It is my great pleasure to welcome you to this Takeda-organised educational symposium at the 25th UEG Week Barcelona 2017 titled “Targeting Mucosal Healing: Optimising Results With Early, Appropriate Therapy in Crohn’s Disease.”
Treatment targets for Crohn’s disease (CD) are evolving from symptom control only toward full disease control by achieving both clinical remission and mucosal healing, with the ultimate goal of preventing disease progression.1 I will start this symposium by making a case for timely intervention in CD, and discuss the importance of identifying appropriate patients who may benefit from early intervention by reviewing two of my patient cases.
My colleague Laurent Peyrin-Biroulet, MD, PhD, will offer a close-up look at the more recent treatment target of endoscopic healing. Objective measures of endoscopic disease activity are needed to standardize the practice, particularly in CD. Dr Peyrin-Biroulet will discuss the pros and cons of two validated endoscopic indices2,3—Crohn’s Disease Endoscopic Index of Severity and Simple Endoscopic Score for CD—and review various definitions of endoscopic healing and response used in different trials. A consensus definition4 newly recommended by the International Organization for the Study of Inflammatory Bowel Diseases will also be reviewed. When treating to the targets of clinical remission and mucosal healing, it is important to keep in mind value-based healthcare and use appropriate therapy with an optimal benefit-risk ratio at the right time.
Vedolizumab is a gut-selective biological therapy that works by inhibiting leukocyte migration into gut mucosa.5 Charlie Lees, MD, PhD, will provide an overview of the latest data on the early and long-term use of vedolizumab for the treatment of CD in both clinical studies and real-world settings. These data indicate that vedolizumab can achieve and maintain the treatment goal of clinical remission for the long term,6 with newly emerging data reporting early symptomatic improvements7 and more prominent clinical remission in biologic-naïve patients.8 Vedolizumab has been shown to achieve and maintain the treatment goal of endoscopic remission, as shown by exploratory and real-world data.9,10 The favourable safety profile of vedolizumab was demonstrated in 5-year pooled clinical studies and real-world studies.11,12
At the end of the symposium, I would like to put our knowledge into practice by reviewing the rationale, treatment decisions, and clinical outcomes of two real-world patient cases. I am confident that this symposium will be an excellent forum for discussing optimal management strategies for our patients with CD and provide insights into how we can better help them cope with this challenging disease. On behalf of Drs Peyrin-Biroulet and Lees, thank you for joining us this afternoon.Julián Panés, MD, PhD
Monday 30 October 2017
|17:45–17:50||Welcome & Introduction||Julián Panés, MD, PhD|
|17:50–18:10||The Case for Early Intervention in Crohn’s Disease||Julián Panés, MD, PhD|
|18:10–18:30||Close-up on Endoscopic Healing as a Treatment Goal: What Do We Need to Know?||Laurent Peyrin-Biroulet, MD, PhD|
|18:30–18:50||Meeting Evolving Treatment Goals With Gut-Selective Therapy||Charlie Lees, MD, PhD|
|18:50–19:10||Putting Knowledge Into Practice: Approach to Patient Cases||Julián Panés, MD, PhD
|19:10–19:15||Summary and Concluding Remarks||Julián Panés, MD, PhD|
Julián Panés, MD, PhD, is Director of the Inflammatory Bowel Diseases Unit at the Hospital Clinic of Barcelona and Assistant Professor of Medicine of the University of Barcelona. Dr Panés’ research group is focused on the development and implementation of new diagnostic tools, with special interest in cross-sectional imaging, the identification of new molecular targets for treatment of IBD, and the development of cell therapies for treatment of IBD.
Dr Panés has published more than 300 manuscripts in international peer-reviewed journals, has served on the Scientific Committees of both the UEG and European Crohn’s and Colitis Organisation (ECCO), the board of the International Organization for the Study of Inflammatory Bowel Disease, and the editorial boards of various international publications. Dr. Panés was Associate Editor of Gut, and is currently President of ECCO.
Laurent Peyrin-Biroulet, MD, PhD, is Professor of Medicine and Head of the Inflammatory Bowel Disease Unit and Professor of Medicine at University Hospital of Nancy. Upon receiving his MD and PhD, Dr Peyrin-Biroulet undertook a postdoctoral fellowship at the IBD Centre in Lille in 2007, before taking a research position at the Mayo Clinic in Rochester, Minnesota, USA from 2008 to 2009.
Dr Peyrin-Biroulet received a Rising Star Award in 2008 from UEG. He is President of both the Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif and President of the Scientific Committee of the Association François Aupetit. Dr Peyrin-Biroulet is Chair of both the IBD Committee of the Société Française d’Endoscopie Digestive and the Clinical Trials Task Force of the International Organization for the Study of Inflammatory Bowel Diseases. He was a member of the Scientific Committee of UEG from 2011 to 2014 and is the current General Secretary of the European Crohn’s and Colitis Organisation (ECCO). Dr Peyrin-Biroulet was Coordinator for both the development of the first IBD Disability Index and the treat-to-target recommendations by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program. He also proposed the first definitions of early Crohn’s disease and disease severity for IBD. Dr Peyrin-Biroulet contributed to the ECCO workshops on mucosal healing and malignancies and participated in the development of the ECCO guidelines on imaging and Crohn’s disease consensus.
The author of more than 350 peer-reviewed articles over the past 10 years and more than 200 non-peer-reviewed articles, Dr Peyrin-Biroulet is Associate Editor of Digestive and Liver Disease, and a member of the editorial boards of Alimentary Pharmacology & Therapeutics, Journal of Crohn’s and Colitis, and Gut. He also serves as Reviewer for several international journals and is a Staff Contributor of the Selected Summary section of Gastroenterology. Dr Peyrin-Biroulet joined the editorial team of the Cochrane Inflammatory Bowel Diseases and Functional Bowel Disorders Review Group in 2014. He served as Councillor to the Immunology, Microbiology and IBD Section of the American Gastroenterological Association Institute Council from 2014 to 2016.
Charlie Lees, MD, PhD, is Honorary Senior Lecturer at The University of Edinburgh and a Consultant Gastroenterologist at Western General Hospital. Dr Lees trained at University College London in the UK and subsequently in Edinburgh, with doctoral studies in the GI Unit at Western General Hospital. He was awarded the prestigious Association des Societé Nationales Européennes et Mediterranénnes des Gastroentérologie (now UEG) European Rising Star in Gastroenterology Award in 2009. His major clinical, research, and teaching interest is IBD.
Dr Lees has been centrally involved with the European Crohn’s and Colitis Organisation (ECCO) and has just taken over as the Chief Scientist Office Scottish Specialty Lead for Gastroenterology. He also chairs the Scottish Society of Gastroenterology IBD Interest Group and sits on the British Society of Gastroenterology IBD Research Committee.
Dr Lees’ major research activities focus on the translational interface between basic science and direct clinical application. This includes the genetics and pharmacogenetics of IBD, the role of diet, nutrition and gut microbiota in disease aetiopathogenesis and prognosis, IBD therapeutics, monitoring, and e-health. He is Chief Investigator of the UK arm of the Genetic Environmental Microbial (GEM) Project, a cohort study investigating the underlying cause of Crohn’s disease, and of the pan-UK The Prognostic Effect of Environmental Factors in Crohn’s and Colitis (PREdiCCt) study. These studies aim to discover how diet, environmental factors, gut microbiota, and host genetics influence the onset of disease (GEM) and disease flare (PREdiCCt).
Dr Lees’ major teaching activities include organizing the year 4 medical student gastroenterology module at The University of Edinburgh, and directing the ECCO Advanced IBD Course, the ECCO-CIMF Chinese Masterclass in IBD, the UEG Summer School and Young Investigators Programme, and the Wellcome Trust Advanced Course in Genomic Medicine for Clinicians.