The American College of Gastroenterology’s Annual Scientific Meeting and Postgraduate Course, ACG 2024, took place in Philadelphia, PA from October 25-30, 2024. This esteemed event was designed to address the educational needs and priorities of clinical GI practitioners, showcasing the latest advancements in clinical GI, hepatology, and endoscopy.

During ACG 2024, several key abstracts were presented focusing on Inflammatory Bowel Disease (IBD). These abstracts covered topics such as optimal treatments for patients, the usage of complementary and alternative medicine, outcomes of IBD and pregnancy, and more. Below are concise summaries of some of the studies highlighted at the conference.

Does Starting PPIs Increase the Risk of Complications in IBD Patients on Biologics or Immunomodulators? A Large Multicenter Cohort Study

  • There is a lack of consistent data regarding the use of Proton Pump Inhibitors (PPIs) in patients with Inflammatory Bowel Disease (IBD). Some studies suggest that PPIs may actually increase the risk of complications in IBD patients, while others argue that there is no increased risk once certain biases are accounted for. While most studies have focused on the impact of PPIs on new IBD diagnoses or complications in patients already using PPIs, there is a lack of research on the risk of starting PPIs in patients with IBD who are also on biologics or immunomodulators. The researchers’ goal is to assess the risk of IBD complications, such as flares, bleeding, abscesses, fistulas, and intestinal obstruction, in this specific group of patients.
  • The study found that the risk of IBD complications was higher in patients on biologics or immunomodulators who were not taking PPIs, compared to those who were started on PPIs. The exact mechanism behind the potential benefits of PPIs in IBD is not yet fully understood. Some theories suggest that the chemical structure of PPIs may be similar to metronidazole, which is known to be effective in treating colitis. Others propose that PPIs may help reduce oxidative stress and nitric oxide levels in the gut. Therefore, previous associations between PPI use and worse clinical outcomes in IBD patients are likely influenced by other factors that have not been fully accounted for. Further research is needed to better understand the relationship between PPI use and IBD complications in patients on biologics or immunomodulators.
  • Summary

Efficacy and Safety of Guselkumab Maintenance Therapy Among Guselkumab Induction Week 24 Clinical Responders: Results From the Phase 3 QUASAR Maintenance Study

  • The QUASAR program assessed the effectiveness of guselkumab (GUS), an interleukin-23p19 subunit inhibitor, in patients with moderately to severely active ulcerative colitis (UC). Patients who did not respond to intravenous (IV) GUS during Induction Week 12 (Week I-12) were switched to subcutaneous (SC) GUS until Week I-24. Responders at Week I-24 were considered for maintenance therapy. This study focuses on the efficacy and safety of maintenance SC GUS in patients who responded to GUS at Week I-24.
  • The researchers found that In this group of patients who responded to GUS at Week I-24, maintenance treatment with GUS showed clinical benefits across various important efficacy measures. The safety findings were in line with the overall population and safety profile of GUS in its approved uses.
  • Summary

Risk of Serious Infections in Patients with Ulcerative Colitis Treated with Tofacitinib Compared to Biologic Treatments in the United States

  • Limited information is available regarding safety events associated with tofacitinib when compared to an active comparator using real-world data. In this comprehensive analysis, they investigated the risk of serious infections (SIs) in patients with ulcerative colitis (UC) who were starting treatment with either tofacitinib or biologics. This study utilized data from an adjudicated United States (US) medical and pharmacy claims database provided by Komodo Health.
  • Through this extensive analysis of US-based claims, which accounted for numerous covariates, the researchers found no significant difference in the risk of serious infections among UC patients receiving tofacitinib compared to those receiving biologics. These results hold significant implications for the management of inflammatory bowel disease (IBD).
  • Summary

Inflammatory Bowel Disease-Related Cardiovascular Mortality: Trends in the United States From 1999 to 2020

  • The correlation between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) due to chronic systemic inflammation and endothelial dysfunction is well-established. However, there is a lack of real-world data on cardiovascular mortality among patients with IBD.
  • The overall decrease in all-cause mortality rate (AAMR) from ASCVD-related deaths in patients with IBD reflects the advancements in managing IBD through a treat-to-target approach with disease-modifying medications. Additionally, there has been an increased focus on recognizing and preventing ASCVD in patients with IBD. Nevertheless, the recent uptick in cardiovascular mortality among IBD patients is concerning and may suggest changes in demographics or disease presentation. Further research is necessary to gain a deeper understanding of the natural progression of ASCVD in the IBD population.
  • Summary

Impact of Inflammatory Bowel Disease on the Outcomes of Pregnancy: A National Inpatient Sample Analysis

  • ge. Approximately half of patients diagnosed with Inflammatory Bowel Disease (IBD) are under the age of 35, with a quarter of them conceiving for the first time after their diagnosis. Therefore, it is important to comprehend the impact of IBD on pregnancy and vice versa.
  • Previous studies have shown a significant link between IBD and negative pregnancy outcomes, such as preterm delivery and miscarriages, which aligns with the findings of our research. It is theorized that an increase in prostaglandins during an IBD flare-up could trigger preterm labor by inducing smooth muscle contractions. Research also indicates that having the disease under control before conception leads to better outcomes, while active disease before and during pregnancy can result in adverse perinatal consequences. Recognizing the importance of managing the disease aggressively to reduce negative perinatal events, a collaborative approach involving obstetricians can help achieve positive health outcomes for both the mother and the baby.
  • Summary

Complementary and Alternative Medicine Use Among Inflammatory Bowel Disease Patients Remains Prevalent, Diverse, and Warrants Multidisciplinary Collaboration

  • The utilization of complementary and alternative medicine (CAM) among patients with inflammatory bowel disease (IBD) is widespread, yet many healthcare providers remain unaware of its prevalence. CAM often exerts physiological effects, prompting patients to incorporate these therapies into their treatment regimens despite limited medical evidence. While multidisciplinary care models have been implemented for IBD patients, the integration of CAM experts within these clinics remains uncommon.
  • In an effort to address this gap in care, we conducted a survey among IBD patients to assess their current CAM usage and interest in receiving referrals to an in-network Integrative Health (IH) clinic for expert guidance on CAM therapies. The findings revealed a high prevalence and diversity of CAM use among IBD patients, consistent with existing literature. Notably, one third of patients expressed a desire for referrals to an IH clinic. In response to these findings, our institution has established a referral system for IBD patients interested in consulting with IH providers. To date, over 100 IBD patients have benefitted from consultations with the in-network IH physicians. Further research is warranted to evaluate the impact of integrating IH services into the multidisciplinary care of IBD patients.
  • Summary

Inflammatory Bowel Disease is Associated With Increased Risk of Cardiovascular Events but Not Mortality. Data From a Large US National Database

  • Inflammatory bowel disease (IBD) has been linked to an increased risk of cardiovascular disease, although data on IBD and mortality remains a topic of debate within the medical community. Our objective was to analyze the occurrence of major adverse cardiovascular events (MACE), heart failure, venous thromboembolism (VTE), and all-cause mortality in IBD patients using a comprehensive national dataset from the United States.
  • The analysis of a large national dataset from various US healthcare organizations revealed that IBD patients face a heightened risk of MACE and VTE compared to their age- and race-matched counterparts. This suggests that the disease itself may be a contributing factor to the elevated risk of cardiovascular events. Interestingly, IBD was associated with a lower risk of all-cause mortality. Further research is necessary to identify the specific risk factors influencing these outcomes and to better understand the complex relationship between IBD and cardiovascular health.
  • Summary

Disease Outcomes in Patients With Inflammatory Bowel Disease and Concurrent Hidradenitis Suppurativa: A Nationwide Cohort Study

  • Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful skin lesions that develop in areas rich in apocrine glands, most commonly the axillary, inguinal, and anogenital regions. Inflammatory bowel disease (IBD), which includes Ulcerative colitis (UC) and Crohn’s disease (CD), is a well-known inflammatory disorder of the gastrointestinal tract with documented extraintestinal manifestations.Research has suggested a potential connection between HS and IBD due to the shared inflammatory nature of both conditions. While TNF-alpha inhibitors have shown efficacy in treating both diseases, there is limited data on the impact of these medications on IBD outcomes in individuals with concurrent HS.
  • The objective is to conduct the largest retrospective cohort study to date focusing on the IBD outcomes in individuals with both HS and IBD. When HS and IBD coexist, there is an increased risk of intestinal complications and extraintestinal manifestations. Additionally, there are notable differences in medication usage compared to individuals without HS. In conclusion, the relationship between HS and IBD is complex and warrants further investigation to better understand the implications for patient care and treatment strategies.
  • Summary

Thank you for joining us for this recap of the ACG 2024 Annual Scientific Meeting and Postgraduate Course. We recommend visiting this link to explore all the posters presented at the event. We look forward to seeing you at ACG 2025!

Sign up for alerts and stay informed on the latest published guidelines and stay tuned for our conference recaps.

Copyright © 2024 Guideline Central, All Rights Reserved.