Digestive Disease Week, May 21-24

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Digestive Disease Week 2016

The annual Digestive Disease Week was held from May 21 to 24 in San Diego and attracted approximately 16,000 participants from around the world, including researchers and academicians in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery. The event was sponsored by the American Association for the Study of Liver Diseases, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and Society for Surgery of the Alimentary Tract.

In one study, Patricia Jones, M.D., of the University of Miami Miller School of Medicine, and colleagues evaluated 999 patients with hepatocellular carcinoma. They found that blacks had lower survival compared to whites (301 versus 535 days). They also found that blacks had lower survival than Hispanics and Asians. This outcome remained the same when the investigators adjusted for insurance status, alcohol consumption, and whether or not they received chemotherapy.

"In an evaluation of a smaller sample of patients, we confirmed what has been shown in national databases," Jones said. "However, we wanted to understand why survival was lower in this population. After a deeper analysis of the patient's charts, we found that blacks tend to present with larger tumors at later stages, which can make them ineligible for some treatments, including liver transplant."

Abstract No. Mo1491

In another study, Lisa Backus, M.D., of the Veterans Affairs Palo Alto Health Care System in California, and colleagues evaluated the efficacy of ledipasvir/sofosbuvir plus or minus ribavirin (LS±RBV) and ombitasvir/paritaprevir/ritonavir plus dasabuvir plus or minus ribavirin (OPrD±RBV) in 6,961 patients with genotype 1 hepatitis C virus (HCV).

"We found that patients in this real-world cohort had sustained viral response (SVR) rates similar to those seen in clinical trials," Backus said. "In multivariate models, African-American race, body mass index (BMI) ≥30 kg/m², fibrosis-4 (FIB-4) score >3.25, and treatment with OPrD plus RBV compared to LS were independent negative predictors of SVR."

In those patients who completed a full 12-week course of treatment, the investigators also found that African-American race and treatment with OPrD plus RBV no longer had a significant impact on odds of SVR, likely arising from excess early treatment discontinuation. However, FIB-4 and BMI ≥30 kg/m² remained significant negative predictors of SVR.

"We now have extremely effective treatment options but patients need to be screened and diagnosed with HCV in order to get treated," Backus said. "In addition, adherence is essential to improved outcomes. Clinicians need to work with patients to make sure they complete a full 12 weeks of treatment."

Abstract No. 501

In a phase II study of patients with moderate-to-severe active Crohn's disease, Brian Feagan, M.D., of Robarts Clinical Trials in London, Canada, and colleagues evaluated the efficacy and safety of BI 655066, a humanized monoclonal antibody that selectively inhibits interleukin (IL)-23 through specific targeting of the IL-23 p19 subunit. The investigators randomized patients with clinically active disease confirmed by endoscopy, previously treated with a tumor necrosis factor antagonist or conventional therapy, to receive either 200 or 600 mg of BI 655066 or placebo.

"We found a clinical remission rate of 24.4 percent with the 200 mg dose and 36.6 percent with the 600 mg dose, compared with 15.4 percent in the placebo group. We also found clinical response rates of 36.6 percent with the 200 mg dose and 41.5 percent with the 600 mg dose, compared with 20.5 percent in the placebo group," Feagan said. "Overall, our results provide compelling evidence for the use of the 200 or 600 mg doses of BI 655066 for the treatment of patients with moderate-to-severe Crohn's disease. Based on these results, a phase III trial is currently underway. In terms of safety, there were no additional safety concerns tied to this agent, as we did not encounter anything unexpected in the clinical trial."

Several authors disclosed financial ties to pharmaceutical companies, including Boehringer Ingelheim, the manufacturer of BI 655066.

Abstract No. 812a

DDW: Incidence of Colorectal Cancer Up in Younger People

WEDNESDAY, May 25, 2016 (HealthDay News) -- Although overall colorectal cancer (CRC) rates are declining, the rates among Americans under 50 have increased in the past decade, according to a study presented at the annual Digestive Disease Week, held from May 21 to 24 in San Diego.

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DDW: New Ingestible Balloon System May Help Fight Obesity

TUESDAY, May 24, 2016 (HealthDay News) -- A new ingestible and inflatable balloon system, Obalon, shows promise as a noninvasive way to curb appetite and assist weight loss efforts, according to research presented at the annual Digestive Disease Week, held from May 21 to 24 in San Diego.

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DDW: Eating Some Solid Foods May Be OK Before Colonoscopy

TUESDAY, May 24, 2016 (HealthDay News) -- A low-residue diet prior to a colonoscopy may be better than clear liquids only, according to research presented at the annual Digestive Disease Week, held from May 21 to 24 in San Diego.

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DDW: Fecal Transplant Might Help Relieve Symptoms of Colitis

TUESDAY, May 24, 2016 (HealthDay News) -- Fecal microbiota transplantation (FMT) appears to alleviate symptoms in treatment-resistant ulcerative colitis patients, according to research presented at the annual Digestive Disease Week, held from May 21 to 24 in San Diego.

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