGICAL TREATMENT IN INFLAMMATORY BOWEL DISEASE: RESULTS FROM NATIONWIDE SWEDISH REGISTERS

Sara Rundquist, Michael C Sachs, Carl Eriksson, Ola Olén, Scott Montgomery, Jonas Halfvarson, SWIBREG Study Group

Aliment Pharmacol Ther 2021;53:471–83. doi: 10.1111/apt.16193.

Samuel Lim © Samuel Lim

Introduction

The advent of monoclonal antibody therapy has propelled the management of Inflammatory Bowel Disease firmly into the biologic era, with numerous biologic therapies now licensed or in various stages of development.

Anti-tumour necrosis factor (TNF) agents such as infliximab [1, 2], adalimumab [3, 4] and golimumab [5] were the first biologics to be developed and have the greatest body of evidence for their effectiveness and safety in the treatment of Crohn’s Disease (CD) and Ulcerative Colitis (UC). The arrival of biosimilars has brought down costs and made treatment with anti-TNF more widespread, such that they are the most important first-line treatment option for moderate to severe IBD.

Johan Burisch © ECCO

Dear Y-ECCO Friends,

I hope that you are all doing fine and that you managed to submit your abstract to the virtual ECCO Congress before the deadline. As always, we will select the best abstracts submitted by Y-ECCO Members for the Y-ECCO Award 2021. We are really excited to read about your research and, of course, hear all about it at the Congress.

Charlotte Hedin © ECCO

Marc Ferrante was appointed assistant professor at KU Leuven (Leuven, Belgium) in 2013, and later became associate professor. He is also a staff member in the Department of Gastroenterology and Hepatology at the University Hospitals Leuven. He is a lecturer for students of Biomedical Sciences and Medicine and a coach for clinical fellows in training. He has previously been chair of both Y-ECCO and ClinCom and was appointed as a SciCom Member in 2019.

AN ANTI-MIGRATION SELF-EXPANDABLE AND REMOVABLE METAL STENT FOR CROHN’S DISEASE STRICTURES: A NATIONWIDE STUDY FROM GETAID AND SFED

Attar A, Branche J, Coron E et al.

J Crohns Colitis 2020 Oct 27. doi: 10.1093/ecco-jcc/jjaa208. Online ahead of print.

Rajan N Patel © Rajan N Patel

Introduction

Crohn’s Disease is complicated by strictures in up to 30% of cases. Medical management with biologics is often suboptimal and surgical treatment is associated with postoperative complications and disease recurrence. Targeted therapy with endoscopic balloon dilatation (EBD) of strictures less than 5 cm has high rates of technical success (passage of endoscope through the stricture) but variable clinical success (relief of obstructive symptoms), with up to 25% of patients requiring surgery at one-year follow-up [1]. Removable fully covered metal stents are safe for the treatment of refractory strictures but the risk of stent migration is high [2].