I nuovi farmaci biologici: anche nell'anziano?
|
|
|
- Joshua Russell
- 5 years ago
- Views:
Transcription
1 LE MALATTIE INFIAMMATORIE CRONICHE INTESTINALI NELL ANZIANO I nuovi farmaci biologici: anche nell'anziano? ANNA KOHN (Roma)
2 increasing incidence Jeuring SFG, Inflamm Bowel Dis 2016
3 IBD Prevalence on December 31,2009 in the Lazio region prevalence slope Di Domenicantonio R et al, DLD 2014 Prevalence CD 91: UC 177: : :
4 Disease course of elderly-onset IBD CD location Crohn s disease Ulcerative colitis L2 colonic location more often left sided (E2) symptoms less bleeding and addominal pain less diarrhoea, abdominal pain and weight loss disease behaviour mostly inflammatory more likely stable extraintestinal manifestations less common less common UC cancer risk Higher risk of NH lymphoma with thiopurine and NMSC with anti-tnf therapy E2 left-sided Sturm A et al., J Crohns Colitis 2016; Taleban S et al, Dig Liver Dis 2016; Nimmonds D et al., World J Gastrointest Pharmacol Ther 2016; Butter M et al, Maturitas 2018; Everhov AH et al., Gastroenterology 2018; Ananthakrishnan AN J Crohns Colitis Charpentier C et al. GUT 2013
5 IBD Epidemiology from a French population -based registry (EPIMAD) disease course 100% 80% 17% Elderly onset CD penetrating 5% 10% stricturing 22% 4% 23% Pediatric onset CD penetrating 32% 60% stricturing 39% 40% 78% inflammatory 68% 20% 73% inflammatory 29% 0% Diagnosis 5 years 10 years 15 years Diagnosis 5 years 10 years 15 years Gower-Rousseau C, et al. Dig Liver Dis 2013
6 hospitalizazion rate The risk of IBD-related hospitalization is higher in elderly UC, but not CD patients, than in younger adults. Everhov AH, Gastroenterology 2018
7 risk of surgery and outcome Conflicting data on the risk of surgery for the elderly IBD. Study based on administrative data report an increased risk due to a mixed population of elderly with long standing IBD and elderly onset IBD. Everhov AH et al., Gastroenterology 2018 Nguyen GC Inflamm Bowel Dis 2017 No difference in surgery risk was observed by populationbased study Jeuring FSG et al; Inflamm Bowel Dis 2016 Lakatos PL et al.; J Crohns Colitis 2011 Everhov AH, Gastroenterology 2018
8 IBD related surgery: postsurgical mortality and complications risk of surgery and outcome Crohns elderly non elderly Ulcerative colitis elderly non elderly 30-day mortality ** ** infectious complications ** cardiac complications ** ** renal complications ** ** neurologic complications venous thromboembolism * ** ** * p<0.05 ** p< 0.01, *** p< Bollegala N et al.; Clin Gastroenterol Hepatol 2015 elderly patients undergoing IBDrelated bowel surgery experience a pronounced 5- to 10-fold higher 30- day mortality than younger IBD patients, as well as number of other systemic complications
9 disease activity Crohn s disease: Disease activity distribution in each year from diagnosis 55% remission 15% low activity 30% high activity Munkholm P et al., Scand J Gastro 1995 P
10 consensus Sturm A et al., J Crohns Colitis 2016
11 medications CD UC ongoing treatments CD UC The elderly are less likely to receive biological agents or IMM. This may be secondary to concerns for risks for infection and cancer; or may reflect that the elderly do have more comorbidities and polypharmacy making the use of more medications riskier. Jeuring FSG et al.,inflamm Bowel Dis 2016
12 safety issues 95 elderly patients treated with biologics 190 adult matched controls treated with biologics 190 elderly controls not treated with biologics UC CD UC CD UC CD Pts n Male/female 20/17 35/23 40/34 70/46 40/34 70/46 Mean age(range) 71 (65-81) 71(65-84) 38(17-64) 39(16-64) 71(65-81) 70(65-80) Remission n (%) 22 (59.5) 38 (65.5) 42(56.7) 68 (58.6) - - Maintenance n (%) 12 (32.4) 39 (67.2) 24 (32.4) 78 (67.2) - - Comorbidity n (%) 35 (94.5) 44 (75.8) 4 (5.4) 6 (5.1) 37 (50) 46(39.6) Deaths (n ) Severe infections (n ) Cancer (n ) Steroids (n ) antitnf+aza/mtx n (%) 7 (19) 15 (26) 17 (23) 32 (28) - - M Cottone et al., Clin Gastroenterol Hepatol 2010
13 safety issues Malignancy and mortality during the follow up in IBD cases: 65 yrs anti TNF as compared with controls Lobaton T et al., Aliment Pharmacol Ther 2015
14 Efficacy of anti-tnf therapy Clinical response at short term (10 weeks) & Clinical response at long term ( 6 months) 65 years < 65 years Lobaton T et al., Aliment Pharmacol Ther 2015
15 Therapeutic Galaxy in IBD Cytokine Receptors Immunomodulators laquinimod Teva / Active Biotech JAK Inhibitors CCX-025 GSK ZP1848 Zealand RDP 58 Genzyme Tofacitinib Pfizer Remestemcel-L Osiris PDA-001 Celgene Cellular Cell Therapies CCX282-B GSK Rifaximin EIR AlphaWessermann NN8555 Novo Nordisk Phase I Phase II Phase III Registered Available Adalimumab AbbVie Certolizumab pegol UCB Cellerix OvaSave TXCell HSCT Infliximab Centocor Golimumab MSD - Merck Debiaerse Neovacs TNFK-005 Neovacs IL Inhibitors C326 QPharm SCH Merck & Co Ustekinumab Centocor Vidofludimus 4SC PF Pfizer PF Pfizer AMG 827 Amgen GSK GSK AIN 457 Novartis ELND-004 Elan/Biogen Idec PF Pfizer Vedolizumab Millenium / Takeda QAX576 Novartis Natalizumab Elan/Biogen Idec HMPL-004 Hutchinson Ozoralizumab Pfizer TNF-α Inhibitors Adhesion Molecules Inhibitors Adapted from Danese S. Gut 2012;61:918 32
16 a4b7 E-cadherin Lymphocytes aeb7 MAdCAM-1 E-cadherin aeb7 Chemoattractant Signal BLOOD ENDOTHELIUM TISSUE EPITHELIUM antiadhesion therapies Lymphocytes Migration and retention of T cells in Gut mucosal tissue Lymphocytes Chemoattractant Signal a4b7 E-cadherin aeb7 MAdCAM-1 E-cadherin aeb7 ETROLIZUMAB VEDOLIZUMAB ETROLIZUMAB NATALIZUMAB Reduced Lymphocyte Migration & Inhibition of Homing of Lymphocytes to the Gut
17 Patients (%) Patients (%) Vedolizumab induction and remission in moderate to severe UC- GEMINI I PBO (n=149) VDZ 300 mg (n=225) p< p< p< Response Remission Mucosal healing week Placebo (n=126) VDZ 300 mg every 8 weeks (n=122) VDZ 300 mg every 4 weeks (n=125) p< ,8 44,8 15,9 23,8 p< , ,8 p< ,6 56 week 52 0 Clinical remission at 52 weeks Durable clinical response (at 6 and 52 weeks) Mucosal healing at 52 weeks Feagan BG, et al., New J Med 2013
18 Efficacy of Vedolizumab in UC and CD patients stratified by age: from the GEMINI trials UC CD Yajinik V et al., Adv Ther 2017
19 UC Adverse events by age < 65 years and 65 years safety 3.2% 65 yrs CD 2% 65 yrs from the Gemini 1 and 2 trials Yajinik V et al., Adv Ther 2017
20 IL-12 and IL-23 pro-inflammatory cytokines sharing p40 subunit Ustekinumab Koutruba L et al.,ther Clin Risk Manag 2010
21 Clinical remission 8 weeks N=741 N=628 Ustekinumab for Crohn s Disease 44 weeks i.v. Ustekinumab induces response and remission in patients with moderately to severely active CD refractory to anti-tnf or conventional therapy. s.c. Ustekinumab maintained remission in patients who had clinical response to induction therapy. Feagan BG et al., N Engl J Med 2016
22 TNF inhibitors IFX, ADA, GOLIMUMAB UC & CD Integrin inhibitors Vedolizumab UC & CD Anti IL12 -IL 23 mab Ustekinumab CD Fast onset Loss of response in 1/3 of cases Very effective on EIM Increased risk of severe infection in elderly IBD Infusion related reactions (iv), opportunistic infections, melanoma, NMSC,demyelinatin disorders, psoriasis, aggravation of heart failure* Rarely, non infectious hepatitis & reduced blood cells count Increased risk of severe infection in elderly IBD Chest X-ray, TB skin tests,ifn- Y-release assay (Quantiferon), HBV testing Inactivated trivalent influenza vaccine, Pneumococcal vaccine ( PCV 13) Cardiological and neurological evaluation Delayed therapeutic effect Persistent efficacy Moderately effective on EIM Suitable for UC patients at risk of infections as first line Nasopharyngitis Infusion related reactions, psoriasis (uncommon) Favorable safety profile Limited data in the elderly Chest X-ray, TB skin tests,ifn- Y- release assay (Quantiferon), HBV testing Inactivated trivalent influenza vaccine, Pneumococcal vaccine ( PCV 13) Fast onset Persistent efficacy Effective on EIM Suitable for CD patients at risk of infections as first line Nasopharyngitis Infusion related reactions (uncommon) Favorable safety profile no data in the elderly Inactivated trivalent influenza vaccine, Pneumococcal vaccine ( PCV 13)
23 when making management decisions in the elderly IBD ageism should be avoided focus on functional status and comorbidities avoid emergent surgeries more frequent clinical assessment Safety Issues Management optimization
Present Situation and Problems of Clinical Trials for inflammatory bowel disease in Japan
PMDA Workshop Future Perspectives in the Development of Novel Medications for IBD (2015.2.4. Tokyo) Present Situation and Problems of Clinical Trials for inflammatory bowel disease in Japan Takayuki Matsumoto
New treatment options in IBD: today and the future. Silvio Danese Istituto Clinico Humanitas, Milan, Italy
New treatment options in IBD: today and the future Silvio Danese Istituto Clinico Humanitas, Milan, Italy Date of preparation: October 2014 GLO/EYV/2014-00010h Overview of the late-stage IBD drug pipeline*
Biologic Therapy for Ulcerative Colitis in 2015
5/6/215 Biologic Therapy for Ulcerative Colitis in 215 John K. Marshall MD MSc FRCPC AGAF Division of Gastroenterology McMaster University Bressler B, Marshall JK, et al. Gastroenterology 215;148: 135-58
Recent Advances in the Management of Refractory IBD
Recent Advances in the Management of Refractory IBD Raina Shivashankar, M.D. Assistant Professor of Medicine Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia, PA Outline
Medical Management of Inflammatory Bowel Disease
Medical Management of Inflammatory Bowel Disease John K. Marshall MD MSc FRCPC AGAF Division of Gastroenterology McMaster University John K. Marshall: Conflicts of Interest Speaker: AbbVie, Allergan, Ferring,
Choosing and Positioning Biologic Therapy for Crohn s Disease: (Still) Looking for the Crystal Ball
Choosing and Positioning Biologic Therapy for Crohn s Disease: (Still) Looking for the Crystal Ball Siddharth Singh, MD, MS Assistant Professor of Medicine Division of Gastroenterology Division of Biomedical
Positioning New Therapies
Positioning New Therapies Stephen Hanauer, MD Professor of Medicine Medical Director, Digestive Disease Center Northwestern Medicine Chicago, Illinois Speaker Disclosure Stephen Hanauer, MD has disclosed
Emerging g therapies for IBD: A practical approach to positioning. Sequential Therapies for IBD
Emerging g therapies for IBD: A practical approach to positioning Stephen B. Hanauer, MD Sequential Therapies for IBD Disease Severity at Presentation Severe Anti-TNF +/IS Cyclosporine (UC) Colectomy (UC)
Medical Therapy for Pediatric IBD: Efficacy and Safety
Medical Therapy for Pediatric IBD: Efficacy and Safety Betsy Maxwell, MD Assistant Professor of Clinical Pediatrics Division of Gastroenterology, Hepatology, and Nutrition Pediatric IBD: Defining Remission
New treatment options in UC. Rob Bryant IBD Consultant Royal Adelaide Hospital
New treatment options in UC Rob Bryant IBD Consultant Royal Adelaide Hospital Talk Outline 1. Raising expectations 2. Optimising UC therapy 3. Clinical trials 4. What s new on the PBS? 5. Questions 1.
Disclosures. What Do I Do When Anti-TNF Therapy Is Not Working Anymore? Fadi Hamid, M.D. Saint Luke s GI Specialists
What Do I Do When Anti-TNF Therapy Is Not Working Anymore? Fadi Hamid, M.D. Saint Luke s GI Specialists Disclosures No financial relationships to disclose. 1 Learning Objectives Case 24M with ileocolonic
Efficacy and Safety of Treatment for Pediatric IBD
Efficacy and Safety of Treatment for Pediatric IBD Andrew B. Grossman MD Co-Director, Center for Pediatric Inflammatory Bowel Disease Associate Professor of Clinical Pediatrics Division of Gastroenterology,
Beyond Anti TNFs: positioning of other biologics for Crohn s disease. Christina Ha, MD Cedars Sinai Inflammatory Bowel Disease Center
Beyond Anti TNFs: positioning of other biologics for Crohn s disease Christina Ha, MD Cedars Sinai Inflammatory Bowel Disease Center Objectives: To define high and low risk patient and disease features
Optimizing Management of IBD: Beyond Anti-TNFs Remo Panaccione, MD, FRCPC
Optimizing Management of IBD: Beyond Anti-TNFs Remo Panaccione, MD, FRCPC Director, Inflammatory Bowel Disease Clinic Professor of Medicine University of Calgary 1 Disclosures: R. Panaccione Consultant
Severe IBD: What to Do When Anti- TNFs Don t Work?
Severe IBD: What to Do When Anti- TNFs Don t Work? David T. Rubin, MD, FACG Professor of Medicine Co-Director, Inflammatory Bowel Disease Center Interim Chief, Section of Gastroenterology, Hepatology and
Update on Biologics in Ulcerative Colitis. Scott Plevy, MD University of North Carolina Chapel Hill, NC
Update on Biologics in Ulcerative Colitis Scott Plevy, MD University of North Carolina Chapel Hill, NC Objectives Discuss the latest advances in the pharmacologic management of ulcerative colitis Describe
Efficacy and Safety of Treatment for Pediatric IBD
Efficacy and Safety of Treatment for Pediatric IBD Andrew B. Grossman MD Co-Director, Center for Pediatric Inflammatory Bowel Disease Assistant Professor of Clinical Pediatrics Division of Gastroenterology,
An Update on the Biologic Treatment for Patients with Inflammatory Bowel Disease. David A. Schwartz, MD
An Update on the Biologic Treatment for Patients with Inflammatory Bowel Disease David A. Schwartz, MD Director, Inflammatory Bowel Disease Center Associate Professor of Medicine Vanderbilt University
September 12, 2015 Millie D. Long MD, MPH, FACG
Update on Biologic Therapy in 2015 September 12, 2015 Millie D. Long MD, MPH, FACG Assistant Professor of Medicine Inflammatory Bowel Disease Center University of North Carolina-Chapel Hill Outline Crohn
Latest Meds Approved for IBD: What are they and how do they work?
Latest Meds Approved for IBD: What are they and how do they work? JAMES LORD, MD PHD BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON MEDICAL CENTER SEPT 30, 2018 Brief history of IBD Dr. Burrill Crohn JAMA
Therapies for IBD: the Pipeline. New Therapeutic Agents in IBD
Therapies for IBD: the Pipeline New Therapeutic Agents in IBD William J. Sandborn, MD Professor & Chief, Division of Gastroenterology Director, UCSD IBD Center Budesonide Oral MMX budesonide Rectal budesonide
IBD Biologicals and Novel therapeutic regimes. Dr S K Sinha Additional Professor Department of Gastroenterology PGIMER, Chandigarh
IBD Biologicals and Novel therapeutic regimes Dr S K Sinha Additional Professor Department of Gastroenterology PGIMER, Chandigarh 1 Treatment aims in IBD Traditional treatment goals of IBD Control of symptoms?improvement
Biologics in 2016: How Do We Select the Most Appropriate Agent? Gary R. Lichtenstein, MD, FACG University of PA School of Medicine Philadelphia, PA
Biologics in 2016: How Do We Select the Most Appropriate Agent? Gary R. Lichtenstein, MD, FACG University of PA School of Medicine Philadelphia, PA Overview Indications and Drug Selection Contraindications
Outline. Biologic Drugs in Inflammatory Bowel Disease Dr. Jason Etzel MD The Vancouver Clinic. Biologic Drugs. Biologic Drugs. Biologic Drugs Anti-TNF
Outline Biologic Drugs in Inflammatory Bowel Disease Dr. Jason Etzel MD The Vancouver Clinic Types of biologic drugs How do they work? How effective are they? Safety/Toxicity concerns with biologics Biologic
New and Future Adhesion Molecule Based Therapies in IBD
New and Future Adhesion Molecule Based Therapies in IBD Brian G. Feagan Professor of Medicine, Epidemiology and Biostatistics University of Western Ontario Robarts Clinical Trials London, Ontario, Canada
IBD Updates. Themes in IBD IBD management journey. New tools for therapeutic monitoring. First-line treatment in IBD
IBD Updates Maria T. Abreu, MD University of Miami Miller School of Medicine Miami, Florida Themes in IBD 213 First-line treatment in IBD New tools for therapeutic monitoring Biologic therapy for CD and
Biologic Therapy for Inflammatory. Is Top-Down Too Top-Heavy? S. Devi Rampertab, MD, FACG, AGAF Associate Professor of Medicine University of Florida
Biologic Therapy for Inflammatory Bowel Disease: Is Top-Down Too Top-Heavy? S. Devi Rampertab, MD, FACG, AGAF Associate Professor of Medicine University of Florida Learning Objectives Evaluate evidence
Azathioprine for Induction and Maintenance of Remission in Crohn s Disease
Azathioprine for Induction and Maintenance of Remission in Crohn s Disease William J. Sandborn, MD Chief, Division of Gastroenterology Director, UCSD IBD Center Objectives Azathioprine as induction and
COPYRIGHT. Inflammatory Bowel Disease What Every Clinician Needs to Know. Adam S. Cheifetz, MD. Director, Center for Inflammatory Bowel Disease
Inflammatory Bowel Disease What Every Clinician Needs to Know Adam S. Cheifetz, MD Director, Center for Inflammatory Bowel Disease Beth Israel Deaconess Medical Center Associate Professor of Medicine Harvard
Ulcerative colitis (UC) is a chronic inflammatory
Induction and Maintenance Therapy with Vedolizumab, a Novel Biologic Therapy for Ulcerative Colitis Feagan BG, Rutgeerts P, Sands BE, et al; GEMINI 1 Study Group. Vedolizumab as induction and maintenance
Initiation of Maintenance Treatment in Moderate to Severe New Onset Crohn s Disease
Initiation of Maintenance Treatment in Moderate to Severe New Onset Crohn s Disease The Case for Starting with Anti-TNFα Agents Maria Oliva-Hemker, M.D. Chief, Division of Pediatric Gastroenterology &
Selection and use of the non-anti- TNF biological therapies: Who? When? How?
Selection and use of the non-anti- TNF biological therapies: Who? When? How? Asher Kornbluth, MD Clinical Professor of Medicine The Henry D. Janowitz Division of Gastroenterology The Icahn School of Medicine
Vedolizumab: policing leukocyte traffic
Oxford Inflammatory Bowel Disease MasterClass Vedolizumab: policing leukocyte traffic Dr Brian Feagan, London, Canada Vedolizumab : Policing Lymphocyte Traficking Brian G. Feagan Professor of Medicine,
John F. Valentine, MD Inflammatory Bowel Disease Program University of Utah
John F. Valentine, MD Inflammatory Bowel Disease Program University of Utah Hawaii 1/20/2017 DISCLOSURES Research Support: NIH, Pfizer, Celgene, AbbVie, Roche/Genentech, Takeda, CCFA OBJECTIVES Review
Biologics in IBD. Brian P. Bosworth, MD, NYSGEF Associate Professor of Medicine Weill Cornell Medical College
Biologics in IBD Brian P. Bosworth, MD, NYSGEF Associate Professor of Medicine Weill Cornell Medical College Case 30 year old man diagnosed with ulcerative proctitis diagnosed in 2003 Had been maintained
Position of Biologics in IBD Circa 2006: Top Down vs. Step Up Therapy
Position of Biologics in IBD Circa 2006: Top Down vs. Step Up Therapy Stephen B. Hanauer, MD University of Chicago Potential Conflicts: Centocor/Schering, Abbott, UCB, Elan, Berlex, PDL Goals of Treatment
Selective leucocyte trafficking inhibitors for treatment of IBD
Selective leucocyte trafficking inhibitors for treatment of IBD Séverine Vermeire MD, PhD Department of Gastroenterology University Hospitals Leuven Belgium Migration of Leucocytes plays a key role in
IBD Understanding Your Medications. Thomas V. Aguirre, MD Santa Barbara GI Consultants
IBD Understanding Your Medications Thomas V. Aguirre, MD Santa Barbara GI Consultants IBD Understanding Your Medications (& Your Doctor) Thomas V. Aguirre, MD Santa Barbara GI Consultants Disclosure I
UNC INFLAMMATORY BOWEL DISEASE DRUG PROTOCOL VEDOLIZUMAB (ENTYVIO)
UNC INFLAMMATORY BOWEL DISEASE DRUG PROTOCOL VEDOLIZUMAB (ENTYVIO) TREATMENT PROTOCOL: Vedolizumab is a humanized immunoglobulin G1 monoclonal antibody that targets 41 integrin and blocks its interaction
Join the conversation at #GIFORUMCCFA
1 Join the conversation at #GIFORUMCCFA 2 Disclosures In accordance with the ACCME Standards for Commercial Support of CME, the speakers for this course have been asked to disclose to participants the
Optimizing the effectiveness of anti-tnf therapy in paediatric IBD
Optimizing the effectiveness of anti-tnf therapy in paediatric IBD Anne Griffiths MD, FRCPC Co-Lead, Inflammatory Bowel Disease Center Northbridge Chair in IBD Hospital for Sick Children, Professor of
Personalized Medicine. Selecting the Right First-line Biologic Agent. Gene Expression Profiles Crohn s Disease. The Right Treatment
Personalized Medicine Selecting the Right First-line Biologic Agent William Tremaine, M.D. Maxine and Jack Zarrow Professor Mayo Clinic Rochester, MN, USA The Right Treatment Pretreatment Genomic Analysis
Positioning Biologics in Ulcerative Colitis
Positioning Biologics in Ulcerative Colitis Bruce E. Sands, MD, MS Acting Chief, Gastrointestinal Unit Massachusetts General Hospital Associate Professor of Medicine Harvard Medical School Sequential Therapies
New and Emerging Therapies in IBD. Sarah Streett MD, AGAF Clinical Associate Professor of Medicine Stanford University
New and Emerging Therapies in IBD Sarah Streett MD, AGAF Clinical Associate Professor of Medicine Stanford University New and Emerging Therapies in IBD I have no relevant financial disclosures. IBD is
Current and Emerging Biologics for Ulcerative Colitis
Gut and Liver, Vol. 9, No. 1, January 2015, pp. 18-27 Review Current and Emerging Biologics for Ulcerative Colitis Sung Chul Park* and Yoon Tae Jeen *Division of Gastroenterology and Hepatology, Department
Mono or Combination Therapy with. Individualized Approach
Mono Combination Therapy with Biologics i in IBD: Developing an Individualized Approach David T. Rubin, MD, FACG Co-Direct, Inflammaty Bowel Disease Center Fellowship Program Direct University of Chicago
Inflammatory bowel disease: Novel therpaies NZ November 2018
Inflammatory bowel disease: Novel therpaies NZ November 2018 Dr Charlie Lees Consultant Gastroenterologist From the Edinburgh IBD Unit at the Western General Hospital History of treatment for IBD 1950s
2nd Nottingham IBD Masterclass, 2017
2nd Nottingham IBD Masterclass, 217 Positioning IL12/IL23 blockade in the Crohn s disease treatment algorithm Prof James Lindsay, Consultant Gastroenterologist, Barts Health NHS Trust Professor in Inflammatory
Gionata Fiorino VEDOLIZUMAB E IBD. Un nuovo target terapeutico
Gionata Fiorino VEDOLIZUMAB E IBD Un nuovo target terapeutico Anti cell adhesion molecules Danese S, NEJM 2011 6 Steps leukocyte recruitment Fiorino G. et al. 2010 Vedolizumab Blocks Fewer Biological Pathways
Carefirst.+.V Family of health care plans
Carefirst.+.V Family of health care plans CVS care mark POLICY Document for ENTYVIO The overall objective of this policy is to support the appropriate and cost effective use of the medication, specific
WHY HAVE WE NOT FINALLY FIGURED OUT COMBINATION THERAPY?
WHY HAVE WE NOT FINALLY FIGURED OUT COMBINATION THERAPY? Siew Ng, Professor MBBS, FRCP, (Lon, Edin), PhD (Lond), AGAF, FHKCP, FHKAM (medicine) Department of Medicine and Therapeutics Chinese University
Adverse Events From Biologic Agents in IBD
Adverse Events From Biologic Agents in IBD David A. Schwartz, MD, FACG Director, Inflammatory Bowel Disease Center Professor of Medicine Vanderbilt University Medical Center Case Page 1 of 24 28 yo with
FOR UK NURSING MEDIA Embargoed until: 00:01 GMT, Friday 13 March 2015
Contact: Ross Selby Takeda UK Ltd Email ross.selby@takeda.com News Release FOR UK NURSING MEDIA Embargoed until: 00:01 GMT, Friday 13 March 2015 World s first gut-selective treatment for ulcerative colitis
The Refractory Crohn s Disease
The Refractory Crohn s Disease Patient David T. Rubin, MD, FACG Professor of Medicine Co-Director, Inflammatory Bowel Disease Center Interim Chief, Section of Gastroenterology, Hepatology and Nutrition
Biologics, Novel Therapeutic Approaches in Inflammatory Bowel Diseases
Biologics, Novel Therapeutic Approaches in Inflammatory Bowel Diseases Walter Reinisch Univ-Klinik für Innere Medizin III Abt. Gastroenterologie & Hepatologie AKH Wien The Biologic s evolution From availabilitydriven
Efficacy and Safety of Vedolizumab in Ulcerative Colitis and Crohn s Disease Patients Stratified by Age
Adv Ther (2017) 34:542 559 DOI 10.1007/s12325-016-0467-6 ORIGINAL RESEARCH Efficacy and Safety of Vedolizumab in Ulcerative Colitis and Crohn s Disease Patients Stratified by Age Vijay Yajnik. Nabeel Khan.
Advances in the development of new biologics in inflammatory bowel disease
INVITED REVIEW Annals of Gastroenterology (2016) 29, 1-6 Advances in the development of new biologics in inflammatory bowel disease Bella Ungar, Uri Kopylov Sheba Medical Center, Tel Hashomer and Sackler
Improving outcome of Inflammatory Bowel Disease in children
Improving outcome of Inflammatory Bowel Disease in children Dinesh Pashankar, MD Pediatric Gastroenterologist Director- Pediatric IBD program Yale University School of Medicine Pediatric Gastroenterology
Optimizing Therapies for Severe Ulcerative Colitis October 19, 2014
Optimizing Therapies for Severe Ulcerative Colitis October 19, 2014 Ellen J. Scherl, MD, FACP, FACG, AGAF, FASGE, NYSGEF Director Jill Roberts Center for Inflammatory Bowel Disease Jill Roberts IBD Research
Progress in Inflammatory Bowel Disease
Progress in Inflammatory Bowel Disease Gary R Lichtenstein, MD Director, Center for IBD University of Pennsylvania School of Medicine Hospital of the University of PA Philadelphia, PA Disclosure Research,
Crohn s
Crohn s Disease David T. Rubin, MD, AGAF Joseph B. Kirsner Professor of Medicine Chief, Section of Gastroenterology, Hepatology, and Nutrition Co-Director, Digestive Diseases Center @IBDMD Disclosures
Management of Refractory Crohn s Disease
Management of Refractory Crohn s Disease @IBDMD David T. Rubin, MD, FACG, FASGE Joseph B. Kirsner Professor of Medicine Chief, Section of Gastroenterology, Hepatology and Nutrition Disclosures Consultant
Inflammatory bowel disease: cause(s), cure(s) and prediction of disease flare NZ Society of GI: 21 st November 2018
Inflammatory bowel disease: cause(s), cure(s) and prediction of disease flare NZ Society of GI: 21 st November 2018 Dr Charlie Lees Consultant Gastroenterologist From the Edinburgh IBD Unit at the Western
Drug Class Review Targeted Immune Modulators
Drug Class Review Targeted Immune Modulators Final Update 5 Report June 2016 The purpose of reports is to make available information regarding the comparative clinical effectiveness and harms of different
Management of Moderate to Severe Ulcerative Colitis
Management of Moderate to Severe Ulcerative Colitis Neilanjan Nandi, MD Assistant Professor of Medicine Associate Program Director Division of Gastroenterology Drexel University College of Medicine Hahnemann
Personalized Medicine in IBD
Personalized Medicine in IBD Anita Afzali MD, MPH Assistant Professor of Medicine Director, Inflammatory Bowel Diseases Program University of Washington Harborview Medical Center CCFA April 2 nd, 2016
The future of IBD therapeutic research
The future of IBD therapeutic research Jean-Frederic Colombel, MD Director Susan and Leonard Feinstein IBD Clinical Center Icahn School of Medicine, Mount Sinai Hospital New York J-F Colombel has served
CROHN'S DISEASE/ULCERATIVE COLITIS TREATMENT ALGORITHM
CROHN'S DISEASE/ULCERATIVE COLITIS TREATMENT ALGORITHM Crohn's Disease Ulcerative Colitis Steroids x 2 No prior AZA/6-MP Biologic Agent AZA/6-MP STEP-UP MANAGEMENT APPROACH Advantages Patients attain remission
Emerging Therapies in IBD: The Future is Bright October 28 th 2017
Emerging Therapies in IBD: The Future is Bright October 28 th 2017 Nirmal Kaur, MD Director, Inflammatory Bowel Disease Center Division of Gastroenterology Henry Ford Health System Disclosures Research
Selby Inflamm Bowel Dis. 2008:14:
Medical Management of Inflammatory Bowel Disease Freddy Caldera D.O. Assistant Professor Division of Gastroenterology Objectives Discuss Crohn s disease and Ulcerative Colitis Discuss Medications for Inflammatory
Slide 1. Slide 2. Slide 3. Inflammatory Bowel Disease in the Elderly. IBD and aging. IBD and aging
Slide 1 Inflammatory Bowel Disease in the Elderly Steven N. Fine, MD Chief of GI, MetroWest Med Cntr Med Director, Boston Endo Cntr Slide 2 IBD and aging Are there differences between older and younger
Immunogenicity of Biologic Agents and How to Prevent Sensitization
Immunogenicity of Biologic Agents and How to Prevent Sensitization William J. Sandborn, MD Professor and Chief, Division of Gastroenterology Director, UCSD IBD Center La Jolla, California, USA Learning
Anti-TNF and cyclosporine are identical choices for severe ulcerative colitis refractory to steroid therapy CON Peter Laszlo LAKATOS Semmelweis
Anti-TNF and cyclosporine are identical choices for severe ulcerative colitis refractory to steroid therapy CON Peter Laszlo LAKATOS Semmelweis University, 1st Department of Medicine Budapest June 13-15,
Personalized Medicine in IBD: Where Are We in 2013
Personalized Medicine in IBD: Where Are We in 2013 David A. Schwartz, MD Director, Inflammatory Bowel Disease Center Associate Professor of Medicine Vanderbilt University Medical Center What is Personalized
How to Optimize Induction and Maintenance Responses: Definitions and Dosing Advances in Inflammatory Bowel Disease December 6, 2009
How to Optimize Induction and Maintenance Responses: Definitions and Dosing 2009 Advances in Inflammatory Bowel Disease December 6, 2009 Fernando Velayos MD MPH University of California, San Francisco
Looking for Answers. IBD Research March 9, Dr. Benjamin Click, MD MS Associate Staff Cleveland Clinic
Looking for Answers IBD Research 2019 March 9, 2019 Dr. Benjamin Click, MD MS Associate Staff Cleveland Clinic Disclosures No relevant financial disclosures There is still no cure for IBD Why me? ETIOLOGY
Crohn's Disease. The What, When, and Why of Treatment
Crohn's Disease The What, When, and Why of Treatment Gary R. Lichtenstein, MD, FACG Professor of Medicine Director, Inflammatory Bowel Disease Program University of Pennsylvania Philadelphia, PA In my
Implementation of disease and safety predictors during disease management in UC
Implementation of disease and safety predictors during disease management in UC DR ARIELLA SHITRIT DIGESTIVE DISEASES INSTITUTE SHAARE ZEDEK MEDICAL CENTER JERUSALEM Case presentation A 52 year old male
Available Data on Pediatric Exposure Response a Clinician s Perspective
Available Data on Pediatric Exposure Response a Clinician s Perspective Marla Dubinsky, MD Professor of Pediatrics and Medicine Chief Pediatric GI and Nutrition Co-Director Susan and Leonard Feinstein
PEDIATRIC INFLAMMATORY BOWEL DISEASE
PEDIATRIC INFLAMMATORY BOWEL DISEASE Alexis Rodriguez, MD Pediatric Gastroenterology Advocate Children s Hospital Disclosers Abbott Nutrition - Speaker Inflammatory Bowel Disease Chronic inflammatory disease
Research Update: Looking for the Answers
Research Update: Looking for the Answers Ted Denson, M.D. Schubert-Martin Inflammatory Bowel Disease Center Research Support: NIH/NIDDK, CCFA, BMRP Figure 2 Approach to Improve Outcomes for our IBD Patients
Future Directions in IBD: Treatments & Approaches JAMES LORD, MD PHD BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON MEDICAL CENTER APRIL 29, 2018
Future Directions in IBD: Treatments & Approaches JAMES LORD, MD PHD BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON MEDICAL CENTER APRIL 29, 2018 Why do pharmaceuticals dominate IBD therapy discussions?
Preventive Care and Monitoring of the IBD Patient
Preventive Care and Monitoring of the IBD Patient Francis A. Farraye, MD, MSc, FACG Clinical Director, Section of Gastroenterology Director, Inflammatory Bowel Disease Center Boston Medical Center Professor
Incorporating Biologics Into Your Practice
Incorporating Biologics Into Your Practice Jeffrey M. Sobell MD Tufts University School of Medicine SkinCare Physicians Ora Clinical Research Disclosure Of Relationships With Industry Amgen AbbVie Celgene
Efficacy of Vedolizumab as Induction Therapy for Inflammatory Bowell Disease in a «real-life» Study. Clinical Study
Efficacy of Vedolizumab as Induction Therapy for Inflammatory Bowell Disease in a «real-life» Study Clinical Study Q. Trefois (1), O. Descamps (2), J-C. Coche (3), M. Schapira (4) 1 Depar t m ent o f H
Best Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease
Best Practices in the Diagnosis and Treatment of Inflammatory Bowel Disease Mark Lazarev, MD Summary Inflammatory bowel disease (IBD) is a complex disease that is costly both in terms of medical costs
Malignancy Risk in Pediatric IBD: What to tell parents and patients?
Malignancy Risk in Pediatric IBD: What to tell parents and patients? Corey A. Siegel, MD, MS Geisel School of Medicine at Dartmouth Dartmouth-Hitchcock Medical Center Digestive Disease Week 2017 Chicago,
Highlights of DDW 2015: Crohn s disease
Highlights of DDW 2015: Crohn s disease Mark S. Silverberg, MD, PhD, FRCPC Associate Professor of Medicine, University of Toronto Staff Gastroenterologist, Mount Sinai Hospital Senior Investigator, Lunenfeld-Tanenbaum
Disease Management Strategies for Moderate to Severe IBD in Adults
Disease Management Strategies for Moderate to Severe IBD in Adults Alyssa Parian, MD Assistant Professor of Medicine Johns Hopkins University April 21, 2016 Outline Overview of IBD Treatments (Benefits/Risks)
VACCINATIONS AND INFLAMMATORY BOWEL DISEASE
VACCINATIONS AND INFLAMMATORY BOWEL DISEASE Bob Kizer MD Assistant Professor of Medicine Creighton University School of Medicine CONFLICTS OF INTEREST None 1 AN OPPORTUNITY FOR IMPROVEMENT IBD patients
My Child Has Inflammatory Bowel Disease : Why? What now? What s next?
My Child Has Inflammatory Bowel Disease : Why? What now? What s next? George M. Zacur, M.D., M.S. Clinical Assistant Professor Department of Pediatrics and Communicable Diseases Division of Gastroenterology
Predicting response to anti - integrin therapy: long term efficacy and roles for optimisation with vedolizumab.
Predicting response to anti - integrin therapy: long term efficacy and roles for optimisation with vedolizumab. Dr Peter Irving Guy s and St Thomas Hospital, London King s College London Response to vedolizumab
Cancer Risk with IBD Therapies How to Discuss with your Patients?
Cancer Risk with IBD Therapies How to Discuss with your Patients? Douglas L Nguyen, MD Assistant Clinical Professor of Medicine University of California, Irvine Medical Center H.H. Chao Comprehensive Digestive
Therapeutic Drug Monitoring και ΙΦΝΕ το 2018
Therapeutic Drug Monitoring και ΙΦΝΕ το 2018 TDM: Ναι το χρειαζόμαστε, σε όλους και πάντοτε Κωνσταντίνος Κατσάνος Conflict of interest By means of this, the speaker confirms that he receives honoraria
Long-term Efficacy of Vedolizumab for Crohn s Disease
Journal of Crohn's and Colitis, 217, 412 424 doi:1.193/ecco-jcc/jjw176 Advance Access publication September 28, 216 Original Article Original Article Long-term Efficacy of Vedolizumab for Crohn s Disease
Mucosal healing: does it really matter?
Oxford Inflammatory Bowel Disease MasterClass Mucosal healing: does it really matter? Professor Jean-Frédéric Colombel, New York, USA Oxford Inflammatory Bowel Disease MasterClass Mucosal healing: does
ENTYVIO (VEDOLIZUMAB)
ENTYVIO (VEDOLIZUMAB) UnitedHealthcare Community Plan Medical Benefit Drug Policy Policy Number: CS2017D0053F Effective Date: July 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS...
Rapid response to vedolizumab therapy in biologic-naïve patients with inflammatory bowel diseases
Accepted Manuscript Rapid response to vedolizumab therapy in biologic-naïve patients with inflammatory bowel diseases Brian G. Feagan, MD, Karen Lasch, MD, Trevor Lissoos, MBBCh, Charlie Cao, PhD, Abigail
Michael D. Kreines, M.D.
Michael D. Kreines, M.D. Gastroenterology Section Chief Medical Director, IBD Program The Christ Hospital of Cincinnati Ohio GI and Liver Institute www.ohiogi.com This Year s Story How to figure out how
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at: