Here are some selected slides and notes from this year’s NASPGHAN’s postrgraduate course. There may be errors in omission or transcription on my part.
Link to the full NASPGHAN PG Syllabus 2019 (Borrowed with permission)
– Intestinal Inflammation Session
192 David T. Rubin, MD, University of Chicago Positioning the new IBD therapies: Merging experience with evidence
Some key points:
- Ustekinumab escalation can increase response. Optimization in CD patients with loss of response led to recapture of response in 69% of patients
- Tofacitinib –given black warning, will likely be used in more refractory patients
- May be able retry a previous therapy (Chicago protocol in slide below)
As an aside, while Dr. Rubin is an excellent speaker, my view is that there are so many terrific pediatric IBD specialists, I would favor having a pediatric IBD specialist give this talk at our postgraduate course. (Some might argue that adult IBD specialists would have more experience with emerging therapies.)
204 Anne Griffiths, MD, FRCPC, Hospital for Sick Children Immunosuppressive therapy in IBD: Can we de-escalate therapy?
- High rate of relapse when biologic therapy is stopped. Use of an immunomodulator may reduce the relapse rate when stopping an anti-TNF agent
215 Stacy Kahn, MD, Boston Children’s Hospital When it is not IBD … rare forms of intestinal inflammation
- For patients with milder microscopic colitis, antidiarrheal agents can be given. For more severe disease, budesonide is effective.
223 Edaire Cheng, MD, UT Southwestern Medical Center Eosinophilic inflammation beyond the esophagus
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