2017 · CGH · Podcast

GI Pearls – September 15-30 2017 – Episode 10

Show Notes for September 15-30, 2017  Episode 010
  1. Global Burden of Disease Study 2016 – Lancet
  2. Proton Pump Inhibitors Decrease Phlebotomy Need in HFE Hemochromatosis: Double-Blind Randomized Placebo-Controlled Trial – Gastro
  3. Influence of Age and Eosinophilic Esophagits on Esophageal Distensibility in a Pediatric cohort – Am J Gastro
  4. Long-Term CRC Incidence After Negative Colonoscopy in the State of Utah: Teh effect of Family History. – Am J Gastro
  5. Fecal Incontinence Is associated with Mortality Among Older Adults with Complex Needs – Am J Gastro
  6. Screening for Occult Cancer in Patients with Unprovoked Venous Thromboembolism – Annals of IM
  7. The Durability of Antireflux Surgery – JAMA
  8. Association of prophylactic endotracheal intubation in critically ill patients with upper GI bleeds and cardiopulmonary unplanned events – GIE
  9. Age of red cells for transfusion and outcomes in critically ill adults. – NEJM
  10. The Natural History of Sever Acute Liver Injury – Am J Gastro
  11. Esophageal Dilation with either bougie or balloon technique as a treatment for eosinophilic esophagitis: a systematic review and meta-analysis – GIE
2017 · Podcast

GI Pearls – September 1-15 2017 – Episode 9

Show Notes for September 1-15 2017  Episode 009
  1. Asthma Is Associated With Subsequent Development of Inflammatory Bowel Disease: A Population-based Case–Control Study  – CGH
  2. Laboratory predictors of bleeding and the effect of platelet and RBC transfusions on bleeding outcomes in the PLADO trial – Blood
  3. Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis – Gut
  4. Major Bleeding Risk During Anticoagulation with Warfarin, Dabigatran, Apixaban, or Rivaroxaban in Patients with Nonvalvular Atrial Fibrillation. – J of Managed Care & Spec Pharm
  5. Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs. – GIE
  6. High Dietary Intake of Specific Fatty Acids Increases Risk of Flares in Patients With Ulcerative Colitis in Remission During Treatment With Aminosalicylates – CGH
  7. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes – Dis of Col and Rectum.
  8. Measurement Bias of Polyp Size at Colonoscopy – Dis of Col and Rectum.
  9. Chronic Pancreatitis and Pancreatic Cancer Risk: A Systematic Review and Meta-analysis – Am J Gastro.
  10. Rural and Urban Residence During Early Life is Associated with Risk of Inflammatory Bowel Disease – AmJGastro
  11. What’s new in Rome IV – Neurogastro & Motility
  12. Fecal Calprotectin Levels Predict Histological Healing in Ulcerative Colitis – IBD Journal
  13. Weight and Metabolic Outcomes 12 Years after Gastric Bypass – NEJM
2015 · Article · Uncategorized

AJM300 – Oral Therapy for Ulcerative Colitis

I am surprised that there are so few new oral drugs coming out for IBD. I guess Infusions are all the rage due to potential profits.  AJM300 has been around for a while, and I remember seeing an abstract for it at DDW last year.

This Article – in Gastroenterology, which has been online for a while, finally came out in print edition.

AJM300 is an alpha4 integrin antagonist. In their paper describing a double-blind, placebo-controlled phase 2a study, AJM300 was shown to be well tolerated and more effective than placebo including both clinical response, remission and mucosal healing.

For those of you like me, who do not remember what Phase 2a is – Pilot clinical trials to evaluate efficacy ( and safety) in selected populations of patients with the disease or condition to be treated, diagnosed, or prevented. Objectives may focus on dose-response, type of patient, frequency of dosing, or numerous other characteristics of safety and efficacy.  (2B being a larger study showing efficacy, the so-called “Pivotal trial”).

Another interesting statement in the article made me aware of the number of cases of PML as a result of Natalizumab treatment – 2.1 cases per 1000 (total of 212 cases out of 99,751 patients treated). Two take aways for me – I had no idea that many patients were treated with Ntalizumab!!!I had no idea that there was a registry, but that makes sense.

Once again, remember,  JCV negative patients never get PML.

Lastly, efficacy in this group: I will only mention mucosal healing which is most important for these pilot studies:  58.8% – AJM300 versus 29.4% in placebo group. – another reminder that a third of patients with UC will just get better.