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Shrinivas Bishu
@IBDimmunology
IBD Clinical Director + GI APD @UMichGIHep, #BillsMafia, minivan driving husband of @jquigleymd, embarrassing dad of daughters. I peaked in 1996.
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Feb 1, 2022
•
5 tweets
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55 min read
@DCharabaty
@P_DeepakIBDMD
@drvishal82
@MondayNightIBD
@southasianIBD
@nehagastrord
@ibdesis
@ownyourcrohns
@FITWITMD
@crohnsbabble
@rebelliousgut
@ibdseb
@drsumitbhatia
@DrAnjaliPandit
@deepakjgastro
@shivaramsingh
@drroshanag
@stevenbollipo
@drkeithsiau
@doctorboletoh
@Rajatgastro
@KailashKolhe
@DrAnuraagJ
@realTBpeople
@anupam_gastro
@UjjwalSonika
@DrAshokGastro
@vandana_midha
@ashok_doctor
@drakashmathur
@Khanna_S
@miNitinjagtap
@jalpa_devi
@DharJahnvi
@SamirGadepalli
@DrSamirAShah1
@SunandaKaneMD
@UmaMahadevanIBD
@BilalMohammadMD
@AsadurRahman87
@ShimaghavimiMD
@ibdmd_kaur
@IBDMD
@PankajG55222170
@bkocharmd
@vipuljairath
@RocioSedanoMD
A7/1: What agents have RCTs for fistulizing disease? IFX and ADA.
pubmed.ncbi.nlm.nih.gov/10228190/
pubmed.ncbi.nlm.nih.gov/14985485/
pubmed.ncbi.nlm.nih.gov/19201775/
So - IFX works, and ADA probably does as well - but the data is weaker.
@sabpeds
@NeeraGuptaMD
- In peds?
#MondayNightIBD
@southasianIBD
@DCharabaty
@P_DeepakIBDMD
@drvishal82
@MondayNightIBD
@southasianIBD
@nehagastrord
@ibdesis
@ownyourcrohns
@FITWITMD
@crohnsbabble
@rebelliousgut
@ibdseb
@drsumitbhatia
@DrAnjaliPandit
@deepakjgastro
@shivaramsingh
@drroshanag
@stevenbollipo
@drkeithsiau
@doctorboletoh
@Rajatgastro
@KailashKolhe
@DrAnuraagJ
@realTBpeople
@anupam_gastro
@UjjwalSonika
@DrAshokGastro
@vandana_midha
@ashok_doctor
@drakashmathur
@Khanna_S
@miNitinjagtap
@jalpa_devi
@DharJahnvi
@SamirGadepalli
@DrSamirAShah1
@SunandaKaneMD
@UmaMahadevanIBD
@BilalMohammadMD
@AsadurRahman87
@ShimaghavimiMD
@ibdmd_kaur
@IBDMD
@PankajG55222170
@bkocharmd
@vipuljairath
@RocioSedanoMD
@sabpeds
@NeeraGuptaMD
A7/2: What about Vedo - limited, NO RCTs
35% remission at 12 months (VICTORY)
pubmed.ncbi.nlm.nih.gov/27296941/
maintained remission in GEMINI2 post-hoc
pubmed.ncbi.nlm.nih.gov/29471381/
but NOT in P4 ENTERPRISE
pubmed.ncbi.nlm.nih.gov/29471381/
▶️need more data!
@GI_PharmD
thoughts?
#MondayNightIBD
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Feb 1, 2022
•
4 tweets
•
41 min read
@DCharabaty
@P_DeepakIBDMD
@drvishal82
@MondayNightIBD
@southasianIBD
@nehagastrord
@ibdesis
@ownyourcrohns
@FITWITMD
@crohnsbabble
@rebelliousgut
@ibdseb
@drsumitbhatia
@DrAnjaliPandit
@deepakjgastro
@shivaramsingh
@drroshanag
@stevenbollipo
@drkeithsiau
@doctorboletoh
@Rajatgastro
@KailashKolhe
@DrAnuraagJ
@realTBpeople
@anupam_gastro
@UjjwalSonika
@DrAshokGastro
@vandana_midha
@ashok_doctor
@drakashmathur
@Khanna_S
@miNitinjagtap
@jalpa_devi
@DharJahnvi
@SamirGadepalli
@DrSamirAShah1
@SunandaKaneMD
@UmaMahadevanIBD
@BilalMohammadMD
@AsadurRahman87
@ShimaghavimiMD
@ibdmd_kaur
@IBDMD
@PankajG55222170
@bkocharmd
@vipuljairath
@RocioSedanoMD
Peri-anal fistulas = big problem, but relatively few studies on the efficacy of biologics here.
Before looking at the studies- lets consider their limitations.
▶️ simple vs complex fistulas
▶️ outcome metrics
▶️ biases
#MondayNightIBD
@southasianIBD
academic.oup.com/ecco-jcc/artic…
@DCharabaty
@P_DeepakIBDMD
@drvishal82
@MondayNightIBD
@southasianIBD
@nehagastrord
@ibdesis
@ownyourcrohns
@FITWITMD
@crohnsbabble
@rebelliousgut
@ibdseb
@drsumitbhatia
@DrAnjaliPandit
@deepakjgastro
@shivaramsingh
@drroshanag
@stevenbollipo
@drkeithsiau
@doctorboletoh
@Rajatgastro
@KailashKolhe
@DrAnuraagJ
@realTBpeople
@anupam_gastro
@UjjwalSonika
@DrAshokGastro
@vandana_midha
@ashok_doctor
@drakashmathur
@Khanna_S
@miNitinjagtap
@jalpa_devi
@DharJahnvi
@SamirGadepalli
@DrSamirAShah1
@SunandaKaneMD
@UmaMahadevanIBD
@BilalMohammadMD
@AsadurRahman87
@ShimaghavimiMD
@ibdmd_kaur
@IBDMD
@PankajG55222170
@bkocharmd
@vipuljairath
@RocioSedanoMD
A6: Fistulas = severe disease, but the nat. hx of simple and complex are unknown.
▶️Most studies reporting efficacy do not distinguish between these
▶️ this distinction is important, b/c complex fistulas will probably have lower healing rates
#MondayNightIBD
@southasianIBD