In It for the Long Haul: Managing the Complexity of Crohn’s Disease

Summary of presentations from the Takeda-Sponsored Symposium held on at the 11th Congress of the European Crohn’s and Colitis Organisation (ECCO) in Amsterdam, Netherlands, on 18th March 2016

Chairperson: Michael A. Kamm1
Speakers: Michael A. Kamm,1 Remo Panaccione,2 Stefan Schreiber3

1. St Vincent’s Hospital, Melbourne, Australia
2. Inflammatory Bowel Disease Group, University of Calgary, Calgary, Canada
3. Department of General Internal Medicine, Christian-Albrechts-Universität zu Kiel, University Hospital Schleswig-Holstein, Kiel, Germany

Disclosure: Michael A. Kamm has received research support from AbbVie and Ferring and has served as a consultant and speaker for AbbVie, Ferring, Janssen, Merck Sharp & Dohme, Pfizer, and Takeda. Remo Panaccione has received research/educational support from AbbVie, Abbott, Ferring, Janssen, Schering-Plough, Centocor, Millennium, Elan, Procter & Gamble, and Bristol-Myers Squibb. He has served as a consultant for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Eisai, Ferring, Janssen, Merck, Schering-Plough, Shire, Centocor, Elan, GlaxoSmithKline, UCB, Pfizer, Bristol-Myers Squibb, Warner Chilcott, Takeda, Cubist, Celgene, Gilead Sciences, and Takeda. Remo Panaccione has also participated on speaker’s bureaus for AbbVie, AstraZeneca, Janssen, Schering-Plough, Shire, Ferring, Centocor, Elan, Prometheus, Warner Chilcott, and Takeda. He has attended Advisory Boards for AbbVie, Abbott, Amgen, Aptalis, AstraZeneca, Baxter, Eisai, Ferring, Genentech, Janssen, Merck, Schering-Plough, Shire, Centocor, Elan, GlaxoSmithKline, UCB, Pfizer, Bristol-Myers Squibb, Warner Chilcott, Takeda, Cubist, Celgene, and Salix. Stefan Schreiber has served as a consultant for AbbVie, BMS, Boehringer Ingelheim, Ferring, Janssen, Medimmune/AstraZeneca, Merck Sharp & Dohme, Pfizer, Sanofi, Takeda, and UCB. He has given paid lectures for AbbVie, Ferring, Merck Sharp & Dohme, Takeda, and UCB.
Acknowledgements: Writing assistance was provided by Ian Woolveridge, MA (Hons), PhD, CMPP, at Ashfield Healthcare Communications Ltd.
Support: The publication of this article was funded by Takeda. The views and opinions expressed are
those of the speakers and not necessarily of Takeda.
Citation: EMJ Gastroenterol. 2016;5[Suppl 6]:2-11.

Meeting Summary

The challenges of, and opportunities for optimal long-term management of Crohn’s disease (CD) and real-world experience of managing CD and its application in clinical practice were discussed at this symposium. CD is a complex disease, which requires effective treatment options to improve the quality of life for patients, both in terms of intestinal and extraintestinal manifestations (EIMs). Increased gut permeability of luminal antigens may play a primary role in the pathogenesis of CD, leading to dysregulation of the host’s immune response, and resulting in increased levels of tumour necrosis factor (TNF)-α and interferon (IFN)-γ in the inflamed mucosa of patients. Appropriate management goals need to be established by the physician and patient together. Anti-TNF therapy is not suitable for all patients, and a significant proportion of patients will be primary non-responders. Safety must also be considered as part of a patient-tailored assessment. Vedolizumab is a gut-selective antibody to α4β7 integrin for the treatment of ulcerative colitis (UC) and CD. An integrated Phase II and III safety analysis showed that vedolizumab exposure was not associated with increased risk of any infection or serious infection, or any cases of progressive multifocal leukoencephalopathy (PML), a rare and usually fatal viral disease characterised by progressive damage of the white matter of the brain at multiple locations. Data from the GEMINI trials with vedolizumab showed it to be effective versus placebo, in terms of eliciting both initial and sustained responses, and inducing remission in CD. The real-world studies with vedolizumab in >800 CD patients, most of whom failed ≥1 anti-TNF therapy, confirmed the efficacy and safety reported in clinical trials. Up to 30% of CD patients are receiving vedolizumab as a first biologic in the real-world setting.

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