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The 2022 American Gastroenterology Society Annual Meeting and Graduate Student Conference (2022 ACG) was held in Charlotte, North Carolina, on October 21~26, 2022, and this article summarizes
the 13 highlight studies on the 2022 ACG.
Previous review: ACG 2022: 13 Highlights Research Express (Part I).
gastroesophageal reflux disease (NERD) onoprazan is a potassium-competitive acid blocker
approved in the United States for the treatment of Helicobacter pylori infection but not for the treatment of reflux disease.
This is an expanded phase II, double-blind trial to observe the efficacy
of receiving vonoraxen once daily in patients with nonerosive reflux disease (NERD).
Participants were randomized to receive placebo or vonoraxen 10 mg, 20 mg, 40 mg as needed
.
Patients cannot take more than one dose of the study drug within 24 hours of the onset of heartburn symptoms and cannot take remedial antacids
within 3 hours of taking the study drug.
The investigators showed a significant effect when patients switched to vonoraxen only as needed, with vonoraxen highly effective
in achieving the primary endpoint of complete and sustained remission.
About 70% of patients treated with a 40 mg dose of vonorazen had a rapid onset of action
within 3 hours.
(References: Fass R, Vaezi MF, Sharma P, et al.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 14.
）
Efficacy of risankizumab in the treatment of Crohn's
disease In a study of drugs for inflammatory bowel disease, intravenous risankizumab, an anti-interleukin-23 (Interleukin-13, IL-23), which has been shown to be more effective than placebo
.
The study provided 52 weeks of follow-up data, with outcomes focused on clinical and endoscopic improvement
.
Results showed that endoscopic response/clinical response rates were 23% and 36%,
respectively, after treatment with 180 mg and 360 mg doses (first by infusion and then subcutaneously).
(References: D'Haens G, Panaccione R, Panés J, et al.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 38.
）
To analyze the effects of vedelizumab and ustekinumab in pregnancy
One study disclosed new data
from the Pregnancy Inflammatory Disease And Neonatal Outcomes (PIANO) registry study.
The results showed no increase in pregnancy or infant-related complications between vedolizumab and ustekinumab in the treatment of inflammatory bowel disease compared with anti–tumor necrosis factor α alpha (TNF-α) drugs, thiopurines, or a combination of these drugs
.
Interestingly, ustekinumab was also associated with
lower rates of preterm birth and caesarean section.
This suggests that it appears safe
to continue using these drugs during pregnancy.
(References: Chugh R, Long M, Weaver K, Beaulieu D, Scherl EJ, Mahadevan U.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 43.
）
Be vigilant about rituximab-related bowel diseases A study from University of Chicago scholars showed that rituximab (Rituximab) treatment may cause gastrointestinal side effects
.
The researchers conducted a retrospective study over a 13-year period and found 10 patients with
bowel disease.
Most of these patients are patients with lymphoma (the most common indication for rituximab).
The pathologic diagnosis in 70% of patients is consistent with
common variable immunodeficiency bowel disease.
All patients were treated with intravenous immunoglobulin, however, only two patients improved their symptoms, and the others received prednisone, budesonide, infliximab, and vedelizumab, none of which achieved clinical improvement
.
Ultimately, 60% of patients require long-term parenteral nutrition therapy
.
(References: Hakimian D, Micic D, Alpert L, Semrad C.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 51.
）
The first of two new treatments for C.
difficile infection is an open-label study of RBX2660, an experimental microbiotic-based biological therapy
administered by enema.
Treatment success is defined as no recurrence within 8 weeks of treatment, and approximately 75% of patients are treated successfully
.
After 6 months of follow-up in responding patients, 84% remained free of Clostridium difficile recurrence
.
(References: Khanna S, Dubberke ER, Knapple WL, et al.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 56.
）
The second is the ECOSPOR IV study, a double-blind, placebo-controlled trial that looked at the efficacy
of SER-109, an oral therapy made from acute spores, in the treatment of Clostridium difficile infection.
4 capsules 3 times daily for 3 days
.
Patients receive a bottle of magnesium citrate induction therapy
.
The treatment showed similar types of effectiveness, with 79% of patients without Clostridium difficile recurrence
at 24 weeks.
(References: Khanna S, Feuerstadt P, Huang E, et al.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 63.
）
Efficacy of bile acid sequestrants in the treatment of microscopic colitis
with bile acid sequestrants.
Prior to this, almost all patients received other medications, including loperamide, budesonide, bismuth subsalicylate, or mesalamine
.
The most commonly used bile acid chelator in research was cholestyramine (65%)
.
The results showed significant improvement in most patients, with nearly 50% having a complete response, 16% having a partial response, and 25% having no response
.
One third of patients in complete or partial response are still on concomitant medications, but most patients have improved
.
(References: Tome J, Sehgal K, Kamboj AK, Harmsen W, Khanna S, Pardi DS.
Program and abstracts of the American College of Gastroenterology 2022 Congress; October 21-26, 2022; Charlotte, North Carolina.
Abstract 58.
）
Reference: David A.
Johnson.
13 Highlights From the American College of Gastroenterology's 2022 Meeting - Medscape - Nov 01, 2022.
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