I did not have the opportunity to hear this #NASPGHAN20 lecture but Dr. Benchimol has shared his slides. Link to Dropbox Slides: IBD Clinical Science: Year in Review
Some of the key points on slides (links to articles below):
- Lots of data on COVID-19 and IBD. Steroids and Thiopurines are associated with more severe disease whereas anti-TNF agents are not
- Reviewed anemia in pediatric IBD guidelines (related blog post: Anemia in IBD -NASPGHAN position paper)
- Lower intestinal barrier function is associated with increased risk for development of Crohn’s disease
- More greenspace associated with lower rates of development of IBD
- Exome sequencing has shown ~3% of pIBD with genetic mutations linked to monogenetic IBD & 1% with mutations which could benefit from HSCT. Identifying specific defects may lead to other treatments as well (eg. Leflunomide for TTC7A deficiency). Related blog posts:
- How Very Early Onset IBD is Different
- Patterns and Puzzles with VEO-IBD This is a very good review and the image on this day has one of my favorite patient t-shirts.
- Underlying Genetic Disease in Pediatric IBD
- VEO-IBD -Useful Position Paper
- Early biologic therapy associated with better long-term outcomes in adult and pediatric IBD
- Reviewed data on adalimumab showing improvement in growth and relationship between good titers and clinical response (related post: IBD Update -September 2020)
- Important to consider adding azathioprine when starting a 2nd anti-TNF in cases of immune-mediated loss of response. X Roblin et al. BMJ; 2020; 69: 1206-1212. Addition of azathioprine to the switch of anti-TNF in patients with IBD in clinical relapse with undetectable anti-TNF trough levels and antidrug antibodies: a prospective randomised trial
Some screenshots:
Links to many of the referenced papers:
- The new SECURE-IBD papers:
https://gut.bmj.com/content/early/2020/10/26/gutjnl-2020-322539
https://www.cghjournal.org/article/S1542-3565(20)31399-9/fulltext - Intestinal barrier function is associated with increased risk for development of Crohn’s disease – https://www.gastrojournal.org/article/S0016-5085(20)35021-6/fulltext
- More greenspace associated with lower rates of development of IBD – https://journals.lww.com/ajg/pages/articleviewer.aspx?year=9000&issue=00000&article=99080&type=Abstract
- Early biologic therapy associated with better long term outcomes in adult and pediatric IBD – https://onlinelibrary.wiley.com/doi/abs/10.1111/apt.15685
Related links:
- Crohn’s and Colitis Canada guidance documents and webinars for patients with IBD
- Also, there will be a webinar for both patients and health care providers on November 19 with the SECURE-IBD steering committee as guests to go over the new data.
- The HCP webinar registration will be here: https://crohnsandcolitis.ca/About-Crohn-s-Colitis/COVID-19-and-IBD/For-Professionals/Webinars
gutsandgrowth 