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12 Recent Developments in IBD
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Inflammatory bowel disease continues to be a topic of interest to Healio Gastroenterology readers, especially in recent weeks. In light of the recent FDA Advisory Committee’s support for Amgen’s biosimilar to Humira, the abundance of new research presented at Digestive Disease Week in San Diego, and numerous IBD studies published in the journals over the past 2 months, there has been a significant uptick in web traffic in our IBD news feed and our Ulcerative Colitis Resource Center.
Here we recap 12 of our most popular recent articles covering the latest developments in Crohn’s disease and ulcerative colitis.
1. FDA advisory committee unanimously recommends approval of biosimilar to Humira
Stephen B. Hanauer
The FDA Arthritis Advisory Committee voted 26-0 in favor of recommending the approval of ABP 501, Amgen’s proposed biosimilar to AbbVie’s Humira.
“Of note to gastroenterologists, similar to the recent Advisory Board and subsequent approval of the biosimilar to Janssen’s Remicade, the clinical trials supporting the approval did not include patients with either ulcerative colitis or Crohn’s disease. Members of both advisory panels were disturbed by the notion of 'extrapolation' without evidence in individual disease states,” Stephen B. Hanauer, MD, AGAF, FACG, professor of medicine at Northwestern University Feinberg School of Medicine in Chicago, told Healio Gastroenterology. Read more
2. IM-UNITI: Stelara maintains clinical remission through 1 year in patients with Crohn’s disease
William Sandborn
SAN DIEGO — Patients with moderate-to-severe Crohn’s disease maintained clinical remission after 1 year of treatment with Stelara, according to results from the phase 3 IM-UNITI maintenance study presented at DDW 2016.
“The results of this comprehensive phase 3 program — which included anti-tumor necrosis factor (TNF)-alpha naive, exposed and failure patients — demonstrate the potential of Stelara to provide significant benefit for patients in need of an effective therapy,” William Sandborn, MD, chief of the division of gastroenterology and professor of medicine at University of California, San Diego, said in a press release. Read more
3. Yoga improves quality of life in patients with ulcerative colitis
SAN DIEGO — A 12-week hatha yoga intervention reduced disease activity and improved quality of life and mental health in patients with ulcerative colitis, according to randomized controlled trial results presented at DDW.
“A 12-week yoga intervention for patients with ulcerative colitis improved quality of life and mental health, and influenced the colitis activity score. The effects persisted for at least 3 months after the end of the intervention, so yoga has potential as a complementary intervention for patients with ulcerative colitis,” Jost Langhorst, MD, from the department of integrative gastroenterology at University Duisburg-Essen in Germany, said during his presentation. Read more
4. VIDEO: Intense FMT induces remission in patients with resistant UC
Sudarshan Paramsothy
SAN DIEGO — In this exclusive video from DDW, Sudarshan Paramsothy, MD, from St. Vincent’s Clinical School, University of South Wales, Australia, discusses randomized controlled trial data showing intense multi-donor fecal microbiota transplantation was effective for inducing clinical and endoscopic remission in patients with resistant active ulcerative colitis.
“Our trial involved intensive fecal microbiota transplantation performed in a randomized double blind controlled study. Patients with active ulcerative colitis were randomized in a one-to-one manner to either FMT or placebo therapy,” he said. “We found that patients who received fecal microbiota transplantation had a significant improvement in their outcomes compared to the patients who were randomized to the placebo arm.” Watch now
5. Poor oral health linked to reduced risk for IBD
Jonas F. Ludvigsson
Researchers observed an inverse association between poor oral health and risk for developing inflammatory bowel disease in a Swedish population-based cohort study.
“Our data on a negative relationship between poor oral health and later IBD supports the ‘hygiene hypothesis,’” Jonas F. Ludvigsson, MD, PhD, from Karolinska Institutet and Örebro University Hospital in Sweden, and colleagues wrote. Read more
6. Less than 3% of IBD patients develop colorectal cancer after colectomy
Frank Hoentjen
The prevalence and incidence of colorectal cancer among patients with inflammatory bowel disease is less than 3% after colectomy and less than 1% after ileal pouch-anal anastomosis, according to the results of a systematic review and meta-analysis.
“The calculated prevalence and incidence for colorectal cancer following colectomy appeared relatively low, especially in the IPAA group. These findings may aid in developing individualized post-surgical surveillance strategies,” Frank Hoentjen, MD, from the Inflammatory Bowel Disease Center at Radboud University Medical Centre in The Netherlands, told Healio Gastroenterology. Read more
7. Mucosal healing strongly associated with positive clinical outcomes in IBD
In patients with inflammatory bowel disease, endoscopic mucosal healing is a significant predictor of favorable clinical outcomes, including fewer surgeries and hospitalizations and long-term clinical remission, according to the results of a meta-analysis.
“Our analysis demonstrates that in both CD and UC, across multiple medication regimens, endoscopic MH is strongly associated with lower rates of subsequent major surgeries, hospitalizations, and active disease,” the researchers concluded. “This provides the best evidence to date for the prognostic benefit of MH.” Read more
8. Vitamin D deficiency associated with mucosal inflammation in UC
Joel Pekow
Serum 25 hydroxyvitamin D concentrations were inversely associated with mucosal inflammation and disease activity in patients with ulcerative colitis, according to the results of a prospective study.
“The findings of this study support routine monitoring of serum vitamin D levels in patients with ulcerative colitis,” Joel Pekow, MD, assistant professor of medicine from the section of gastroenterology at University of Chicago Medicine, told Healio Gastroenterology. Read more
9. PSC common in patients with long-term IBD
Aida Kapic Lunder
Magnetic resonance cholangiography analysis showed presence of lesions associated with primary sclerosing cholangitis, indicating this liver disease was common in patients with long-term inflammatory bowel disease, according to results of a population-based study.
“We found the prevalence of PSC to be almost fourfold higher than that detected based on symptoms. PSC appears to progress in patients with subclinical disease, but long-term outcomes are not known,” Aida Kapic Lunder, MD, a PhD student and resident at the department of radiology, Akershus University Hospital and Oslo University, Norway, and colleagues wrote. Read more
10. Anti-TNFs effective for extraintestinal manifestations in IBD
Laurent Peyrin-Biroulet
Humira and Remicade appear to provide clinical benefit for some extraintestinal manifestations of inflammatory bowel disease, including musculoskeletal, cutaneous and ocular manifestations, and to a lesser degree in metabolic bone disease and hematologic or vascular manifestations, according to a systematic review.
“The results of this systematic review support the recommendations provided in the recent ECCO consensus document on the use of anti-TNF drugs for the management of EIMs in IBD patients,” Laurent Peyrin-Biroulet, MD, PhD, from the gastroenterology department at Lorraine University in Vandoeuvre, France, and colleagues wrote. Read more
11. Active IBD near conception increases relapse risk during pregnancy
Women with inflammatory bowel disease who have active disease near the time of conception have an increased risk for relapsing during pregnancy, according to prospective study data.
Investigators also found that women with ulcerative colitis were more likely to relapse during pregnancy than women with Crohn’s disease. Read more
12. Statins linked to reduced risk for new onset IBD
Jean-Frédéric Colombel
Ashish Atreja
Statins may protect against new onset inflammatory bowel disease, especially among older patients with Crohn’s disease, according to retrospective study data.
“The identification of interventions that may decrease the risk of developing IBD not only can highlight molecular pathways important in disease pathogenesis but also may lead to prevention strategies for patients at higher risk for IBD. Future prospective studies should confirm this beneficial effect of statins,” Jean-Frédéric Colombel, MD, Ashish Atreja, MD, MPH, and colleagues from the division of gastroenterology, Icahn School of Medicine at Mount Sinai, New York, wrote. Read more