ECCO 23

Once remission is achieved is it feasible to stop biologic therapy? What are the reload rates? Are there biomarkers that could guide our choice?

Following diagnosis what should the best therapeutic strategy? Post-hoc analysis from RCTs has indicated that early introduction of biologics may improve outcomes, but real-world data are needed. Likewise, should top-down strategy include surgery?

Biologic therapy has been ineffective for preventing colectomy. Dr. João Pedro Guedelha Sabino explains how the Dutch cohort found colectomy reduced risk for PSC death/liver transplant.

Dr. Tim Raine discusses an epidemiological study looking at outcomes for Children newly diagnosed with Crohn's disease and treated either with initial central nutrition or with corticosteroids, and tracking long-term outcomes for these patients in terms of the need for hospitalization or exposure to biologics.

Dr. Tim Raine summarize for us the results of the study, which was a randomized controlled trial in patients hospitalized with acute severe colitis testing, Anakin versus placebo when given alongside standard of care with intravenous cortical steroids.

Dr. Joao Pedro Guedelha Sabino explains about how IBD is associated with several extra-intestinal risks, hence we need to asses and treat our patients accordingly.

Many IBD pts suffer from abdominal pain, urgency and fatigue. This is increasingly investigated and reported in clinical trials. Ins Katie nts with IBS-like symptoms several interventions can be used such as antidepressant drugs and dietary interventions such as the low FODMAP diet.

Early ileocecal resection was confirmed to be at least as good as early anti’-TNF treatment in ileocecal Crohn´s. The need for colectomy has not changed much over recent decades despite novel treatments. Pts with PSC and IBD do generally better after a proctocolectomy with ileostomy than when they haver a pouch or an ileorectal anastomosis.

The ECCO Scientific Committee has discussed postoperative current disease and research has been conducted to investigate how to prevent recurrence. RNA sequencing biopsies have identified networks with GPSF as a key player, and further research is needed to find a cure.

Advanced technologies are providing insights into how drugs may work, and a predictive biomarker has been designed to help identify patients who will benefit most from a given biological, aiding precision medicine in IBD.