#IBDHorizons24 Recap
🤝Multi-d + IBD-CRS expert
👨🏽‍🦳Every pt differs - individualize
💊LoR is common - Proactive monitoring
🌀IUS valuable with multi other tools
🥊Fight insurance
👩🏻‍🦰Women have specific dz needs
🔦Cancer risk is IBD care & new tools for managing
🔮New therapy class…

#IBDHorizons24 Fausel

Case:
38yo with #Crohns
💉previously in remission on 90mg UST every 8 weeks

New findings:
😖pain
🚽diarrhea
🧪calprotectin level of 2000 mcg/g
🌀IUS shows the following image
🤔What next steps to assess & manage with the patient?

If preg, changes to plan?

#IBDHorizons24 #JeffreyJacobs
How would you answer this Q?

Which is TRUE for #UlcerativeColitis
A) ADA > VDZ & UST in H2H for UC & CD endo remission
B) Combo AZA/IFX more effective than IFX mono in CD & UC
C) TOFA & UPA approved as 1L in UC
D) All of above

#IBD Twitter
The day has arrived! 🎉

Join us for #IBD Horizons24 in collab with The Oregon Clinic live from the City of Roses - PDX Symposium🌹

🌹All day we'll be bringing invaluable pearls of #IBD wisdom

We're excited & we hope you are too!

IBDHorizons.org
Dr Feza Remzi

#IBDHorizons24 Bincy Abraham, MD, MS
How would you answer this Q?

Which is FALSE:
A) Most dysplastic lesions are endo visible
B) Screening for SB cancer is indicated annually with ileal #Crohns
C) Dz duration, extent, & activity are a/w dysplasia risk
D) PSC a/w⬆️dysplasia risk…

#IBD Horizons24 Dr Feza Remzi

#IBD surgery is a lifelong relationship between the CRS & patient‼️

Some pts would rather have ileo than #jpouch
👂Listen to the pt in front of you, don't instill bias
🖐️Digital exam very important part of surgical procedure

#IBDHorizons24 Monitoring Panel
Antibodies matter other than TNF's?
BF: depending but no
All panel: no

Inflammation monitoring choice?
Elisa Boden, MD: Enterography
Ghassan Wahbeh, MD: endo & image
JJ: no great way to assess
BF: depends

Retained VCE med emergency?
All panel NO‼️

#IBDHorizons24 Dr Feza Remzi

How would you answer this Q?

Which is FALSE regarding #Jpouch #IPAA expectations:
A. Pts have ~4-5 bm at night
B. >50% of pts have no urgency
C. Majority of pts happy with surg
D. Majority of pts have full continence

#IBD Horizons24 Feagan

🚨NEW CLASS of #IBD therapies🚨
TL1A
mod to severe #UlcerativeColitis
🆕TNFa antagonist naive
❌didn't respond/tolerate other (AZA, 6-MP, cortico)
🛑stop IMM
👺Cortico up to 20 mg/d of pred or equal w tapering from 6wk

#IBDHorizons24 Ghassan Wahbeh, MD
How would you answer this?

Which is TRUE for POC intestinal ultrasound (IUS):
A) Pts fast for 4hrs
B) IUS helpful in monitoring #Crohns but not #UlcerativeColitis
C) Bowel wall thickness/color Doppler correlate with endo
D) There's small radiation

#IBDHorizons24 Elisa Boden, MD

How would you answer this #WomensHealth Q?

Which is FALSE:
A. Flex sigmoid w/o sedation safe during🤰
B. Active dz a/w ⬆️risk of🤰complications
C. All advanced tx is contraindicated during🤰
D. Thiopurines a/w ⬆️ risk of cervical dysplasia

#IBD Horizons24 Jacobs

Treatments & 1st choice factors:
Safety
Efficacy- IFX tends to be default
Delivery - Keep needle phobia pts in mind; VDZ now subq
Comorbidities - communicate with rheum colleagues who use these #IBD meds
Severity of dz
Age of pt
Fight insurance with data

#IBDHorizons24 #RebeccaFausel The Oregon Clinic

How would you answer this Q?

Which is TRUE for fecal calprotectin (FCP):
A) Level can be elevated in pts on NSAIDs & PPI
B) reliable during pregnancy
C) Normal range is variable based on pt age
D) All of above

🛍️ #SpeakerSpotlight 🛍️

🥼The wonderful Dr #BrianFeagan brings his #IBD research pipeline knowledge to #IBD Horizons24 & PDX is the next on his passport!

📖Here’s fun facts about Dr Feagan

🔗Learn more about us ibdhorizons.org

#MedEd #Crohns #UlcerativeColitis #GITwitter

Ghassan Wahbeh, MD #IBDHorizons24 Ghassan Wahbeh, MD
*Answers*
How would you answer?

Which is TRUE for POC intestinal ultrasound (IUS):
A) Pts fast for 4hrs
B) IUS helpful in monitoring #Crohns but not #UlcerativeColitis
C) BWT/color Doppler correlate with endo
D) There's small radiation

#IBD Horizons24 Fausel

Loss of Response - What does it mean in #IBD & what next?

To consider when checking LOR:
⏲️Timing - post induction
🩺comborbidities - DVT, CHF, Age, EIM
🔥Activity & severity
🔦Involvement
🧬Phenotype
⬆️dose
💊Switch class

#IBDHorizons24 Jacobs

Case:
78yo patient
current smoker
newly diagnosed ileocecal #Crohns disease with moderate ulcerations and no stricture.

🤔 Therapy choices to discuss with patient?

Bincy Abraham, MD, MS Achintya Singh Moheb Boktor Reza Gholami Umar Iqbal Aditi Kumar carlos rettally Amanda Lin Andrew Tinsley Becky Matro MD #IBDHorizons24 #JeffreyJacobs
*Answers*
How would you answer this Q?

Which is TRUE for #UlcerativeColitis
A) ADA > VDZ & UST in H2H for UC & CD endo remission
B) Combo AZA/IFX more effective than IFX mono in CD & UC
C) TOFA & UPA approved as 1L in UC
D) All of above

#IBD Horizons24 #BrianFeagan

Research in #IBD :
VDZ works well for pouchitis
UPA for #UlcerativeColitis
Risa for #Crohns
Combo is the way to go, no monotherapy for UC
IL23’s likely more effective than the others

#IBD Horizons24 Ghassan Wahbeh, MD

Monitoring response to therapy:
‼️Damage ongoing even if inflammation not visible to GI's‼️

🥼🤝🙋🏼
Determine patient's tx goals
Try for MH - STRIDE

🧪Is CRP reliable?
NOS
#IBD location
External factors interfere (age, time of day, meds, comorbs)