Making the Most of IBD Treatment

Announcer:
Welcome to Crohn’s & Colitis Foundation Perspectives on ReachMD. Here’s your host, Dr.Charles Turck.

Dr. Turck:
This is Dr. Charles Turck for ReachMD here talking to several faculty from the upcoming Crohn's and Colitis Congress, a partnership of the Crohn's and Colitis Foundation and the American Gastroenterological Association. Joining me to talk about some of the highlights from her upcoming presentation at the Congress is Dr. Marla Dubinsky from Mount Sinai Kravis Children's Hospital. Dr. Dubinsky, it's great to have you with us.

Dr. Dubinsky:
Thank you so much for having me.

Dr. Turck:
She'll be speaking on getting the most from the drugs we have at our disposal to treat IBD at the Congress, and I'd love to hear a quick overview of the topics you'll cover during your presentation.

Dr. Dubinsky:
Sure. When it comes to the concept of getting the most out of the drugs we have, I think it involves really integrating some key pillars of care, which I will be covering in the lecture. One is the use of therapies early in order to get the best outcomes from our therapies. Two is to use a target that these therapies can achieve, and three is to use tight control including therapeutic drug monitoring as a way to keep your patient achieving that target long term.

Dr. Turck:
What do you feel will be the key takeaway from your presentation?

Dr. Dubinsky:
So, there's a couple of key takeaways, and they all fall under these three pillars. One is treat early. We know that our therapies work best when you use them early before disease progression - or what we say - bowel-wall damage has occurred, because our therapies, when you use them later do not work as well as they do earlier, which is where we speak to this concept of a window of opportunity, which is pre-irreversible bowel-wall damage has occurred. The concept of choosing a target, we know that this is a moving target, we move from a symptom-based target to a symptom-plus-endoscopic target, and we're even potentially moving deeper, which is beyond endoscopic improvement, but also targeting histology, particularly when it comes to ulcerative colitis. So, this concept of understanding symptoms plus an objective measure, and then we talk about tight control, which is really the utilization of noninvasive biomarkers or markers of inflammation, for which you can track early on after you've started a therapy to look for a reduction or a change, which gives you an idea that you are on your way towards achieving the target, benchmarking those biomarkers against the target to confirm that once you have reached your target these biomarkers do indeed match, and therefore you can then use these biomarkers to tightly control the disease and keep them at the target, and that includes fecal markers, serum markers, maybe even bowel-wall ultrasound, and also therapeutic drug monitoring.

Dr. Turck:
And, from your perspective, how might your peers best translate what to learn from your presentation into practice?

Dr. Dubinsky:
Sure, I think that if all of us as IBD providers take into account these three pillars of care of early effective intervention, treats target, and tight control, and actually communicate those goals to the patient, I think together we'll be able to coordinate the care such that patients are achieving their outcome of normal quality of life, no disability, and be able to actually allow patients or afford them the opportunity to thrive and not just survive.

Dr. Turck:
Dr. Dubinsky, thank you so much for taking the time to speak with us today.

Dr. Dubinsky:
Thank you so much for having me.

Dr. Turck:
We're eager to hear your presentation and the other great content from the 2021 Crohn's and Colitis Congress taking place January 21st-24th. Learn more about this and other presentations at www.crohnscolitiscongress.org. I'm Dr. Charles Turck with ReachMD. Thank you for joining us.

Announcer:
This episode was brought to you in collaboration with the Crohn’s & Colitis Foundation and
the American Gastroenterological Association. To learn more about the Crohn's & Colitis
Congress, please visit crohnscolitiscongress.org. Thanks for listening!