Volume 26, Issue 4, April 2020

The review adopts a translational approach examining proof-of-concept from preclinical studies and clinical evidence supporting the role of the bidirectional gut-brain axis in IBD and describes implications for optimal management.

This article summarizes 2 Cochrane systematic reviews on cannabis use in IBD. The safety and effectiveness of cannabis and cannabinoids in IBD were uncertain due to generally low quality and sparse data. Larger studies with higher methodological quality are needed.

The article comments on the recent systematic review and meta-analysis of dietary interventions for Crohn’s disease and ulcerative colitis. We discuss the pitfalls of current data and emphasize the importance of further research into diets and inflammatory bowel diseases.

Protocol-specified corticosteroid tapering regimens vary across trials. Most trials keep the dose of corticosteroids stable during induction therapy, after which a mandatory and structured taper is implemented, albeit with the investigators’ discretion depending on clinical status. Rates of corticosteroid-free clinical remission are 18%–24% lower than overall rates clinical remission.

miRNAs and interleukin (IL)-6/signal transducers and activators of transcription 3 (STAT3) signaling plays an important role in the development of colitis-associated colorectal cancer. In this study, we investigated whether higher miR-29a-5p levels and IL-6/STAT3 activation might compose a positive circle for maintaining the inflammatory environment.

Decreased expression and function of intestinal chloride transporter DRA are key contributing factors in IBD-associated diarrhea. This study highlights the therapeutic importance of the micronutrient ATRA in ameliorating diarrhea by counteracting inflammation-induced downregulation of DRA expression in vitro and in vivo.

With the present study, we demonstrate that siblings with different genotypes but the same mother and fed by the same milk develop a specific genotype-dependent intestinal microbiota at 4 weeks of age; differences between microbial communities persist and consolidate with age.

This study shows that ulcerative colitis (UC) patients display a TH2/TH1 or Th17/M1 monocyte-driven phenotype. These conditions are reflected in the NOD/scid IL-2Rγ ^null (NSG)–UC mouse model. The response to adalimumab in the NSG-UC model is higher in the TH2/TH1-driven group.

Personalized, model-based induction dosing aiming at here-established target concentrations may account for interindividual pharmacokinetic variability and thus provide patients with more equal chances of achieving endoscopic remission. Higher golimumab induction dosing requires investigation to secure its future in clinical practice.

Although the incidence of inflammatory bowel disease (IBD) in Manitoba, Canada, is decreasing over time, we have identified geographic areas with persistently higher IBD incidence that warrant further study for etiologic clues.

High-dose influenza vaccine improves immunogenicity compared with standard-dose vaccine in patients with IBD on anti-TNF therapy and may provide better protection against infection. Vedolizumab does not impact immune response to influenza vaccine in patients with IBD.

Almost half of the 1122 patients who switched to a second anti-TNF after primary failure, secondary failure, or intolerance to the first anti-TNF achieved remission after switching. Factors associated with loss of response were type of IBD and combo therapy.

With increasing treatment options for the care of inflammatory bowel disease (IBD), providers need additional information to assist with sequencing treatments. This editorial summarizes the results of a recently cohort study and provides guidelines for sequencing therapies in IBD patients.

Inflammatory bowel disease (IBD) prevalence in the United States has not been updated in nearly 10 years. We used real-world data from 2016 to re-estimate IBD prevalence. We found that IBD prevalence has been increasing greatly in both pediatric and adult populations.

The prevalence of inflammatory bowel disease and costs of care are rising in the United States and highlight the need for effective, cost-effective therapies.

Switching from infliximab originator to CT-P13 was not associated with an increased risk of treatment discontinuation, loss of clinical remission, or adverse events. No significant changes in infliximab trough levels or immunogenicity were identified.

Pediatric inflammatory bowel disease is increasing in incidence and severity, which raises concern for related health care expenditures. Severity of disease at time of diagnosis and use of biologic infusion therapy dramatically increase costs in the first year after diagnosis.

The single-center retrospective study by Fondell et al. demonstrates the high direct cost of care for pediatric inflammatory bowel disease. Their data highlight critical issues that must be tackled to ensure access and affordability for those affected and their families.

BT-11 treatment is well-tolerated with no dose-limiting toxicities or systemic immunosuppression up to daily oral doses of 100 mg/kg in the first-in-human single ascending dose and 7-day multiple ascending dose studies.

After treatment with vedolizumab, a patient with diarrhea and malnutrition secondary to common variable immune deficiency (CVID)–related enteropathy was able to achieve clinical, endoscopic, and histological improvement. Vedolizumab may be a treatment option for patients with CVID-associated enteropathy.

Current IBD vaccination and immunization guidelines need to be widespread.