Daily Recap, Monday, October 10

Monday at UEG Week 2022!

Browse our Daily Recap and get a taste of the action from Monday at UEG Week, featuring state-of-the-art scientific presentations, late-breaking abstracts and more congress awards.

Journal Best Paper Awardee – Laurent Goessens

The first session in the Live TV Studio today saw Laurent Goessens pick up the Journal Best Paper Award 2022.

Laurent Goessens, the first author of the winning article Safety and efficacy of combining biologics or small molecules for inflammatory bowel disease or immune-mediated inflammatory diseases: A European retrospective observational study, is a Gastroenterologist in the Centre hospitalier de Mouscron, Belgium and the Centre hospitalier de Tourcoing, France.

Laurent Goessens and the authors of the study asked a simple question: Is the combination of biologics with or without small molecules safe and effective? Using a large collaborative European multicentre study endorsed by the IBD National Study Group, they found that the combination initiated in active inflammatory bowel disease improved the clinical and endoscopic picture in more than 50% of patients. In addition, this therapeutic approach controlled the extra‐intestinal manifestations. This important data for this difficult-to-treat disease have immediate implications for patient care.

Laurent Goessens was joined in the Live TV Studio by Joost PH Drenth, UEG Journal Editor-in-Chief, Katarzyna Pawlak, UEG Journal Trainee Editor, and Wafaa Khannoussi, Chair of the UEG Quality of Care Task Force Committee. Wafaa Khannoussi discussed the guidelines, standards and quality care initiatives that are currently being explored by the Quality of Care Task Force Committee, and encouraged delegates to download the GI Guidelines App. The app, available free of charge, is the first of its kind to provide diagnosis and treatment recommendations for a range of digestive diseases.

Top Abstract: Helicobacter pylori Eradication Aspirin Trial (HEAT)

Christopher Hawkey presented one of the Top Abstracts from the congress in yesterday’s Opening Session Part II. The Helicobacter pylori Eradication Aspirin Trial (HEAT) investigated whether H. pylori eradication could reduce UGI ulcer bleeding at a population level over long periods.

Between 2012 and 2017, 30,024 patients underwent C13 urea H. pylori breath testing. Those with positive tests (n=5353) were randomised to receive active eradication treatment (twice daily lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 400 mg; n=2677) or matched placebos (n=2676). In the 10% sample of patients who underwent an end of study breath test, 90.7% who received treatment had become H. pylori negative, compared with 24.0% of controls (p<0.001). During 26,667 person-years of follow up (to 30 June 2000), only 18 episodes of UGI ulcer bleeding were seen in patients who received active eradication, vs 27 in the control group. A pre-specified Schoenfeld analysis showed a significant, time-dependant departure from proportional hazards assumptions (p=0.0027), with early treatment-related differences in ulcer bleeding rates. During the first 2.5 years, there were 6 episodes of bleeding in the eradication group (0.92/1000 person-years) versus 17 in controls (2.61/1000 patient-years; p<0.03). This advantage remained statistically significant for both the per protocol analysis (p=0.018) and an analysis adjusted for the competing risk of death (p=0.028).

Chris Hawkey reported that during the first 2.5 years, use of antiplatelet medication fell in both the eradication and control groups (by 12.7% and 12.3%, respectively), while use of PPIs increased (by 9.7% and 10.1%, respectively) but analyses adjusted for medication use during the 2.5 years follow up remained significant (p=0.03).

For the 22 ulcer bleeds occurring after the first 2.5 years, there was no advantage for the active eradication group (p=0.70). No benefit of eradication was shown for other causes of clinically significant GI bleeding, clinically detected uncomplicated ulcers, or GP-recorded dyspepsia. Death occurred in 306 actively treated patients and 351 controls.

Digestive diseases: Big burden, low funding?

To continue raising public and political awareness on digestive health and to support the implementation of ambitious prevention, screening and treatment strategies at the European and national level, UEG recently commissioned the White Book 2. The ambitious project uses the latest pan-European data to provide an international analysis on the burden of digestive diseases and priorities for digestive health research.

The report highlights worrying increases in the prevalence of several digestive diseases since 2000. UEG conducted a comparable study in 2014 which highlighted similar burdens and, with limited improvements since, the results and outcomes of this new UEG study will assist in accelerating progress in reducing the burden of digestive disorders. It will also help to identify priority areas where research and investment are required across the whole of Europe as well as individual nations.

Initiated by the UEG Research Committee, the report’s main findings were discussed in the Live TV Studio today during a session ‘Digestive diseases: Big burden, low funding?’.

Luigi Ricciadiello, Chair of the UEG Research Committee, explained “The White Book 2 represents an important milestone for UEG Research and Public Affairs strategies. It lays the foundations for ambitious advocacy efforts in the coming years based on evidence-based data and will underpin the definition and prioritisation of UEG calls for policymakers, both at European and national level.

“It affirms the importance of strong public health policies and adequate research funding and the role of our scientific societies in providing the latest science & expertise to policymakers”, he added.

Find out more about the White Book 2

Enjoy a world of state-of-the-art science

Today’s enriching programme included a number of abstract-based sessions, enabling delegates to discuss and debate the latest original research from the digestive health field.

A variety of topics were explored, from biomarkers in liver disease to pancreatic imaging. The late-breaking abstracts session (11:00-12:00 CEST) revealed fresh insight into a number of key studies, including the ENDOAID-TRAIN STUDY and the NORDICC randomised trial.

Other abstract-based session highlights included:

• Clinical trials in ulcerative colitis 
• COVID-19 complications in the lower GI tract
• Artificial intelligence in endoscopy
• Clinical care for patients with cirrhosis

Missed a session? We've got your covered! Watch on the UEG Week 2022 library!

Late-breaking highlight: Computer-aided polyp detection

Although colonoscopy is considered the gold standard for detection and removal of premalignant polyps, up to 26% of lesions are missed in tandem studies. Computer-aided polyp detection (CADe) has shown promise in increasing polyp detection rates.

One of today’s late-breaking abstract presentations, presented by Michiel Maas, evaluated a novel CADe system, ‘Magentiq Eye Automatic Polyp Detection System’ (ME-APDS), for screening and surveillance colonoscopy. This multicentre, randomised, controlled trial was at 10 hospitals in Europe, United States and Israel.

In total, 950 patients were enrolled, of which 916 completed the assigned colonoscopy, 449 in the MEAC group and 467 in the conventional colonoscopy (CC) group.

ME-APDS increased adenoma detection (both adenoma per colonoscopy and adenoma detection rate) in screening and surveillance colonoscopies, and reduced adenoma miss rate by two-fold compared to CC. Apart from diminutive lesions, ME-APDS increased the detection of 6-9mm adenomas and suggested that this novel CADe system is able to detect more clinically relevant lesions.

Late-breaking highlight: The NordiCC trial

Another eagerly-awaited late-breaking abstract presented today at UEG Week was the 10-year follow-up results from the NordiCC trial.

Presented by Michael Bretthauer, the aim of this large-scale population-based randomised trial is to assess the effectiveness of colonoscopy screening on colorectal cancer (CRC) incidence and mortality after 10 to 15 years. Asymptomatic men and women 55 to 64 years were drawn from population registries in Poland, Norway, and Sweden between 2009 and 2014 and randomly assigned in a 1:2 ratio to an invitation for screening colonoscopy (28,220 individuals) or standard-of-care (no-screening, 56,365 individuals). Screening attendance was 42.0%. 

Michael Bretthauer reported that fifteen patients experienced bleeding after polyp removal and that there were no perforations or screening-related deaths within 30 days. During median 10-years follow-up, 259 colorectal cancers were diagnosed in the screening group versus 622 in the no-screening group. In intention-to-treat analyses, 10-year CRC incidence was 0.98% in the screening group versus 1.20% in the no-screening group, a risk reduction of 18%.

CRC mortality was 0.28% in the screening group and 0.31% in the no-screening group The number needed to invite for screening to prevent one CRC was 455. In adjusted per-protocol analyses, CRC incidence was reduced from 1.22% to 0.84% and CRC mortality from 0.3% to 0.15%.

The study concluded that once-only CRC screening with colonoscopy reduces CRC incidence over 10 years.

Time to celebrate: 30 years of UEG!

This year marks a very special 30 years of UEG and the occasion was marked by an anniversary session (14:00-15:00) chaired by Helena Cortez-Pinto and Christoph Beglinger.

Opening the session, Helena Cortez-Pinto welcomed “five fantastic talks from five fantastic specialists in GI”, who each took to the stage to give concise overviews on the state of play across key areas of digestive health:

• Hana Algül on ‘Pancreatic cancer: Wil it ever be solved?’
• Christoph Sarrazin on ‘The history of Hepatitis C: A book closed, a problem solved’
• Alessandro Repici on ‘Everything has become resectable: Is endoscopy the ultimate solution?’
• Severine Vermeire on ‘IBD: Ever increasing treatment options and still not solved’
• Michael Farthing on ‘What UEG contributed in 30 years and where we are going’

Research Fellowship 2022: Antonio Molinaro

UEG awards € 50,000 to a researcher to spend 12 months working with a renowned European principal investigator as part of the UEG Research Fellowship. The main purpose of the fellowship is to support the development of a basic or clinical research project and give the fellow the chance to improve their scientific skills.

Congratulations to Antonio Molinaro, who was awarded the UEG Research Fellowship 2022! He will visit the Norwegian PSC Research Center (NoPSC), Institute of Clinical Medicine, Oslo, Norway and, together with his host Tom Hemming Karlsen, will carry out a research project: “Investigating The Role Of Imidazole Propionate In The Pathogenesis Of Primary Sclerosing Cholangitis” for the duration of 12 months.

Antonio Molinaro is a consultant hepatologist at Sahlgrenska University Hospital in Gothenburg, Sweden. He completed his specialist training at University of Rome Sapienza in 2015 and his PhD in 2018 working on microbial produced metabolites and host physiology. Since then, Antonio has been working as researcher at the Wallenberg laboratory at Sahlgrenska Academy with the support from Bengt Ihre Fellowship and the agreement between the Swedish government and the country council (ALF-agreement) fellowship.

That's all for today's recap! Tune in tomorrow for the final day of UEG Week 2022!