ACG highlights: 7 IBD updates
Healio Gastroenterology and Liver Disease presents a list of some of the top stories that included some of the top research and discussions pertaining to inflammatory bowel disease presented at the American College of Gastroenterology Annual Meeting
Our readers were most interested in research that identified predictors of response to Stelara, as well as research that analyzed a series of interventions in reducing opioid use among hospitalized patients with IBD.
Predictors of response to Stelara identified in Crohn’s
Researchers were able to identify predictors of response to Stelara in Crohn’s disease, and subsequently model those predictors into a decision-support tool model that helped predict both achievement of clinical remission and rapidity with which symptoms reduced.
“Several studies have looked and identified potential predictors of treatment outcomes, but the optimal approach to integrating these predictors and integrating the therapy into practice is uncertain and unknown,” Parambir S. Dulai, MBBS, a gastroenterologist at UC San Diego Health, said during his presentation at the American College of Gastroenterology Annual Meeting. “We wanted to create an easy to use prediction model that is a support tool to guide the use of ustekinumab in Crohn’s disease within the emerging paradigm of treatment options.” READ MORE.
Mesalamine most commonly prescribed Crohn’s disease treatment among older patients
Older patients with Crohn’s disease were less likely to receive biologic agents and more than twice as likely to receive mesalamine compared with younger patients, according to data presented at the American College of Gastroenterology Annual Meeting.
Researchers observed these findings from data on patients enrolled in TARGET-IBD, an observational cohort of more than 3,000 patients with inflammatory bowel disease receiving usual care at 34 community and academic practices across the United States. READ MORE.
VIDEO: IBD anti-TNF use in early pregnancy linked to preeclampsia risk
In this exclusive video from the American College of Gastroenterology Annual Meeting, Sunanda V. Kane, MD, a gastroenterologist and professor of medicine at Mayo Clinic in Rochester, Minnesota, discusses the results of a study that demonstrated that pregnant women with inflammatory bowel disease receiving anti-TNF therapy are at an increased risk for preeclampsia.
“We know that women with inflammatory bowel disease when they are pregnant are at increased risk for adverse pregnancy outcomes,” Kane told Healio Gastroenterology and Liver Disease. “Preeclampsia is one of those conditions that we believe is more prevalent in the IBD population because of the chronic inflammatory state and it’s interesting that we know that in preeclampsia that there are elevated levels of TNF-alpha.” READ MORE.
Entyvio exhibits favorable real-world safety profile in biologic-naive IBD patients
Entyvio was associated with significantly fewer serious adverse events and serious infections compared with anti-TNF therapy in biologic-naive patients with inflammatory bowel disease, according to data from the EVOLVE trial presented at the American College of Gastroenterology Annual Meeting.
Andres Yarur , MD, assistant professor of medicine at the Medical College of Wisconsin, said the findings offer a real-world perspective on how Entyvio (vedolizumab, Takeda) compares to anti-TNF therapy in practice. READ MORE.
Multimodal intervention reduces opioid use in hospitalized patients with IBD
A series of interventions promoting guidance and appropriate therapy for pain management significantly reduced opioid use among hospitalized patients with inflammatory bowel disease, according to research presented at the American College of Gastroenterology Annual Meeting.
Current data show that up to 70% of hospitalized patients with IBD receive opioids, although the drugs are associated with excess mortality and severe infectious complications among this patient population, according to Rahul S. Dalal, MD, of the department of medicine at the Perelman School of Medicine at the University of Pennsylvania and gastroenterology fellow at Brigham and Women’s Hospital. READ MORE.
Geriatric IBD mortality trend highlights need for ‘more standardized guidelines’
The odds of inpatient mortality were nearly four times higher among geriatric adults than adults aged younger than 75 years who were admitted to a hospital primarily for inflammatory bowel disease, according to data presented at the American College of Gastroenterology Annual Meeting.
The data further showed that the disparity in mortality was more than double the mortality difference of geriatric vs. nongeriatric patients with non-IBD hospital admissions. The findings underscore the importance of developing “more standardized guidelines and quality metrics tailored to the unique needs of the elderly population,” Jeffrey Schwartz, MD, physician in the division of internal medicine at Beth Israel Deaconess Medical Center, and colleagues reported. READ MORE.
More data needed on Xeljanz , venous thromboembolism risk in ulcerative colitis
A post hoc analysis evaluating the safety of Xeljanz in ulcerative colitis revealed comparable incidence rates of pulmonary embolism and deep vein thrombosis in patients who did and did not receive the agent. However, researchers at the American College of Gastroenterology Annual Meeting stressed the need for more data to better understand the link between the agent and venous thromboembolic events after previous safety signals led to a change in prescribing guidelines in the United States.
“On one level, these data are somewhat reassuring,” William J. Sandborn, MD, director of the inflammatory bowel disease center at University of California, San Diego Health, said during a presentation. “On the other hand, we still have a relatively small sample size. We should not overinterpret these findings.” READ MORE.