gastroenterology and hepatology

Host: Neilanjan Nandi, MD
Guest: Monica Schwartzman, MD, MS

It's currently estimated that 50 percent of IBD patients experience some form of joint stiffness, otherwise known as arthralgia. With so many patients being affected, how can you determine if it’s inflammatory or noninflammatory arthralgia and treat it appropriately? To find out, Dr. Neil Nandi speaks with Dr. Monica Schwartzman, assistant attending physician at the Hospital for Special Surgery and Clinical Instructor of Medicine at Weill Cornell Medical College. Together, they’ll discuss the screening tools gastroenterologists can use to differentiate the types of arthralgia in their patients as well as key management approaches.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Emily Carroll, JD, MSW

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Emily Carroll, JD, MSW

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Emily Carroll, JD, MSW

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Emily Carroll, JD, MSW

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Host: Neilanjan Nandi, MD, FACP
Guest: Sergio Schwartzman, MD

Inflammatory bowel disease (IBD) has long been associated with the development of arthritis, which can be detected in up to 30 percent of IBD patients. So how can gastroenterologists and rheumatologists work together to detect and manage IBD-associated arthritis? To find out, Dr. Neil Nandi speaks with rheumatologist Dr. Sergio Schwartzman about IBD-associated arthritis.

Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Russell D. Cohen, MD, FACG, AGAF

Are patients with inflammatory bowel disease (IBD) at increased risk for COVID-19 infection? And what should we recommend for an IBD patient in remission who tests positive for COVID-19 versus a patient with active disease? These are just some of the questions that have arisen since the onset of the COVID-19 pandemic, and the questions Dr. Peter Buch explores with Dr. Russell Cohen, Director of Inflammatory Bowel Disease Center and Co-Director of the Advanced IBD Fellowship Program at the University of Chicago School of Medicine.

Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Asher A. Kornbluth, MD

Since the onset of the COVID-19 pandemic, many questions have arisen regarding the care of our patients with IBD. Are they at increased risk of COVID-19? How should we treat a patient with IBD who has active COVID-19? Should they get vaccinated, and if so, when? These are all questions Dr. Peter Buch addresses with Dr. Asher Kornbluth, Clinical Professor of Medicine and Gastroenterology at Mount Sinai School of Medicine in New York, to help us optimize our approach to care amid the COVID-19 pandemic.

Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Andres Nieto, MD

The COVID-19 pandemic has demonstrated the effectiveness of telemedicine, but will this approach still be utilized after the pandemic ends? Dr. Peter Buch is joined by Dr. Andres Nieto, Assistant Professor at Frank H. Netter MD School of Medicine, to discuss the role of telemedicine and its future

Host: Neilanjan Nandi, MD
Guest: Folasade P. May, MD, PhD, MPhil

Racial and ethnic bias prevent patients with colorectal cancer from receiving the highest quality of care. Dr. Neil Nandi is joined by Dr. Fola May, Assistant Professor of Medicine at UCLA, to discuss racial inequalities in access to care and screening for patients with colorectal cancer.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Frank Scott

Dr. Charles Turck is joined by Dr. Frank Scott from the University of Colorado School of Medicine to share some highlights from his session, “Challenges and New Approaches to Managing IBD in the COVID-19 Era,” at Crohn’s & Colitis Congress 2021.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Frank Scott

Dr. Charles Turck is joined by Dr. Frank Scott from the University of Colorado School of Medicine to share some highlights from his session, “Challenges and New Approaches to Managing IBD in the COVID-19 Era,” at Crohn’s & Colitis Congress 2021.

Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Myron Brand, MD

While many know that COVID-19 can affect the respiratory system, but how can this disease also influence the gastrointestinal tract? Tune in to hear Dr. Peter Buch discuss with Dr. Myron Brand, a Clinical Professor of Medicine, Yale University School of Medicine, the impact of COVID-19 on the GI system and GI disorders.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Michael D. Kappelman, MD, MPH

Pediatric care has evolved amid the COVID-19 pandemic. And when it comes to treating inflammatory bowel disorder, or IBD, gastroenterologists are faced with a unique set of challenges. Join us as Dr. Kappelman shares highlights of his presentation at the 2021 Crohn’s & Colitis Congress on what needs to be acknowledged while treating children with IBD during the COVID-19 pandemic.

Host: Charles Turck, PharmD, BCPS, BCCCP
Guest: Maria M. Oliva-Hemker, MD

With current treatment approaches in mind, how do immunomodulators fit into the therapeutic landscape for inflammatory bowel disorders, or IBD? In preparation for the 2021 Crohn’s & Colitis Congress, Dr. Charles Turck speaks with Dr. Maria Oliva-Hemker from Johns Hopkins University School of Medicine about her presentation at the event.

Host: Neilanjan Nandi, MD, FACP
Host: Peter Buch, MD, FACG, AGAF, FACP

Facing winter during the COVID-19 pandemic has been challenging for many patients. What are some ways gastroenterologists can protect the health of their patients this season? Tune in to hear our GI Insights hosts Dr. Neil Nandi and Dr. Peter Buch share some tips on how you keep your patients safe throughout the wintertime.

Host: Ivy Ka Man Law, PhD

A Specific Mutation in Muc2 Determines Early Dysbiosis in Colitis-Prone Winnie Mice

Marina Liso, Stefania De Santis, Giulio Verna, Manuela Dicarlo, Maria Calasso, Angelo Santino, Isabella Gigante, Rajaraman Eri, Sathuwarman Raveenthiraraj, Anastasia Sobolewski, Valeria Palmitessa, Antonio Lippolis, Mauro Mastronardi, Raffaele Armentano, Grazia Serino, Maria De Angelis, Marcello Chieppa

Background: Inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), is a multifactorial disorder characterized by chronic inflammation and altered gut barrier function. Dysbiosis, a condition defined by dysregulation of the gut microbiome, has been reported in patients with IBD and in experimental models of colitis. Although several factors have been implicated in directly affecting gut microbial composition, the genetic determinants impacting intestinal dysbiosis in IBD remain relatively unknown.

Methods: We compared the microbiome of normal, uninflamed wild-type (WT) mice with that of a murine model of UC (ie, Winnie strain). Winnie mice …

Host: Abdullah Abdussalam, MD

Proactive Vs Reactive Therapeutic Drug Monitoring of Infliximab in Crohn’s

Diana M Negoescu, Eva A Enns, PhD, Brooke Swanhorst, Bonnie Baumgartner, James P Campbell, Mark T Osterman, MD, Konstantinos Papamichael, PhD, Adam S Cheifetz, MD, Byron P Vaughn, MD

Background: Therapeutic drug monitoring (TDM) is increasingly performed for Infliximab (IFX) in patients with Crohn's disease (CD). Reactive TDM is a cost-effective strategy to empiric IFX dose escalation. The cost-effectiveness of proactive TDM is unknown. The aim of this study is to assess the cost-effectiveness of proactive vs reactive TDM in a simulated population of CD patients on IFX.

Methods: We developed a stochastic simulation model of CD patients on IFX and evaluated the expected health costs and outcomes of a proactive TDM strategy compared with a reactive strategy. The proactive strategy measured IFX concentration and antibody status every 6 months, or at the time of a flare, and dosed IFX to a therapeutic window. The reactive strategy only did so at the time of a flare.

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Guest: Anish Patel, DO, FACG

Real-world Pattern of Biologic Use in Patients With Inflammatory Bowel Disease: Treatment Persistence, Switching, and Importance of Concurrent Immunosuppressive Therapy

Chao Chen, PhD, Abraham G Hartzema, PhD, Hong Xiao, PhD, Yu-Jung Wei, PhD, Naueen Chaudhry, MD, Ofor Ewelukwa, MD, Sarah C Glover, DO, Ellen M Zimmermann, MD

BACKGROUND AND AIMS:
Medication persistence, defined as the time from drug initiation to discontinuation of therapy, has been suggested as a proxy for real-world therapeutic benefit and safety. This study seeks to compare the persistence of biologic drugs among patients with inflammatory bowel disease (IBD).

METHODS:
Patients with newly diagnosed IBD were included in a retrospective study using Truven MarketScan database. Treatment persistence and switching was compared among biologic medications including infliximab, adalimumab, certolizumab, golimumab, and vedolizumab. Predictors for discontinuation and switching were evaluated using time-dependent proportional hazard regression.

RESULTS:
In total, 5612 patients with Crohn's disease (CD) and 3533 patients with ulcerative colitis (UC) were included in this analysis. Less than half of the patients continued using their initial biologic treatment after 1 year (48.48% in CD cohort; 44.78% …

Guest: Robin Dalal, MD

Improving the Quality of Inpatient Ulcerative Colitis Management: Promoting Evidence-Based Practice and Reducing Care Variation With an Inpatient Protocol

Sara M Lewin, MD, Ryan A McConnell, MD, Roshan Patel, MD, Suzanne R Sharpton, MD, MAS, Fernando Velayos, MD, MPH, Uma Mahadevan, MD

BACKGROUND:
Hospitalization for ulcerative colitis is a high-risk period associated with increased risk of Clostridium difficile infection, thromboembolism, and opiate use. The study aim was to develop and implement a quality-improvement intervention for inpatient ulcerative colitis management that standardizes gastroenterology consultant recommendations and improves delivery of evidence-based care.

METHODS:
All adult patients hospitalized for ulcerative colitis between July 1, 2014, and December 31, 2017, who received intravenous corticosteroids were included. On July 1, 2016, the UCSF Inpatient Ulcerative Colitis Protocol was implemented, featuring standardized core recommendations and a daily checklist for gastroenterology consultant notes, a bundled IBD electronic order set, and an opiate awareness campaign. The composite primary outcome was adherence to all 3 evidence-based care metrics: C. difficile testing performed, pharmacologic venous thromboembolism (VTE) prophylaxis ordered, and opiates avoided.

RESULTS:
Ninety-three ulcerative colitis hospitalizations occurred, including 36 preintervention and 57 …