Crohn's and Colitis Congress roundup: Intestinal ultrasound, cultural barriers in IBD
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Healio presents the following collection of stories from Crohn’s and Colitis Congress 2022. Topics include the effectiveness of intestinal ultrasound, cultural barriers in inflammatory bowel disease care, therapeutics coming down the IBD pipeline and more.
Intestinal ultrasound effective in detecting postoperative Crohn’s recurrence
Intestinal ultrasound is an accurate, noninvasive tool in the detection of postoperative Crohn’s disease recurrence, according to research presented at the Crohn’s and Colitis Congress.
“Surgery for Crohn's disease, unfortunately, is still common with a 10-year cumulative risk of 26%. We also know that endoscopic recurrence after resection is very common and patients who go untreated can have recurrence up to 90% in one year, and this is often clinically silent,” Michael Dolinger, MD, MBA, of the Icahn School of Medicine at Mount Sinai, said. “Colonoscopy is the gold standard. ... However, studies have shown that colonoscopy has poor compliance, is not without risk and is not ideal for repeated monitoring when patients have ulcerations at the scope. Less invasive monitoring tools for postoperative recurrence would be really valuable and important for patients.” Read more.
VIDEO: Cultural barriers, mental health can be ‘back breaking’ for IBD patients
In a Healio exclusive video, Tina Aswani Omprakash, a presenter at the Crohn’s and Colitis Congress, shares her experience with cultural competency as it relates to mental health and surgery for inflammatory bowel disease.
“Surgery isn’t a last resort,” Omprakash, a patient advocate for Crohn’s disease and founder of the blog Own your Crohn’s, said. “It never should be. It should always be considered a treatment option and not left to become an emergency.” Read more.
Mirikizumab reduces disease severity in Crohn’s, ulcerative colitis
Mirikizumab correlated with a greater reduction in disease severity among patients with ulcerative colitis and moderate to severe Crohn’s disease, according to a poster presentation at the Crohn’s and Colitis Congress.
“Mirikizumab, an anti-IL-23p19 inhibitor, has demonstrated efficacy in patients with ulcerative colitis and moderately to severely active Crohn’s disease in a phase 2, randomized, double-blind, placebo-controlled study,” David T. Rubin, MD, AGAF, chief of gastroenterology, hepatology and nutrition at the University of Chicago Medicine, and colleagues wrote. Read more.
Starting Entyvio within ‘30 days of diagnosis’ improved treatment response in UC
Patients with ulcerative colitis were more likely to respond to therapy if started on Entyvio within 30 days of diagnosis rather than if delayed by other initial treatments, according to a presenter at the Crohn’s and Colitis Congress.
“Patients with newly diagnosed ulcerative colitis are often prescribed corticosteroids, immunomodulators and [5-aminosalicylic acid],” Noa Krugliak Cleveland, MD, clinical instructor at the University of Chicago Medicine, told attendees. “Delayed initiation of biologic therapy may increase complications and consequent cost. However, data are lacking on the effects of early biologic therapy in patients with ulcerative colitis. The RALEE study aimed to investigate the effect of early vs. delayed initiation of vedolizumab on treatment outcomes and medical costs.” Read more.
No benefit seen with 5ASA combined with corticosteroids for acute, severe UC
Corticosteroids plus 5-aminosalicylic acid did not benefit patients with acute, severe ulcerative colitis compared with corticosteroids alone, according to a presenter at the Crohn’s and Colitis Congress.
“These results should inform our [inflammatory bowel disease] community, and specialists when they manage these challenging patients, to stop unnecessary 5ASA during hospitalization,” Shomron Ben-Horin, MD, professor of medicine at Sheba Medical Center in Tel Aviv, Israel, said during the presentation. “On the other hand, I think future studies are warranted to investigate this interesting exploratory signal of a better long-term outcome, at least as far as a reduced need for biologics by day 90 among the patient receiving the combination of corticosteroids with 5ASA.” Read more.
VIDEO: Want to get your work published? Expert advises ‘don’t give up’
In a Healio video exclusive, David T. Rubin, MD, chief of gastroenterology, hepatology and nutrition at the University of Chicago Medicine, outlines tips for getting your work published in a medical journal.
Originally presented at the Crohn’s and Colitis Congress with colleagues Fabio Cominelli, MD, PhD, of Case Western Reserve University, and Siddharth Singh, MD, of the University of California, San Diego, Rubin highlighted the importance of choosing the most appropriate journal, sending pre-submission inquiries, creating a compelling cover letter and more. Read more.
Novel endpoint is ‘reliable’ for assessment of endoscopic improvement in Crohn’s
The simplified endoscopic mucosal assessment of Crohn’s disease is highly effective in evaluating endoscopic improvement in patients, according to results presented at the Crohn’s and Colitis Congress.
“SEMA-CD is reliable, it is reproducible, and it is sensitive to change from before to after treatment,” Jeremy Adler, MD, MSc, clinical associate professor of pediatric gastroenterology at C.S. Molt Children’s Hospital at the University of Michigan, told attendees. “It is validated for use in both adult and pediatric patients and is considerably easier to use than SES-CD. Routine use of the SEMA-CD should enhance the quality of real-world evidence recorded in registries and recorded in clinical practice.” Read more.
Real-time intestinal ultrasound images promote shared understanding in IBD patients
According to a presenter at the Crohn’s and Colitis Congress, point-of-care intestinal ultrasound in pediatric patients with inflammatory bowel disease eliminates intolerable preparation and promotes shared understanding.
“We need to reframe the way in which we're using imaging for monitoring and managing IBD patients,” Michael Dolinger, MD, MBA, advanced pediatric IBD fellow at the Icahn School of Medicine at Mount Sinai, said. “We can actually use imaging for tight control to show patient’s inflammation, improvement and lack thereof and adjust treatment therapies early to alter the natural history of IBD. The way we can do this is incorporating point-of-care intestinal ultrasound into a tight-control monitoring algorithm.” Read more.
IBD patients using specific carbohydrate diet report symptom improvement
Patients with inflammatory bowel disease reported improvement in symptoms using a personalized specific carbohydrate diet, according to a presenter at the Crohn’s and Colitis Congress.
Ali Arjomand, PhD, director of Modulla Health in Washington, and colleagues developed My SCD Protocol, a customizable plan for patients with IBD, based on the specific carbohydrate diet (SCD). The digital protocol provides educational resources, self-assessment tools and instructions for patients interested in using the SCD. Read more.
IBD therapies ‘still plateauing’ despite progress: Combining drugs may help break ceiling
Despite the considerable progress made in the care of inflammatory bowel disease, current therapies are “still plateauing” in terms of response and remission, according to the keynote speaker at the Crohn’s and Colitis Congress.
However, combining therapies with “complementary mechanisms of action” may offer one strategy to help overcome this therapeutic plateau. Read more.
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