What’s New in Ulcerative Colitis?

United European Gastroenterology (UEG) Week reflects one of the world leading meetings in the field of gastroenterology and hepatology and will take place 20–24 October 2018 in Vienna. This meeting aims to bring together clinicians and basic scientists from all over the world to discuss and debate progress in gastrointestinal disorders. Excellent international speakers and scientists will present state-of-the art knowledge from many areas of our field. The PGT course has improved over the years and evolved as very attractive for attendees. Success has been mainly because of the introduction of a three-year rotation programme which was started in 2014. In 2017, we started our “second term” with an adapted programme. This course allows clinicians participating regularly at UEG Week to receive a continuous state-of-the-art update of the most relevant gastrointestinal disorders from leading clinical authorities. Quality has also been improved in recent years by having a lead discussant in most sessions to boost interaction between attendants and speakers. The previously called “round tables” are now organised as case-based symposia to focus on problem-solving of challenging clinical issues. These sessions will cover many different areas of gastroenterology and hepatology, allow intense discussion and exchange and will be dominantly clinically based. This format should be highly attractive for clinicians and especially young gastroenterologists. Interdisciplinary symposia will bring together physicians from different fields including gastroenterology, pathology, radiology and surgery discussing the current management of gastrointestinal and hepatic disorders. We plan especially to address topics in the field of gastrointestinal cancer, the rapidly evolving field of intestinal microbiota and nutrition. Another important format is covered by “From guidelines to clinical practice,” which will discuss the use and value of clinical guidelines and how they might affect clinical practice. UEG Week intends to improve patient management all over Europe and this is also supported by National Societies symposia which will deal with the most common entities in our field. One new format launched in 2018 is called crash courses. In these very focussed sessions we want to cover a clinical topic, e.g. perianal Crohn’s disease, to allow attendants to receive a perfect overview from various angles in a clinically highly relevant area. In these courses, we will focus in the future on highly relevant practical issues. We are convinced that this new format will further help to strengthen the quality of our meeting. This programme part has been highly successful in past years and is a contribution to the increasing number of basic scientists attending UEG Week. The planned TSTM topic in 2018 is “Regenerative Medicine in GI Disorders”. This thrilling topic with major advances especially in basic science might become of major relevance in gastroenterology and hepatology in the near future. UEG Week’s TSTM series will continue to enforce the so-important dialogue between basic scientists and clinicians to ultimately support at clinical innovation. The poster area is the “heart” of UEG Week and we encourage researchers to submit their best work to our meeting and thereby contribute to its success. It is not only the format by which the best research is presented, but also allows all delegates to interact within the GI community. Several recent changes of the format such as Posterchamp Sessions and Posters in the Spotlight have proven highly successful and allow in-depth interactions among scientists. One strength of our meeting has been the increasing attendance of highly motivated and talented young delegates. We believe that several initiatives from the past years such as Young GI Network, Young GI Track and Young GI Lounge have contributed to this. UEG Week aims to become a platform for as many young GI clinicians and scientists as possible. We will close our meeting with the highly attractive lecture series entitled “What’s new in 2018?” We believe that attending next year’s UEG Week will be highly attractive both for basic scientists and clinicians from all over the world, and we are very happy to welcome you there! 26th UEG Week Vienna 2018 20–24 October 2018 ACV, Vienna, Austria Online registration opens 22 January 2018 Abstract submission opens 22 January 2018 Find out more https://www.ueg.eu/week/ueg-week-2018

United European Gastroenterology (UEG) is the flagship of all gastroenterology in Europe, representing 16 ordinary and 46 national societies. In turn, it is not surprising that the UEG Week has become one of or, maybe, the most relevant of the meetings worldwide in the field of Gastroenterology. A substantial number of 13,203 participants from 114 countries attended the UEG Week in 2015, fostering such a view. My career as a clinician scientist started in 2006, and now I hold the position of an assistant professor at Ulm University in Germany. My aim is to develop novel pancreatic disease models based on differentiating human pluripotent stem cells and genetically engineered mouse models. The first time I joined the UEG Week was in Berlin in 2013. From the very beginning I was engaged by the tingly atmosphere of the UEG Week and, to my great surprise, both abstracts I had submitted received attention from the UEG Scientific Committee. One abstract dealt with the role of ataxia telangiectasia mutated (ATM) during pancreatic cancer formation and the other with our initial efforts to drive human pluripotent stem cells toward the exocrine pancreatic lineage. The latter was selected for an oral presentation, while the ATM poster won a Top Poster Prize providing me with a free ticket for the Post Graduate Teaching Programme at UEG Week in Vienna in 2014. However, in any case I would have joined the UEG Week in Vienna in 2014 with its Post Graduate Teaching Programme, an absolute ‘must see’ which perfectly complements the main meeting. Here, the exciting atmosphere unifies state of the art clinical/basic research with novel standards in clinical care across Europe, hands-on teaching courses, round table discussions and several interactive sessions. At this point, I would like to draw the putative participant's attention to the variety of different award categories announced by the UEG including dozens of travel awards, the Poster Champ Awards for the five best daily posters, the prestigious Rising Star Awards for emerging clinical scientists with a very promising track record, and the Top Abstract Prize. From all of the meetings and international conferences I have experienced, I can assure you that the various awards are not only a unique appraisal of our work, but also an opportunity providing motivation to strive for even better research in the future. But is an award really the right term to describe what UEG has set up at this stage? Instead, I would consider the awards category more as a unique and novel opportunity to access new resources for funding of either clinical and basic research in the field of gastroenterology. Here, the Research Prize and the five Top Abstract Prizes particularly stand out. Each of the latter is honoured with € 10,000, which can be freely spent on your future research. But let's put this in relation to the funding landscape in gastroenterology: (a) the Top Abstract Prizes are awarded only on the basis of the quality of your scientific work; (b) importantly, the support received is free of restrictions providing a unique resource for risky research investments that would be rather difficult to fund otherwise; (c) most importantly, in case your work is selected for one of the Top Abstract Prizes you get the unique opportunity to present your work in the Plenary Session of the meeting, and with a total number of 13,203 participants in 2015 you can imagine the tension you will feel when you enter the stage having not only a huge crowd but also a professional audience in front of you; (d) finally, the UEG has launched the UEG Journal as an official platform to report on novel findings and cutting-edge research in the field of gastroenterology and hepatology. Of note, UEG Journal achieved a start-up impact factor of 2.08 to underscore the potential of the society’s journal. Here, the Top Abstract Prize winners get the unique opportunity to finally outline their research field in an invited review article undergoing peer-review. All in all, the UEG has put together a unique package for scientists at all stages of their career, which is exclusively driven to support reputation, interaction and the careers of the Top Abstract Prize winners. From my personal perspective, this is a unique chance which offers unequalled opportunities. Having said this, one may ask for strategies to be selected for a Top Abstract Prize, considering the more than 2000 abstracts presented at UEG Week? Honestly speaking, I believe that there is no strategy better than to report on solidly conducted research spiked with a fancy technique and complemented with a clinical outlook. We received the Top Abstract Prize for the development of ‘A pancreatic differentiation platform to study cystic fibrosis in a dish’. In this particular situation I was in the fortuitous position to report on a virtually complete story at the time of abstract submission in 2015. The top abstracts are chosen by the UEG Scientific Committee from a pool of abstracts which have been top-ranked and thereby pre-selected by external referees. Having previously reviewed abstracts myself, I know this ranking process quite well and it requires rapid assessment of quality, cutting-edge potential and thorough study performance reported in a half-page content. Therefore, your abstract needs to pinpoint these issues and the central theme of your work to raise the curiosity of referees. This makes writing of an abstract even more difficult than a full article as the entire information has to be conveyed in a shorter framework. So, take your time and avoid ‘incidentally’ written abstracts. Usually, I start with the development of the title which should be an eye-catcher to stimulate the interest of the reader in the rest of your text. Essentially, the title should condense the entire abstract information in one sentence. A precise writing style devoid of ordinary language, filler words and unnecessary sentences applies throughout. These style rules should then be used to introduce your topic effectively in a way that people from other fields are able to track and judge your claims. Keep in mind that nothing is worse than an untaught reviewer! Then, you introduce your hypothesis or outline why your work is required and, after a very condensed methods part, report your results. Finally, you should underpin the added value of your work to the field and give your work a translational fate in case you report on basic research. Your clinical research should explain the immediate value and the potential to change clinical guidelines and to underpin the benefit for patients' care. Following these suggestions may increase your chance of winning but, of course, is no guarantee. However, in case your work is not selected for a prize, do not be disappointed, just present it in one of the various poster formats which the UEG has set for scientific exchange and networking, and enjoy the scientific discussions with your peers at the E-poster terminals. Complemented with printed posters, this will allow you a more detailed presentation and also assessment of your work and will give rise to novel ideas and projects. But still, even if you would just like to visit the UEG Week without submitting an abstract, it remains a ‘must see' for young gastroenterologists striving for further education, networking and scientific exchange in an international, multi-cultural environment. Find out more, visit www.ueg.eu/week Be sure to meet me there.

United European Gastroenterology (UEG) Week will in 2016 return to the Austria Center Vienna (ACV) and will take place October 15–19, and the meeting will feature a broad range of highly interactive and interesting sessions for the congress delegates. Just like previous years, the aim of UEG Week is that it should be attractive for young as well as for more-experienced clinicians, and for basic, translational and clinical scientists alike. The goal for the meeting is to advance science and to link people with different backgrounds in our gastroenterology community. Introduced in 2015, we will keep the UEG Week Hotspot, which is the premier place to be at UEG Week where the most controversial sessions, hottest debates and interactive abstract discussions will take place. These sessions promise to be most intense and very well attended. Heated discussions of the UEG “Abstracts on FIRE ” (F rontiers I n RE search) and breaking news will be presented at this center stage of UEG Week. Another interactive and highly interesting feature at the Hotspot are the Clinical Trials Revisited sessions, where results from recently published large clinical trials will be presented, reviewed and discussed by experts. For the practicing clinicians, our Clinical Case sessions in the poster area will be of great interest. Among a large number of submitted original cases, the most interesting cases with the greatest learning objective for the attending audience have been selected for poster presentation and will be discussed with a panel of clinical experts. The sessions “From guidelines to clinical practice” will discuss how well European and/or national clinical guidelines are translated into clinical practice. These sessions will be of great relevance to the busy clinician, since experts will present current guidelines in common diseases, and discuss how they are used in the clinical setting today and how they should be used. Our clinically oriented one-day symposium within the meeting, entitled “Advances in Clinical Gastroenterology and Hepatology, ” will like in previous years focus on an area where substantial clinically useful progress has been made, and in 2016 the topic is Inflammatory Bowel Disease – an area in which we without doubt have seen substantial progress during the last years. Continuing from the success of previous meetings, the two-day initiative “Today's Science; Tomorrow's Medicine” is again on the program for 2016 with a very interesting theme: “Advanced diagnostics for individualized medicine,” which should be of interest both for scientists and clinicians, as we already today strive to individualize our treatment choices for patients based on results from tests and investigations. The “heart of the congress” is the poster area, where cutting-edge science is presented by the best researchers, and our aim is that this should be a very interactive area, with e-poster terminals, poster champ sessions, poster discussions and exchange of ideas between investigators. Moreover, in-depth discussions of selected posters take place in the Posters in the Spotlight sessions – a highly appreciated feature at UEG Week. The quantity and quality of submitted original work has steadily increased at our meeting over the last years, which we are very proud of. Good science is the basis for a successful meeting! The future of our meeting are our young delegates, and therefore we have several initiatives for the young attendees, such as the Young gastrointestinal (GI) network, a special Young GI Track through the program and the Young GI Lounge, as well as several awards for young investigators. These were just a few of the highlights of the upcoming UEG Week 2016, but I am sure that you will find other highlights as well at our meeting, so therefore attending the meeting is highly recommended! I hope to see you in Vienna in October 2016!

Endoscopic assessment of mucosal disease activity is routinely used to determine eligibility and response to therapy in clinical trials of ulcerative colitis. The operating properties of the existing endoscopic scoring indices are unclear. A systematic review was undertaken to evaluate the development and operating characteristics of endoscopic scoring indices for the evaluation of ulcerative colitis. We searched MEDLINE, Embase and CENTRAL from inception to 5 July 2016. We also searched references and conference proceedings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organization). Any study design (e.g. randomized controlled trials, cohort studies, case series) that evaluated endoscopic indices for evaluation of ulcerative colitis disease activity were considered for inclusion. Eligible participants were adult patients (> 16 years), diagnosed with ulcerative colitis using conventional clinical, radiologic and endoscopic criteria. Two authors independently reviewed the studies identified from the literature search. These authors also independently extracted and recorded data on the number of patients enrolled; number of patients per treatment arm; patient characteristics including age and gender distribution; endoscopic index; and outcomes such as reliability (intra-rater and inter-rater), validity (content, construct, criterion), responsiveness and feasibility. Any disagreements regarding study inclusion or data extraction were resolved by discussion and consensus with a third author. Risk of bias was assessed by determining whether assessors were blinded to clinical information and whether assessors scored the endoscopic index independently. We also assessed the methodological quality of the validation studies using the COSMIN checklist MAIN RESULTS: A total of 23 reports of 20 studies met the pre-defined inclusion criteria and were included in the review. Of the 20 included validation studies, 19 endoscopic scoring indices were assessed, including the Azzolini Classification, Baron Score, Blackstone Endoscopic Interpretation, Chinese Grading System of Ulcerative Colitis, Endoscopic Activty Index, Jeroen Score, Magnifying Colonoscopy Grade, Matts Score, Mayo Clinic Endoscopic Subscore, Modified Baron Score, Modified Mayo Clinic Endoscopic Subscore, Osada Score, Rachmilewtiz Endoscopic Score, St. Mark's Index, Ulcerative Colitis Colonoscopic Index of Serverity (UCCIS), endoscopic component of the Ulcerative Colitis Disease Activity Index (UCDAI), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), Witts Sigmoidoscopic Score and Watson Grade. The individuals who performed the endoscopic scoring were blinded to clinical and/or histologic information in ten of the included studies, not blinded to clinical and/or histologic information in one of the included studies, and it was unclear whether blinding occurred in the remaining nine included studies. Independent observation was confirmed in four of the included studies, unclear in five of the included studies, and non-applicable (since inter-rater reliability was not assessed) in the remaining eleven included studies. The methodological quality (COSMIN checklist) of most of the included studies was rated as 'good' or 'excellent'. One study that assessed responsiveness was rated as 'fair'. The inter-rater reliability of nine endoscopic scoring indices including the Baron Score, Blackstone Endoscopic Interpretation, Endoscopic Activity Index, Matts Score, Mayo Clinic Endoscopic Subscore, Osada Score, UCCIS, UCEIS, Watson Grade was assessed in seven studies, with estimates of correlation, ƙ, ranging from 0.44 to 0.97. The iIntra-rater reliability of seven endoscopic scoring indices including the Baron Score, Blackstone Endoscopic Interpretation, Matts Score, Mayo Clinic Endoscopic Subscore, Osada Score, UCCIS and UCEIS was assessed in three studies, with estimates of correlation, ƙ, ranging from 0.41 to 0.86. No studies assessed content validity. Three studies evaluated the criterion validity of three endoscopic scoring indices including the Rachmilewitz Endoscopic Score, Magnifying Colonoscopy Grade and the UCCIS. These indices were correlated with objective markers of disease activity including albumin, blood leukocytes, C-reactive protein, fecal calprotectin, hemoglobin, mucosal interleukin-8 concentration and platelet count. Correlation estimates ranged from r = -0.19 to 0.83. Thirteen endoscopic scoring indices were tested for construct validity in 13 studies. Estimates of correlation between the endoscopic scoring indices and other measures of disease activity ranged from r = 0.27 to 0.93. Two studies explored the responsiveness of four endoscopic scoring indices including the Mayo Endoscopic Subscore, Modified Baron Score, Modified Mayo Endoscopic Subscore and UCEIS. One study concluded that the Modified Baron Score, Modified Mayo Endoscopic Subscore and UCEIS had similar responsiveness for detecting disease change in ulcerative colitis. The other included study concluded that the UCEIS may be the most accurate endoscopic scoring tool. None of the included studies formally assessed feasibility. While the UCEIS, UCCIS and Mayo Clinic Endoscopic Subscore have undergone extensive validation, none of these instruments have been fully validated and only two studies assessed responsiveness. Further research on the operating properties of these indices is needed given the lack of a fully-validated endoscopic scoring instrument for the evaluation of disease activity in ulcerative colitis.

Loss of Response to Vedolizumab and Ability of Dose Intensification to Restore Response in Patients With Crohn’s Disease or Ulcerative Colitis: A Systematic Review and Meta-analysis

There is a great unmet clinical need for efficacious, tolerable, economical and orally administrated drugs for the treatment of inflammatory bowel disease (IBD). New therapeutic avenues have become possible including the development of medications that target specific genetic pathways found to be relevant in other immune mediated diseases. To provide an overview of recent clinical trials for new generation oral targeted medications that may have a future role in IBD management. Pubmed and Medline searches were performed up to 1 March 2018 using keywords: "IBD", "UC", "CD", "inflammatory bowel disease" "ulcerative colitis", "Crohn's disease" in combination with "phase", "study", "trial" and "oral". A manual search of the clinical trial register, article reference lists, abstracts from meetings of Digestive Disease Week, United European Gastroenterology Week and ECCO congress were also conducted. In randomised controlled trials primary efficacy endpoints were met for tofacitinib (JAK 1/3 inhibitor-phase III), upadacitinib (JAK 1 inhibitor-phase II) and AJM300 (α4-integrin antagonist-phase II) in ulcerative colitis. Ozanimod (S1P receptor agonist-phase II) also demonstrated clinical remission. For Crohn's disease, filgotinib (JAK1 inhibitor-phase II) met primary endpoints and laquinimod (quinolone-3-carboxide small molecule-phase II) was also efficacious. Trials using mongersen (SMAD7 inhibitor) and vidofludimus (dihydroorotate dehydrogenase inhibitor) have been halted. This is potentially the start of an exciting new era in which multiple therapeutic options are at the disposal of physicians to treat IBD on an individualised basis. Head-to-head studies with existing treatments and longer term safety data are needed for this to be possible.

Abstracts presentations at scientific meetings enable rapid dissemination of novel research. The percentage of abstracts that proceed to full publication from differing medical specialties is highly variable. This study aims to evaluate the outcomes of abstracts presented at the United European Gastroenterology Week (UEGW). All abstracts presented at UEGW between 2009 and 2011 were assessed. Cross-referencing of the first author, senior author and at least one keyword of the abstract was performed using PubMed and EMBASE databases. Abstracts and possible resultant full publications were then examined in tandem to ensure that they represented the same study. Data were also collected on lag time to publication, journal impact factors, country of the author and factors influencing subsequent publication. A total of 6785 abstracts (1438 oral and 5347 poster presentations) were presented during the period assessed. Of these, 2099 (30.9%) proceeded to full publication in indexed journals. Oral abstract presentations were most likely to proceed to full publication compared with poster presentations (odds ratio: 1.38, 95% confidence interval: 1.22-1.56) and were more likely to achieve publication in higher impact journals (median impact factor 4.78 vs. 2.89, P<0.0005). The median lag time to full publication was 15 (IQR: 7-15) months. The Netherlands had the highest United European Gastroenterology abstract conversion rate to full publication (46.8%). This is the first study to assess the publication rates of UEGW. Findings are favourable with similar studies from other societies.

Diverticulosis is a common anatomical condition, which appears to be age-dependent. Individuals who develop chronic gastrointestinal symptoms or complications are referred to as having diverticular disease. Although the diagnosis of this condition can be relatively straightforward, randomized controlled trials are scarce and management often follows tradition rather than principles of evidence-based medicine. This report deals with the topics discussed during a symposium held during the United European Gastroenterology Week (Barcelona, October 2017). During the meeting, the role of dysbiosis in the pathogenesis of diverticular disease and its treatment were thoroughly discussed, by examining the efficacy and mechanisms of action of the currently used drugs. Recent studies have shown the presence of dysbiosis in patients with diverticular disease and suggest an imbalance in favor of bacteria with pro-inflammatory and pathogenetic potential. These microbiota changes correlate with mucosal immune activation, mirrored by a marked increase of macrophages in colonic mucosa, both in the diverticular region and at distant sites. The low-grade inflammation, driven by bacteria-induced immune activation, could be involved in the pathophysiology of symptoms. As a consequence, pharmacological approaches targeting enteric bacteria (with poorly absorbed antibiotics, like rifaximin, or probiotics) or intestinal inflammation (with 5-ASA derivatives or rifaximin) have shown capability of controlling symptoms and also preventing complications, albeit more research is needed to establish the optimal regimen (daily dose and duration) of therapy. Well-designed randomized-controlled trials (RCTs), including homogeneous populations of patients, are therefore needed. The future of management of many GI diseases, including symptomatic uncomplicated diverticular disease, will rely on the so-called ‘microbiota-directed therapies’.

The biologic era revolutionized the medical management of inflammatory bowel disease (IBD) and allowed for a paradigm shift away from a therapeutic strategy that traditionally relied on corticosteroids and immunomodulators. IBD treatment has now further evolved to encompass novel non-biologic agents. An electronic database search, spanning up to September 2018, was conducted using PubMed, Web of Science, Google Scholar, and Scopus. Abstracts were also reviewed from Digestive Diseases Week, European Crohn's and Colitis Organization congress, Canadian Digestive Diseases Week, and United European Gastroenterology Week. The JAK1/3 inhibitor, tofacitinib, was shown to both induce and maintain clinical remission and mucosal healing in ulcerative colitis (UC). Also, the sphingosine-1-phosphate (SIP) S1P1/S1P5 receptor agonist ozanimod showed benefit with clinical remission and mucosal healing in UC. Anti-trafficking non-biologic therapies such as AJM300 and a phosphodiesterase (PDE) PDE4 inhibitor, apremilast, have shown benefit in terms of clinical response, clinical remission, and mucosal healing in UC. Upadacitinib and filgotinib have shown initial favorable outcomes in CD patients, with further ongoing trials. Non-biologic agents comprise a growing number of mechanisms of action with the promise of safe and effective oral therapy for patients with IBD.

Selecting End Points for Disease-Modification Trials in Inflammatory Bowel Disease: the SPIRIT Consensus From the IOIBD

Diverticular disease is a common condition that increases in prevalence with age. Recent theories on the pathogenesis of diverticular inflammation have implicated chronic inflammation similar to that seen in ulcerative colitis. Mesalamine, or 5-aminosalicylic acid (5-ASA), is a mainstay of therapy for individuals with ulcerative colitis. Accordingly, 5-ASA has been studied for prevention of recurrent diverticulitis. To evaluate the efficacy of mesalamine (5-ASA) for prevention of recurrent diverticulitis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 8), in the Cochrane Library; Ovid MEDLINE (from 1950 to 9 September 2017); Ovid Embase (from 1974 to 9 September 2017); and two clinical trials registries for ongoing trials - Clinicaltrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform database (9 September 2017).We also searched proceedings from major gastrointestinal conferences - Digestive Disease Week (DDW), United European Gastroenterology Week (UEGW), and the American College of Gastroenterology (ACG) Annual Scientific Meeting - from 2010 to September 2017. In addition, we scanned reference lists from eligible publications, and we contacted corresponding authors to ask about additional trials. We included randomised controlled clinical trials comparing the efficacy of 5-ASA versus placebo or another active drug for prevention of recurrent diverticulitis. We used standard methodological procedures as defined by Cochrane. Three review authors assessed eligibility for inclusion. Two review authors selected studies, extracted data, and assessed methodological quality independently. We calculated risk ratios (RRs) for prevention of diverticulitis recurrence using an intention-to-treat principle and random-effects models. We assessed heterogeneity using criteria for Chi2 (P < 0.10) and I2 tests (> 50%). To explore sources of heterogeneity, we conducted a priori subgroup analyses. To assess the robustness of our results, we carried out sensitivity analyses using different summary statistics (RR vs odds ratio (OR)) and meta-analytical models (fixed-effect vs random-effects). We included in this review seven studies with a total of 1805 participants. We judged all seven studies to have unclear or high risk of bias. Investigators found no evidence of an effect when comparing 5-ASA versus control for prevention of recurrent diverticulitis (31.3% vs 29.8%; RR 0.69, 95% confidence interval (CI) 0.43 to 1.09); very low quality of evidence).Five of the seven studies provided data on adverse events of 5-ASA therapy. The most commonly reported side effects were gastrointestinal symptoms (epigastric pain, nausea, and diarrhoea). No significant difference was seen between 5-ASA and control (67.8% vs 64.6%; RR 0.98, 95% CI 0.91 to 1.06; P = 0.63; moderate quality of evidence), nor was significant heterogeneity observed (I2 = 0%; P = 0.50). The effects of 5-ASA on recurrence of diverticulitis are uncertain owing to the small number of heterogenous trials included in this review. Rates of recurrent diverticulitis were similar among participants using 5-ASA and control participants. Effective medical strategies for prevention of recurrent diverticulitis are needed, and further randomised, double-blinded, placebo-controlled trials of rigorous design are warranted to specify the effects of 5-ASA (mesalamine) in the management of diverticulitis.

BACKGROUNDThe inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated disorders of the digestive tract. IBD is considered to be a risk factor for developing osteoporosis; however current literature on this matter is inconsistent.AIMTo assess prevalence and development of osteoporosis and low bone mineral density (BMD), and its risk factors, in IBD patients.METHODSSystematic review of population-based studies. Studies were identified by electronic (January 2018) and manual searches (May 2018). Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week, the European Crohn’s and Colitis Organisation congress, and Digestive Disease Week were screened. Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients. Studies on children under the age of 18 were excluded. Only population-based studies were included. All risk factors for osteoporosis and low BMD investigated in any included article were considered. Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale.RESULTSTwelve studies including 3661 IBD patients and 12789 healthy controls were included. Prevalence of osteoporosis varied between 4%-9% in studies including both CD and UC patients; 2%-9% in studies including UC patients, and 7%-15% in studies including CD patients. Among healthy controls, prevalence of osteoporosis was 3% and 10% in two studies. CD diagnosis, lower body mass index (BMI), and lower body weight were risk factors associated with osteoporosis or low BMD. Findings regarding gender showed inconsistent results. CD patients had an increased risk for osteoporosis or low BMD over time, while UC patients did not. Increased age was associated with decreased BMD, and there was a positive association between weight and BMI and BMD over time. Great heterogeneity was found in the included studies in terms of study methodologies, definitions and the assessment of osteoporosis, and only a small number of population-based studies was available.CONCLUSIONThis systematic review found a possible increase of prevalence of osteoporosis in CD cohorts when compared to UC and cohorts including both disease types. Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBD patients. The results varied considerably between studies.

Ozanimod is an oral medication indicated for the treatment of moderately-to-severely active ulcerative colitis (UC) in adults. This review article summarises the latest data on the long-term efficacy and safety of ozanimod in patients with UC, presented at the United European Gastroenterology Week (UEGW) held in Vienna, Austria, between 12th–15th October 2024 and the American College of Gastroenterology’s (ACG) Annual Scientific Meeting held in Philadelphia, Pennsylvania, USA, between 25th–30th October 2024. Updated analyses of the True North study (which met its primary endpoint) and associated ongoing open label extension (OLE) study demonstrated that ozanimod efficacy and generally well tolerated safety profile were durable over 5 years of continuous treatment. In a real-world setting, ozanimod induced a clinical response in both advanced therapy (AT)-naïve and AT-experienced patients, though remission rates were slightly lower in patients with prior exposure to ≥3 ATs. In addition, an evaluation of long-term exposure to ozanimod over 16,000 patient years (PY), in a pooled analysis of clinical studies in moderately-to-severely active UC or relapsing multiple sclerosis (RMS), showed that incidence rates for the most frequent treatment-emergent adverse events (TEAE) and TEAEs of interest were low and were similar across both patient populations. Together, these new data confirm that the ongoing efficacy and safety profile of ozanimod is consistent with previous analyses.

The 25th United European Gastroenterology Week (UEGW), the largest European conference centered on diseases of the stomach, bowel, esophagus, liver, pancreas and gallbladder, was held in Barcelona, Spain. This 5-day meeting attracted over 13,000 delegates to share recent research in the treatment of gastrointestinal and liver diseases. The conference provided teaching material, workshops and live sessions to all the attendants. The reports will cover the latest research into treatments for these diseases.

This year saw the 20th anniversary of the first United European Gastroenterology Week (UEGW), the largest European conference focused on diseases of the stomach, bowel, esophagus, liver, pancreas and gallbladder. UEGW 2012, which was held in Amsterdam, the Netherlands, attracted over 14,000 delegates who discussed recent developments in the treatment of these diseases, including multidisciplinary care and the effect of obesity and alcohol on gastrointestinal and liver diseases.