🥊 #HitMeWithYourBestShot: Reguiero vs Siegel

@MRegueiroMD➕anti-TNFs "Why wouldn't we use anti-TNF as first line #IBD therapy?!"

#AIBD2021 @IBDConference @DrCoreySiegel ImageImageImageImage
Anti-TNFs are EFFECTIVE ImageImageImageImage
We know a LOT about #TDM in anti-TNFs ImageImageImageImage
We have PRECISION MEDICINE with anti-TNFs Image
Anti-TNFs
⬆️infections, but otherwise very safe Image
Anti-TNFs work for MULTIPLE ASPECTS of #IBD, especially fistulae Image
Anti-TNFs are effective for POSTOP CROHN DISEASE ImageImage
Anti-TNFs are THE BEST treatment for EIMs Image
ACESS is easiest with anti-TNFs

Think of biosimilars like fingerprints ImageImageImageImage
"Dr. @DrCoreySiegel, @DartmouthHitch gastroenterologist, scientist, and future Nobel Prize winner 🏅: -@MRegueiroMD 😂 Image
Cons of non anti-TNF biologics ImageImage
@MRegueiroMD: start with anti-TNFs Image
@DrCoreySiegel: anything BUT anti-TNF!

Many factors go into choosing the right therapy for the right patient Image
The data for safety of VDZ and UST speak for themselves. "Probably as safe as not being on any drug in terms of side effects." ImageImage
While there is a small ⬆️ risk of lymphoma and skin cancers in anti-TNFs, there is NO risk of cancers in vedolizumab or ustekinumab. Image
"@MRegueiroMD, this is YOUR safety pyramid!" 😂

While efficacy is about equivalent, safety is better for VDZ/UST Image
Need to consider the efficacy and safety profile of COMBO therapy with anti-TNFs Image
Immunogenicity is highest for anti-TNFs Image
From real world EVOLVE-UC, it doesn't matter if we start or end at anti-TNF. So we CAN try non-TNFs first without worry. Image
Ustekinumab used first ⬆️⬆️⬆️⬆️QALYs Image
How to select first biologic:

Apart from ASUC and perianal CD, the efficacy of TNFs and non-TNFs are basically the same. The non-TNFs are safer. We don't lose efficacy of TNF if we start with non-TNF.

Shared decision making with patient! 🤝 Image

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#GITwitter #GI #FGID #DGBI
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All TDM should be performed in the context of the clinical disease activity and severity -@IBDMD
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#GITwitter #IBD
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