IBD MD at University of Colorado. Clinician and researcher. Tweets my own. Retweet not endorsement.
Joined May 2018
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🙏 @IBDimmunology They are likely localized CD as @JeanFredericCo1 referenced. IMO induced by microenvironment tissue trauma/ischemia. 🧐 that isolated anastomotic ulcers generally stay localized and less likely to progress than ileal. So it seems more “contained”
‼️Important HBV reaction prevention in IBD pts. Note JAKi mod risk > aTNF in sAg(-), cAb(+) -> antiviral ppx. @GI_PharmD @JHashashMD @fudmanMD @Waseem_AhmedMD @IBDPharmD
gastrojournal.org/article/S0…
Crowdsourcing IBD journal club ideas. What are your biggest clinical impact recent articles? @fudmanMD @DCharabaty @IBDimmunology @Waseem_AhmedMD @EdwardLoftus2 @MLongMD @Bealoquebea
Ben Click retweeted
Maybe time to just get the C diff test?
The first RCT of GI-PCR for acute diarrhea
👎more antibiotic use in PCR arm
👉no difference in any outcome
🤷♂️less time in isolation for PCR arm
This test is 💩, friends
Instead:
Supportive care
Test sparingly
Mostly cdiff
thelancet.com/action/showPdf…
Makes sense and highlights 💊💉needs after ASUC 🏥, but still high (~50%) rate of “treatment failure” in IVCS responsive -> IFX + AZA. ? rapid steroid taper in IFX. ? No proactive TDM in high risk pop. Other thoughts? @Waseem_AhmedMD @berinsj @IBDimmunology
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Yeah that was an immediate “WTF” call. Turns out their system just messed up and they meant Remicade. Thanks for the unnecessary work CVS
Ben Click retweeted
🚨AGA New Guideline Alert🚨
🔗gastrojournal.org/article/S0…
▶️AGA Living Guideline: Pharmacological Management of Moderate-Severe Ulcerative Colitis
I’ll break down its 14 recommendations down over the next 7 tweets 🧵 👇
#AGA #GI #UC #IBD #MedTwitter
1/9
First non aTNF to demonstrate efficacy in RCT to 🛑 endo recurrence. Good option and reassuring data to have.
Vedolizumab to prevent postoperative recurrence of Crohn's disease (REPREVIO): a multicentre, double-blind, randomised, placebo-controlled trial - The Lancet Gastroenterology & Hepatology thelancet.com/journals/langa…
Ditto, maybe even higher which is largely patient driven selection. Virtual care for IBD in Medicare in danger of pre-2020 coverage unless new legislation passed by 1/2025.
Ben Click retweeted
More RWE that combo-AT effective in refractory IBD (n=79) @jensemineriomd
🟢Mean Mayo 3▶️1
🟢Mean SES-CD 12▶️4
🟢73% clin improvement
🔴47% AEs (URIs and derm issues mostly)
bit.ly/4fm80WI
Always several year lag behind new recommendation/intervention and routine clinical uptake. Need time to educate community providers. Hopefully will 📈 next few years.
Ben Click retweeted
@ABennettMD did an amazing job at #ACG2024 presenting a multi-center study evaluating outcomes in transgender pts with IBD on gender affirming hormones!
@VUMCibd @VictorChedidMD @KiraNewmanMDPhD @JustinFieldMD @BenClickMD
Not pertinent to case as still endo active dz, albeit better, but in absence of endo dz, no prospective data that treat to histo healing improves clin outcomes. So histo is 👍 if achieved but I do not (yet) treat to proactively. If histo nl in case, 🤔 sampling
Yup. SC is modeled for AUC. Similar findings to Roblin et al. May need higher “targets” for SC IFX to equate to IV
pubmed.ncbi.nlm.nih.gov/3793…
