Part 2 -- Dr David Johnson offers yet more practice-changing observations from DDW2023, which featured an abundance of data on novel treatments and new revelations about established interventions.
Dr Stephen Hanauer presented results in patients with moderately to severely active Crohn's disease who were successfully in remission after initial induction. They were followed up for 54 weeks to determine the co-primary endpoints of clinical remission and endoscopic response. These co-primary endpoints were significantly better in the patients who received subcutaneous infliximab. The endoscopic response rate was 51.1% in the active subcutaneous infliximab cohort compared with only 17.
They conducted a single-arm study of 14 patients with type 2 diabetes, who were then followed during a 2-week post-procedural isocaloric liquid diet. The primary endpoint at 6 months was whether the patients could be off insulin entirely and achieve an A1c ≤ 7.5%. At 6 months, there was a significant improvement, with 86% off insulin entirely, and all showing improvements in glycemic control.
In this multicenter study, 70 patients were randomized to direct endoscopic necrosectomy at the index exam after a lumen-apposing metal stent or a step-up approach where they came back and underwent necrosectomy after no clinical improvement. Lo and behold, they found that the aggressive de novo approach was substantially better as far as length of hospitalization, which decreased by 10 days, although there was no significant difference in treatment success.
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9 Highlights From Digestive Disease Week 2023➡️ Dr David Johnson has returned from DDW2023 - where there was a bevy of information — so much so that we're splitting this into two separate discussions of all the significant findings to possibly have practice-changing implications.
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