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Risk stratification, algorithm helps utilize new IBD therapies in practice

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LAS VEGAS — In this exclusive video from the Crohn’s & Colitis Congress, Edward V. Loftus, Jr., MD, professor of medicine in the division of gastroenterology and hepatology at the Mayo Clinic, Rochester, Minn., and chief medical editor of Healio Gastroenterology and Liver Disease, discusses his keynote clinical presentation on how physicians can incorporate new therapies for inflammatory bowel disease into their current practice.

“First, I talked about risk stratification,” Loftus said. “You have to, when you first see a patient, decide are they a low-risk or a high-risk patient, and that will help you determine which pathway to go down in terms of medical therapy.”

Most patients with Crohn’s disease (about 70%) are going to be high-risk patients and require biologics, he noted.

“The choice of the biologic is complicated now because we have multiple choices,” but using the available data on the different options, providers can profile patients that may benefit from one drug over another, he said. “You can start developing these profiles of patients based on their past history, based on their age, etc., and maybe define algorithms for your own practice on how you’re going to use these biologics.”

Finally, he noted that the CALM study “is one of the first studies showing that using an algorithmic approach using objective endpoints, like driving down [C-reactive protein] and fecal calprotectin, resulted in higher rates of endoscopic remission at the end of a year, and this approach is going to lead to favorable outcomes in terms of fewer hospitalizations, and not at a cost of increased adverse events.”

Reference:

Loftus EV. Keynote Clinical Presentation: How to Incorporate New Therapies into Current Practice. Presented at: Crohn’s & Colitis Congress; Jan. 19-20, 2018; Las Vegas, NV.

Disclosures: Loftus reports financial relationships with AbbVie, Allergan, Amgen, Celgene, Celltrion, CVS Caremark, Eli Lilly, Genentech, Gilead, Janssen, MedImmune, Mesoblast, Pfizer, Robarts Clinical Trials, Salix, Seres, Takeda and UCB.