The latest in IBD from the European Crohn’s and Colitis Organisation (ECCO) 2019 Congress

Written by Jenny Feehan on Wednesday 27th March 2019

The 14th ECCO Congress was held in Copenhagen, Denmark this year, and welcomed over 6,500 participants to share the most recent updates in inflammatory bowel disease (IBD). Under the theme of ‘research drives clinical care’, the focus was on new ways to optimise current treatments and the potential of novel therapies. I was lucky enough to attend the congress and learn more about the latest in IBD, whilst also having the opportunity to explore the city of Copenhagen. Here are some of my highlights:

Are biologics prescribed early enough in IBD?

This question was consistently asked throughout the four-day event. Biologics are often prescribed later in the course of the disease due to high cost and adverse events; however, recent data support a ‘top-down treatment approach’, i.e. using top-tier drugs such as biologics as the initial treatment. In a presentation entitled ‘When do you start a biologic?’, Professor Simon Travis explained that biologics should be used when the course of the disease can still be changed. Using sailing as an analogy for the treatment of IBD, he told the ECCO audience that they should ‘catch the morning tide’ in regard to biologics.

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IBD in the developing world

The management of IBD in developing countries was also discussed at ECCO 2019.
Dr Rupa Banerjee discussed how ‘best in practice’ treatment approaches are not always feasible outside of the developed world, using her home country of India as an example. As a result of globalisation, IBD prevalence is increasing in developing countries and is becoming a global disease; however, issues such as increased risk of infection and restricted access to costly treatments further complicate the management of IBD in developing countries. Dr Banerjee has recently initiated the IBD-Emerging Economies Group, comprised of 16 countries from South Asia and the Middle East. To conclude her presentation, Dr Banerjee called for global collaboration on IBD research and treatment.

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Future agents and navigating personalised treatment in IBD

The numerous sessions discussing novel treatments at ECCO 2019 made it clear that IBD is an exciting therapy area with many new treatments on the horizon. Novel IBD treatments include anti-integrin therapies, anti-IL-12/23 and anti-IL-22 monoclonal antibodies, JAK inhibitors, anti-adhesion molecules and S1P receptor modulators. While new treatments will offer more choice for patients and the potential for more personalised treatment in IBD, studies testing the efficacy and safety of novel combinations will be required. In addition, presenters highlighted the need for head-to-head comparative trials to help guide treatment decisions.

IBD is a chronic and debilitating disease that has a profound effect on a patient’s life. Currently, there is no cure for IBD; however, seeing the broad range of developments in basic science, translational medicine and clinical management from some of the world’s top scientists at the ECCO Congress, the future management of this condition is certainly looking positive.

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