Ben Click

@IBDimmunology @Bealoquebea 🙏 @IBDimmunology They are likely localized CD as @JeanFredericCo1 referenced. IMO induced by microenvironment tissue trauma/ischemia. 🧐 that isolated anastomotic ulcers generally stay localized and less likely to progress than ileal. So it seems more “contained”

@Bealoquebea Curious what @BenClickMD thinks about this, his focus area

How common are ischemic ulcers at the anastomosis after colonic resection in colon cancer vs Crohn's disease? This study sheds light on a question many have asked ⚠️ Isolated anastomotic ulcerations: 19% in CD vs. 3% in CRC (p < 0.01, OR 6.3) sciencedirect.com/science/articl…

‼️Important HBV reaction prevention in IBD pts. Note JAKi mod risk > aTNF in sAg(-), cAb(+) -> antiviral ppx. @GI_PharmD @JHashashMD @fudmanMD @Waseem_AhmedMD @IBDPharmD #fig2" target="_blank" rel="nofollow noopener">gastrojournal.org/article/S0016-…

Crowdsourcing IBD journal club ideas. What are your biggest clinical impact recent articles? @fudmanMD @DCharabaty @IBDimmunology @Waseem_AhmedMD @EdwardLoftus2 @MLongMD @Bealoquebea

Maybe time to just get the C diff test?

Makes sense and highlights 💊💉needs after ASUC 🏥, but still high (~50%) rate of “treatment failure” in IVCS responsive -> IFX + AZA. ? rapid steroid taper in IFX. ? No proactive TDM in high risk pop. Other thoughts? @Waseem_AhmedMD @berinsj @IBDimmunology

@IBDimmunology @SophieBalzoraMD @Aetna Yeah that was an immediate “WTF” call. Turns out their system just messed up and they meant Remicade. Thanks for the unnecessary work CVS

@BenClickMD @SophieBalzoraMD @Aetna Say WTF? Rituxan?

Not @Aetna now denying coverage on Stelara for a patient in #IBD deep remission after being on drug for almost a year and suggesting Cosentyx and Taltz as alternative treatment options. Yes, you read that right. 🤬

@IBDimmunology @Bealoquebea @LancetGastroHep No 💊💉 works better in SB than colon. Comparatively VDZ may not be as good as others. Postop is diff. Prevention after 🔪 induced remission may be “easier” than healing mod-sev ileal dz. So yes a bit of bad dogmatic rap

As noted by @BenClickMD & @Bealoquebea 🟢VDZ works for POR @LancetGastroHep 👇🏾 ⏺️based on these data, do you think it’s better for ileal CD than given credit for? sciencedirect.com/science/articl…

@JamesLewisGIEpi @DrsMeena Most people get it in their arm, but you have always been a trailblazer!

Use your head and get vaccinated before the holiday season ⁦@DrsMeena⁩

🚨AGA New Guideline Alert🚨 🔗#msdynmkt_trackingcontext=8534adf0-8e34-46ef-b49c-86f0fc90a0ea" target="_blank" rel="nofollow noopener">gastrojournal.org/article/S0016-… ▶️AGA Living Guideline: Pharmacological Management of Moderate-Severe Ulcerative Colitis I’ll break down its 14 recommendations down over the next 7 tweets 🧵 👇 #AGA #GI #UC #IBD #MedTwitter 1/9

First non aTNF to demonstrate efficacy in RCT to 🛑 endo recurrence. Good option and reassuring data to have.

@DuekerJeffrey @IBDimmunology @JHashashMD @FITWITMD @LoriPlung @ownyourcrohns Ditto, maybe even higher which is largely patient driven selection. Virtual care for IBD in Medicare in danger of pre-2020 coverage unless new legislation passed by 1/2025.

Analytics show I do 64.6% telemedicine clinic visits in 2024. New status quo? What are others doing? #ibdtwitter #ibdx @IBDimmunology @JHashashMD @BenClickMD @FITWITMD What do patient advocates think @LoriPlung @ownyourcrohns

More RWE that combo-AT effective in refractory IBD (n=79) @jensemineriomd 🟢Mean Mayo 3▶️1 🟢Mean SES-CD 12▶️4 🟢73% clin improvement 🔴47% AEs (URIs and derm issues mostly) bit.ly/4fm80WI

@GI_PharmD @CrohnsColitisFn Always several year lag behind new recommendation/intervention and routine clinical uptake. Need time to educate community providers. Hopefully will 📈 next few years.

Unfortunate to 👀 that RSV vaccination 💉 rates were low in #IBD population. Per @CrohnsColitisFn health maintenance checklist, RSV vaccination is recommended: crohnscolitisfoundation.org/science-and-pr…

@ABennettMD did an amazing job at #ACG2024 presenting a multi-center study evaluating outcomes in transgender pts with IBD on gender affirming hormones! @VUMCibd @VictorChedidMD @KiraNewmanMDPhD @JustinFieldMD @BenClickMD

@IBDimmunology @DCharabaty @ibdgijami @MondayNightIBD @EliLillyandCo @JosephHabibi_MD @P_DeepakIBDMD @ibdnaik @joshsteinbergMD @Waseem_AhmedMD @JHashashMD @SchairerIBDMD @BattatMD4IBD @fudmanMD @IBD_Houston Not pertinent to case as still endo active dz, albeit better, but in absence of endo dz, no prospective data that treat to histo healing improves clin outcomes. So histo is 👍 if achieved but I do not (yet) treat to proactively. If histo nl in case, 🤔 sampling

@DCharabaty @ibdgijami @MondayNightIBD @EliLillyandCo @JosephHabibi_MD @P_DeepakIBDMD @ibdnaik @joshsteinbergMD @Waseem_AhmedMD @JHashashMD @SchairerIBDMD @BattatMD4IBD @fudmanMD @IBD_Houston Let’s play some scenarios 1. What if pt still symptomatic (on ancillary therapies)? - are you more likely to change MOA? 2. What are people thinking about ‘histologic remission” in CD? Is perfect the enemy of good? Or T2T is histo remission?

🍁Join us now for a vignette convo w @ibdgijami @DCharabaty 🎯Implementing T2T strategy in practice: When to do more, make changes or stay the course? 🆓#CME👉🏽bit.ly/T2Tconvo 🗳️#IBPoll👇🏽 & share your 💭with us ! Supported by educational grant @EliLillyandCo

@IBD_FloMD @Tamara_alhobayb @catherinechoimd @LindsayClarkeMD @dunleavy_katie @GI_Jimmy15 @SGhoneimGI @AKohli_MD @SNaffouj @silverman_anna @JosephHabibi_MD @HSystromMD @SiriUrquhartMD @RussellYanofsky @GI_Zhou @MilestoneIBD @MRegueiroMD @tinahamd @DrsMeena Can someone please sit with @tinahamd ?

#MILESTONE2024 day 2. Amazing experience with the next generation of #IBD leaders @Tamara_alhobayb @catherinechoimd @lindsayclarkemd @dunleavy_katie @gi_jimmy15 @sghoneimgi @akohli_md @snaffouj @silverman_anna @josephhabibi_md @hsystrommd @siriurquhartmd @russellyanofsky @GI_zhou

@fudmanMD @AmelieT27 @JVG_GIMD @DCharabaty @MondayNightIBD @abbvie @JanssenUS @TakedaPharma @IBDJournals @DarrellPardi @john_damianosMD @IBD_JohnD @EugeneYenMD @JonathanMoses77 @KofiClarkeMD @DrRosenIBD @BenjaminLebwohl @RituVermaMD @CeliacResearch @BIDMC_GI @peter_bossuyt @BattatMD4IBD @BenClement_MD @AmJGastro @Khanna_S Coverage and copay is/was a pragmatic issue with MMX. Esp in older pop, fixed income, etc.

@AmelieT27 @JVG_GIMD @DCharabaty @MondayNightIBD @abbvie @JanssenUS @TakedaPharma @IBDJournals @DarrellPardi @john_damianosMD @IBD_JohnD @EugeneYenMD @JonathanMoses77 @KofiClarkeMD @DrRosenIBD @BenjaminLebwohl @RituVermaMD @CeliacResearch @BIDMC_GI @peter_bossuyt @BattatMD4IBD @BenClement_MD @AmJGastro @Khanna_S You bring up interesting point- why do we default to entocort over uceris in MC?

⏰Join us now for a convo led by @JVG_GIMD @DCharabaty 🎯How do you manage a (sometimes stubborn & life altering) cousin of #IBD: #MicroscopicColitis 🗳️#IBDPoll👇🏽& share your thoughts 💭 with us ! Support by educational grants from @abbvie @JanssenUS @TakedaPharma

@EdwardLoftus2 @JCC_IBD @amelia_kellar @pilarnos @guthealthmd @AndresYarur @maria_chs @JoanaTo62523004 @Y_ECCO_IBD Yup. SC is modeled for AUC. Similar findings to Roblin et al. May need higher “targets” for SC IFX to equate to IV pubmed.ncbi.nlm.nih.gov/37934041/

@JCC_IBD @amelia_kellar @pilarnos @guthealthmd @AndresYarur @maria_chs @JoanaTo62523004 @Y_ECCO_IBD Based on these graphs a level of 5 is “bad” and a level of 15 is “good”. Whereas in IV for nonfistulizimg CD a level of 5 is “OK”. Maybe it’s the AUC not the level that matters? Perplexing

Subcutaneous Infliximab Cutoff Points in Patients With #IBD: Data From the ENEIDA Registry. Iborra et al. @pilarnos academic.oup.com/ecco-jcc/advan…

@ibddoctor @EdwardLoftus2 @IBDimmunology @GI_PharmD @MRegueiroMD @ibdgijami Agree, but in a few years we should have decent RWE since the confounding by indication will be rather limited. Would also allow larger sample sizes using multi center or claims data to reduce type II error.

@BenClickMD @EdwardLoftus2 @IBDimmunology @GI_PharmD @MRegueiroMD @ibdgijami Likely never to see HTH, as efficacy is generally in the same neighborhood, and any deltas will be small - so any HTH post Risa-Uste would be very expensive (big sample size) and risky. And once Uste is biosimilar, access to first line p19s will asymptotically approach zero.

📣 New tx for #UC: Tremfya is now FDA approved! jnj.com/media-center/p…