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Prenatal exposure to tobacco smoke and antibiotics increases IBD risk in offspring
Key clinical point: Prenatal exposure to tobacco smoke and antibiotics and early life otitis media were risk factors for inflammatory bowel disease (IBD).
Major finding: Prenatal exposure to tobacco smoke (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17-1.90) and antibiotics (OR, 1.75; 95% CI, 1.22-2.51), and early life otitis media (OR, 2.11; 95% CI, 1.22-3.62) were positively associated with IBD.
Study details: Findings are from a meta-analysis of 39 studies that evaluated the association between early life (prenatal life to 5 years of age) exposures and subsequent risk for IBD.
Disclosures: The study did not receive any funding. Some of the authors reported receiving grants, speaker fees, advisory board fees, personal fees, consultancy, and/or lectures, and/or honoraria from multiple sources. All other authors had no disclosures.
Source: Agrawal M et al. EClinicalMedicine. 2021 May 15. doi: 10.1016/j.eclinm.2021.100884.
Key clinical point: Prenatal exposure to tobacco smoke and antibiotics and early life otitis media were risk factors for inflammatory bowel disease (IBD).
Major finding: Prenatal exposure to tobacco smoke (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17-1.90) and antibiotics (OR, 1.75; 95% CI, 1.22-2.51), and early life otitis media (OR, 2.11; 95% CI, 1.22-3.62) were positively associated with IBD.
Study details: Findings are from a meta-analysis of 39 studies that evaluated the association between early life (prenatal life to 5 years of age) exposures and subsequent risk for IBD.
Disclosures: The study did not receive any funding. Some of the authors reported receiving grants, speaker fees, advisory board fees, personal fees, consultancy, and/or lectures, and/or honoraria from multiple sources. All other authors had no disclosures.
Source: Agrawal M et al. EClinicalMedicine. 2021 May 15. doi: 10.1016/j.eclinm.2021.100884.
Key clinical point: Prenatal exposure to tobacco smoke and antibiotics and early life otitis media were risk factors for inflammatory bowel disease (IBD).
Major finding: Prenatal exposure to tobacco smoke (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17-1.90) and antibiotics (OR, 1.75; 95% CI, 1.22-2.51), and early life otitis media (OR, 2.11; 95% CI, 1.22-3.62) were positively associated with IBD.
Study details: Findings are from a meta-analysis of 39 studies that evaluated the association between early life (prenatal life to 5 years of age) exposures and subsequent risk for IBD.
Disclosures: The study did not receive any funding. Some of the authors reported receiving grants, speaker fees, advisory board fees, personal fees, consultancy, and/or lectures, and/or honoraria from multiple sources. All other authors had no disclosures.
Source: Agrawal M et al. EClinicalMedicine. 2021 May 15. doi: 10.1016/j.eclinm.2021.100884.
AMA selects dermatologist as incoming president for 2022
Known for his advocacy efforts – promoting telemedicine and digital health and fighting rising prescription drug prices, among other issues – he has testified in Congressional hearings on all those topics and other issues crucial for a functioning U.S. health care system.
Colleagues describe him as well informed, intelligent, and an excellent listener who is skilled at understanding all sides of difficult issues.
“I am committed to relentlessly advocating for physicians and patients on issues that matter most to us, and look forward to the continued meaningful advancements our AMA will make as we strive to improve the health of the nation,” Dr. Resneck said in a statement issued by the AMA. “Now more than ever, I am proud to be part of an AMA that is dedicated to driving the future of medicine, removing obstacles to patient care, and leading the charge to prevent chronic disease and confront public health crises – all while prioritizing our goal of eliminating longstanding health inequities.”
Dr. Resneck called this a “pivotal time of learning from the COVID-19 pandemic experience as we plan for the future of medicine and public health.”
“Jack is one of the most well-informed people I know,” Barbara L. McAneny, MD, president of the AMA from 2018 to 2019 and CEO of the New Mexico Cancer Center, Albuquerque, said in an interview. “Now that the pandemic is slowly decreasing, the underlying problems in our health care system will resurface. Jack understands how the insurance industry uses prior authorization and other techniques to harm physicians and patients. He is very well positioned to be a voice of reason that is sorely needed in today’s healthcare industry.”
David O. Barbe, MD, MHA, president of the World Medical Association and president of the AMA from 2017 to 2018, calls Dr. Resneck “extremely smart, very analytical. I think one of his great strengths is, he is an excellent listener and can capture the essence of all sides of the issues. He does a remarkable job at achieving consensus.” Dr. Barbe is a family physician in Mountain Grove, Mo.
Dr. Resneck has a long history of serving the AMA, the California Medical Association, and dermatology organizations such as the American Academy of Dermatology.
“Dr. Resneck’s exemplary leadership on a number of AAD/A committees and councils and as a member of the boards of directors has made a lasting impact on the academy, and he is poised to do the same as president-elect of the American Medical Association,” AAD president Ken Tomecki, MD, said in a statement provided by the AAD. “We congratulate Dr. Resneck on his achievement, and we’re proud to have a dermatologist serving as a leading voice in the house of medicine.”
First elected to the AMA board of trustees in 2014, Dr. Resneck held the office of board chair from 2018 to 2019. He was also chair of the AMA Council on Legislation and was a delegate to the AMA House of Delegates. He has had leadership roles in the California Society of Dermatology and Dermatologic Surgery, the American Academy of Dermatology and the California Medical Association. He is vice chair and professor of dermatology at the University of California, San Francisco, with a joint appointment at the Philip R. Lee Institute for Health Policy Studies.
As a researcher, his citation list includes numerous published studies about patient access to care, telemedicine, quality metrics, prior authorization, and public health. He is on the editorial board of the Journal of the American Academy of Dermatology and the board of directors of the National Quality Forum. His undergraduate degree in public policy is from Brown University, Providence, R.I. He earned his medical degree from UCSF, where he also completed an internal medicine internship, a residency training in dermatology and a health policy fellowship.
Gerald Harmon, MD, a family practice physician in coastal South Carolina, will be inaugurated as the AMA president for 2021-2022 on June 15.
Known for his advocacy efforts – promoting telemedicine and digital health and fighting rising prescription drug prices, among other issues – he has testified in Congressional hearings on all those topics and other issues crucial for a functioning U.S. health care system.
Colleagues describe him as well informed, intelligent, and an excellent listener who is skilled at understanding all sides of difficult issues.
“I am committed to relentlessly advocating for physicians and patients on issues that matter most to us, and look forward to the continued meaningful advancements our AMA will make as we strive to improve the health of the nation,” Dr. Resneck said in a statement issued by the AMA. “Now more than ever, I am proud to be part of an AMA that is dedicated to driving the future of medicine, removing obstacles to patient care, and leading the charge to prevent chronic disease and confront public health crises – all while prioritizing our goal of eliminating longstanding health inequities.”
Dr. Resneck called this a “pivotal time of learning from the COVID-19 pandemic experience as we plan for the future of medicine and public health.”
“Jack is one of the most well-informed people I know,” Barbara L. McAneny, MD, president of the AMA from 2018 to 2019 and CEO of the New Mexico Cancer Center, Albuquerque, said in an interview. “Now that the pandemic is slowly decreasing, the underlying problems in our health care system will resurface. Jack understands how the insurance industry uses prior authorization and other techniques to harm physicians and patients. He is very well positioned to be a voice of reason that is sorely needed in today’s healthcare industry.”
David O. Barbe, MD, MHA, president of the World Medical Association and president of the AMA from 2017 to 2018, calls Dr. Resneck “extremely smart, very analytical. I think one of his great strengths is, he is an excellent listener and can capture the essence of all sides of the issues. He does a remarkable job at achieving consensus.” Dr. Barbe is a family physician in Mountain Grove, Mo.
Dr. Resneck has a long history of serving the AMA, the California Medical Association, and dermatology organizations such as the American Academy of Dermatology.
“Dr. Resneck’s exemplary leadership on a number of AAD/A committees and councils and as a member of the boards of directors has made a lasting impact on the academy, and he is poised to do the same as president-elect of the American Medical Association,” AAD president Ken Tomecki, MD, said in a statement provided by the AAD. “We congratulate Dr. Resneck on his achievement, and we’re proud to have a dermatologist serving as a leading voice in the house of medicine.”
First elected to the AMA board of trustees in 2014, Dr. Resneck held the office of board chair from 2018 to 2019. He was also chair of the AMA Council on Legislation and was a delegate to the AMA House of Delegates. He has had leadership roles in the California Society of Dermatology and Dermatologic Surgery, the American Academy of Dermatology and the California Medical Association. He is vice chair and professor of dermatology at the University of California, San Francisco, with a joint appointment at the Philip R. Lee Institute for Health Policy Studies.
As a researcher, his citation list includes numerous published studies about patient access to care, telemedicine, quality metrics, prior authorization, and public health. He is on the editorial board of the Journal of the American Academy of Dermatology and the board of directors of the National Quality Forum. His undergraduate degree in public policy is from Brown University, Providence, R.I. He earned his medical degree from UCSF, where he also completed an internal medicine internship, a residency training in dermatology and a health policy fellowship.
Gerald Harmon, MD, a family practice physician in coastal South Carolina, will be inaugurated as the AMA president for 2021-2022 on June 15.
Known for his advocacy efforts – promoting telemedicine and digital health and fighting rising prescription drug prices, among other issues – he has testified in Congressional hearings on all those topics and other issues crucial for a functioning U.S. health care system.
Colleagues describe him as well informed, intelligent, and an excellent listener who is skilled at understanding all sides of difficult issues.
“I am committed to relentlessly advocating for physicians and patients on issues that matter most to us, and look forward to the continued meaningful advancements our AMA will make as we strive to improve the health of the nation,” Dr. Resneck said in a statement issued by the AMA. “Now more than ever, I am proud to be part of an AMA that is dedicated to driving the future of medicine, removing obstacles to patient care, and leading the charge to prevent chronic disease and confront public health crises – all while prioritizing our goal of eliminating longstanding health inequities.”
Dr. Resneck called this a “pivotal time of learning from the COVID-19 pandemic experience as we plan for the future of medicine and public health.”
“Jack is one of the most well-informed people I know,” Barbara L. McAneny, MD, president of the AMA from 2018 to 2019 and CEO of the New Mexico Cancer Center, Albuquerque, said in an interview. “Now that the pandemic is slowly decreasing, the underlying problems in our health care system will resurface. Jack understands how the insurance industry uses prior authorization and other techniques to harm physicians and patients. He is very well positioned to be a voice of reason that is sorely needed in today’s healthcare industry.”
David O. Barbe, MD, MHA, president of the World Medical Association and president of the AMA from 2017 to 2018, calls Dr. Resneck “extremely smart, very analytical. I think one of his great strengths is, he is an excellent listener and can capture the essence of all sides of the issues. He does a remarkable job at achieving consensus.” Dr. Barbe is a family physician in Mountain Grove, Mo.
Dr. Resneck has a long history of serving the AMA, the California Medical Association, and dermatology organizations such as the American Academy of Dermatology.
“Dr. Resneck’s exemplary leadership on a number of AAD/A committees and councils and as a member of the boards of directors has made a lasting impact on the academy, and he is poised to do the same as president-elect of the American Medical Association,” AAD president Ken Tomecki, MD, said in a statement provided by the AAD. “We congratulate Dr. Resneck on his achievement, and we’re proud to have a dermatologist serving as a leading voice in the house of medicine.”
First elected to the AMA board of trustees in 2014, Dr. Resneck held the office of board chair from 2018 to 2019. He was also chair of the AMA Council on Legislation and was a delegate to the AMA House of Delegates. He has had leadership roles in the California Society of Dermatology and Dermatologic Surgery, the American Academy of Dermatology and the California Medical Association. He is vice chair and professor of dermatology at the University of California, San Francisco, with a joint appointment at the Philip R. Lee Institute for Health Policy Studies.
As a researcher, his citation list includes numerous published studies about patient access to care, telemedicine, quality metrics, prior authorization, and public health. He is on the editorial board of the Journal of the American Academy of Dermatology and the board of directors of the National Quality Forum. His undergraduate degree in public policy is from Brown University, Providence, R.I. He earned his medical degree from UCSF, where he also completed an internal medicine internship, a residency training in dermatology and a health policy fellowship.
Gerald Harmon, MD, a family practice physician in coastal South Carolina, will be inaugurated as the AMA president for 2021-2022 on June 15.
Crohn's disease: Ustekinumab more effective than vedolizumab in patients refractory to anti-TNF therapy
Key clinical point: Ustekinumab showed higher short- and long-term efficacy than vedolizumab in patients with Crohn's disease with prior antitumor necrosis factor (TNF) therapy failure.
Major finding: Ustekinumab vs. vedolizumab was more effective in achieving corticosteroid-free clinical remission at week 54 (50.6% vs. 40.6%; P = .047) and deep remission at week 14 (17.9% vs. 5.7%; P = .047). Patients treated with ustekinumab vs. vedolizumab had a lower rate of primary nonresponse (6.7% vs. 14.8%, P = .034), a longer time to therapeutic escalation (hazard ratio [HR], 1.35; P = .043), and lower risk for drug discontinuation (HR, 1.53; P = .029).
Study details: This was a retrospective cohort study of 312 patients with Crohn's disease treated with ustekinumab (n=224) or vedolizumab (n=88) after exposure to at least 1 anti-TNF agent.
Disclosures: No information on funding was available. A Buisson reported receiving consulting and lecture fees from multiple sources. The other authors had no disclosures.
Source: Manlay L et al. Aliment Pharmacol Ther. 2021 Apr 28. doi: 10.1111/apt.16377.
Key clinical point: Ustekinumab showed higher short- and long-term efficacy than vedolizumab in patients with Crohn's disease with prior antitumor necrosis factor (TNF) therapy failure.
Major finding: Ustekinumab vs. vedolizumab was more effective in achieving corticosteroid-free clinical remission at week 54 (50.6% vs. 40.6%; P = .047) and deep remission at week 14 (17.9% vs. 5.7%; P = .047). Patients treated with ustekinumab vs. vedolizumab had a lower rate of primary nonresponse (6.7% vs. 14.8%, P = .034), a longer time to therapeutic escalation (hazard ratio [HR], 1.35; P = .043), and lower risk for drug discontinuation (HR, 1.53; P = .029).
Study details: This was a retrospective cohort study of 312 patients with Crohn's disease treated with ustekinumab (n=224) or vedolizumab (n=88) after exposure to at least 1 anti-TNF agent.
Disclosures: No information on funding was available. A Buisson reported receiving consulting and lecture fees from multiple sources. The other authors had no disclosures.
Source: Manlay L et al. Aliment Pharmacol Ther. 2021 Apr 28. doi: 10.1111/apt.16377.
Key clinical point: Ustekinumab showed higher short- and long-term efficacy than vedolizumab in patients with Crohn's disease with prior antitumor necrosis factor (TNF) therapy failure.
Major finding: Ustekinumab vs. vedolizumab was more effective in achieving corticosteroid-free clinical remission at week 54 (50.6% vs. 40.6%; P = .047) and deep remission at week 14 (17.9% vs. 5.7%; P = .047). Patients treated with ustekinumab vs. vedolizumab had a lower rate of primary nonresponse (6.7% vs. 14.8%, P = .034), a longer time to therapeutic escalation (hazard ratio [HR], 1.35; P = .043), and lower risk for drug discontinuation (HR, 1.53; P = .029).
Study details: This was a retrospective cohort study of 312 patients with Crohn's disease treated with ustekinumab (n=224) or vedolizumab (n=88) after exposure to at least 1 anti-TNF agent.
Disclosures: No information on funding was available. A Buisson reported receiving consulting and lecture fees from multiple sources. The other authors had no disclosures.
Source: Manlay L et al. Aliment Pharmacol Ther. 2021 Apr 28. doi: 10.1111/apt.16377.
Crohn’s disease: Partial restoration of intestinal microbiome in anti-TNF responders
Key clinical point: Patients with Crohn’s disease (CD) who responded to antitumor necrosis factor (anti-TNF) treatment showed partial restoration of intestinal microbiome characteristics of healthy individuals.
Major finding: Patients with CD vs. healthy cohort showed a decrease in genera of the class Clostridia and an increase in the phylum Proteobacteria (P less than .01). Anti-TNF treatment allowed restoration of bacteria belonging to the class Clostridia in responders. The genus Escherichia/Shigella reduced significantly vs. baseline but did not reach statistical significance in responders vs. healthy control.
Study details: Data come from a prospective multicenter observational study of 27 patients with CD who initiated anti-TNF treatment and 16 healthy individuals. Based on inflammatory activity, patients were classified into responders and nonresponders.
Disclosures: No information on funding was available. The authors declared no conflicts of interest.
Source: Sanchis-Artero L et al. Sci Rep. 2021 May 11. doi: 10.1038/s41598-021-88823-2.
Key clinical point: Patients with Crohn’s disease (CD) who responded to antitumor necrosis factor (anti-TNF) treatment showed partial restoration of intestinal microbiome characteristics of healthy individuals.
Major finding: Patients with CD vs. healthy cohort showed a decrease in genera of the class Clostridia and an increase in the phylum Proteobacteria (P less than .01). Anti-TNF treatment allowed restoration of bacteria belonging to the class Clostridia in responders. The genus Escherichia/Shigella reduced significantly vs. baseline but did not reach statistical significance in responders vs. healthy control.
Study details: Data come from a prospective multicenter observational study of 27 patients with CD who initiated anti-TNF treatment and 16 healthy individuals. Based on inflammatory activity, patients were classified into responders and nonresponders.
Disclosures: No information on funding was available. The authors declared no conflicts of interest.
Source: Sanchis-Artero L et al. Sci Rep. 2021 May 11. doi: 10.1038/s41598-021-88823-2.
Key clinical point: Patients with Crohn’s disease (CD) who responded to antitumor necrosis factor (anti-TNF) treatment showed partial restoration of intestinal microbiome characteristics of healthy individuals.
Major finding: Patients with CD vs. healthy cohort showed a decrease in genera of the class Clostridia and an increase in the phylum Proteobacteria (P less than .01). Anti-TNF treatment allowed restoration of bacteria belonging to the class Clostridia in responders. The genus Escherichia/Shigella reduced significantly vs. baseline but did not reach statistical significance in responders vs. healthy control.
Study details: Data come from a prospective multicenter observational study of 27 patients with CD who initiated anti-TNF treatment and 16 healthy individuals. Based on inflammatory activity, patients were classified into responders and nonresponders.
Disclosures: No information on funding was available. The authors declared no conflicts of interest.
Source: Sanchis-Artero L et al. Sci Rep. 2021 May 11. doi: 10.1038/s41598-021-88823-2.
Crohn’s disease: Ustekinumab safe and effective in a real-world setting
Key clinical point: Ustekinumab was effective and relatively safe in a real-world cohort of patients with Crohn’s disease (CD).
Major finding: After 104 weeks of ustekinumab treatment, 34.0% of patients were in corticosteroid-free clinical remission (Cf-CR). Among patients who were in Cf-CR at week 24, 48.1% remained at Cf-CR at week 104. Lack of response (61.7%) and loss of response (18.3%) were the main reasons for treatment discontinuation. No new safety signals were identified.
Study details: Findings are from a cohort study of 252 patients with CD who initiated ustekinumab and completed at least 2 years of follow-up.
Disclosures: No information on funding was available. The authors declared serving as a speaker, consultant, principal investigator, advisory board member for and/or receiving sponsorship, grants/honoraria, advisory, and/or speaker fees from multiple sources.
Source: Straatmijer T et al. J Crohns Colitis. 2021 Apr 28. doi: 10.1093/ecco-jcc/jjab081.
Key clinical point: Ustekinumab was effective and relatively safe in a real-world cohort of patients with Crohn’s disease (CD).
Major finding: After 104 weeks of ustekinumab treatment, 34.0% of patients were in corticosteroid-free clinical remission (Cf-CR). Among patients who were in Cf-CR at week 24, 48.1% remained at Cf-CR at week 104. Lack of response (61.7%) and loss of response (18.3%) were the main reasons for treatment discontinuation. No new safety signals were identified.
Study details: Findings are from a cohort study of 252 patients with CD who initiated ustekinumab and completed at least 2 years of follow-up.
Disclosures: No information on funding was available. The authors declared serving as a speaker, consultant, principal investigator, advisory board member for and/or receiving sponsorship, grants/honoraria, advisory, and/or speaker fees from multiple sources.
Source: Straatmijer T et al. J Crohns Colitis. 2021 Apr 28. doi: 10.1093/ecco-jcc/jjab081.
Key clinical point: Ustekinumab was effective and relatively safe in a real-world cohort of patients with Crohn’s disease (CD).
Major finding: After 104 weeks of ustekinumab treatment, 34.0% of patients were in corticosteroid-free clinical remission (Cf-CR). Among patients who were in Cf-CR at week 24, 48.1% remained at Cf-CR at week 104. Lack of response (61.7%) and loss of response (18.3%) were the main reasons for treatment discontinuation. No new safety signals were identified.
Study details: Findings are from a cohort study of 252 patients with CD who initiated ustekinumab and completed at least 2 years of follow-up.
Disclosures: No information on funding was available. The authors declared serving as a speaker, consultant, principal investigator, advisory board member for and/or receiving sponsorship, grants/honoraria, advisory, and/or speaker fees from multiple sources.
Source: Straatmijer T et al. J Crohns Colitis. 2021 Apr 28. doi: 10.1093/ecco-jcc/jjab081.
Intravenous steroids for acute inflammatory bowel disease
Key clinical point: Patients with an acute flare of inflammatory bowel disease (IBD) treated with intravenous methylprednisolone (IVMP) required significantly more rescue biologics or cyclosporine. Additionally, IVMP significantly reduced rates of hypokalemia compared with intravenous hydrocortisone (IVHC).
Major finding: IVMP was associated with a greater requirement for rescue biologics or cyclosporine (odds ratio [OR], 2.79; P less than .001) and lower rates of hypokalemia (OR, 0.49; P = .005) than IVHC.
Study details: This was a multicenter cohort study of 359 patients hospitalized with an acute flare of IBD and treated with either IVMP 60 mg daily (n=129) or IVHC 100 mg 4 times daily (n=230).
Disclosures: The study did not receive any funding. All the authors declared no conflicts of interest.
Source: Schauer C et al. J Gastroenterol Hepatol. 2021 May 3. doi: 10.1111/jgh.15535.
Key clinical point: Patients with an acute flare of inflammatory bowel disease (IBD) treated with intravenous methylprednisolone (IVMP) required significantly more rescue biologics or cyclosporine. Additionally, IVMP significantly reduced rates of hypokalemia compared with intravenous hydrocortisone (IVHC).
Major finding: IVMP was associated with a greater requirement for rescue biologics or cyclosporine (odds ratio [OR], 2.79; P less than .001) and lower rates of hypokalemia (OR, 0.49; P = .005) than IVHC.
Study details: This was a multicenter cohort study of 359 patients hospitalized with an acute flare of IBD and treated with either IVMP 60 mg daily (n=129) or IVHC 100 mg 4 times daily (n=230).
Disclosures: The study did not receive any funding. All the authors declared no conflicts of interest.
Source: Schauer C et al. J Gastroenterol Hepatol. 2021 May 3. doi: 10.1111/jgh.15535.
Key clinical point: Patients with an acute flare of inflammatory bowel disease (IBD) treated with intravenous methylprednisolone (IVMP) required significantly more rescue biologics or cyclosporine. Additionally, IVMP significantly reduced rates of hypokalemia compared with intravenous hydrocortisone (IVHC).
Major finding: IVMP was associated with a greater requirement for rescue biologics or cyclosporine (odds ratio [OR], 2.79; P less than .001) and lower rates of hypokalemia (OR, 0.49; P = .005) than IVHC.
Study details: This was a multicenter cohort study of 359 patients hospitalized with an acute flare of IBD and treated with either IVMP 60 mg daily (n=129) or IVHC 100 mg 4 times daily (n=230).
Disclosures: The study did not receive any funding. All the authors declared no conflicts of interest.
Source: Schauer C et al. J Gastroenterol Hepatol. 2021 May 3. doi: 10.1111/jgh.15535.
IBD: Significant proportion of patients remain in remission after anti-TNF discontinuation
Key clinical point: A significant proportion of patients with inflammatory bowel disease (IBD) remain in remission after discontinuation of antitumor necrosis factor-alpha (anti-TNF) post clinical remission.
Major finding: After a median follow-up of 34 months, incidence rate of relapse was 12% per patient-year (95% confidence interval [CI], 11-14) and the cumulative incidence of relapse was 50% (95% CI, 47-53) with 19%, 31%, 38%, 44%, and 48% at 1, 2, 3, 4, and 5 years of follow-up.
Study details: Data come from an extension of the EVODIS study that included 1,055 patients with Crohn's disease or ulcerative colitis who discontinued anti-TNF therapy after achieving clinical remission.
Disclosures: The study did not receive any funding. Some of the authors reported serving as a speaker, consultant, advisory member, and receiving research and/or education funding from multiple sources.
Source: Casanova MJ et al. Aliment Pharmacol Ther. 2021 May 7. doi: 10.1111/apt.16361.
Key clinical point: A significant proportion of patients with inflammatory bowel disease (IBD) remain in remission after discontinuation of antitumor necrosis factor-alpha (anti-TNF) post clinical remission.
Major finding: After a median follow-up of 34 months, incidence rate of relapse was 12% per patient-year (95% confidence interval [CI], 11-14) and the cumulative incidence of relapse was 50% (95% CI, 47-53) with 19%, 31%, 38%, 44%, and 48% at 1, 2, 3, 4, and 5 years of follow-up.
Study details: Data come from an extension of the EVODIS study that included 1,055 patients with Crohn's disease or ulcerative colitis who discontinued anti-TNF therapy after achieving clinical remission.
Disclosures: The study did not receive any funding. Some of the authors reported serving as a speaker, consultant, advisory member, and receiving research and/or education funding from multiple sources.
Source: Casanova MJ et al. Aliment Pharmacol Ther. 2021 May 7. doi: 10.1111/apt.16361.
Key clinical point: A significant proportion of patients with inflammatory bowel disease (IBD) remain in remission after discontinuation of antitumor necrosis factor-alpha (anti-TNF) post clinical remission.
Major finding: After a median follow-up of 34 months, incidence rate of relapse was 12% per patient-year (95% confidence interval [CI], 11-14) and the cumulative incidence of relapse was 50% (95% CI, 47-53) with 19%, 31%, 38%, 44%, and 48% at 1, 2, 3, 4, and 5 years of follow-up.
Study details: Data come from an extension of the EVODIS study that included 1,055 patients with Crohn's disease or ulcerative colitis who discontinued anti-TNF therapy after achieving clinical remission.
Disclosures: The study did not receive any funding. Some of the authors reported serving as a speaker, consultant, advisory member, and receiving research and/or education funding from multiple sources.
Source: Casanova MJ et al. Aliment Pharmacol Ther. 2021 May 7. doi: 10.1111/apt.16361.
Delaying second dose of SARS-CoV-2 vaccine not advisable in IBD patients treated with infliximab
Key clinical point: Patients with inflammatory bowel disease (IBD) treated with infliximab vs. vedolizumab showed attenuated immunogenicity to a single dose of BNT162b2 and adenovirus-ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Reassuringly, second dose of the vaccine led to seroconversion in most patients.
Major finding: Anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab vs. vedolizumab following vaccination with a single dose of either BNT162b2 (fold change [FC], 0.29; P less than .0001) or ChAdOx1 nCoV-19 (FC, 0.39; P less than .0001). After second vaccine dose, 85% of infliximab- and 86% of vedolizumab-treated patients seroconverted (P = .68).
Study details: Findings are from the CLARITY IBD study that included patients with IBD without evidence of prior SARS-CoV-2 infection who were treated with infliximab (n=865) or vedolizumab (n=428).
Disclosures: The study was funded by F. Hoffmann-La Roche AG (Switzerland), Biogen GmbH (Switzerland), Celltrion Healthcare (South Korea), and others. Some of the authors reported receiving grants, personal fees, and/or financial or nonfinancial support from multiple sources.
Source: Kennedy NA et al. Gut. 2021 Apr 26. doi: 10.1136/gutjnl-2021-324789.
Key clinical point: Patients with inflammatory bowel disease (IBD) treated with infliximab vs. vedolizumab showed attenuated immunogenicity to a single dose of BNT162b2 and adenovirus-ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Reassuringly, second dose of the vaccine led to seroconversion in most patients.
Major finding: Anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab vs. vedolizumab following vaccination with a single dose of either BNT162b2 (fold change [FC], 0.29; P less than .0001) or ChAdOx1 nCoV-19 (FC, 0.39; P less than .0001). After second vaccine dose, 85% of infliximab- and 86% of vedolizumab-treated patients seroconverted (P = .68).
Study details: Findings are from the CLARITY IBD study that included patients with IBD without evidence of prior SARS-CoV-2 infection who were treated with infliximab (n=865) or vedolizumab (n=428).
Disclosures: The study was funded by F. Hoffmann-La Roche AG (Switzerland), Biogen GmbH (Switzerland), Celltrion Healthcare (South Korea), and others. Some of the authors reported receiving grants, personal fees, and/or financial or nonfinancial support from multiple sources.
Source: Kennedy NA et al. Gut. 2021 Apr 26. doi: 10.1136/gutjnl-2021-324789.
Key clinical point: Patients with inflammatory bowel disease (IBD) treated with infliximab vs. vedolizumab showed attenuated immunogenicity to a single dose of BNT162b2 and adenovirus-ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Reassuringly, second dose of the vaccine led to seroconversion in most patients.
Major finding: Anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab vs. vedolizumab following vaccination with a single dose of either BNT162b2 (fold change [FC], 0.29; P less than .0001) or ChAdOx1 nCoV-19 (FC, 0.39; P less than .0001). After second vaccine dose, 85% of infliximab- and 86% of vedolizumab-treated patients seroconverted (P = .68).
Study details: Findings are from the CLARITY IBD study that included patients with IBD without evidence of prior SARS-CoV-2 infection who were treated with infliximab (n=865) or vedolizumab (n=428).
Disclosures: The study was funded by F. Hoffmann-La Roche AG (Switzerland), Biogen GmbH (Switzerland), Celltrion Healthcare (South Korea), and others. Some of the authors reported receiving grants, personal fees, and/or financial or nonfinancial support from multiple sources.
Source: Kennedy NA et al. Gut. 2021 Apr 26. doi: 10.1136/gutjnl-2021-324789.
Minnesota named best place to practice in 2021
For physicians who are just starting out or thinking about moving, the “Land of 10,000 Lakes” could be the land of opportunity, according to a recent Medscape analysis.
In a ranking of the 50 states, Minnesota “claimed top marks for livability, low incidence of adverse actions against doctors, and the performance of its health system,” Shelly Reese wrote in Medscape’s “Best & Worst Places to Practice 2021.”
Minnesota is below average where it’s good to be below average – share of physicians reporting burnout and/or depression – but above average in the share of physicians who say they’re “very happy” outside of work, Medscape said in the annual report.
and adverse actions and a high level of livability. Third place went to Washington (called the most livable state in the country by U.S. News and World Report), fourth to Colorado (physicians happy at and outside of work, high retention rate for residents), and fifth to Utah (low crime rate, high quality of life), Medscape said.
At the bottom of the list for 2021 is West Virginia, where physicians “may confront a bevy of challenges” in the form of low livability, a high rate of adverse actions, and relatively high malpractice payouts, Ms. Reese noted in the report.
State number 49 is Louisiana, where livability is low, malpractice payouts are high, and more than half of physicians say that they’re burned out and/or depressed. New Mexico is 48th (very high rate of adverse actions, poor resident retention), Nevada is 47th (low marks for avoidable hospital use and disparity in care), and Rhode Island is 46th (high malpractice payouts, low physician compensation), Medscape said.
Continuing with the group-of-five theme, America’s three most populous states finished in the top half of the ranking – California 16th, Texas 11th, and Florida 21st – but New York and Pennsylvania, numbers four and five by population size, did not.
The rankings are based on states’ performance in 10 different measures, three of which were sourced from Medscape surveys – happiness at work, happiness outside of work, and burnout/depression – and seven from other organizations: adverse actions against physicians, malpractice payouts, compensation (adjusted for cost of living), overall health, health system performance, overall livability, resident retention.
For physicians who are just starting out or thinking about moving, the “Land of 10,000 Lakes” could be the land of opportunity, according to a recent Medscape analysis.
In a ranking of the 50 states, Minnesota “claimed top marks for livability, low incidence of adverse actions against doctors, and the performance of its health system,” Shelly Reese wrote in Medscape’s “Best & Worst Places to Practice 2021.”
Minnesota is below average where it’s good to be below average – share of physicians reporting burnout and/or depression – but above average in the share of physicians who say they’re “very happy” outside of work, Medscape said in the annual report.
and adverse actions and a high level of livability. Third place went to Washington (called the most livable state in the country by U.S. News and World Report), fourth to Colorado (physicians happy at and outside of work, high retention rate for residents), and fifth to Utah (low crime rate, high quality of life), Medscape said.
At the bottom of the list for 2021 is West Virginia, where physicians “may confront a bevy of challenges” in the form of low livability, a high rate of adverse actions, and relatively high malpractice payouts, Ms. Reese noted in the report.
State number 49 is Louisiana, where livability is low, malpractice payouts are high, and more than half of physicians say that they’re burned out and/or depressed. New Mexico is 48th (very high rate of adverse actions, poor resident retention), Nevada is 47th (low marks for avoidable hospital use and disparity in care), and Rhode Island is 46th (high malpractice payouts, low physician compensation), Medscape said.
Continuing with the group-of-five theme, America’s three most populous states finished in the top half of the ranking – California 16th, Texas 11th, and Florida 21st – but New York and Pennsylvania, numbers four and five by population size, did not.
The rankings are based on states’ performance in 10 different measures, three of which were sourced from Medscape surveys – happiness at work, happiness outside of work, and burnout/depression – and seven from other organizations: adverse actions against physicians, malpractice payouts, compensation (adjusted for cost of living), overall health, health system performance, overall livability, resident retention.
For physicians who are just starting out or thinking about moving, the “Land of 10,000 Lakes” could be the land of opportunity, according to a recent Medscape analysis.
In a ranking of the 50 states, Minnesota “claimed top marks for livability, low incidence of adverse actions against doctors, and the performance of its health system,” Shelly Reese wrote in Medscape’s “Best & Worst Places to Practice 2021.”
Minnesota is below average where it’s good to be below average – share of physicians reporting burnout and/or depression – but above average in the share of physicians who say they’re “very happy” outside of work, Medscape said in the annual report.
and adverse actions and a high level of livability. Third place went to Washington (called the most livable state in the country by U.S. News and World Report), fourth to Colorado (physicians happy at and outside of work, high retention rate for residents), and fifth to Utah (low crime rate, high quality of life), Medscape said.
At the bottom of the list for 2021 is West Virginia, where physicians “may confront a bevy of challenges” in the form of low livability, a high rate of adverse actions, and relatively high malpractice payouts, Ms. Reese noted in the report.
State number 49 is Louisiana, where livability is low, malpractice payouts are high, and more than half of physicians say that they’re burned out and/or depressed. New Mexico is 48th (very high rate of adverse actions, poor resident retention), Nevada is 47th (low marks for avoidable hospital use and disparity in care), and Rhode Island is 46th (high malpractice payouts, low physician compensation), Medscape said.
Continuing with the group-of-five theme, America’s three most populous states finished in the top half of the ranking – California 16th, Texas 11th, and Florida 21st – but New York and Pennsylvania, numbers four and five by population size, did not.
The rankings are based on states’ performance in 10 different measures, three of which were sourced from Medscape surveys – happiness at work, happiness outside of work, and burnout/depression – and seven from other organizations: adverse actions against physicians, malpractice payouts, compensation (adjusted for cost of living), overall health, health system performance, overall livability, resident retention.