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12June2019

Y-ECCO Interview Corner: David Rampton

Charlotte Hedin, Y-ECCO Member

Charlotte HedinCharlotte Hedin
© ECCO

Early clinical trials, the advent of biologics and the IBD Nurse and how the clinical presentation of IBD has changed over a 46-year career: The interviewee in this issue is Professor David Rampton, who has had a long career as an IBD clinician and researcher in East London. Respected by colleagues and patients alike, his career has spanned an era during which much has changed in IBD.

Posted in ECCO News, Volume 14, Issue 2, Committee News, Y-ECCO

12June2019

Y-ECCO Literature Review: Rohit Rao

Rohit Rao

Rates and characteristics of postcolonoscopy colorectal cancer in the Swedish IBD population: What are the differences from a non-IBD population?

Stjärngrim J, Ekbom A, Hammar U, Hultcrantz R, Forsberg AM

Gut 2018 Dec 15; doi: 10.1136/gutjnl-2018-316651

Introduction

Rohit Rao 3
Rohit Rao 
© Rohit Rao

Individuals with IBD have an increased risk of colorectal cancer (CRC) [1, 2]. In an effort to address this, societal guidelines recommend surveillance colonoscopy 8–10 years after diagnosis and at varying intervals thereafter, depending on risk [3, 4]. A 2017 Cochrane systematic review [5] demonstrated a benefit in this strategy, noting reductions in the development of both CRC and the rate of CRC‐associated death. Despite this, dysplasia detection is challenging and CRC still accounts for 10%–15% of all IBD deaths [6, 7]. Of further concern is the reported increased rate of post-colonoscopy colorectal cancer (PCCRC) in IBD. 

Posted in Y-ECCO Literature Reviews, ECCO News, Committee News, Volume 14, Issue 2, Y-ECCO

12June2019

Y-ECCO Literature Review: Misha Kabir

Misha Kabir

Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn’s disease: A prospective, multicentre, cohort study

Kennedy NA, Heap GA, Green HD, Hamilton B, Bewshea C, Walker GJ, Thomas A, Nice R, Perry MH, Bouri S, Chanchlani N, Heerasing NM, Hendy P, Lin S, Gaya DR, Cummings JRF, Selinger CP, Lees CW, Hart AL, Parkes M, Sebastian S, Mansfield JC, Irving PM, Lindsay J, Russell RK, McDonald TJ, McGovern D, Goodhand JR, Ahmad T, UK Inflammatory Bowel Disease Pharmacogenetics Study Group*

Lancet Gastroenterol Hepatol. 2019;4:341–53

Introduction

Misha Kabir photo2
Misha Kabir 
© Misha Kabir

The anti-TNF monoclonal antibodies infliximab and adalimumab have been integral to the management of Crohn’s Disease over the past two decades. However, primary non-response and secondary loss of response in the first year of treatment remain common, at 10%–40% [1–3] and 23%–46% [4] respectively. Immunogenicity has been implicated as an important predictive factor for anti-TNF therapy failure. However, target-to-treat drug and anti-drug antibody concentrations have not yet been validated in an adequately powered prospective study. The Personalised Anti-TNF Therapy in Crohn’s Disease Study (PANTS) aimed to investigate the factors that predict primary non-response, non-remission and adverse events with anti-TNF therapy in luminal Crohn’s Disease.

Posted in Y-ECCO Literature Reviews, ECCO News, Committee News, Volume 14, Issue 2, Y-ECCO

12June2019

Y-ECCO Literature Review: Georgina Cunningham

Georgina Cunningham

Early combined immunosuppression may be effective and safe in older patients with Crohn’s disease: post hoc analysis of REACT

Singh S, Stitt LW, Zou G, et al.

Aliment Pharmacol Ther. 2019;49:1188–94.

Introduction

GCunningham photo
Georgina Cunningham 
© Georgina Cunningham

Due to the ageing population and the chronicity of the disease, increasing numbers of patients with Inflammatory Bowel Disease (IBD) are now over the age of 60 [1]. The management of IBD in this group poses some challenges, mainly centered on the balance between risk of immunosuppression and the burden of active disease [2]. Although older IBD patients usually display a more indolent disease course, they are more likely to be hospitalised and have higher in-hospital mortality than their younger counterparts [3]. There is no doubt that there is room for improvement in our management of IBD in elderly patients, and guidance is needed to help physicians decide whether more aggressive treatment strategies, widely accepted in certain younger IBD patients [4], are also warranted in this cohort, and especially those at high risk of disease complications.

Posted in Y-ECCO Literature Reviews, ECCO News, Committee News, Volume 14, Issue 2, Y-ECCO

12June2019

Y-ECCO Members’ Address

Dominik Bettenworth, Y-ECCO Chair

Dominik Bettenworth 2Dominik Bettenworth
© ECCO

Dear Y-ECCO Friends,

One of the main tasks of the Young ECCO Committee (Y-ECCO) is to offer Y-ECCO Members opportunities to expand their scientific skills and develop their own research projects. Following the last Y-ECCO Basic Science Workshop in Copenhagen, which was a great success in terms of attendance and participant feedback, plans for the 6th Y-ECCO Basic Science Workshop at the 15th Congress of ECCO in Vienna 2020 are already in full swing. The potential for the successful establishment of intestinal organoids will substantially expand the basic research on Inflammatory Bowel Diseases (IBD). In addition, experimental research should always focus on an effective translation of experimental results into the clinic in order to improve the treatment of our IBD patients in the long term. Therefore, organoids and translational basic science research will be the two main topics of the 6th Y-ECCO Basic Science Workshop. Fortunately, we were able to expand the structure of the workshop so that three awardees of the ECCO Research Fellowships Programme will present their results at the workshop and will also be available to answer all your questions regarding the pros and cons of a fellowship. 

Posted in ECCO News, Volume 14, Issue 2, Committee News, Y-ECCO

12June2019

Histopathological features of colitis due to immunotherapies

Magali Svrcek, H-ECCO Member

Magali Svrcek
Magali Svrcek
© ECCO

Immune checkpoints (ICK) are downregulators of T cell immunity. Immune checkpoint inhibitors (ICKi), by blocking the co-inhibitory receptors on T cells to activate their cytotoxic immune function, have become a major therapeutic tool in oncology, notably for the treatment of metastatic melanoma, non-small cell lung carcinoma, renal cell carcinoma, urothelial carcinoma and mismatch repair (MMR) deficient/microsatellite-unstable tumours. In particular, therapeutic monoclonal antibodies have emerged against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), which primarily inhibits T cell activation, and programmed cell death 1 (PD-1), which limits the effector function of activated T cells in the periphery. Food and Drug Administration-approved ICKi include ipilimumab (CTLA-4 inhibitor), pembrolizumab and nivolumab (anti-PD-1) and atezolizumab (anti-PD-L1).

Posted in ECCO News, Volume 14, Issue 2, Committee News, H-ECCO

12June2019

Microbiome and diet are partners in CD pathogenesis and treatment

Johan Van Limbergen 2019
Johan Van Limbergen 
© ECCO
Konstantinos Gerasimidis wrc 2015
Konstantinos Gerasimidis
© ECCO

Johan Van Limbergen1,2, Konstantinos Gerasimidis3

Crohn’s Disease (CD) is increasing in incidence worldwide [1]. In spite of increased use of immune suppression, which has markedly changed the need for in-hospital care, paediatric CD remains associated with considerable morbidity as well as increased mortality [2, 3]. The onset of disease in childhood and adolescence often interferes with growth and development, both physically and psychologically. In a subset of patients, the progressive nature of disease may be associated with a fibrotic phenotype that does not respond adequately to the currently available immune suppressive medications, yet use of these medications is still associated with increased risk of myelosuppression, opportunistic infections, immune-mediated phenomena and malignancy [2, 4–6]. 

Posted in ECCO News, Volume 14, Issue 2, Committee News, P-ECCO

12June2019

A New Member for the S-ECCO Committee in 2019!

Yves Panis, S-ECCO Chair

Yves Panis
Yves Panis © ECCO

As chair of the S-ECCO Committee, it is my pleasure to introduce a newly elected member for 2019, Pär Myrelid, who will stay for 3 years, up to February 2022. Thus, the current members of the S-ECCO Committee are: Michel Adamina (Winterthur, Switzerland) (who will be, after me, the next chair), Yves Panis (Clichy, France) (chair up to February 2020), Christianne Buskens (Amsterdam, who will stay up to February 2021), Hagit Tulchinsky (Tel Aviv, who will also stay up to February 2021) and Pär Myrelid.

Posted in ECCO News, Volume 14, Issue 2, Committee News, S-ECCO

12June2019

Future of D-ECCO

Marjo Campmans-Kuijpers, D-ECCO Chair

Marjo Campmans KuijpersMarjo Campmans-
Kuijpers © ECCO

The importance of nutrition in IBD Management is increasingly recognised. Of course, the best evidence that nutrition deserves a place in IBD Treatment is the fact that exclusive enteral nutrition (EEN) is the primary treatment in children with active Crohn’s Disease (CD). In addition, some dietary patterns are associated with the outcomes in IBD, and recently it was shown that partial enteral nutrition, accompanied by a special CD exclusion diet, is as effective as EEN and brings into remission even those patients who fail on biologics.

Posted in ECCO News, Volume 14, Issue 2, Committee News, D-ECCO

12June2019

New GuiCom 2019 - Viewpoint of a Surgeon as a New Member

Antonino Spinelli, GuiCom Member

Antonino Spinelli 2019Antonino Spinelli
© ECCO

GuiCom has earned the reputation of being one of the busiest ECCO Committees. Looking at the number and importance of the ongoing projects in 2019, it is evident that this fame is well deserved: it is sufficient to mention the near completion of the new Crohn’s Disease (CD) Guidelines and the launch of the upcoming Ulcerative Colitis (UC) Guidelines.

Posted in ECCO News, Volume 14, Issue 2, Committee News, GuiCom