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FDA accepts supplemental New Drug Application to expand lorcaserin label
The Food and Drug Administration has accepted a supplemental New Drug Application from Eisai to update the label for the weight-loss drug lorcaserin (Belviq) with long-term efficacy and safety data from the CAMELLIA-TIMI 61 trial.
In CAMELLIA-TIMI 61, a double-blind, placebo-controlled, parallel-group, phase 3b/4 clinical trial, about 12,000 people who were overweight or obese and had cardiovascular disease or CVD risk factors, such as type 2 diabetes, received lorcaserin or placebo. In a study published in the New England Journal of Medicine last fall, lorcaserin, a serotonin 2C receptor agonist, met the primary safety endpoint of noninferiority to placebo in the rate of major adverse cardiovascular events (hazard ratio, 0.99; 95% confidence interval, 0.85-1.14; P less than .001).
After meeting the primary endpoint, the trial investigators continued the study, assessing for a broader composite endpoint consisting of cardiovascular death, nonfatal MI, nonfatal stroke, hospitalization caused by unstable angina, heart failure, or coronary revascularization. Although lorcaserin was not superior to placebo in this expanded study, it remained noninferior.
Lorcaserin is contraindicated in women who are pregnant and in patients hypersensitive to lorcaserin. The most common adverse events in patients without diabetes were headache, dizziness, fatigue, nausea, dry mouth, and constipation; in patients with diabetes, the most common adverse events were hypoglycemia, headache, back pain, cough, and fatigue.
“This sNDA file acceptance brings us one step closer to potentially incorporating data into our label based on the first completed large-scale cardiovascular outcomes trial for a weight loss agent,” Lynn Kramer, MD, chief clinical officer and chief medical officer of the Neurology Business Group at Eisai, said in the press release.
Find the full press release on the Eisai website.
The Food and Drug Administration has accepted a supplemental New Drug Application from Eisai to update the label for the weight-loss drug lorcaserin (Belviq) with long-term efficacy and safety data from the CAMELLIA-TIMI 61 trial.
In CAMELLIA-TIMI 61, a double-blind, placebo-controlled, parallel-group, phase 3b/4 clinical trial, about 12,000 people who were overweight or obese and had cardiovascular disease or CVD risk factors, such as type 2 diabetes, received lorcaserin or placebo. In a study published in the New England Journal of Medicine last fall, lorcaserin, a serotonin 2C receptor agonist, met the primary safety endpoint of noninferiority to placebo in the rate of major adverse cardiovascular events (hazard ratio, 0.99; 95% confidence interval, 0.85-1.14; P less than .001).
After meeting the primary endpoint, the trial investigators continued the study, assessing for a broader composite endpoint consisting of cardiovascular death, nonfatal MI, nonfatal stroke, hospitalization caused by unstable angina, heart failure, or coronary revascularization. Although lorcaserin was not superior to placebo in this expanded study, it remained noninferior.
Lorcaserin is contraindicated in women who are pregnant and in patients hypersensitive to lorcaserin. The most common adverse events in patients without diabetes were headache, dizziness, fatigue, nausea, dry mouth, and constipation; in patients with diabetes, the most common adverse events were hypoglycemia, headache, back pain, cough, and fatigue.
“This sNDA file acceptance brings us one step closer to potentially incorporating data into our label based on the first completed large-scale cardiovascular outcomes trial for a weight loss agent,” Lynn Kramer, MD, chief clinical officer and chief medical officer of the Neurology Business Group at Eisai, said in the press release.
Find the full press release on the Eisai website.
The Food and Drug Administration has accepted a supplemental New Drug Application from Eisai to update the label for the weight-loss drug lorcaserin (Belviq) with long-term efficacy and safety data from the CAMELLIA-TIMI 61 trial.
In CAMELLIA-TIMI 61, a double-blind, placebo-controlled, parallel-group, phase 3b/4 clinical trial, about 12,000 people who were overweight or obese and had cardiovascular disease or CVD risk factors, such as type 2 diabetes, received lorcaserin or placebo. In a study published in the New England Journal of Medicine last fall, lorcaserin, a serotonin 2C receptor agonist, met the primary safety endpoint of noninferiority to placebo in the rate of major adverse cardiovascular events (hazard ratio, 0.99; 95% confidence interval, 0.85-1.14; P less than .001).
After meeting the primary endpoint, the trial investigators continued the study, assessing for a broader composite endpoint consisting of cardiovascular death, nonfatal MI, nonfatal stroke, hospitalization caused by unstable angina, heart failure, or coronary revascularization. Although lorcaserin was not superior to placebo in this expanded study, it remained noninferior.
Lorcaserin is contraindicated in women who are pregnant and in patients hypersensitive to lorcaserin. The most common adverse events in patients without diabetes were headache, dizziness, fatigue, nausea, dry mouth, and constipation; in patients with diabetes, the most common adverse events were hypoglycemia, headache, back pain, cough, and fatigue.
“This sNDA file acceptance brings us one step closer to potentially incorporating data into our label based on the first completed large-scale cardiovascular outcomes trial for a weight loss agent,” Lynn Kramer, MD, chief clinical officer and chief medical officer of the Neurology Business Group at Eisai, said in the press release.
Find the full press release on the Eisai website.
Rhymin’ pediatric dermatologist provides Demodex tips
WAIKOLOA, HAWAII – Pediatric dermatologist Andrea L. Zaenglein, MD, has composed a whimsical couplet to help physicians broaden their differential diagnosis for acneiform rashes in children.
Pustules on noses: Think demodicosis!
The classic teaching has been that Demodex carriage and its pathologic clinical expression, demodicosis, are rare in children. Not so, Dr. Zaenglein asserted at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“One of the things that we never used to see in kids but now I see all the time, probably because I’m looking for it, is Demodex. You’re not born with Demodex. Your carriage rate will increase over the years and by the time you’re elderly, 95% of us will have it – but not me. I just decided I’m not having these. I’m not looking for them, and I don’t want to know if they’re there,” she quipped, referring to the creepiness factor surrounding these facial parasitic mites invisible to the naked eye.
The mites live in pilosebaceous units. In animals, the disease is called mange. In humans, demodicosis is caused by two species of mites: Demodex folliculorum and D. brevis. The diagnosis is made by microscopic examination of mineral oil skin scrapings.
Primary demodicosis can take the form of pityriasis folliculorum, also known as spinulate demodicosis, papulopustular perioral, periauricular, or periorbital demodicosis, or a nodulocystic/conglobate version.
More commonly, however, .
“Demodicosis can be associated with immunosuppression. Kids with Langerhans cell histiocytosis seem to be prone to it. But you can see it in kids who don’t have any underlying immunosuppression, and I think there are more and more cases of that as we go looking for it,” said Dr. Zaenglein, professor of dermatology and pediatrics at Penn State University, Hershey, and immediate past president of the Society for Pediatric Dermatology.
Look for Demodex in children with somewhat atypical versions of common acneiform eruptions: for example, the ‘pustules on noses’ variant.
“Finding Demodex can alter your treatment and make it easier in these cases,” she said.
Metronidazole and ivermectin are the systemic treatment options for pediatric demodicosis.
“I tend to use topical permethrin, just because it’s easy to get. I’ll treat them once a week for 3 weeks in a row. But also make sure to treat the underlying primary inflammatory disorder,” the pediatric dermatologist advised.
Other topical options include ivermectin cream, crotamiton cream, metronidazole gel, and salicylic acid cream.
Dr. Zaenglein reported having financial relationships with Sun Pharmaceuticals, Allergan, and Ortho Dermatologics.
SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.
WAIKOLOA, HAWAII – Pediatric dermatologist Andrea L. Zaenglein, MD, has composed a whimsical couplet to help physicians broaden their differential diagnosis for acneiform rashes in children.
Pustules on noses: Think demodicosis!
The classic teaching has been that Demodex carriage and its pathologic clinical expression, demodicosis, are rare in children. Not so, Dr. Zaenglein asserted at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“One of the things that we never used to see in kids but now I see all the time, probably because I’m looking for it, is Demodex. You’re not born with Demodex. Your carriage rate will increase over the years and by the time you’re elderly, 95% of us will have it – but not me. I just decided I’m not having these. I’m not looking for them, and I don’t want to know if they’re there,” she quipped, referring to the creepiness factor surrounding these facial parasitic mites invisible to the naked eye.
The mites live in pilosebaceous units. In animals, the disease is called mange. In humans, demodicosis is caused by two species of mites: Demodex folliculorum and D. brevis. The diagnosis is made by microscopic examination of mineral oil skin scrapings.
Primary demodicosis can take the form of pityriasis folliculorum, also known as spinulate demodicosis, papulopustular perioral, periauricular, or periorbital demodicosis, or a nodulocystic/conglobate version.
More commonly, however, .
“Demodicosis can be associated with immunosuppression. Kids with Langerhans cell histiocytosis seem to be prone to it. But you can see it in kids who don’t have any underlying immunosuppression, and I think there are more and more cases of that as we go looking for it,” said Dr. Zaenglein, professor of dermatology and pediatrics at Penn State University, Hershey, and immediate past president of the Society for Pediatric Dermatology.
Look for Demodex in children with somewhat atypical versions of common acneiform eruptions: for example, the ‘pustules on noses’ variant.
“Finding Demodex can alter your treatment and make it easier in these cases,” she said.
Metronidazole and ivermectin are the systemic treatment options for pediatric demodicosis.
“I tend to use topical permethrin, just because it’s easy to get. I’ll treat them once a week for 3 weeks in a row. But also make sure to treat the underlying primary inflammatory disorder,” the pediatric dermatologist advised.
Other topical options include ivermectin cream, crotamiton cream, metronidazole gel, and salicylic acid cream.
Dr. Zaenglein reported having financial relationships with Sun Pharmaceuticals, Allergan, and Ortho Dermatologics.
SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.
WAIKOLOA, HAWAII – Pediatric dermatologist Andrea L. Zaenglein, MD, has composed a whimsical couplet to help physicians broaden their differential diagnosis for acneiform rashes in children.
Pustules on noses: Think demodicosis!
The classic teaching has been that Demodex carriage and its pathologic clinical expression, demodicosis, are rare in children. Not so, Dr. Zaenglein asserted at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“One of the things that we never used to see in kids but now I see all the time, probably because I’m looking for it, is Demodex. You’re not born with Demodex. Your carriage rate will increase over the years and by the time you’re elderly, 95% of us will have it – but not me. I just decided I’m not having these. I’m not looking for them, and I don’t want to know if they’re there,” she quipped, referring to the creepiness factor surrounding these facial parasitic mites invisible to the naked eye.
The mites live in pilosebaceous units. In animals, the disease is called mange. In humans, demodicosis is caused by two species of mites: Demodex folliculorum and D. brevis. The diagnosis is made by microscopic examination of mineral oil skin scrapings.
Primary demodicosis can take the form of pityriasis folliculorum, also known as spinulate demodicosis, papulopustular perioral, periauricular, or periorbital demodicosis, or a nodulocystic/conglobate version.
More commonly, however, .
“Demodicosis can be associated with immunosuppression. Kids with Langerhans cell histiocytosis seem to be prone to it. But you can see it in kids who don’t have any underlying immunosuppression, and I think there are more and more cases of that as we go looking for it,” said Dr. Zaenglein, professor of dermatology and pediatrics at Penn State University, Hershey, and immediate past president of the Society for Pediatric Dermatology.
Look for Demodex in children with somewhat atypical versions of common acneiform eruptions: for example, the ‘pustules on noses’ variant.
“Finding Demodex can alter your treatment and make it easier in these cases,” she said.
Metronidazole and ivermectin are the systemic treatment options for pediatric demodicosis.
“I tend to use topical permethrin, just because it’s easy to get. I’ll treat them once a week for 3 weeks in a row. But also make sure to treat the underlying primary inflammatory disorder,” the pediatric dermatologist advised.
Other topical options include ivermectin cream, crotamiton cream, metronidazole gel, and salicylic acid cream.
Dr. Zaenglein reported having financial relationships with Sun Pharmaceuticals, Allergan, and Ortho Dermatologics.
SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.
REPORTING FROM SDEF HAWAII DERMATOLOGY SEMINAR
Top AGA Community patient cases
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org/discussions) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.
In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Ileoclonic Crohn’s in VA patient
A 77-year-old patient with chronic kidney disease, dementia and congestive heart failure was seen to evaluate chronic diarrhea. His colonoscopy revealed active inflammation and a stricture at the anastomosis, which prevented the physician from bypassing with a pediatric colonoscope. The patient’s diarrhea improved once he was started on budesonide. The discussion in the AGA Community forum outlined next steps and the best course of treatment for this complicated patient.
2. H. pylori in a penicillin allergic patient
A patient diagnosed with H. pylori during an endoscopy has a history of a severe penicillin allergy and has used clarithromycin in the past year. Antibiotic resistance testing revealed genetic pattern suggesting resistance to clarithromycin, fluoroquinolones and metronidazole. Recommendations from GIs included combination therapy with proton pump inhibitors (PPIs), antacids and antibiotics.
3. Reintroduction of azathioprine after moderate leukopenia
This 48-year-old patient has a history of ulcerative colitis pancolitis and developed antibodies to Humira monotherapy. Her GI is adjusting her azathioprine dose and repeating lab work to recover her white blood cell counts and is soliciting advice from the practice community on using methotrexate for combination therapy.
More clinical cases and discussions are at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org/discussions) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.
In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Ileoclonic Crohn’s in VA patient
A 77-year-old patient with chronic kidney disease, dementia and congestive heart failure was seen to evaluate chronic diarrhea. His colonoscopy revealed active inflammation and a stricture at the anastomosis, which prevented the physician from bypassing with a pediatric colonoscope. The patient’s diarrhea improved once he was started on budesonide. The discussion in the AGA Community forum outlined next steps and the best course of treatment for this complicated patient.
2. H. pylori in a penicillin allergic patient
A patient diagnosed with H. pylori during an endoscopy has a history of a severe penicillin allergy and has used clarithromycin in the past year. Antibiotic resistance testing revealed genetic pattern suggesting resistance to clarithromycin, fluoroquinolones and metronidazole. Recommendations from GIs included combination therapy with proton pump inhibitors (PPIs), antacids and antibiotics.
3. Reintroduction of azathioprine after moderate leukopenia
This 48-year-old patient has a history of ulcerative colitis pancolitis and developed antibodies to Humira monotherapy. Her GI is adjusting her azathioprine dose and repeating lab work to recover her white blood cell counts and is soliciting advice from the practice community on using methotrexate for combination therapy.
More clinical cases and discussions are at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org/discussions) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.
In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Ileoclonic Crohn’s in VA patient
A 77-year-old patient with chronic kidney disease, dementia and congestive heart failure was seen to evaluate chronic diarrhea. His colonoscopy revealed active inflammation and a stricture at the anastomosis, which prevented the physician from bypassing with a pediatric colonoscope. The patient’s diarrhea improved once he was started on budesonide. The discussion in the AGA Community forum outlined next steps and the best course of treatment for this complicated patient.
2. H. pylori in a penicillin allergic patient
A patient diagnosed with H. pylori during an endoscopy has a history of a severe penicillin allergy and has used clarithromycin in the past year. Antibiotic resistance testing revealed genetic pattern suggesting resistance to clarithromycin, fluoroquinolones and metronidazole. Recommendations from GIs included combination therapy with proton pump inhibitors (PPIs), antacids and antibiotics.
3. Reintroduction of azathioprine after moderate leukopenia
This 48-year-old patient has a history of ulcerative colitis pancolitis and developed antibodies to Humira monotherapy. Her GI is adjusting her azathioprine dose and repeating lab work to recover her white blood cell counts and is soliciting advice from the practice community on using methotrexate for combination therapy.
More clinical cases and discussions are at https://community.gastro.org/discussions.
New guideline provides recommendations for the treatment of mild to moderate UC
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
Sesame allergy’s surprising threat
Teens are likely to mimic their parents’ opioid use. Smoking cessation could delay or prevent rheumatoid arthritis. And death data spur a boxed warning for the gout drug febuxistat.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Teens are likely to mimic their parents’ opioid use. Smoking cessation could delay or prevent rheumatoid arthritis. And death data spur a boxed warning for the gout drug febuxistat.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Teens are likely to mimic their parents’ opioid use. Smoking cessation could delay or prevent rheumatoid arthritis. And death data spur a boxed warning for the gout drug febuxistat.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Masterclass: Marlene Freeman on treating bipolar disorder in women
during pregnancy. Dr. Freeman, associate professor of psychiatry at Harvard Medical School, also shares preliminary data on the impact of exposure to atypical antipsychotics from the National Pregnancy Registry for Psychiatric Medications at Massachusetts General Hospital, where she also serves as associate director of Women’s Mental Health.
Amazon
Apple Podcasts
Google Podcasts
Spotify
during pregnancy. Dr. Freeman, associate professor of psychiatry at Harvard Medical School, also shares preliminary data on the impact of exposure to atypical antipsychotics from the National Pregnancy Registry for Psychiatric Medications at Massachusetts General Hospital, where she also serves as associate director of Women’s Mental Health.
Amazon
Apple Podcasts
Google Podcasts
Spotify
during pregnancy. Dr. Freeman, associate professor of psychiatry at Harvard Medical School, also shares preliminary data on the impact of exposure to atypical antipsychotics from the National Pregnancy Registry for Psychiatric Medications at Massachusetts General Hospital, where she also serves as associate director of Women’s Mental Health.
Amazon
Apple Podcasts
Google Podcasts
Spotify
How Are Schizophrenic Patients Treated After Myocardial Infarction?
Patients with schizophrenia may not always get the cardiac treatment they should following a myocardial infarction (MI), according to researchers from Aalborg University Hospital, Denmark.
Studies have already established that patients with schizophrenia have a higher prevalence of cardiovascular disease (CVD) and that there is a strong correlation between MI and schizophrenia, the researchers say. Patients with schizophrenia also undergo fewer cardiac procedures compared with the general population. To try to find out why that might be, the researchers focused on the 4-stage process from initial admission following MI: offer of examination, acceptance of examination, offer of treatment, and acceptance of treatment.
Of 141 patients with a first MI, 47 also had a diagnosis of schizophrenia.
The researchers say their data show a “clear difference” between the 2 groups studied. Patients with schizophrenia were statistically significantly less likely to be offered and accept examination and to be offered and accept treatment than were the psychiatrically healthy controls. However, when the researchers analyzed each stage separately, none of the secondary results were statistically significant. Still they say, as a whole the stages contribute to the primary outcome of less cardiac treatment for these patients.
The researchers did find 2 significant differences between the 2 groups: Patients with schizophrenia were more likely to be smokers and have a lower familial predisposition to CVD. They also were less likely to be in treatment for diabetes, hypercholesterolemia and hypertension at the first MI, although that did not reach statistical significance. The 2 groups also differed in the treatments offered. Patients with schizophrenia were less often offered invasive coronary angiography (CAG) and more often offered exercise-ECG. In contrast, the controls were more likely to be offered CAG.
Without statistical significance, the researchers could not pinpoint whether physician bias, patients’ unwillingness to receive health care, or both were at the root of the discrepancies. They note that the clinical manifestations of schizophrenia “may be seen as a complication for postoperative care” and influence decisions about cardiac procedures. Those decisions may be based on “tacit assumptions rather than on standard guidelines based on medical outcomes,” the researchers add. Three patients in the study reported that they had previously visited the hospital complaining of typical chest pain but were sent home without examination. The researchers cite another study that found patients with schizophrenia receive care only when their symptoms are “severe enough.”
However, patients with schizophrenia also are known to be more likely to decline treatment, perhaps in part because they do not understand the importance of treatment, the researchers say.
The researchers suggest that the way patients are handled by the treating doctor “needs to be reformed.” It is important, they say, that health care providers are aware of the limits of dealing with a double-diagnosed patient and of the possibility of unintentional bias. A “more personalized approach,” they conclude, might make patients with schizophrenia more willing to cooperate with offers of treatment.
Patients with schizophrenia may not always get the cardiac treatment they should following a myocardial infarction (MI), according to researchers from Aalborg University Hospital, Denmark.
Studies have already established that patients with schizophrenia have a higher prevalence of cardiovascular disease (CVD) and that there is a strong correlation between MI and schizophrenia, the researchers say. Patients with schizophrenia also undergo fewer cardiac procedures compared with the general population. To try to find out why that might be, the researchers focused on the 4-stage process from initial admission following MI: offer of examination, acceptance of examination, offer of treatment, and acceptance of treatment.
Of 141 patients with a first MI, 47 also had a diagnosis of schizophrenia.
The researchers say their data show a “clear difference” between the 2 groups studied. Patients with schizophrenia were statistically significantly less likely to be offered and accept examination and to be offered and accept treatment than were the psychiatrically healthy controls. However, when the researchers analyzed each stage separately, none of the secondary results were statistically significant. Still they say, as a whole the stages contribute to the primary outcome of less cardiac treatment for these patients.
The researchers did find 2 significant differences between the 2 groups: Patients with schizophrenia were more likely to be smokers and have a lower familial predisposition to CVD. They also were less likely to be in treatment for diabetes, hypercholesterolemia and hypertension at the first MI, although that did not reach statistical significance. The 2 groups also differed in the treatments offered. Patients with schizophrenia were less often offered invasive coronary angiography (CAG) and more often offered exercise-ECG. In contrast, the controls were more likely to be offered CAG.
Without statistical significance, the researchers could not pinpoint whether physician bias, patients’ unwillingness to receive health care, or both were at the root of the discrepancies. They note that the clinical manifestations of schizophrenia “may be seen as a complication for postoperative care” and influence decisions about cardiac procedures. Those decisions may be based on “tacit assumptions rather than on standard guidelines based on medical outcomes,” the researchers add. Three patients in the study reported that they had previously visited the hospital complaining of typical chest pain but were sent home without examination. The researchers cite another study that found patients with schizophrenia receive care only when their symptoms are “severe enough.”
However, patients with schizophrenia also are known to be more likely to decline treatment, perhaps in part because they do not understand the importance of treatment, the researchers say.
The researchers suggest that the way patients are handled by the treating doctor “needs to be reformed.” It is important, they say, that health care providers are aware of the limits of dealing with a double-diagnosed patient and of the possibility of unintentional bias. A “more personalized approach,” they conclude, might make patients with schizophrenia more willing to cooperate with offers of treatment.
Patients with schizophrenia may not always get the cardiac treatment they should following a myocardial infarction (MI), according to researchers from Aalborg University Hospital, Denmark.
Studies have already established that patients with schizophrenia have a higher prevalence of cardiovascular disease (CVD) and that there is a strong correlation between MI and schizophrenia, the researchers say. Patients with schizophrenia also undergo fewer cardiac procedures compared with the general population. To try to find out why that might be, the researchers focused on the 4-stage process from initial admission following MI: offer of examination, acceptance of examination, offer of treatment, and acceptance of treatment.
Of 141 patients with a first MI, 47 also had a diagnosis of schizophrenia.
The researchers say their data show a “clear difference” between the 2 groups studied. Patients with schizophrenia were statistically significantly less likely to be offered and accept examination and to be offered and accept treatment than were the psychiatrically healthy controls. However, when the researchers analyzed each stage separately, none of the secondary results were statistically significant. Still they say, as a whole the stages contribute to the primary outcome of less cardiac treatment for these patients.
The researchers did find 2 significant differences between the 2 groups: Patients with schizophrenia were more likely to be smokers and have a lower familial predisposition to CVD. They also were less likely to be in treatment for diabetes, hypercholesterolemia and hypertension at the first MI, although that did not reach statistical significance. The 2 groups also differed in the treatments offered. Patients with schizophrenia were less often offered invasive coronary angiography (CAG) and more often offered exercise-ECG. In contrast, the controls were more likely to be offered CAG.
Without statistical significance, the researchers could not pinpoint whether physician bias, patients’ unwillingness to receive health care, or both were at the root of the discrepancies. They note that the clinical manifestations of schizophrenia “may be seen as a complication for postoperative care” and influence decisions about cardiac procedures. Those decisions may be based on “tacit assumptions rather than on standard guidelines based on medical outcomes,” the researchers add. Three patients in the study reported that they had previously visited the hospital complaining of typical chest pain but were sent home without examination. The researchers cite another study that found patients with schizophrenia receive care only when their symptoms are “severe enough.”
However, patients with schizophrenia also are known to be more likely to decline treatment, perhaps in part because they do not understand the importance of treatment, the researchers say.
The researchers suggest that the way patients are handled by the treating doctor “needs to be reformed.” It is important, they say, that health care providers are aware of the limits of dealing with a double-diagnosed patient and of the possibility of unintentional bias. A “more personalized approach,” they conclude, might make patients with schizophrenia more willing to cooperate with offers of treatment.
GI leaders recognized by AGA’s prestigious recognition awards
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA Legacy Society members bolster research
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at stuneski@gastro.org or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at stuneski@gastro.org or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at stuneski@gastro.org or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
New online resource from the AGA IBD Parenthood Project provides guidance, dispels fears about pregnancy for women with IBD
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).