Intestinal ultrasound, cultural barriers in IBD

February 05, 2022

4 minute read

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Healio presents the following collection of stories from the 2022 Crohn’s and Colitis Congress. Topics include the effectiveness of bowel ultrasound, cultural barriers in inflammatory bowel disease care, upcoming therapies in the IBD pipeline and more.

Intestinal ultrasound effective in detecting postoperative Crohn’s recurrence

Bowel ultrasound is an accurate, non-invasive tool in detecting postoperative Crohn’s disease recurrence, according to a study presented at the Congress on Crohn’s Disease and Colitis.

“Surgery for Crohn’s disease is unfortunately still common with a 10-year cumulative risk of 26%. We also know that endoscopic recurrence after resection is very common and patients who are left untreated can have up to 90% recurrence within a year, and this is often clinically silent,” Michael Dolinger, MD, MBA, from 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 repeat monitoring when patients present with range ulcerations. Less invasive monitoring tools for postoperative recurrences would be truly valuable and important for patients. Read more.

VIDEO: Cultural Barriers and Mental Health Can Be ‘Terrifying’ for IBD Patients

In an exclusive Healio video, Tina Aswani Omprakash a conference speaker on Crohn’s disease and colitis, shares her experience with cultural competence as it relates to mental health and inflammatory bowel disease surgery.

“Surgery is not a last resort,” said Omprakash, a Crohn’s disease patient advocate and founder of the Own your Crohn’s blog. “That should never be the case. It should always be considered a treatment option and not become an emergency. Read more.

Mirikizumab reduces severity of Crohn’s disease, ulcerative colitis

Mirikizumab was correlated with a greater reduction in disease severity in 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, demonstrated efficacy in patients with ulcerative colitis and moderate to severe 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 his colleagues wrote. Read more.

Starting Entyvio within 30 days of diagnosis improved treatment response in UC

According to a presenter from Crohn’s and Colitis Congress, patients with ulcerative colitis were more likely to respond to treatment if they were started on Entyvio within 30 days of diagnosis rather than if they were delayed by other initial treatments.

“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 associated costs. 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 or Delayed Initiation of Vedolizumab on Treatment Outcomes and Medical Costs.” Read More.

No benefit observed with 5ASA plus corticosteroids for acute and severe UC

Corticosteroids plus 5-aminosalicylic acid were not beneficial for patients with acute and severe ulcerative colitis compared to corticosteroids alone, according to a presenter at Crohn’s and Colitis Congress.

“These results should inform our [inflammatory bowel disease] community and specialists when managing these difficult 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 believe that future studies are warranted to investigate this interesting exploratory signal of better long-term outcome, at least with respect to a reduced need for biologics at day 90 in the patient receiving the combination of corticosteroids with 5ASA.” Read More.

VIDEO: Want to publish your work? Expert advises ‘don’t give up’

In an exclusive Healio video, David T. Rubin, MD, chief of the department of gastroenterology, hepatology, and nutrition at the Medical University of Chicago, gives advice on getting your work published in a medical journal.

Originally presented at Crohn’s Disease and Colitis Congress with Colleagues fabio CominelliMD, PhD, from Case Western Reserve University, and Siddharth Singh, MD, from the University of California, San Diego, Rubin highlighted the importance of choosing the most appropriate journal, sending out pre-submission inquiries, creating a compelling cover letter and more. Read more.

New endpoint is ‘reliable’ for assessing endoscopic improvement in Crohn’s disease

Simplified endoscopic assessment of Crohn’s disease mucosa is highly effective in assessing endoscopic improvement in patients, according to findings presented at the Congress on Crohn’s Disease and Colitis.

“SEMA-CD is reliable, reproducible and sensitive to changes from before to after treatment”, Jeremy Adler, MD, MSc, clinical associate professor of pediatric gastroenterology at CS Molt Children’s Hospital at the University of Michigan, told attendees. “It is validated for use in adult and pediatric patients and is considerably easier to use than the SES-CD. Routine use of the SEMA-CD should improve 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 patients with IBD

Point-of-care bowel ultrasound in pediatric patients with inflammatory bowel disease eliminates intolerable preparation and promotes shared understanding, according to a Crohn’s Disease and Colitis Congress presenter.

“We need to reframe how we use imaging to monitor and manage patients with IBD,” Michael Dolinger, MD, MBA, advanced fellow in IBD pediatrics at the Icahn School of Medicine at Mount Sinai, said. “We can actually use imaging for tight control to show the patient’s inflammation, improvement and absence of inflammation and adjust treatment therapies early to alter the natural history of IBD. The way we can do this is to integrate point-of-care bowel ultrasound into a tight-control monitoring algorithm. Read more.

Patients with IBD who follow a specific carbohydrate diet report improved symptoms

According to a Crohn’s disease and colitis congress presenter, patients with inflammatory bowel disease have reported improvement in symptoms using a specific personalized carbohydrate diet.

Ali Arjomand, PhD, director of Modulla Health in Washington, and his colleagues developed My SCD Protocol, a customizable plan for IBD patients 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.

Despite Advances, IBD Therapies Still ‘Cap’: Drug Combination May Help Break the Cap

Despite significant advances in the management of inflammatory bowel disease, current therapies are still “plateauing” in terms of response and remission, according to the Congressional Keynote Speaker on Crohn’s Disease and Colitis.

However, combining therapies with “complementary mechanisms of action” may offer a strategy to help overcome this therapeutic plateau. Read more.

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