Healio Gastroenterology and Liver Disease presents the following reports on the most recent research on inflammatory bowel disease
These reports include new research on loss of response in biologics, the impact of opioid exposure and the pregnancy-related challenges.
Inpatient opioids linked with future opioid use in IBD
Patients who received intravenous or non-intravenous opioids while in the hospital are more likely to be exposed to opioids after they are discharged, according to study results.
Gary R. Lichtenstein, MD, of the Perelman Center for Advanced Medicine at the University of Pennsylvania, and colleagues wrote that previous evidence has shown that opioid use is associated with severe infections and increased mortality among patients with IBD, as well as other complications. READ MORE
Intestinal ultrasound helps monitor response in ulcerative colitis
Assessing bowel wall thickness with intestinal ultrasound can be a helpful tool to monitor therapeutic response in patients with ulcerative colitis, according to study results published in Gut.
Christian Maaser , MD, of the outpatient department of gastroenterology at Lüneburg Hospital in Germany, and colleagues wrote that reliable, but non-invasive methods to assess mucosal healing are in high demand in the world of IBD. READ MORE
Switch to Entyvio after calcineurin inhibitor induction safe, effective for ulcerative colitis
Transitioning to Entyvio after achieving induction of remission with calcineurin inhibitor therapy is safe and effective for patients with ulcerative colitis, according to study results.
“While highly effective at inducing remission in patients with ulcerative colitis protracted use of calcineurin inhibitors [CNIs] is limited by adverse events, including infection, nephrotoxicity, hypercholesterolemia and hypertension. Consequently, their use in inflammatory bowel disease has been limited to induction therapy,” David T. Rubin, MD, section chief of gastroenterology, hepatology and nutrition, and co-director of the Digestive Diseases Center at the University of Chicago Medicine, and colleagues wrote. “[Entyvio’s (vedolizumab, Takeda)] impressive safety data makes it an ideal candidate agent for use as maintenance therapy in combination with the fast-acting CNIs as induction therapy.” READ MORE
Anti-TNF alpha not linked with recurrent, new primary cancers in IBD
Patients with inflammatory bowel disease and other immune-mediated diseases treated with anti-TNF alpha who previously had cancer are not at greater risk for recurrent or new primary cancers, according to the results of a population-based study.“Historically, clinicians have been concerned about whether [anti-TNF alpha] therapies predispose people to cancer, resulting in a reluctance to prescribe these medications to patients with a history of cancer,” Akbar K. Waljee, MD, of the division of gastroenterology and hepatology at the University of Michigan, and colleagues wrote. “Because [anti-TNF alpha] therapy is often avoided in patients with a history of cancer, little is known about the risk of recurrent cancers in association with anti-TNF use.” READ MORE
Pregnancy presents additional challenges in IBD
Pregnancy has the potential to present some difficult medical scenarios for women with inflammatory bowel disease. Sunanda V. Kane, MD, MSPH, FACG, of the Mayo Clinic in Rochester, Minnesota, told Healio Gastroenterology and Liver Disease that to manage these patients, there needs to be an emphasis on collaboration, the disease needs to be controlled beforehand if possible and physicians need to talk to the mother to find out her preferences at the beginning of the process. Finally, they need to know when to be aggressive to get the disease under control.
Kane participated in a discussion panel at Advances in IBD that presented several difficult cases involving pregnant women with IBD to help physicians manage some of the important scenarios that could come around during pregnancy. READ MORE
All C. difficile tests not created equal, especially among patients with IBD
Identifying Clostridioides difficile infection among patients with inflammatory bowel disease can be a particularly tricky task, according to Jessica Allegretti, MD, MPH, of the Brigham and Women’s Hospital Crohn’s and Colitis Center. Since both are diarrhea-predominant, there is a lot of symptoms overlap.
“Distinguishing between C. diff and IBD is very challenging,” Allegretti told Healio Gastroenterology and Liver Disease in an interview. “So how do you do that appropriately?” READ MORE
Testing for loss of response could shape future IBD care
Adding genetic testing to the management of patients with inflammatory bowel disease may present an opportunity to determine which patients are at greater risk for loss of response and help select the best therapies for each individual patient, according to an expert.
Jami Ann Rothe Kinnucan , MD, of Michigan Medicine, told Healio Gastroenterology and Liver Disease that identifying potential for loss of response is critical. READ MORE