Trending Clinical Topic: IBD

Ryan Syrek

Disclosures

August 20, 2021

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, share them with us on Twitter or Facebook. Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A large-scale analysis that confirmed a long-suspected inflammatory bowel disease (IBD) risk factor — as well as news about COVID vaccination, venous thromboembolism (VTE) concerns, and treatment findings — resulted in this week's top trending clinical topic.

New research found an association between consumption of overprocessed foods and an increased risk for IBD (see Infographic below). Ultraprocessed food was defined as all packaged and formulated foods and beverages that contained food additives, artificial flavors or colors, or other chemical ingredients. The categories included processed meat, cold breakfast cereal, various sauces, soft drinks, and fruit drinks, and refined sweetened foods, such as candy, chocolate, jam, jelly, and brownies. The study included data obtained between 2003 and 2016 from more than 100,000 patients. Overall, 467 participants developed IBD, including 90 with Crohn's disease and 377 with ulcerative colitis. These findings are of particular concern, given that a new study found that ultraprocessed foods account for most calories consumed by younger Americans.

Elsewhere, in encouraging news, full vaccination was found to be more than 80% effective at reducing COVID infection in people with IBD taking immunosuppressive medications. The study examined postvaccine infection rates in a Veterans Affairs cohort and validated the efficacy of vaccination. Of the nearly 15,000 patients with IBD who were included, 3561 had received both doses of the Moderna vaccine and 3017 had received both doses of the Pfizer vaccine. Compared with unvaccinated patients, full vaccination status was associated with a 69% reduction in the hazard ratio of infection (0.31). Corresponding vaccine efficacy rates were 25.1% for partial vaccination and 80.4% for full vaccination. An important limitation of this study was the inclusion of mostly older, predominantly White men (80.4%). This factor may limit the generalizability of the findings to women and patients of other races/ethnicities.

In terms of other health risks associated with IBD, a new study concluded that thrombophilia does not add to the risk for VTE. The small, case-control study found that, unlike immobilization and surgery, thrombophilia does not appear to be a risk factor for VTE development. Researchers say the findings do not support exhaustive thrombophilia workup in patients with IBD; however, those patients should be evaluated for a personal and family history of thrombosis and prothrombotic drug use. Others have also suggested that these individuals should be screened for specific IBD-related risk factors for VTE development, including hospitalization, immobilization, surgery, and previous and current medications.

When it comes to treatment for IBD itself, medications may be more targeted in the future. Researchers are developing a way to deliver drugs directly to the colonic mucosa, which could increase the accuracy of drug delivery to the diseased area while reducing systemic drug exposure. Although existing targeted colonic drug delivery systems are better than nonspecific drug delivery, they are typically limited by relying on patient physiology, which varies and can lead to inconsistencies. The drug delivery system being developed by Progenity, now known as DDS2, uses anatomy rather than physiology for targeted drug delivery. From risk factors to emerging treatment options, a wide range of news about IBD made it this week's top trending clinical topic.

Review key clinical information on IBD.

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