I am delighted to welcome you to a Takeda-organised satellite symposium at the 25th UEG Week Barcelona 2017: “Mission: Rapid Action and Lasting Remission—Focus on Disease Progression in Ulcerative Colitis.”
Ulcerative colitis (UC) is a chronically progressive disease. Until now, major endpoints of natural history studies of UC have been disease proximal extension, colectomy and hospitalization rates, and cancer.1 Lack of direct, operational measures for disease progression may have contributed to misunderstandings of UC being less progressive than Crohn’s disease and, consequently, delayed treatment and undermanagement of the disease. I will review studies that show early, lasting remission is associated with improved long-term outcomes in UC2 and that based on lessons learned from Crohn’s disease, starting intensive therapy at the right time may be warranted in appropriate patients with UC using a global evaluation of overall disease severity.3
Patients and clinicians desire a medical therapy with rapid onset, high efficacy, long-lasting action, and favourable safety.4 Despite the availability of effective therapies, limitations remain. My colleague Geert D’Haens, MD, PhD, will discuss how inappropriate use of currently available therapies, such as overuse of steroids and immunomodulators, and delayed and suboptimal use of biological therapies, along with patients’ and physicians’ underestimation of UC disease activity, presents significant challenges for patients to achieve optimal disease control. To overcome these challenges, it is recommended that we not only intervene with biologics at the right time, but also treat to the composite targets of clinical remission and mucosal healing with shared decision-making, perform tight control and monitoring after achieving target, and individualise patient care on a case-by-case basis.5
To further evaluate optimal use of biological agents, Remo Panaccione, MD, will review the efficacy and safety of systemic antitumor necrosis factor agents and the gut-selective anti-α4β7 integrin vedolizumab, based on the 4 important attributes patients value most.4 Antitumor necrosis factor agents are effective in some patients and generally well tolerated, but their induction and maintenance efficacy can be limited, and some safety issues remain, such as serious infections6 associated with systemic immunosuppression. For vedolizumab, the latest clinical and real-world data show it can induce symptomatic improvements as early as week 2;7 treatment targets of clinical remission and endoscopic remission are achieved in a substantial proportion of patients and maintained for the long term.8,9 The favourable benefit: risk balance10,11 makes the gut-selective vedolizumab a suitable agent for early and long-term use to achieve rapid symptom control and long-lasting remission.
We are confident this symposium will provide useful information that you can incorporate into your own practice for the successful management of patients with UC. On behalf of my fellow colleagues, thank you for joining us this evening. We also encourage you to attend tomorrow’s second Takeda-organised symposium—“Targeting Mucosal Healing: Optimising Results With Early, Appropriate Therapy in Crohn’s Disease”—which will be held here at 17:45–19:15.William J. Sandborn, MD
Sunday 29 October 2017
|18:00–18:05||Welcome & Introduction||William J. Sandborn, MD|
|18:05–18:20||Mission Assigned: Rapid Onset and Lasting Remission in Ulcerative Colitis||William J. Sandborn, MD|
|18:25–18:45||Mission Assessed: Challenges and Strategies to Achieve Early, Lasting Remission||Geert D’Haens, MD, PhD|
|18:50–19:10||Mission: Remission—Optimising Rapid Onset and Long-term Outcomes With Gut-Selective Therapy||Remo Panaccione, MD|
|19:15–19:30||Panel Discussion||William J. Sandborn, MD|
William J. Sandborn, MD, completed medical school and an internal medicine residency at Loma Linda University in Loma Linda, California. Dr Sandborn completed a gastroenterology fellowship at the Mayo Clinic in Rochester, Minnesota, USA in 1993. From 1993 to 2010, he was on the faculty of the Mayo Clinic, rising to Professor of Medicine, Vice Chairman of the Division of Gastroenterology and Hepatology, and Associate Dean of Research for Intellectual Property and Industry Relations. In 2011, Dr Sandborn became a tenured Professor of Medicine and Adjunct Professor of Surgery at UC San Diego, and Director of the IBD Center and Chief of the Division of Gastroenterology for the UC San Diego Health System. He is also Vice Chair for Clinical Operations for the Dept of Medicine, and a member of the UC San Diego Health System Board of Governors and Clinical Practice Operations Board (which oversees the clinical practice for the entire UC San Diego Health System). Dr Sandborn has published over 625 peer-reviewed articles in such journals as the New England Journal of Medicine, Nature, Lancet, JAMA, Annals of Internal Medicine, and Gastroenterology, and his h-index is 111. His research interests include clinical trials and clinical pharmacology related to inflammatory bowel disease.
Since 2011, Geert D’Haens, MD, PhD, has been Professor of Gastroenterology at the Academic Medical Center of the University of Amsterdam, where he leads a group of more than 35 IBD researchers. After graduating from the University of Leuven in Belgium, Prof D’Haens was trained in gastroenterology, gastrointestinal endoscopy, and inflammatory bowel diseases at the University Hospitals in Leuven and The University of Chicago Medicine in Chicago, Illinois, USA, under the mentorship of Prof Paul Rutgeerts and Dr Steven Hanauer, respectively. In 1996, he finished his PhD thesis on mechanisms causing postoperative recurrence of Crohn’s disease. Since then, most of his research efforts have focused on the mechanisms of action of new IBD drugs, the development of endoscopic endpoints and surrogate markers for IBD, and the effect of early intervention with anti-tumor necrosis factor (TNF) agents. In 1999, Prof D’Haens cofounded the European Crohn’s and Colitis Organisation (ECCO). He is also Medical Director of Robarts Clinical Trials, Inc. in Amsterdam and Chair of the International Organization for the Study of Inflammatory Bowel Diseases. Prof D’Haens has authored more than 300 peer-reviewed articles and participates in many drug development programs for IBD.
Remo Panaccione, MD, is Professor of Medicine at the University of Calgary and Director of the University of Calgary IBD Clinic.
Dr Panaccione received his MD from the University of Western Ontario in London, Ontario, Canada, in 1993, where he went on to complete his internal medicine and gastroenterology training. He is certified as a Fellow of the Royal College of Physicians and Surgeons of Canada in both internal medicine and gastroenterology. Dr Panaccione completed advanced training in IBD at the Mayo Clinic in Rochester, Minnesota, USA. He joined the Faculty of Medicine at the University of Calgary in 1999. Dr Panaccione is currently Medical Director of the Calgary Chapter of the Crohn’s & Colitis Foundation and serves on the Medical Advisory Council of Crohn’s and Colitis Canada.
Dr Panaccione has lectured across North America on various topics in IBD and has delivered over 120 lectures in the last 5 years. He is also the author of many peer-reviewed articles and book chapters on IBD. His special interest lies in the fields of advanced immunomodulation and biological therapy, and he is a recognized authority on the use of infliximab in Canada and co-authored the guidelines on the use of infliximab for the Canadian Association of Gastroenterology. Dr Panaccione actively participates in clinical trials of new therapeutic agents in Crohn’s disease and ulcerative colitis.
Dr Panaccione’s other interest is medical education. He has been recognized as a Gold Star Lecturer, Small Groups Leader, and Clinical Preceptor by the University of Calgary Cumming School of Medicine, where he has been selected three times as the top postgraduate teacher in gastroenterology by the Gastroenterology Fellows. Most recently, he was selected as one of the University of Calgary’s “Greatest Teachers”.