John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. Microbiome, probiotics, brain-gut, diet, motility, IBD, MedEd 🇬🇷

Oct 23, 2022, 19 tweets

Discussing inflammatory bowel disease treatments with patients, with @tinahamd

#MedTwitter #GITwitter #IBD #ACG2022

First, need to explain #IBD itself to patients

🔌anti-TNFs "block the plug," preventing turning on the inflammatory pathways

Factors that influence PK of anti-TNFs

Adverse effects of anti-TNFs: what are they and more importantly, how can we prevent them?

Practical tips for anti-TNFs

⛔️Vedolizumab blocks lymphocytes from entering GI lumen

Adverse effects of vedolizumab

Low immunogenicity

Practical tips for vedolizumab

🔌p19 and p40 agents: dual-pronged plug

Adverse effects of p19 and p40 agents

Low immunogenicity

Practical tips for p19 and p40 agents

💡Great option for patients with dermatologic conditions (but not great if spondyloarthropathies)

🀄️Jak inhibitors: prevent domino effect of inflammatory cascade

Adverse effects of Jak-inhibitors

💡Remember that active disease and steroids also ⬆️ thromboembolic risk

Practical tips for Jak-inhibitors

💡Especially helpful in axial spondyloarthropathies

💡Use validated CVD risk scores

S1P agents: a parking lot, a highway, and a target site

Adverse effects of S1Ps

Practical tips for S1Ps

What to consider when selecting #IBD treatment

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