Crohns & Colitis Foundation Perspectives

Hear from experts, patients, and caregivers as they discuss the latest in IBD in the Crohn’s & Colitis Foundation Perspectives series.

Hear from Michael Osso, President and CEO of the Crohn’s & Colitis Foundation, as he talks about the Crohn’s & Colitis Foundation Perspectives series on ReachMD.

Host: Brian P. McDonough, MD, FAAFP Guest: John D. Betteridge, MD Guest: Philip Stein, MD Guest: Thomas Judge, M.D. From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Brian McDonough moderates an expert gastroenterology panel exploring some of the top issues in IBD management: the best time for primary care clinicians to refer patients to GI, challenges to making an early diagnosis, and differences between IBD and IBS. Panel participants include: Dr. John Betteridge, Gastroenterologist at Lancaster General Hospital and Regional Gi Medical Center in Lancaster, PA Dr. Tom Judge, Gastroenterologist and Director of the Inflammatory Bowel Disease Center at Cooper University Health Care, and Associate Professor of Medicine at the Cooper Medical School of Rowan University Dr. Philip Stein, Pediatric Gastroenterologist at St. Christopher's Hospital and faculty member in the Department of Pediatrics at Drexel University College of Medicine

Host: Philip Stein, MD From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Philip Stein talks with Claire Griffin and Bill Johnson, patients and counselors at CCF's Camp Oasis. Claire and Bill discuss their respective involvements with the camp, why they made the decision to go, how they became their own personal advocates, and what Camp Oasis taught them about adjusting to their disease.

Host: Philip Stein, MD Guest: Neilanjan Nandi, MD Guest: Susan Peck, MSN, CRNP From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Philip Stein talks with Dr. Neilanjan Nandi and nurse practitioner Susan Peck about their respective experiences with The Crohn’s & Colitis Foundation's Camp Oasis. This camp gives children with IBD the opportunity to meet other kids with the same chronic illness, teaching them how to cope with their disease, manage their own medical needs, try new sports and activities, build confidence and independence, and most importantly, spend quality time just being a kid.

Host: Adam Ehrlich, MD, MPH Guest: Adam Kaufman, MD From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Adam C. Ehrlich talks with Dr. Adam Kaufman, Gastroenterologist at Main Line Gastroenterology Associates. Dr. Kaufman brings to the forefront the importance of preparing your IBD patient for travel. Discussion points include scheduling a pre-travel counsel visit, medication choices and proper storage procedures, vaccination considerations, blood clot prophylaxis, and travel insurance.

Host: Robert Frankel, MD Guest: Neilanjan Nandi, MD From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Robert Frankel talks with Dr. Neilanjan Nandi, Assistant Professor in the Division of Gastroenterology & Hepatology and Associate Director of the Gastroenterology Fellowship program at Drexel University College of Medicine. Dr. Nandi shares new insights on how to approach sexual and intimacy issues for IBD patients. Discussion points include quality of life measures, methods for maintaining healthy intimate relationships, respecting boundaries, and top health practitioner resources.

Infliximab Trough Levels at Induction to Predict Treatment Failure During Maintenance. Liefferinckx C1, Minsart C, Toubeau JF, Cremer A, Amininejad L, Quertinmont E, Devière J, Gils A, van Gossum A, Franchimont D. BACKGROUND: Infliximab (IFX) is indicated for the treatment of inflammatory bowel diseases (IBD). Nevertheless, loss of response (LOR) to IFX is reported in up to 10% to 30% of patients within the first year of treatment. Our objective was to evaluate the impact of the pharmacokinetics of IFX at induction on treatment failure. METHODS: This is a longitudinal cohort study on 269 patients with IBD treated with IFX in a single center. A total of 2331 blood samples were prospectively collected from 2007 until March 2015 with a retrospective analysis of clinical data. IFX trough levels (TLs) were measured by enzyme-linked immunosorbent assay. Antibodies to IFX were measured by drug-sensitive bridging assay. RESULTS: During follow-up, patients were defined according to treatment outcome. At week 6, med

From the 42nd Annual Renaissance Ball in Philadelphia benefiting the Crohn's & Colitis Foundation, host Lu Ann Cahn talks with Dr. David Piccoli, Chief of the Division of Gastroenterology, Hepatology and Nutrition, Director of the Biesecker PediatricLiver Center, and a board-certified pediatric gastroenterologist at Children's Hospital of Philadelphia. Dr. Piccoli discusses the RISK study, supported by the Crohn’s & Colitis Foundation, and the challenges patients face with response to treatment. This pediatric study enrolled 1,800 patients at the time of their diagnosis and collected clinical, genetic, treatment and microbiome information to help to determine how the immune system works over time.

From the 42nd Annual Renaissance Ball in Philadelphia benefiting the Crohn's & Colitis Foundation, host Lu Ann Cahn talks with Dr. Jose Fernando Del Rosario, head of Pediatric Gastroenterology at the Nemours Alfred I. duPont Hospital for Children in Wilmington, DE. Dr. Del Rosario and his department are the recipients of this year’s Gold Medallion Award from the Foundation. He discusses providing a positive experience for the patient and the importance of teaching children how to manage their health while living with a chronic condition, regaining quality of life and the most recent treatments for managing IBD, including nutritional therapy.

From the 42nd Annual Renaissance Ball in Philadelphia benefiting the Crohn's & Colitis Foundation, host Lu Ann Cahn talks with Michael and Ellen Araten, recipients of the Founders Award for the Philadelphia Chapter. The Aratens have been involved with the Foundation for over 20 years and discuss how the organization has assisted Ellen and her family upon her diagnosis. Ellen offers her perspective as a patient and the struggles she has overcome with the support of the organization.

Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study. Vavricka SR1, Gubler M, Gantenbein C, Spoerri M, Froehlich F, Seibold F, Protic M, Michetti P, Straumann A, Fournier N, Juillerat P, Biedermann L, Zeitz J, Misselwitz B, Scharl M, Heinrich H, Manser CN, Safroneeva E, Raja Ali RA, Rogler G, Schoepfer AM, Greuter T; Swiss IBD Cohort Study Group. BACKGROUND: Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti-tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution. METHODS: Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation. RESULTS: Of the 366 patient

Host: Adam Ehrlich, MD, MPH Guest: Alison Kaufman, PsyD Our body responds to stress and anxiety in a variety of ways. For patients with IBD, the body manifests stress into various psychological issues, creating a link between IBD and mental health. Dr. Alison Kaufman, a psychologist at Children’s Hospital of Philadelphia will discuss the common emotional reactions of IBD patients, suggesting ways for physicians to help these patients cope with their chronic disease. She is joined by Dr. Adam Ehrlich of Temple University.

Host: Adam Ehrlich, MD, MPH Guest: Philip Stein, MD The majority of adolescents with inflammatory bowel disease (IBD) will transition from a pediatric to an adult specialist. This process can be daunting, especially if patients are not ready to take control of their health care. However, with the right communication and preparation, the transition can be smooth for the patient, parent, and physician. Host Dr. Adam Ehrlich joins Dr. Philip Stein, a pediatric gastroenterologist at St. Christopher’s Hospital for Children, to discuss how physicians can best prepare patients to transition and overcome potential difficulties.

Host: Rebecca Kaplan Dealing with inflammatory bowel disease (IBD) on its own is difficult, but managing it with a professional athletic schedule is another task altogether. Dajuan Wagner, a former NBA player, was diagnosed with IBD early in his career. In this episode, he will discuss how he learned to manage his disease, and his advice for physicians treating IBD patients who are also athletes. He is joined by Rebecca Kaplan of the Crohn’s and Colitis Foundation.

Host: Rebecca Kaplan Guest: Michael E. Kwiatt, MD When should surgery be considered as a treatment option for patients with Crohn’s or colitis? Host Rebecca Kaplan of the Crohn’s and Colitis Foundation is joined by Dr. Michael Kwiatt, Assistant Professor of Surgery at Cooper University Hospital in New Jersey, to discuss when to consider surgery. Additionally, he will touch on the common surgical complications and differences in surgical approach for patients with respective diseases.

Host: Rebecca Kaplan Guest: Neil Nandi, MD For patients with Crohn's and Colitis diseases, fecal matter transplants could be the therapy they have been waiting for. Dr. Neil Nandi, Director of the Center for Inflammatory Bowel Diseases at Drexel University College of Medicine, will discuss what fecal transplants are, outline the risks and benefits of treatment, and forecast upcoming research. He is joined by Rebecca Kaplan of the Crohn's and Colitis Foundation.

Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease in Patients Naïve to or Who Have Failed Tumor Necrosis Factor Antagonist Therapy. Sands BE1, Sandborn WJ, Van Assche G, Lukas M, Xu J, James A, Abhyankar B, Lasch K. BACKGROUND: Vedolizumab is a gut-selective α4β7 integrin antagonist for the treatment of moderately to severely active Crohn's disease (CD). Aims of this study were to characterize the efficacy and safety of vedolizumab induction and maintenance therapy in patients who were naïve to tumor necrosis factor-alpha (TNF-α) antagonist therapy (TNF-naïve) or who had discontinued TNF-α antagonist therapy because of inadequate response (i.e., primary nonresponse), loss of response, or intolerance (collectively classified as the TNF-failure population). METHODS: Post hoc analyses of the efficacy data for 516 TNF-naïve and 960 TNF-failure patients from the GEMINI 2 and GEMINI 3 trials were evaluated at weeks 6, 10, and 52 and included clinical remission (CD Activity Index [CDAI] score ≤150

Making an appropriate diagnosis of inflammatory bowel disease (IBD) requires a variety of laboratory tests, serologic studies, imaging techniques and procedures such as endoscopies, and biopsies. While many methods are widely used when IBD is suspected based on symptoms and history, some confusion persists around newer diagnostic modalities such as MRE and capsule endoscopies, as well as the utility of emerging serologic biomarker tests. Additionally, uncommon presentations of IBD such as asymptomatic ileitis further complicate diagnostic workups. On this episode, Laura Wingate, Vice President of Education, Support, and Advocacy at the Crohn’s & Colitis Foundation, joins gastroenterologist Dr. David Binion, Co-Director at the IBD Center on Translational Research and Director of Nutrition Support Service at the University of Pittsburgh. The two discuss special diagnostic considerations for patients with IBD.

Host: Laura Wingate Guest: Kim Isaacs, MD Some of the most severe complications associated with ulcerative colitis are toxic megacolon, bleeding, fulminant colitis, and perforation of the bowel, while abscesses, intestinal bleeding, fistulas are more commonly associated with Crohn’s disease. While the development of emergency complications in IBD is uncommon, it can be life-threatening and result in permanent organ damage. On this episode focusing on IBD emergencies, host Laura Wingate, Vice President of Education, Support, and Advocacy at the Crohn’s & Colitis Foundation, welcomes gastroenterologist Dr. Kim Isaacs, Professor of Medicine and Co-director of the UNC Multidisciplinary Center for IBD Research and Treatment at University of North Carolina–Chapel Hill.