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TL1a

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TL1a

Silvio Danese 1

Affiliations

1 Vita-Salute San Raffaele University - IRCCS San Raffaele Scientific Institute, Milan, Italy

Summary

AI Generated

TL1A pathway inhibition represents an emerging therapeutic target for inflammatory bowel disease, with three monoclonal antibodies in late-stage development showing consistent efficacy across both ulcerative colitis and Crohn's disease in phase 2 trials.

  • The speaker reported that TL1A antibodies demonstrated overwhelming efficacy in phase 2 studies for ulcerative colitis, with clinical remission rates of approximately 25% versus 1% for placebo at 12 weeks, and efficacy growing over time to week 50-56 across multiple antibodies
  • For Crohn's disease, the speaker stated that phase 2 data showed approximately half of patients achieved clinical remission, with endoscopic remission rates of 17-26% at week 14, and efficacy maintained across different doses
  • All three antibodies in late-stage development showed clean safety profiles with no immune suppressant signals captured in the phase 2 studies, though the speaker noted long-term safety data are not yet available
  • The speaker presented animal model data suggesting TL1A inhibition may have anti-fibrotic potential, with antibody treatment reversing fibrosis in transgenic mice and preliminary human biopsy data showing down-regulation of fibrosis pathways in ulcerative colitis patients
  • In the Q&A, the speaker indicated these drugs appear effective across lines of treatment including in anti-TNF failures, with most phase 2 patients having failed multiple prior therapies
  • The speaker noted that current data are limited to luminal disease, with insufficient evidence yet for extra-intestinal manifestations, and that questions remain about biomarker validation and whether these therapies will be used as monotherapy or in combination
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Abstract

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine

Session

What's new in advanced therapies for IBD in 2025?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Green endoscopy: Step by step to a paper free endoscopy unit

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Green endoscopy: Step by step to a paper free endoscopy unit

Konstantinos Triantafyllou 1

Affiliations

1 Attikon University General Hospital, Athens, Greece

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Green endoscopy: What makes sense?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Management of pregnant women with chronic liver disease: Key points of vigilance

Nathalie Ganne-Carrié 1

Affiliations

1 Hôpital Jean Verdier, APHP et Université Paris 13, Paris, France

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Hepatobiliary Paediatrics

Session

Liver and pregnancy: Beware of dangerous liaisons

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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UEG Poster
Standard Poster
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A CHALLENGING CASE OF PENETRATING AND GENITAL CROHN’S DISEASE

Francisco Vara-Luiz 1,2, Ivo Mendes 1,2, Carolina Palma 1,2, Margarida André 1, António Magarreiro Silva 1, Sofia Antunes 1, Eduardo Fernandes 1, Marta Patita 1, Irina Mocanu 1, Ana Isabel Vieira 1, Unknown Unknown 1

Affiliations

1 Hospital Garcia de Orta, Almada, Portugal

2 Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal

Summary

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Clinical Case Summary

27-year-old male with penetrating Crohn's disease (CD; A1, L2, pB3), diagnosed at the age of 9, with multiple hospitalizations. The patient was treated with infliximab + azathioprine for three years. Colonoscopy at 16 years showed pancolitis and was complicated with perforation, being submitted to total colectomy with rectal preservation and ileostomy. Therapy was switched to adalimumab+methotrexate, with partial clinical response. After seven years, due to severe complex fistulizing perianal disease, adalimumab was switched to ustekinumab. After 2 years of Ustekinumab monotherapy, he presented disabling symptoms and developed an enterocutaneous fistula peri-ileostomy. Combination therapy with ustekinumab+vedolizumab was started. The patient still maintained discharge from the enterocutaneous and perianal fistulas. After 1 year, a painful circumferential penile ulcer with swelling and seropurulent discharge was noted. Other causes, namely infections were excluded. Biopsies were performed and revealed non-caseous granulomatous inflammation with lymphocytic and eosinophilic infiltrates, compatible with CD. Topical therapy with tacrolimus ointment was applied, with no response. Ustekinumab+vedolizumab was switched to upadacitinib. There was a substantial improvement of the penile lesion, the enterocutaneous fistula discharge reduced, and perianal symptoms resolved on maintenance therapy with Upadacitinib.
Genital metastatic CD is uncommon and mainly occurs in the setting of colonic involvement and perianal disease. Treatment options for MCD remain underwhelming due to the limited available evidence and varying responses of reported therapeutic methods. Optimization of biologic therapy is mandatory.

References

For this case we'll include:
- Pictures ​of the penile ulcers before and during maintenance therapy with upadacitinib
- Endoscopic evaluation during follow-up
- Histological specimen of colectomy and from multiple endoscopic evaluations performed
- Radiological evidence of perianal and peri-ileostomy enterocutaneous fistula

Conference

UEG Week Berlin 2025

Topics

IBD

Submission format

Clinical Case

Session

CLINICAL CASES (Posters)

Published

2025

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BEYOND ENDOSCOPY: EVALUATING NON-INVASIVE TOOLS FOR MONITORING POSTOPERATIVE CROHN'S DISEASE RECURRENCE

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BEYOND ENDOSCOPY: EVALUATING NON-INVASIVE TOOLS FOR MONITORING POSTOPERATIVE CROHN'S DISEASE RECURRENCE

Luisa Bertin 1, Benedetta Masoni 2, Silvia Ferretti 2, Alessandro Armuzzi 2, Cristina Bezzio 2, Miriana Zanconato 1, Gianluca Semprucci 1, Davide Giuseppe Ribaldone 3, Adele Capello 3, Giorgia Bodini 4, Francesco Calabrese 4, ANDREA PASTA 4, Linda Ceccarelli 5, Francesco Costa 5, Lorenzo Bertani 6, Marco Marino 7, Luca Navarria 7, Gianluca Benevento 8, Renato Sablich 8, Marta Ascolani 9, Michele Campigotto 9, Andrea Buda 10, Gaia Riguccio 10, Nicoletta Merlini 11, Elisabetta Dal Pont 12, Daniele Canova 13, Fabiana Zingone 1, Edoardo Vincenzo Savarino 1

Affiliations

1 University of Padova, Padova, Italy

2 IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

3 University of Turin, Turin, Italy

4 Policlinico San Martino, Genova, Italy

5 AOU Pisa, Pisa, Italy

6 University of Pisa, Pisa, Italy

7 Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

8 Ospedale S.Maria degli Angeli, Pordenone, Italy

9 Ospedale Ca'Foncello, Treviso, Italy

10 Ospedale di Santa Maria del Prato di Feltre, Feltre, Italy

11 Ospedale Vittorio Emanuele III, Montecchio, Italy

12 Ospedale San Martino di Belluno, Belluno, Italy

13 San Bortolo Hospital, Vicenza, Italy

Summary

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Post-operative recurrence (POR) affects a substantial proportion of Crohn's disease (CD) patients following intestinal resection. While ileocolonoscopy remains the gold standard for detecting recurrence, its invasive nature and patient burden have spurred interest in non-invasive monitoring approaches. This study evaluates the performance of faecal calprotectin (FC) and cross-sectional imaging at different timepoints in predicting endoscopic recurrence in postoperative CD patients.

Aims & Methods

In this multicenter retrospective cohort of 895 CD patients who underwent ileocecal resection, we analyzed the diagnostic accuracy of FC measurements at 3, 6-12, and 18-24 months postoperatively for predicting endoscopic recurrence (Rutgeerts score ≥i2 or SES-CD ≥3). Additionally, we assessed the concordance between intestinal ultrasound (IUS) and magnetic resonance imagings (MRI) and endoscopic findings at both 6-12- and 18-24-months using kappa statistics.

Results

FC demonstrated modest discriminatory ability at 3 months (AUC 0.642, 95% CI: 0.530-0.753) and 6-12 months (AUC 0.653, 95% CI: 0.593-0.713), with improved performance at 18-24 months (AUC 0.676, 95% CI: 0.608-0.744). The optimal cutoff values for FC (47.5 μg/g at 3 and 6-12 months; 80.0 μg/g at 18-24 months) were substantially lower than standard thresholds (150-250 μg/g) used in non-operated patients.
At 6-12 months, radiological and endoscopic assessments showed moderate agreement (κ=0.426, p<0.001) with 63.2% concordance. At 18-24 months, IUS demonstrated superior agreement with endoscopic findings (κ=0.531, p<0.001; sensitivity 83.8%, specificity 72.7%) compared to MRI (κ=0.324, p<0.001). Notably, radiological remission at 18-24 months was identified as a significant protective factor against surgical recurrence (OR 0.356, 95% CI: 0.179-0.705, p=0.003).

Table I: Concordance between endoscopic and radiologic findings (IUS and MRI) for inflammation and remission at 18–24 months post-ileocecal resection. Abbreviations: IUS: Intestinal ultrasound, MRI: Magnetic resonance imaging.

ComparisonnκStrength of Agreementp-valueConditionEndoscopic ActivityEndoscopic Remission
Endoscopic Remission 18–24m vs. IUS 18–24m1230.531Moderate<0.001Active Inflammation607
Remission2135
Total8142
Endoscopic Remission 18–24m vs. MRI 18–24m1400.324Fair<0.001Active Inflammation6417
Remission2831
Total9248

Conclusion

Non-invasive monitoring with FC shows promise in postoperative CD surveillance, though diagnostic thresholds differ substantially from those established for non-operated patients. IUS demonstrates superior concordance with endoscopic findings compared to MRI, particularly at later timepoints. The protective role of radiological remission against surgical recurrence highlights the importance of transmural healing. Combining FC with radiological assessment, especially IUS, may provide a comprehensive, patient-friendly approach to monitoring postoperative CD, potentially reducing the need for invasive procedures in selected patients but further studies are needed in this direction.

Event

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Predicting clinical outcomes in IBD

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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CRC in IBD: Biologically different from sporadic colorectal cancer?

Michael Schumann 1

Affiliations

1 Charité Berlin, Berlin, Germany

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Digestive Oncology IBD

Session

Cancer and IBD: Mitigating risk among uncertainty

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Marta Lecuona Muñoz Marta Lecuona Muñoz, Eduardo Redondo-Cerezo, Mercedes López de Hierro Ruiz, Clara Heredia Carrasco, Rita Jiménez-Rosales

UEG Poster
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THERAPEUTIC STRATEGIES IN PT1 COLORECTAL ADENOCARCINOMA AND THEIR IMPACT ON PROGRESSION: SURGERY VS. ENDOSCOPIC TREATMENT

Marta Lecuona Muñoz 1, Rita Jiménez-Rosales 1, Clara Heredia Carrasco 1, Mercedes López de Hierro Ruiz 1, Eduardo Redondo-Cerezo 1

Affiliations

1 Hospital Universitario Virgen de Las Nieves, Granada, Spain

Summary

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Abstract

Introduction

The standard treatment for pT1 colorectal cancer classified as high risk (poor differentiation, deep submucosal invasion, intense tumor budding, resection margins that are positive or lymphovascular invasion) is surgery [1]. However, some studies have revealed that patients who undergo surgery and endoscopic treatment have similar disease progression outcomes, and it is also controversial which histological factors influence disease progression [2,3].

Aims & Methods

The aim of this study was to analyze the characteristics and evolution of patients undergoing surgery or endoscopic treatment after the resection of pT1 colorectal adenocarcinoma with histological findings considered high risk for lymph node metastasis.
We conducted an observational study of historical cohorts. We included patients with pT1 Adenocarcinoma and histological criteria of poor prognosis with at least six months of follow-up, and who were diagnosed between 2018 and 2024. The therapeutic approach was determined by a multidisciplinary committee.

Results

We included 54 patients (74.1% male) with a mean age of 65.3 years and mean follow-up time of 3.07 years; no significant differences in both groups. The indications for colonoscopy were screening (42.6%), alarm symptoms (38.9%), radiological findings (3.7%), prior polypectomy (9.3%), history of colorectal cancer (1.9%), and family history (3.7%). The rate of patients with endoscopic complications was 2.9% intraprocedural bleeding and 2.9% delayed bleeding.
The mean lesion size was 23.48 mm, and the most common location was the rectum.
Regarding the therapeutic approach, 63.0% of patients underwent surgery and 29.6% underwent endoscopic surveillance. Among the surgical patients, complications included suture dehiscence (6%), and hemorrhage (2%). In the surgical specimen analysis, residual lesion was found in 6 patients, and metastatic lymph nodes in 2. 5.55% required adjuvant therapy due to lymph node involvement, and 1.85% were stage IV at diagnosis, excluded from the comparative analysis.
Comparing both study groups, the surgical group had a significantly higher rate of submucosal invasion, with no differences in the remaining characteristics studied. During the study period, progression with lymph node involvement was observed in one patient who underwent surgery and two patients who underwent endoscopy treatment (average time 11 and 24.5 months, respectively). No patient has developed distant metastases to date.


Surgery treatment (n =34)Endoscopic therapy (n = 16)p-value
Piecemeal resection (n, %)16 (47.05%)8 (50%)p > 0.05
Poor differentiation (n, %)1 (2.9%)0p > 0.05
Deep submucosal invasion (n, %)33 (97%)11 (68.75%)P = 0.016
Margins affected or not precise (n, %)14 (41.17%)6 (37.5%)p > 0.05
Lymphovascular invasion (n, %)6 (18.18%)0P = 0.06
Perineural invasion (n, %)2 (6.66%)0p > 0.05
Intense tumor budding (n, %)00
Total number of poor prognostic factors (media, SD)2,59 (1,076)1,93 (1,03)P = 0.043
Disease progression (n, %)1 (2,9%)2 (1,25%)p > 0.05

Conclusion

In our study, patients who underwent endoscopic treatment did not present significant differences with respect to those who received surgery in terms of long-term tumor progression, despite having a higher rate of submucosal invasion. Further studies with larger sample sizes are needed to determine which factors and to what extent influence lymphatic and distant dissemination of pT1 adenocarcinoma.

References

  1. Hassan C, Wysocki PT, Fuccio L, Seufferlein T, Dinis-Ribeiro M, Brandão C, et al. Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline. Endoscopy 2019;51:266–77. https://doi.org/10.1055/a-0831-2522.
  2. Ozeki T, Shimura T, Ozeki T, Ebi M, Iwasaki H, Kato H, et al. The risk analyses of lymph node metastasis and recurrence for submucosal invasive colorectal cancer: Novel criteria to skip completion surgery. Cancers (Basel) 2022;14:822. https://doi.org/10.3390/cancers14030822.
  3. Zwager LW, Bastiaansen BAJ, Montazeri NSM, Hompes R, Barresi V, Ichimasa K, et al. Deep submucosal invasion is not an independent risk factor for lymph node metastasis in T1 colorectal cancer: A meta-analysis. Gastroenterology 2022;163:174–89. https://doi.org/10.1053/j.gastro.2022.04.010.

Conference

UEG Week Berlin 2025

Topics

Colorectal

Submission format

Abstract

Session

LOWER GI (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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