• Managing Crohn's Disease After Surgery
    Sep 22 2022

    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

    Show more Show less
    25 mins
  • Breaking the Therapeutic Ceiling in Crohn's Disease
    Aug 23 2022

    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

    Show more Show less
    25 mins
  • Anti–interleukin-23 Medications and Durable Remission for Patients With Crohn's Disease
    Jul 21 2022

    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/

    Show more Show less
    26 mins
  • How Physicians Can Help Patients With Crohn's Disease Navigate Insurance Delays and Denials
    Jun 21 2022

    Drs Peter Higgins and Frank Scott discuss the challenges of delays in care for patients with Crohn's disease, how insurance denials and delays harm patients, and what doctors can do to help.

    Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/967624). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

    Resources

    Specialty Drug Coverage Varies Across Commercial Health Plans in the US https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.1553

    2021 AMA Prior Authorization (PA) Physician Survey https://www.ama-assn.org/system/files/prior-authorization-survey.pdf

    Corticosteroid Use and Complications in a US Inflammatory Bowel Disease Cohort https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918923/

    Increased Risk of Venous Thromboembolic Events With Corticosteroid vs Biologic Therapy for Inflammatory Bowel Disease https://www.cghjournal.org/article/S1542-3565(14)01045-3/fulltext

    Impact of Prior Authorization of Antiepileptic Drugs in Children With Epilepsy https://www.pedneur.com/article/S0887-8994(18)30151-6/fulltext

    Prior Authorization Delays Biologic Initiation and Is Associated With a Risk of Asthma Exacerbations https://pubmed.ncbi.nlm.nih.gov/33404389/

    Treatment Delays Associated With Prior Authorization for Infusible Medications: A Cohort Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062557/

    Delays Related to Prior Authorization in Inflammatory Bowel Disease https://publications.aap.org/pediatrics/article/149/3/e2021052501/184867/Delays-Related-to-Prior-Authorization-in

    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

    Variation In Use and Content of Prescription Drug Step Therapy Protocols, Within and Across Health Plans https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00822?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

    What Is Step Therapy/Fail First? https://www.crohnscolitisfoundation.org/get-involved/be-an-advocate/steptherapy

    H.R. 2163 – Safe Step Act https://www.congress.gov/bill/117th-congress/house-bill/2163

    Step Therapy's Balancing Act — Protecting Patients While Addressing High Drug Prices https://www.nejm.org/doi/10.1056/NEJMp2117582?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

    Battle Heats up Over Bill on "Step Therapy," Drug Rebates https://www.coloradopolitics.com/legislature/battle-heats-up-over-bill-on-step-therapy-drug-rebates/article_0f6e56c4-c0b8-11ec-9ead-47fa6f99ac6e.html

    Crohn Disease Pathology https://emedicine.medscape.com/article/1986158-overview#a6

    Show more Show less
    23 mins
  • Are We Any Closer to Intestinal Gene Therapy in Crohn's Disease?
    May 24 2022

    Drs Peter Higgins and Judy Cho discuss recent success in sickle cell anemia and whether we're any closer to using intestinal gene therapy in Crohn's disease. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/967621). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

    Resources

    Sickle Cell Anemia https://emedicine.medscape.com/article/205926-overview

    Crohn's Disease https://emedicine.medscape.com/article/172940-overview

    Inflammatory Bowel Disease https://emedicine.medscape.com/article/179037-overview

    CRISPR-Cas systems: Overview, Innovations and Applications in Human Disease Research and Gene Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508700/

    CRISPR-Cas9 Gene Editing for Sickle Cell Disease and β-Thalassemia https://www.nejm.org/doi/full/10.1056/NEJMoa2031054

    Biologic and Clinical Efficacy of LentiGlobin for Sickle Cell Disease https://www.nejm.org/doi/10.1056/NEJMoa2117175

    Causes of Crohn's disease https://medlineplus.gov/genetics/condition/crohn-disease/#causes

    IL-10R Polymorphisms Are Associated With Very-Early-Onset Ulcerative Colitis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744177/

    Characterization of Crohn Disease In X-Linked Inhibitor of Apoptosis-Deficient Male Patients and Female Symptomatic Carriers https://pubmed.ncbi.nlm.nih.gov/24942515/

    A Frameshift Mutation in NOD2 Associated With Susceptibility to Crohn's Disease https://www.nature.com/articles/35079114

    Extended Haplotype Association Study in Crohn's Disease Identifies a Novel, Ashkenazi Jewish-Specific Missense Mutation in the NF-κB Pathway Gene, HEATR3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785105/

    Autologous Stem Cell Transplant for Crohn's Disease https://www.mountsinai.org/clinical-trials/autologous-stem-cell-transplant-for-crohns-disease

    Stem-Cell Transplantation for Crohn's Disease: Same Authors, Different Conclusions? https://www.thelancet.com/journals/langas/article/PIIS2468-1253(17)30076-6/fulltext#%20

    A Myeloid-Stromal Niche and gp130 Rescue in NOD2-Driven Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284870/

    Expression of NOD2 in Paneth Cells: A Possible Link to Crohn's Ileitis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773866/

    Role of ATG16L, NOD2 and IL23R in Crohn's Disease Pathogenesis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270503/

    Show more Show less
    21 mins
  • Early Risk Markers, Interventions, and Prevention in Crohn's Disease
    May 24 2022

    Drs Peter Higgins and Jean-Frederic Colombel discuss exciting new evidence in Crohn's disease research that may help in identifying those at risk before disease starts and pave the way for a vaccine. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/967620). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

    Resources

    Inflammatory Bowel Disease https://emedicine.medscape.com/article/179037-overview

    Crohn Disease https://emedicine.medscape.com/article/172940-overview

    Ulcerative Colitis https://emedicine.medscape.com/article/183084-overview

    Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047110/

    Cohort Profile of the PRoteomic Evaluation and Discovery in an IBD Cohort of Tri-service Subjects (PREDICTS) Study: Rationale, Organization, Design, and Baseline Characteristics https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446072/

    Combined Serological, Genetic, and Inflammatory Markers Differentiate Non-IBD, Crohn's Disease, and Ulcerative Colitis Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792797/

    The GEM PROJECT https://crohnsandcolitis.ca/Research/Funded-research/The-gem-project

    Serum Zonulin Measured by Commercial Kit Fails to Correlate With Physiologic Measures of Altered Gut Permeability in First Degree Relatives of Crohn's Disease Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027468/

    Tofacitinib and Newer JAK Inhibitors in Inflammatory Bowel Disease — Where We Are and Where We Are Going https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007061/

    Effects of B-Cell Directed Therapy on the Preclinical Stage of Rheumatoid Arthritis: The PRAIRI Study https://ard.bmj.com/content/annrheumdis/78/2/179.full.pdf

    Longitudinal Analysis Reveals High Prevalence of Epstein-Barr Virus Associated With Multiple Sclerosis https://www.science.org/doi/10.1126/science.abj8222

    Digestive Disease Week abstracts https://ddw.org/education/abstracts/

    Serious Infections in Pediatric Inflammatory Bowel Disease 2002-2017 — A Nationwide Cohort Study https://www.jpeds.com/article/S0022-3476(21)00658-2/fulltext#%20

    GM-CSF Autoantibodies: Predictors of Crohn's Disease Development and a Novel Therapeutic Approach https://academic.oup.com/jcag/article/4/Supplement_1/5/6158591

    Show more Show less
    23 mins