Takeda-sponsored symposia at the 18th ECCO Congress 2023, Copenhagen, Denmark

Keeping it real: Less is more in complex Crohn’s perianal fistulas!

Thursday, 2 March 2023

The Takeda-sponsored educational symposium during the 12^th S-ECCO IBD Masterclass was delivered by expert colorectal surgeon Dr Charlotte Hauser, a Senior Physician and Head of the IBD Surgical Unit at the University Medical Center Schleswig-Holstein in Kiel, Germany.

Dr Hauser delved into the experiences of patients living with complex Crohn’s perianal fistulas (CPF), highlighting the burden of this debilitating disease, and the impacts on quality of life. She also discussed how the short- and long-term treatment goals that are part of the journey to effective fistula closure may differ between the patient and surgeon. 

Dr Hauser provided a review of all treatment approaches and surgical options for complex CPF. She also presented data from key Phase III and real-world studies, including the pivotal ADMIRE-CD study on the use of mesenchymal stem cells as a non-cutting, sphincter-sparing option to possibly achieve sustained closure of fistulas. Finally, she discussed her own clinical experience in using stem cell therapy to treat complex CPF, sharing insights on the clinical examinations, treatment journey, impact on quality of life, and details of follow-up.

Over 180 attendees actively interacted with the speaker throughout via live polling. Following the presentation, attendees asked questions and gained valuable insights into the use of setons, the multidisciplinary care approach and how to work together with gastroenterologists, malignancy testing following curettage, and how to make informed treatment choices for individual patients to optimize their outcomes. 

Boosting adherence in patients with IBD! How you can make a difference

Thursday, 2 March 2023

The Takeda-sponsored educational symposium during the 17^th N-ECCO Network Meeting was presented by Ms Bianca Deparade-Berger, a Study Nurse at the Waldfriede Hospital in Berlin, Germany, and Ms Kerry Robinson, an IBD Clinical Nurse Specialist at the Royal Hallamshire Hospital in Sheffield, UK. This stimulating two-part, joint session was attended by over 170 healthcare professionals. The symposium explored the importance of patient adherence in IBD, the many risk factors for non-adherence, and how non-adherence can be reduced by IBD nurses with simple practical steps.

Ms Deparade-Berger kicked off the symposium with her talk, ‘Adherence matters! Space for improvement’. She explained the concept of adherence as a major determinant of treatment success, what this means for patients and healthcare professionals, and the possible detrimental consequences of non-adherence for patients with IBD.

Ms Robinson then explored the ways in which nurses can increase patient commitment to treatment in her talk, ‘Fuelling a difference! Practical tips for boosting adherence’. She discussed the ‘SIMPLE’ framework, which provides an overview of research-supported strategies to boost adherence in patient care settings. This framework is broken down into several important measures: Simplifying regimen characteristics, Imparting knowledge, Motivating patients, Patient communication, Leaving the bias, and Evaluating adherence (Atreja A, et al. 2005). Using this, Ms Robinson emphasized the need for clear patient interaction, tailored care plans, accessible treatment-related information, and frequent follow-up to continually assess adherence.

The presentations were followed by a lively Q&A session in which the expert nurses discussed the importance and ideal frequency of face-to-face communication with patients, the involvement of members of the multidisciplinary team in treatment decisions that impact adherence, and the challenges associated with managing the care of patients who are persistently non-adherent. A key point of the discussion focused on the value of face-to-face communication versus virtual communication when counselling patients with IBD and how this can allow nurses to better understand and guide their patients.

Were you unable to attend, or do you want to rewatch the session? Look no further and click here!

The great debate: Is disease clearance a realistic therapeutic goal in Ulcerative Colitis?

Thursday, 2 March 2023

This Takeda-sponsored symposium was chaired by Professor Stephen B. Hanauer (Medical Director of the Digestive Health Center at Northwestern Memorial Hospital, Chicago, IL, USA). This highly successful event was attended by approximately 1000 delegates from over 50 countries.

Professor Axel Dignass (Head of the Department of Medicine at the Agaplesion Markus Hospital, Goethe University, Frankfurt, Germany) provided an overview of the current approaches to UC management. He explained how treatment goals have evolved and outlined the current Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE II) and Selecting Endpoints for Disease Modification Trials (SPIRIT) consensus recommendations. He stressed the importance of considering early intervention, and discussed how a deeper level of remission can be achieved by targeting endoscopic and mucosal healing. He finished by posing the question, “Are current treatment goals in UC sufficient, or should we continue to aspire for more?”.

Professor Fernando Magro (Consultant in Gastroenterology at the University Hospital Center of São João, Porto, Portugal) then explored the future of UC management. He defined the disease clearance concept and discussed its feasibility and potential as a future, realistic treatment goal to significantly modify the course of the disease. He also emphasized the importance of measuring neutrophil levels to determine histological activity and the resulting implications for long-term outcomes. Professor Magro concluded by recognizing recent trials that include the disease clearance concept and related outcomes as endpoints, emphasizing the clinical potential surrounding the concept of disease clearance.

A final Q&A and panel discussion allowed the audience to ask insightful questions directly to the expert panel, including “Is histological remission a realistic goal?” and “What pre-clinical models are being used to predict the clinical effects in patients?”. Delegate perception of the disease clearance concept was measured through interactive polling questions before, during and after the didactic presentations; the proportion of respondents who agreed that disease clearance could be a realistic goal in UC increased from 72% prior to the presentations to 83% at the end of the symposium.

Navigating complex CPF management with stem cells

Friday, 3 March 2023

The Takeda-sponsored satellite symposium featured leading experts Dr Krisztina Gecse, Consultant Gastroenterologist at the Amsterdam University Medical Center in Amsterdam, the Netherlands, and Dr Ian White, Consultant Colorectal Surgeon at the Rabin Medical Center in Petah Tikva, Israel. They tackled key topics in the management of complex CPF and the role stem cell therapy can play. The experts brought the topics to life by sharing their expertise and real clinical experience, and almost 200 attendees were treated to an intimate conversation between key members of the multidisciplinary team (MDT). The symposium was a resounding success, with great engagement in the live polling and Q&A session.

Dr Krisztina Gecse opened with a discussion on what successful management of complex CPF looks like. She combined data, guidelines, the 2022 CPF expert consensus (Geldof J, et al. 2022), and her clinical experience into an engaging narrative which highlighted the importance of:

• A ‘treat-to-patient goal’ approach
• A multimodal, stepwise treatment approach, combining medical and surgical management
• The use of a cohesive and advanced MDT

Dr Gecse then passed the baton to Dr Ian White, who shared a surgeon’s perspective on how to utilize stem cells in complex CPF. Dr White expertly navigated the audience through the rationale for using mesenchymal stem cells with an exploration of pathophysiology and mechanism of action.

He discussed key long-term efficacy and safety data from week 104 of the ADMIRE-CD extension study (Garcia-Olmo D, et al. 2022) and real-world case series from across Europe – including the ‘hot off the press’ French study by Fathallah N, et al. (2023)⁠ – and closed with a compelling case from his own practice.

Following the presentations, it was time for the audience to join the conversation! They were eager to pick the brains of the presenters, with Dr Gecse and Dr White enjoying a continuous stream of thought-provoking questions.

Key topics included:

• The presenters’ real-world experiences of using stem cell therapy
• Considerations for medical therapy, such as biologics and antibiotics, when using stem cell therapy
• MDT follow-up after stem cell therapy administration

Crohn’s Disease: From disease discovery to patient recovery

Friday, 3 March 2023

This Takeda-sponsored symposium was chaired by Dr David Rubin (Joseph B. Kirsner Professor of Medicine, Chief of Gastroenterology, Hepatology & Nutrition, and Co-Director of the Digestive Diseases Center at the University of Chicago Medicine, Chicago, IL, USA). This case-based, interactive event engaged approximately 1,000 attending delegates from over 46 countries.

The symposium opened with a joint presentation by Dr Séverine Vermeire (Professor of Medicine in the Department of Gastroenterology at University Hospitals Leuven, Leuven, Belgium) and Professor Shomron Ben-Horin (Chief of the Gastroenterology Department at Sheba Medical Center, Tel HaShomer, Israel), which emphasized the importance and complexity of treatment sequencing in CD management.

The presentation centered around a hypothetical case: a female with CD, risk factors including smoking and ileum involvement, and a complex symptom constellation. Delegates were invited to vote on therapeutic decisions at various stages of the disease journey, with Dr Vermeire and Professor Ben-Horin then exploring the data supporting the advantages and disadvantages of each approach. Votes were divided across therapeutic options at each decision point (diagnosis, symptomatic relapse following improvement, and following ileocecal resection), with no overall consensus besides agreement on the importance of early intervention.

A final Q&A and panel discussion allowed the faculty to debate audience questions, including “Is there an optimal treatment sequence for most patients with Crohn’s disease?”. This symposium highlighted the challenges and complexities of treatment decision-making in CD and the need for an individualized approach to disease management.

Abbreviations
CD: Crohn’s disease; CPF: Crohn’s perianal fistulas; ECCO: European Crohn’s and Colitis Organisation; IBD: inflammatory bowel disease; MDT: multidisciplinary team; UC: ulcerative colitis.

References
Atreja A, et al. MedGenMed. 2005;7:4.
Fathallah N, et al. Tech Coloproctol. 2023;doi: 10.1007/s10151-023-02765-7.
Garcia-Olmo D, et al. Dis Colon Rectum. 2022;65:713–20.
Geldof J, et al. Lancet Gastroenterol Hepatol. 2022;7:576–84.

© 2023 Takeda Pharmaceuticals International AG. All rights reserved. ​

These educational symposia were intended for healthcare professionals and were initiated, organized, and funded by ​Takeda Pharmaceuticals International AG, Thurgauerstrasse 130, 8152 Glattpark-Opfikon, Zurich, Switzerland.​

These programmes were not affiliated with ECCO.​

Date of preparation: April 2023 | VV-MEDMAT-84302