Breaking the Therapeutic Ceiling in Crohn's Disease
08/23/22 • 24 min
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Drs Peter Higgins and Bram Verstockt discuss breaking the therapeutic ceiling in Crohn's disease and the differential effectiveness of therapies and phenotypes in identifying responses to treatment.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967626). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Crohn's Disease https://emedicine.medscape.com/article/172940-overview
A Blood-Based Prognostic Biomarker in IBD https://gut.bmj.com/content/68/8/1386
Role of the IL23/IL17 Pathway in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042267/
A Study of Efficacy and Safety of Combination Therapy With Guselkumab and Golimumab in Participants With Moderately to Severely Active Ulcerative Colitis (VEGA) https://clinicaltrials.gov/ct2/show/NCT03662542
Results of Novel Clinical Study Show Adults With Moderately to Severely Active Ulcerative Colitis Achieved Higher Rates of Clinical Response, Clinical Remission, and Endoscopic Improvement at 12 Weeks With Guselkumab and Golimumab Combination Therapy Versus Either Monotherapy Alone https://www.prnewswire.com/news-releases/results-of-novel-clinical-study-show-adults-with-moderately-to-severely-active-ulcerative-colitis-achieved-higher-rates-of-clinical-response-clinical-remission-and-endoscopic-improvement-at-12-weeks-with-guselkumab-and-golimumab-301486054.html
Digestive Disease Week 2022 https://ddw.org/
Triple Combination Therapy in High Risk Crohn's Disease (CD) https://clinicaltrials.gov/ct2/show/NCT02764762
Anti-TNF and Crohn's Disease: When Should We Stop? http://www.eurekaselect.com/article/15866
Drs Peter Higgins and Bram Verstockt discuss breaking the therapeutic ceiling in Crohn's disease and the differential effectiveness of therapies and phenotypes in identifying responses to treatment.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967626). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Crohn's Disease https://emedicine.medscape.com/article/172940-overview
A Blood-Based Prognostic Biomarker in IBD https://gut.bmj.com/content/68/8/1386
Role of the IL23/IL17 Pathway in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042267/
A Study of Efficacy and Safety of Combination Therapy With Guselkumab and Golimumab in Participants With Moderately to Severely Active Ulcerative Colitis (VEGA) https://clinicaltrials.gov/ct2/show/NCT03662542
Results of Novel Clinical Study Show Adults With Moderately to Severely Active Ulcerative Colitis Achieved Higher Rates of Clinical Response, Clinical Remission, and Endoscopic Improvement at 12 Weeks With Guselkumab and Golimumab Combination Therapy Versus Either Monotherapy Alone https://www.prnewswire.com/news-releases/results-of-novel-clinical-study-show-adults-with-moderately-to-severely-active-ulcerative-colitis-achieved-higher-rates-of-clinical-response-clinical-remission-and-endoscopic-improvement-at-12-weeks-with-guselkumab-and-golimumab-301486054.html
Digestive Disease Week 2022 https://ddw.org/
Triple Combination Therapy in High Risk Crohn's Disease (CD) https://clinicaltrials.gov/ct2/show/NCT02764762
Anti-TNF and Crohn's Disease: When Should We Stop? http://www.eurekaselect.com/article/15866
Previous Episode
Anti–interleukin-23 Medications and Durable Remission for Patients With Crohn's Disease
Drs Peter Higgins and Raja Atreya discuss the phenomenon of durable drug free remission in a subset of patients with Crohn's disease and the future of intermittent induction and sequencing of therapies.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967625). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Efficacy and Safety of Mirikizumab in a Randomized Phase 2 Study of Patients With Crohn's Disease https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(21)03725-2
Long-Term Safety and Efficacy of Risankizumab Treatment in Patients with Crohn's Disease: Results from the Phase 2 Open-Label Extension Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8684487/
Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn's Disease: The IM-UNITI Trial https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(21)00203-2
Ustekinumab as Induction and Maintenance Therapy for Crohn's Disease https://www.nejm.org/doi/full/10.1056/NEJMoa1602773
Risankizumab as Induction Therapy for Crohn's Disease: Results from the Phase 3 ADVANCE and MOTIVATE Induction Trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00467-6/fulltext
Risankizumab as Maintenance Therapy for Moderately to Severely Active Crohn's Disease: Results from the Multicentre, Randomised, Double-Blind, Placebo-Controlled, Withdrawal Phase 3 FORTIFY Maintenance Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00466-4/fulltext
A37 Efficacy and Safety of Risankizumab as Maintenance Therapy in Patients With Crohn's Disease: 52 Week Results From the Phase 3 Fortify Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859234/
Th17 Cells in Inflammatory Bowel Disease: Cytokines, Plasticity, and Therapies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846404
Expansion of IL-23 Receptor Bearing TNFR2+ T Cells Is Associated With Molecular Resistance to Anti-TNF Therapy in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580782/
Comparative Efficacy and Safety of Biologic Therapies for Moderate-to-Severe Crohn's Disease: A Systematic Review and Network Meta-analysis https://linkinghub.elsevier.com/retrieve/pii/S2468-1253(21)00312-5
European Crohn's and Colitis Organisation https://www.ecco-ibd.eu/
Mercaptopurine Therapy and TPMT and NUDT15 Genotype https://www.ncbi.nlm.nih.gov/books/NBK100660/
Next Episode
Managing Crohn's Disease After Surgery
Drs Peter Higgins and Michael Chiorean discuss risk stratification, monitoring, and treatment of Crohn's disease after surgery.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967627). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Laparoscopic Ileocaecal Resection Versus Infliximab for Terminal Ileitis in Crohn's Disease: Retrospective Long-term Follow-up of the LIR!C Trial https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30117-5/fulltext
Infliximab Reduces Endoscopic, but Not Clinical, Recurrence of Crohn's Disease After Ileocolonic Resection https://www.gastrojournal.org/article/S0016-5085(16)00293-6/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
Crohn's Disease Management After Intestinal Resection: A Randomised Trial https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61908-5.pdf
Controlled Trial of Metronidazole Treatment for Prevention of Crohn's Recurrence After Ileal Resection https://www.gastrojournal.org/article/0016-5085(95)90121-3/pdf?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
Metronidazole https://reference.medscape.com/drug/flagyl-metronidazole-342566
Nitroimidazoles https://reference.medscape.com/drugs/nitroimidazoles
Ciprofloxacin for the Prevention of Postoperative Recurrence in Patients With Crohn's Disease: A Randomized, Double-blind, Placebo-Controlled Pilot Study https://academic.oup.com/ibdjournal/article/19/5/1073/4603177?login=true
Postoperative Therapy With Infliximab Prevents Long-term Crohn's Disease Recurrence https://www.cghjournal.org/article/S1542-3565(14)00053-6/fulltext
Mesalamine https://reference.medscape.com/drug/asacol-hd-pentasa-mesalamine-342074
Infliximab https://reference.medscape.com/drug/remicade-inflectra-infliximab-343202
Infliximab, Azathioprine, or Combination Therapy for Crohn's Disease https://www.nejm.org/doi/full/10.1056/nejmoa0904492
Adalimumab https://reference.medscape.com/drug/amjevita-humira-adalimumab-343187
What Is the Role of Fecal Calprotectin Levels in the Diagnosis of Inflammatory Bowel Disease (IBD)? https://www.medscape.com/answers/179037-54913/what-is-the-role-of-fecal-calprotectin-levels-in-the-diagnosis-of-inflammatory-bowel-disease-ibd
P115 Monitoring Faecal Calprotectin at 3 Months Post-Surgery Is Useful to Predict Further Postoperative Endoscopic Recurrence in Crohn's Disease https://academic.oup.com/ecco-jcc/article/13/Supplement_1/S145/5300800
Ustekinumab https://reference.medscape.com/drug/stelara-ustekinumab-345050
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