News in brief: IBD research priorities; Thiopurine safety in pregnancy; Colorectal cancers undiagnosed in lockdown

What are your research priorities for IBD?

Gastroenterologists are being asked by Crohn’s & Colitis Australia (CCA) to identify the top 10 research priorities for people with IBD.

A survey open until 14 March aims to  help identify the most common unanswered research questions in IBD. A second survey will then prioritise these questions and a final list of the top 10 unanswered research questions will be shared with researchers and research funders. The project done in collaboration with The James Lind Alliance aims to encourage a focus on the most urgent and relevant needs of people living with IBD with a view to attracting more research funding to IBD, says CCA.

Australian study of thiopurine risks in pregnancy

Thiopurines appear generally safe in pregnancy but women with IBD should be considered for  monitoring of metabolite levels, full blood and liver function tests during the second and third trimesters, according to Victorian researchers. Infants exposed to thiopurine should also be monitored, they suggested, after transient thrombocytosis and abnormal liver function tests were seen in 80% of babies at 6 weeks.

Dr Emma Flanagan and colleagues at the Department of Gastroenterology, St Vincent’s Hospital, Melbourne, conducted a study involving 40 women with IBD taking thiopurine during pregnancy, and found that elevated levels of the metabolite 6‐MMP were seen in the second trimester.

The cause of the changes in infants was uncertain as they occurred in the absence of detectable 6‐TGN or 6‐MMP levels, the researchers said, noting the babies remained clinically well.

“However, we do not think these findings are sufficient to change the current recommendations regarding thiopurines use in pregnancy and breastfeeding in women with IBD,” they wrote in Alimentary Pharmacology and Therapeutics.

Colorectal cancers missed during lockdown

Victoria’s pandemic restrictions in 2020 led to hundreds of colorectal cancer diagnoses being either delayed or missed, according to modelling  of observed vs expected cases released by the Victorian Cancer registry.

Published in the MJA, the analysis found that 5063 colorectal cancers were predicted for the period of 1 April – 15 October 2020 in Victoria but only 4838 were recorded. The difference of 4.4% translated into an estimated 113 undiagnosed colorectal tumours, the researchers said. There was an overall drop of 10% in cancer pathology reporting with the biggest reductions in notifications being for prostate (-26%), head and neck cancer (-15%) and melanoma (-13%).

“Planning for a possible surge in cancer diagnoses over the coming 6-12 months, and media campaigns encouraging people to not further delay seeking medical attention, may ameliorate any negative impact of delayed cancer diagnosis,” the authors wrote.

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