What’s in store at ECCO 2019

The European Crohn’s and Colitis Organisation (ECCO) Congress has become one of the major IBD meetings in the world, and this year it is taking place in Copenhagen, Denmark from Thursday 7th March to Saturday 9th March.

The limbic will be on the ground reporting from the many sessions and we will also be live tweeting them on social media at @thelimbicgastro.

As usual, this year’s ECCO 2019 conference will feature many of the well-known international clinicians and researchers in IBD such as Professor Bill Sandborn from the USA and Professors Brian Feagan and Reena Khanna of Canada.

ECCO will kick off with provocative sessions posing the question can we prevent IBD based on characterisation of an individual’s genetic and gut microbiome profiles. Presenters will also ask whether the fibrotic complications of IBD are reversible, with a focus on genetic markers such as PTPN2.

The evolving role of diet in Crohn’s disease will also be explored with approaches based on glycans. New findings from a trial of an exclusion diet coupled with partial enteral nutrition (PEN), designed to reduce exposure to dietary components thought to negatively affect the microbiome, will also be presented.

Other trial results will shed light on the role of autophagy-impairment in the pathogenesis of  IBD, and the role of precision medicine, with results from the OPERA II study of the monoclonal antibody SHP647 in Crohn’s disease.

Friday sees a focus on best practice in ulcerative colitis (UC), with results presented from trials of agents such as etrasimod, an oral sphingosine 1 phosphate (S1P) receptor modulator. Prof. Bill Sandborn will be presenting findings from the  U-ACHIEVE study of upadacitinib, an oral, selective Janus Kinase 1 inhibitor, in patients with UC who had inadequate response, loss of response or intolerance to corticosteroids, immunosuppressants, or biologic therapies.

The potential for genomics in IBD will also be discussed with the release of results from a trial that evaluated UC-associated single-nucleotide polymorphisms (SNPs).  By identifying the genomic footprint of IBD patients, UK researchers will propose a method to identify cohort-specific pathogenic and patient-specific targetable therapeutic pathways.

The controversial question of proactive therapeutic drug measurement of anti-TNF agents will be discussed with the release of results from the PILOT trial comparing adalimumab treatment based on trough levels with management based on clinical indices, CRP, and faecal calprotectin.

On Saturday, Melbourne gastroenterologist Dr Nik S Ding will host a session on the future of IBD that will look at the potential for artificial intelligence in IBD management, robot surgery in colitis and how ‘Big Data’ is changing the research landscape. The session will also present findings from major trials, with 44 week results reported from the UNIFI study of ustekinumab as maintenance therapy in ulcerative colitis.

Eagerly awaited results from the first study to directly compare two biological agents in IBD will be presented by Stefan Schrieber, of Kiel, Germany on Saturday. The VARSITY study is a double-blind randomised controlled trial of vedolizumab vs adalimumab in patients with active UC.

The final day will also see further results presented from CALM, the first study to show that timely escalation with anti-tumour necrosis factor therapy on the basis of clinical symptoms combined with biomarkers may enhance remission in patients with early Crohn’s disease.

The full scientific programme can be accessed here.

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