Christina Ha MD, FACG, AGAFAssociate Professor of Medicine at Cedars-Sinai Medical Center, Los Angeles
Parambir Dulai MBBS, MD, AGAFAssistant Professor of Clinical Medicine at University of California, San Diego
Brian Bressler MD, MS, FRCPCClinical Associate Professor of Medicine, Division of Gastroenterology at University of British Columbia’s Department of Medicine
William Sandborn MDProfessor of Medicine University of California, San Diego
The agenda for this live webinar includes three 35-minute Presentations and a 10-minute Panel Discussion moderated by Prof. William Sandborn with Dr. Christina Ha, Dr. Parambir Dulai and Dr. Brian Bressler.
10:00 – 10:05: Opening and Introduction
10:05 – 10:40: Lecture 1 – What’s New in Treating IBD in 2021?
10:40 – 11:15: Lecture 2 – What Does Comparative Evidence and Predictors of Response Teach Us About Choosing Therapies in IBD?
11:15 – 11:50: Lecture 3 – Role of Sequencing Biologics and Small Molecules in IBD
11:50 – 12:00: Panel Discussion and Question & Answers
Lecture 1 – What’s New in Treating IBD in 2021?
(Speaker: Dr. Christina Ha)
We have come a long way learning about the disease progression of IBD and how to best manage IBD patients especially with the development of more advanced therapies such as biologics and small molecules.
Management of IBD in the past primarily focused on the induction of clinical remission and steroid free remission. As we fast forward to 2021, the treatment strategies have dramatically changed as more evidence start appearing in the literature.
In this presentation, Dr. Christina Ha will review the evolving treatment strategies in IBD and what we should know in 2021 when treating IBD. She will review the concepts of the treat to target underpinning the STRIDE guideline. What the latest AGA guidelines teach us about risk stratification approach of identifying high risk vs low-risk patients when deciding on which therapies to use and most importantly what are the new trends in IBD management ahead of us as we move into 2021.
Lecture 2 – What Does Comparative Evidence and Predictors of Response Teach Us About Choosing Therapies in IBD?
(Speaker: Dr. Parambir Dulai)
From conventional therapies like steroid, mesalamine and immunomodulators to biologics which have dramatically changed patient’s life. More recently, tofacitinib entered the market as effective induction therapy and other immunosuppressive drugs are expected to be launched in the near future.
Nevertheless, clinical decisions in many scenarios are simply intuitive with no hard evidence guiding neither patients nor physicians. Whilst physician can rely on the comparative evidence through meta-analysis and propensity balanced comparative studies, Head-to-Head studies, being the gold standard for comparative study are hard to come by. Decisional making process often goes beyond comparative effectiveness and safety. The physician also needs to consider patient preference, compliance-based on the route of administration and most importantly, how do we decide when it is better to administer a particular biologic in a particular type of patient? We have learnt that the immunobiology for IBD is different for different patient and the type of advanced therapy that will be best responsive for the patient is also different. Should we recommend to a particular patient to abandon infliximab? Should we use a combination or mono-therapy?
With the emergence of personalized medicine in several conditions, we should swift our treatment strategies to individual predictions. Whilst prediction using genetic signature is still a work in progress, several predictive models have been developed to predict response to therapy based on patient profile and history of treatment.
In this presentation, Dr. Parambir Dulai will review the comparative evidence for ulcerative colitis and Crohn's disease and visit some of the clinical decision tools that can help to support physicians choosing the biologics that will best respond for the individual patient profile.
Lecture 3 – Role of Sequencing Biologics and Small Molecules in IBD
(Speaker: Dr. Brian Bressler)
As the therapeutic armamentarium for IBD grows, it becomes increasingly important to gain an understanding on the positioning of various advanced therapies (biologics and small molecules) used in a way that can maximize drug efficacy and patient outcome. We have to date: Anti-TNF biologics such as Infliximab, Adalimumab, Golimumab and Anti-integrin biologics like vedolizumab and natalizumab. What is in front of us, we have ustekinumab and small molecules like Tofacitinib for UC. Bearing in mind that a previous therapy may influence the maximal effect of a subsequent drug, this means not only looking at comparative efficacy and safety but also the sequencing of each medicine when choosing first-line biologic or small molecule. In this presentation, Dr. Brian Bressler will look at some of the evidence in the literature that can help guide us in choosing the right therapy for the right patient at the right time and sequence to maximize patient outcome.
Dr. Christina Ha received her BA from Harvard College and MD from the Albert Einstein College of Medicine in New York. She completed her internal medicine residency and fellowship at the Washington University in St. Louis School of Medicine and then received additional training as the Present-Levison Inflammatory Bowel Diseases Fellow at the Mount Sinai School of Medicine. After fellowship, she joined the faculty as Co-Associate Director of Clinical Research at the Meyerhoff Inflammatory Bowel Disease Center at the Johns Hopkins School of Medicine. From there, she became the Associate Director of Clinical Programs for the Center for Inflammatory Bowel Diseases at the David Geffen School of Medicine and now is a member of the Inflammatory Bowel Disease Faculty as an Associate Professor of Medicine at Cedars-Sinai Medical Center. Her clinical research interests focus on the impact of ageing on the natural history of the inflammatory bowel diseases, especially the pathogenesis and natural history of late-onset IBD.
She is the Director of the Inflammatory Bowel Disease fellowship at Cedars-Sinai Medical Center and active within the gastroenterological societies, serving on multiple committees within the Crohn’s and Colitis Foundation, American College of Gastroenterology, American Gastroenterological Association Gastroenterology (ACG) and the American Society for Gastrointestinal Endoscopy (ASGE).
Parambir Dulai, MBBS, is a board-certified gastroenterologist with expertise in inflammatory bowel disease (IBD). Dr. Dulai's research focus is on IBD, which includes ulcerative colitis and Crohn's disease. He is the recipient of the 2019 American Gastroenterology Association research scholar award and currently runs a multi-centre clinical trial. Dr. Dulai is a reviewer in gastroenterology journals and presents his research at national and international conferences.
As an assistant professor in the Department of Medicine, he trains medical students, residents, and fellows at UC San Diego School of Medicine.
Dr. Dulai completed his gastroenterology fellowship, which included a focused year of IBD training, at UC San Diego School of Medicine. He also served as the chief gastroenterology fellow. He completed a residency in internal medicine at Dartmouth-Hitchcock Medical Center, where he was a chief resident. He earned his medical degree (MBBS) from Dayanand Medical College and Hospital. He is board-certified in internal medicine and gastroenterology.
Dr. Dulai is a member of the American Society of Gastrointestinal Endoscopy, American College of Gastroenterology, and the Gold Humanism Honor Society.
Dr. Brian Bressler is a Clinical Associate Professor of Medicine, in the Division of Gastroenterology at the University of British Columbia’s Department of Medicine.
Dr. Bressler received his MD from the University of British Columbia and completed his residency in internal medicine and gastroenterology at the University of Toronto.
He received an MS in Epidemiology from the Harvard Public School of Health and completed an advanced fellowship in IBD at Massachusetts General Hospital, Harvard Medical School.
Dr. Bressler is the Director of the Advanced IBD training program at the University of British Columbia and Co-Founder of the IBD Centre of BC and is a recognized expert in inflammatory bowel disease with over 100 peer-reviewed manuscripts.
Prof. William Sandborn, MD, is a board-certified gastroenterologist who is one of the world's top experts in the management of ulcerative colitis and Crohn’s disease. He directs the Inflammatory Bowel Disease (IBD) Center at UC San Diego Health. He is also chief of the Division of Gastroenterology, vice chair of clinical operations for the Department of Medicine, and a member of the Clinical Practice Oversight (CPO) Board for UC San Diego Health.
He is a Professor in the Department of Medicine at UC San Diego School of Medicine, Dr. Sandborn conducts clinical trials in IBD and leads a team of physicians, research fellows, nurses, and study coordinators.
With his physician collaborators, he evaluates and develops new diagnostic modalities and medical therapies for inflammatory bowel disease.
Dr. Sandborn is internationally recognized for his contributions in the fields of biotechnology therapy, clinical pharmacology, the conduct of clinical trials, diagnostic and treatment of pouchitis, epidemiology and natural history, and endoscopic and radiographic imaging techniques.
Dr. Sandborn clinical trials have been instrumental to developing modern treatments for IBD. He has published nearly 600 articles in prestigious journals, including the New England Journal of Medicine, The Lancet, JAMA, the Annals of Internal Medicine, and Gastroenterology.
Prior to joining UC San Diego Health, Dr. Sandborn worked in the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, Minn. He completed his fellowship at Mayo Clinic, and did his residency and earned his medical degree at Loma Linda University School of Medicine. He is board-certified in gastroenterology.
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