Inflammatory Bowel Disease

This month’s cover story on pregnant women with inflammatory bowel disease covered all the relevant points. The important message is that the “enemy” here is not the medication — it’s the active Crohn’s disease or active ulcerative colitis. Treating the inflammation is of paramount importance, to maximize the chance of good pregnancy outcomes. The physicians interviewed said to develop a plan where you’re continuing the biologic throughout pregnancy. Trying to develop a plan to hold the drug in the last half of pregnancy makes things more complex, so it’s easier for patients and for providers to remember to just continue the biologic throughout pregnancy. There is a safety concern that if you do hold the biologic during the last half or last third of pregnancy, that will increase the risk for postpartum flare. The last thing a new mother needs is a flare of her IBD. It’s better all-around to just continue the medication. The main exceptions to this recommendation are methotrexate, which is totally contraindicated, and then to a lesser extent tofacitinib (Xeljanz, Pfizer) just because we don’t have enough data on it.

Inflammatory bowel disease is somewhat unique compared with other immune-mediated diseases. Its closest cousins, like rheumatoid arthritis, usually affect patients later in life.

For patients with inflammatory bowel disease, risk factors associated with severe COVID-19 infection included increasing age, comorbidities and corticosteroid use, according to an initial analysis of a large, international registry.

In this exclusive video, Anita Afzali, MD, from The Ohio State University Wexner Medical Center, discusses data she presented for Digestive Disease Week from a survey that assessed patient and provider perspectives on the management of inflammatory bowel disease.

In value-based care programs, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis may require more intense management compared with other chronic gastrointestinal conditions due to much higher cost volatility, according to data from DDW.

Administration of Remicade using a top-down approach was superior to step-up therapy in achieving clinical remission in children with Crohn’s disease, according to research from Digestive Disease Week.

Six months after investigating fatigue in patients with IBD, 26% of patients developed new onset fatigue, demonstrating the substantial impact of fatigue on patients with inflammatory bowel disease, according to data from Digestive Disease Week.

Patients’ clearance of Remicade was a ‘strong predictor’ of colectomy rates within 30 days, 6 months and 1 year of hospitalization for acute severe ulcerative colitis, according to data from Digestive Disease Week.

A gut-selective Janis kinase inhibitor called TD-1473 showed a trend toward reduced ulcerative colitis disease activity in a translational medicine program.

Patients who are obese and underwent treatment with either bariatric surgery or weight-loss medications compared with persistently obese patients not exposed to either intervention are at lower risk for development of de-novo inflammatory bowel disease, according to study results.