Crohns & Colitis Foundation Perspectives

Host: Louis J Cohen, MD Impact of Obesity on Short- and Intermediate-Term Outcomes in Inflammatory Bowel Disease: Pooled Analysis of Placebo Arms of Infliximab Clinical Trials. Siddharth Singh, MD, MS James Proudfoot, MS Ronghui Xu, PhDWilliam J Sandborn, MD Background: To assess whether obesity may affect natural history of inflammatory bowel diseases (IBD), we conducted an individual participant data (IPD) pooled analysis of placebo arms, using data from clinical trials of infliximab in IBD and using the Yale Open Data Access (YODA) Project. Methods: We obtained IPD from 4 placebo-controlled trials of infliximab in adults with IBD (ACCENT-I and ACCENT-II; ACT-1 and ACT-2). Patients were categorized into quartiles based on body mass index (BMI) or weight at time of trial entry. Primary outcome was clinical remission (Crohn’s disease activity index [CDAI]<150, Mayo Clinic Score <3); secondary outcomes were clinical response and mucosal healing. Using multivariable logistic regression analysis, we c

Host: Alka Goyal, MD Higher Postinduction Infliximab Serum Trough Levels Are Associated With Healing of Fistulizing Perianal Crohn’s Disease in Children. Wael El-Matary, MD, MSc Thomas D Walters, MD Hien Q Huynh, MDJennifer deBruyn, MD David R Mack, MD Kevan Jacobson, MD Mary E Sherlock, MDPeter Church, MD Eytan Wine, MD, PhD Matthew W Carroll, MD, Eric I Benchimol, MD, PhD Sally Lawrence, MD Anne M Griffiths, MD Background: There is some evidence in adults that higher serum infliximab (IFX) levels are needed to adequately treat fistulizing perianal Crohn's disease (CD). However, data in children are lacking. We aimed to determine postinduction serum trough IFX levels that are associated with healing of fistulizing perianal CD (PCD) at week 24. Methods: In a multicenter inception cohort study, consecutive children younger than age 17 years with fistulizing perianal CD treated with IFX between April 2014 and June 2017 who had serum trough IFX titers measured before the fourth infusion were included. Area

Host: Animesh Jain, MD Guest: David P. Hudesman, MD The number of IBD patients who find themselves with colorectal cancer has decreased over the past ten years due to better screening tools and medication. And to help continue that trend, Dr. Animesh Jain and Dr. David Hudesman discuss the unique risk factors and the importance of early screening at the second annual Crohn’s & Colitis Congress in Las Vegas.

Host: Alan C. Moss, MD To help ensure that you and your patients are on the same page, the Crohn’s & Colitis Foundation creates a Health Maintenance Checklist each year. Join Dr. Alan Moss as he breaks down this checklist at the second annual Crohn’s & Colitis Congress in Las Vegas.

Host: Alessandro Fichera, MD Guest: Judy Cho, MD At the second annual Crohn’s & Colitis Congress in Las Vegas, Dr. Alesandro Fichera and Dr. Judy Cho discuss the session that they co-moderated about the management of complicated IBD and the breakthroughs for Crohn's disease management that could limit your patients’ need for surgery.

Host: Maria T. Abreu, MD Guest: Michael Rosen, MD, MSCI Dr. Maria Abreu and the Medical Director of Schubert-Martin Inflammatory Bowel Disease Center Dr. Michael Rosen discuss one of the sessions at the second annual Crohn’s & Colitis Congress, entitled “Environmental Triggers and Stemming the Rising Tide of IBD.”

Host: Athos Bousvaros, MD, MPH Guest: Andrew B. Grossman, MD Recorded at the second annual Crohn’s & Colitis Congress in Las Vegas, Dr. Athos Bousvaros and Dr. Andrew Grossman discuss IBD among pediatric patients and how optimizing various therapies is critically important to achieving disease remission.

Host: Gary R. Lichtenstein, MD, FACG, FACP, AGAF Guest: Marla Dubinsky, MD Not every IBD patient fits into IBD care guidelines, which is why Dr. Gary Lichtenstein and Dr. Marla Dubinsky discuss the best ways to use these guidelines in your practice at the second annual Crohn’s & Colitis Congress in Las Vegas.

Host: Brent Polk, MD, AGAF Guest: Maria T. Abreu, MD Sit in on the conversation between the chair and co-chair of the Crohn’s & Colitis Congress Dr. Brent Polk and Dr. Maria Abreau, as they discuss highlights from the second annual conference held in Las Vegas and why this meeting is so important for clinicians and scientists alike.

Host: Kelly Issokson, MS, RD, CNSC Guest: James D. Lewis, MD, MSCE After the “Nutritional Therapy for IBD: From Theory to Your Practice” session at the second annual Crohn’s & Colitis Congress in Las Vegas, dietician Kelly Issokson and Dr. James Lewis recap the key takeaways, how you can implement those takeaways into your practice, and the benefits of recruiting dieticians and other healthcare professionals to provide your IBD patients with nutritional therapy.

Host: Laurie Keefer, PhD Guest: Joel R. Rosh, MD Joining Dr. Laurie Keefer at the second annual Crohn’s & Colitis Congress in Las Vegas to discuss one of the conference’s highly anticipated sessions is Dr. Joel Rosh, a pediatric gastroenterologist from Atlantic Health System.

Host: Damian Maseda, D.M.Sc., PhD Iron Sequestration in Microbiota Biofilms As A Novel Strategy for Treating Inflammatory Bowel Disease. Jean-Paul Motta, PhD Thibault Allain, PhD Luke E Green-Harrison, BScRyan A Groves, MSc Troy Feener, MSc Hena Ramay, PhD Paul L Beck, MD/PhDIan A Lewis, PhD John L Wallace, PhD Andre G Buret, PhD ABSTRACT: Significant alterations of intestinal microbiota and anemia are hallmarks of inflammatory bowel disease (IBD). It is widely accepted that iron is a key nutrient for pathogenic bacteria, but little is known about its impact on microbiota associated with IBD. We used a model device to grow human mucosa-associated microbiota in its physiological anaerobic biofilm phenotype. Compared to microbiota from healthy donors, microbiota from IBD patients generate biofilms ex vivo that were larger in size and cell numbers, contained higher intracellular iron concentrations, and exhibited heightened virulence in a model of human intestinal epithelia in vitro and in the nematode Caen

Host: Eva M. Szigethy, MD, PhD Guest: Megan E. Riehl, PsyD Psychosocial disorders like anxiety and depression can be especially severe when combined with the physical symptoms of IBD. Fortunately, there are ways gastroenterologists, primary care providers, and mental health specialists can all work together to address these effects as early as possible, as Dr. Megan Riehl, Clinical Assistant Professor of Medicine and Clinical Psychologist at the University of Michigan, explains.

Host: Lu Ann Cahn Guest: James D. Lewis, MD, MSCE Whether they’re not getting enough calories or not eating a balanced diet due to disease restrictions, patients with IBD often have difficulty maintaining a healthy diet. So how can you help them navigate these diet and nutrition challenges? Filmed live at the 2018 Crohn's and Colitis Evening of Hope, Dr. James Lewis from the University of Pennsylvania discusses strategies you can implement in your practice.

Host: Jennifer Caudle, DO Guest: Fabrizio Michelassi, MD As a gastrointestinal surgeon and Chairman of Surgery at Weill Cornell, Dr. Fabrizio Michelassi has witnessed the possible complications that can stem from Crohn's disease. He joins Dr. Jennifer Caudle to provide his perspective on new surgical approaches to treat strictures and fibrostenotic complications.

Guest: Shail Govani, MD, MSc Incidence and Predictors of Success of Adalimumab Dose Escalation and De-escalation in Ulcerative Colitis: a Real-World Belgian Cohort Study. Saartje Van de Vondel, MD, Filip Baert, MD, PhD, Christine Reenaers, MD, PhD, Stijn Vanden Branden, MD, Leila Amininejad, MD, Pieter Dewint, MD, PhD, Wouter Van Moerkercke, MD, Jean-François Rahier, MD, PhD, Pieter Hindryckx, MD, PhD, Peter Bossuyt, MD, Marc Ferrante, MD, PhD, and Belgian IBD Research and Development (BIRD) BACKGROUND: Adalimumab (ADM) has been shown efficacious in ulcerative colitis (UC). In randomized controlled trials, dose escalation from 40 mg ADM every other week to 40 mg every week was required in 20%–25% of patients within 1 year. Real-life data suggest higher escalation rates. Attempts for dose de-escalation have not been studied yet. We assessed the need for, outcome of, and predictors of dose escalation and de-escalation in a large retrospective cohort of UC patients treated with ADM. METHODS: We included 231

Guest: Yash Mittal, MD Reliability of Measuring Ileo-Colonic Disease Activity in Crohn's Disease by Magnetic Resonance Enterography. Vipul Jairath, MD, PhD, Ingrid Ordas, MD, PhD, Guangyong Zou, PhD, Julian Panes, MD, Jaap Stoker, MD, PhD, Stuart A Taylor, MD, Cynthia Santillan, MD, Karin Horsthuis, MD, Mark A Samaan, MD, Lisa M Shackelton, PhD, Larry W Stitt, MSc, Pieter Hindryckx, MD, PhD, Reena Khanna, MD, William J Sandborn, MD ,Geert D'Haens, MD, PhD, Brian G Feagan, MD, Barrett G Levesque, MD, and Jordi Rimola, MD, PhD BACKGROUND: Magnetic resonance enterography is increasingly utilized for assessment of luminal Crohn's disease activity. The Magnetic Resonance Index of Activity and the London Index are the most commonly used outcome measures in clinical trials. We assessed the reliability of these indices and several additional items. METHODS: A consensus process clarified scoring conventions and identified additional items based on face validity. Four experienced radiologists evaluated 50 images i

The Crohn’s & Colitis Foundation, in partnership with the American Gastroenterological Association, will hold their 2nd Annual Congress from February 7 - 9, 2019 at the Bellagio Hotel in Las Vegas. To give you an inside look into the premier meeting for all IBD professionals and researchers, here’s a special message from Michael Osso, President & CEO of the Crohn’s & Colitis Foundation. For more information and to register, please go to: www.crohnscolitiscongress.org.

Host: Jennifer Caudle, DO For many IBD patients and their parents, becoming involved with advocacy groups provides an excellent support system, especially since this can be a difficult disease to manage. But some also use these groups to make a difference not only locally, but also nationally. Sharing his personal-turned-professional journey with Dr. Jennifer Caudle is Frank Russomano, President and CEO of ReachMD, who is also joined by the President & CEO of the Crohn’s & Colitis Foundation, Michael Osso.

Host: Jennifer Caudle, DO With no cure for inflammatory bowel disease, or IBD, currently available, educating healthcare professionals and their patients on the best ways to manage IBD is essential. That’s why the Crohn’s & Colitis Foundation created training programs as part of their mission to eradicate these painful diseases, and here to talk more about these resources and programs with Dr. Jennifer Caudle is Michael Osso, President & CEO of the Crohn’s & Colitis Foundation.