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Charlie Lees Profile picture
Charlie Lees
@charlie_lees
I write about inflammatory bowel disease providing inspiration, education and deep community. I am Professor of Gastroenterology and UKRIFLF. I also run a lot.
Dec 28, 2022 • 20 tweets • 22 min read
IBD and COVID - a personal recap 🧵

The papers published in chronological order

Guidelines for clinical teams and patients, risk of severe covid, immune response to infection and vaccines - from wild-type virus to Omicron

It is all covered here 👇 Most of this is thanks to the tireless work of @clarityibd and @VIPStudy1 teams

With thanks to all the investigators across the UK

And to the thousands of patients who contributed 🙏
Dec 27, 2022 • 14 tweets • 13 min read
Top 12 papers on gut inflammation from 2022

These are the scientific / translational papers that had the biggest impact on me this year

• Heavily focused on diet and the microbiome

• High quality science papers from @Nature @ScienceMagazine and @CellCellPress @Nature @ScienceMagazine @CellCellPress Klebsiella pneumonia increased in IBD and killed by a cocktail of phages

Phage cocktail shown to treat colitis in mouse models and to alter microbiome in healthy individuals

An exciting window into future microbiome therapeutics

cell.com/cell/fulltext/…
Dec 26, 2022 • 12 tweets • 4 min read
10 important randomised clinical trials in IBD published in 2022

Thread featuring:

• UPA for UC
• RISA for CD
• ABX464 in UC
• Filgotinib for UC
• Ozanimod for UC
• ADA vs USTE in CD
• FMT plus AID for UC
• High-dose ADA in IBD SEAVUE: adalimumab and ustekinumab equally effective in bionaive Crohn's disease

Important data for now - ADA considerably more cost-effective
Important data for the near future - USTE biosimilars from q1 2024

thelancet.com/journals/lance…
Dec 12, 2022 • 17 tweets • 6 min read
An illustrated thread 🧵 on JAK inhibitors for IBD

Game-changing small molecules that
• work fast
• work when TNF fails
• don't need steroids to work

Follow along as I outline the key themes 👇 Image JAKs are a family of intracellular tyrosine kinases

First discovered by Wilks in 1989

There are four JAKS - JAK1, JAK2, JAK3 and TYK2

They are the hub for >50 cytokine pathways

The biology is beautiful Image
Jul 4, 2022 • 23 tweets • 17 min read
Introduction to advanced therapies in IBD

My talk to the surgeons @ACPGBI today @eicc

🧵 covering:
• therapeutic targets
• treatment strategies
• therapeutic ceiling
• early effective therapies in Crohn's
• the pros and cons of anti-TNF
• new small molecules for UC @ACPGBI @eicc Therapeutic targets in IBD

Informed by gene discovery & mucosal immunology

• anti-TNF
• anti-IL12/IL23
• JAK inhibitors
• S1P modulators
• anti-integrins

In future we will hit increasingly specific targets, multiple pathways at once and the gut microbiome
Mar 28, 2022 • 14 tweets • 5 min read
Head to head studies in IBD - 🧵 SONIC (2010) is probably the most important head to head study in IBD

First clear proof that anti-TNF was better than thiopurines in Crohn's disease

This was the start of the end of thiopurine monotherapy
Mar 20, 2022 • 8 tweets • 5 min read
Treatment landscape for Crohn's disease and UC.

• A timeline based on EMA approval dates
• A slide needing regular updates
• New molecules and biosimiliars

Good news for clinicians and patients.

Let's discuss a little more ... 🧵 It is definitely a good thing to have a choice of effective therapies with with to treat Crohn's disease and UC

We now have an important challenge to ensure we get
• right drug, for the
• right patient, at the
• right time

Lots of interesting questions, and rapid progress
Nov 24, 2021 • 32 tweets • 14 min read
Treatment principles in Crohn's disease: a graphical thread 🧵 (n~28)

There is lots covered here
• impact of CD
• early effective therapy
• surgical trends
• biosimilars
• head to head studies
• mucosal healing

Follow along below👇 Crohn's disease can have a significant impact on a person's life:

• physical aspects
• psychological aspects
• long-term complications of disease (and therapy)
• everyday life

We should remember this as physicians when we talk to our patients in clinic
Aug 8, 2021 • 18 tweets • 9 min read
What is the impact of immunosuppression on COVID?

Follow along; I will describe:
• serological response to infection
• vaccines: antibody and T cell responses
• durability of response to vaccine

Data from the 7000 person @clarityibd study
• infliximab vs vedolizumab in IBD Breakdown of the questions asked and answered in this dataset

Full publications available online
gut.bmj.com/content/70/5/8…
gut.bmj.com/content/early/…
researchsquare.com/article/rs-755…

20 minute video with full explanation here